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EMSs, Stress & Cardiovascular Diseases

by Michal Kotian, Miloš Šlepecký & Antonia Kotianova

General Abstract:

The symposium topic is to explore the relationships among early maladaptive schemas measured by YSQ - S3 inventory, their avoidance measured by YRAI inventory, hypercompensation coping styles measured by YCI inventory, dissociation measured by Dissociative experience scale, temperament traits measured by Cloningers the temperament and character inventory, physiological parameters of stress reaction and cardiovascular risk anthropometric factors as waist hip ration and percentage of visceral fat. The data was taken on the sample of 227 healthy persons in the age of 20-65 year old on out patient internal medicine department in the Slovak republic.

Presentation 1

Title: Relationships Between Early Maladaptive Schemas, Temperament and Character Dimensions and Maladaptive Coping Styles

Presenter's Name: Michal Kotian

General Abstract for Presentation 1:

Aim: The aim of the study was to explore the relationships between early maladaptive schemas (EMS), temperament and maladaptive coping styles and to examine gender differences in these variables.
Methods: Research sample was consisted of 157 healthy adults (mean age 38,35; SD=13,57), 137 were women (mean age 39,13; SD=11,98) and 90 were men (mean age 39,13; SD=11,70). We used the following measures: Temperament and Character Inventory – Revisited (TCI-R), Young Schema Questionnaire – Short Form (YSQ-S3), Young – Rygh Avoidance Inventory (YRAI) and Young Compensation Inventory (YCI). Statistical analysis of the data were made by descriptive indicators, correlation and comparative analyses, simple linear and multivariate regression analysis and simple mediation analysis.

Results and conclusion: Harm avoidance (HA) was related to both maladaptive coping styles. HA also correlated with 14 of 18 EMS. Self-Directedness was negatively related to all EMS. Maladaptive coping styles were related to almost all EMS. Women scored higher in harm avoidance, reward dependence, avoidant coping style and in EMS of abandonment, enmeshment and self-sacrifice. Men had higher scores in novelty seeking and overcompensation by social control. Using regression analyses it was found that temperament traits explained 13,8 % of EMS variance. Adding maladaptive coping styles explained additional 18,9 % of EMS variance. Using mediation analysis it was found that impact of temperament on EMS is mediated by maladaptive coping styles.

Presentation 2


Presenter's Name: Miloš Šlepecký

General Abstract for Presentation 2:

The aim of this study is to explore the relationship between early maladaptive schemas, their schema coping styles, and risk anthropometric factor of cardiovascular diseases.
Method: Cross sectional study collected the data from Young Schema Questionnaire (YSQ-S3), Young Compensation Inventory (YCI); Young-Rygh Avoidance Inventory (YRAI), and basic anthropometric parameters waist/height ratio and percentage of abdominal fat. Relationships between outcome factors and other variables factors were analyzed by partial correlations and regression analyses. Results: 227 healthy participants with the mean age 39.6 + 12.9 years participated in the cross-sectional study. Both antropometric measures positively correlated with the age. Higher levels of social control, measured by YCI, was connected with female overweight. High levels of personal and social control, assessed by YCI, were linked with overweight and abdominal fat in women. In women but not in men, schema avoidance (measured by YRAI total score) moderately positively correlated with waist/height ratio and weakly with percentage of visceral fat. In women, schemas Approval-seeking and Negativity/pessimism passed through a regression when Waist/height ratio was the dependent variable and schema Defectiveness/shame and Negativity/pessimism passed through when Percentage of visceral fat was the dependent variable.
Conclusions: There is a relationship between body anthropometric parameters and particular schemas and schema coping styles.

Presentation 3


Presenter's Name: Antonia Kotianova

General Abstract for Presentation 3:

Aim of the study was to analyse the relations among early maladaptives schemas, dissociation, coping styles and arousal measured by physiological ANS parameters.
The research sample: 227 participants (137 woman) mean 39.6 years (SD=12.89), men mean 39.72 (SD=14.23), woman mean 39.47 (SD=11.98).

Methods: Young Schema Questionnaire (YSQ-S3), Young Compensation Inventory (YCI), Young-Rygh Avoidance Inventory (YRAI), Dissociative Experience Scale (DES), and a demographic questionnaire and psychophysiology measures were used. Reactivity in ANS was evaluated by heart rate variability (HRV), electrodermal activity (EDA) and respiration rate.
Results: In women subgroup Behavioral-somatic scale YRAI significantly negatively predicted parasympathetic parameter HF relative in rest and in mental stress. Overcompensate scale Personal control and schema Social isolation are connected with changing the equilibrium in favour for sympathetic part of ANS, which may be risk related to cardiovascular diseases. Schema Vulnerability to harm and illnesses predict EDA values negatively. Higher score in Self-sacrifice schema significantly predict lower total HRV (SDNN) values in rest, while higher scores in schema Entitlement / Grandiosity predict higher HRV (SDNN) values in mental stress.

In the subgroup of men we have also proved significant positive relationships of dissociation and coping styles. YCI subscale Personal control predicts the deflection of the sympathetic - parasympathetic equilibrium in favour of parasympathetic in rest and together with dissociation also in mental stress. Overcompensation Subscale Individuality predicts the deflection of the balance in favour of sympathetic part of ANS positively. Predictive relationships of schema Mistrust / Abuse to heart rate (HR) and LF relative may be related to the vigilant setting according the III. Phenotype according calibration theory of stress.

It is one thing to get rid of dysfunctional modes and schemas, but another to build on the healthy ones. During the course of therapy, the schema therapist is aware of building on things like healthy standards, flexibility, self-compassion, perseverance, strength, etc. Especially during the (phase of) behavioral change, the patient is challenged to keep self-confidence and faith in their possibilities. Here the patient, more than ever, needs the therapists’ support in strengthening the Healthy Adult (HA). Even at the end of treatment things can get shaky in sessions How can we keep track of letting the HA grow? How can we stay with the patient, but simultaneously give the patient confidence in their possibilities? How can we "withdraw" and stimulate autonomy, without patients are feeling neglected? 

This skill class provides a clear guideline for the needed therapist attitude and how to act in challenging situations in the last phase of (group) therapy. There will be demonstrations how to use experiential techniques to strengthen the HA in group and individual sessions. After the demonstration, the participants will work in small groups to practice these skills. 

Level of Experience Required for Participants: 

All participants

About the Presenters:

Michal Kotian

Michal Kotian is a psychologist, working in clinical practice in Liptovsky Mikulas, Slovakia as a CBT and ST trainee. He is a member of Slovak Schema Therapy Institute. He is a co-author of several research articles.

Miloš Šlepecký

Associate professor Miloš Šlepecký, PhD is University lecturer at Constantine The Philosopher University in Nitra, member of ISST (basic level schema therapist) and director of Slovak schema therapy institute. He works as clinical psychologist and psychotherapist in Liptovsky Mikulas, Slovakia. He is coauthor of many articles and books. (Cognitive Behavioural Therapy (2017), Biofeedback v teorii a praxi ( Biofeedback in theory and praxis) (2017), Třetí vlna  v KBT, (Third wave in CBT, including chapter of schema therapy), (2018).

Antonia Kotianova

PhD., is a clinical psychologist and CBT psychotherapist. She lives and works in Liptovsky Mikulas (Slovak Republic), she has been in clinical practice since 2007. She also works as a lecturer of CBT and biofeedback training. She is member of ISST and Slovak Schema Therapy Institute She is also co-author of Cognitive behavioral therapy (Ankara, 2017), Biofeedback in theory and practice (Grada 2017) and Third Wave in CBT (portal  2018).

Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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