The role of maladaptive cognitive schemas in the pathogenesis of comorbid affective disorders in persons with social anxiety and social phobias
DOI:
https://doi.org/10.29038/2227-1376-2023-42-avrKeywords:
social anxiety, social phobia, social isolation, depression, early maladaptive schemasAbstract
Purpose: to study the influence of cognitive maladaptive schemas on the severity of comorbid affective pathology, using the example of depressive symptoms in persons with social phobia.
Methods. The search for previous studies was carried out using PubMed, Web-of-Science, and Research Gate services, focusing on research on social phobia and comorbid depressive conditions. The empirical study covered the indicators of samples with clinically significant signs of depressive symptoms according to DSM-5 criteria - the main group: 737 people with pronounced social anxiety and 582 people, the control group, without signs of social phobia. The results were evaluated according to the YSQ-S, SPIN, PHQ-9, and corresponding subscales of the SCL-90-R technique.
Results. The statistical analysis results demonstrated that the level of severity of symptoms of depressive disorders and conditions in persons with social anxiety disorder is higher than in the control group. A significant difference was also demonstrated by indicators of the overall severity of symptoms and the index of symptomatologic distress. The analysis of actual early dysfunctional schemas showed significant differences (p<0.05) compared to the control group for the following categories: social isolation, emotional deprivation, defectiveness/shame, emotional inhibition, self-sacrifice, unrelenting standards, and expectation of failure/incompetence. The contribution of variance in social anxiety and depressive symptoms can be explained by cognitive, emotional, and behavioral responses according to the schemas: social isolation, unrelenting standards, defectiveness/shame, and expectation of failure/incompetence. Typical beliefs that are characteristic of social phobia and associated with the expectation of negative evaluation from others are reinforced by negative thoughts that are characteristic of a depressed mood. Avoiding direct social contact due to fear of abandonment, a person chooses maladaptive strategies of defensive behavior, such as emotional deprivation and social withdrawal, and rationalizes a disturbed sense of social belonging.
Conclusions. The analysis of the results of the empirical study confirms the close relationship between maladaptive beliefs and the severity of critical depressive psychopathology in individuals with social anxiety disorder. Further research can expand the role of early dysfunctional schemas in the pathogenesis of comorbid conditions thanks to the mediation analysis of the role of cognitive, emotional (negative), or behavioral avoidance mechanisms in the acquisition of corrective experiences as an aspect of psychological inflexibility and adaptation disorders.
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