A Theoretical Model of Substance Use Based on Schema Therapy Concepts
Summary
Among individuals suffering from substance use disorders (SUD), personality pathology is highly prevalent. Unfortunately, patients suffering from comorbid personality pathology benefit significantly less from usual treatments for SUD. More effective appeared, e.g., dual focus schema therapy (DFST), in which SUD and personality pathology are treated in combination. Yet, research stressed the need for further improvement of DFST. Therefore, the aim of the current study was to critically test a conceptual model of SUD, in which associations between concepts from schema therapy and substance use behavior were proposed. In this cross-sectional study, substance use, maladaptive schemas, and schema modes were assessed among recreational substance users. Results suggest that emotional pain caused by maladaptive schemas in the Disconnection & Rejection domain lead to substance use and that this relation is mediated by avoidant coping modes. Treatment implications and directions for future research are discussed.