New Approach to Early Maladaptive Schemas and its Relationship with Alcohol use Disorder. Role of Psychopathology and Prognostic Variables.

Early maladaptive schemas (EMS), dysfunctional patterns of thought and emotions originated during childhood, latent in most mental disorders, might play a role in the onset of alcohol use disorder (AUD), although their impact on prognosis remains unknown. Our aim is to determine the presence of EMS in patients with AUD and their role in the psychopathology and course of addiction (relapse and withdrawal time). The sample included 104 patients and 100 controls. The diagnosis of AUD was made according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, EMS were determined with the Young Schema Questionnaire in its Spanish version (YSQ-S3) and psychopathology with Symptom Checklist-27 (SCL-27). AUD group showed significantly higher scores in emotional deprivation, confused attachment, emotional inhibition and failure schemas. In addition, vulnerability schema correlated (> 0.500) with all subscales of SCL-27. Whereas social isolation, insufficient self-control and grandiosity schemas correlated with a higher number of relapses. But it was the grandiosity and punishment schemas that correlated with shorter abstinence time. These findings suggest that EMS are overrepresented in the AUD population and some correlate with psychopathology and worse AUD outcomes.

How, when, and to what degree do people with alcohol dependence recover their psychological wellbeing and quality of life? The Madrid Recovery Project.

Introduction: The consensus on recovery from alcohol use disorder (AUD) has shifted toward encompassing psychological wellbeing and quality of life dimensions. However, few studies have explored the long-term recovery process and its dimensions, timing, styles, and modes. The aim of this study was to investigate the extent, timing, and process of psychological wellbeing and quality of life recovery in alcohol use disorder (AUD) patients, as well as the relationship with classic dimensions of AUD recovery. Method: A cross-sectional study has been carried out with 348 participants with AUD, in different abstinence periods (1 month-28 years), and 171 control subjects. Participants underwent a psychological evaluation, which included self-informed measures of psychological wellbeing, quality of life, negative emotionality, and coping strategies related to alcohol consumption avoidance. Statistical analysis included linear and non-linear regression models between psychological dimensions and maintenance of abstinence, as well as matching the scores of the sample with AUD to those of controls. Scatter plots were used to explore inflection points. In addition, mean comparison tests were performed between participants with AUD and controls and by gender. Results: In general, according to the regression models, there were pronounced increases in indices of wellbeing and coping strategies (and pronounced decreases in negative emotionality) during the first 5 years of abstinence, followed by less pronounced improvements. The matching of AUD subjects in wellbeing and negative emotionality indices with controls occurs at different times: (a) 1 year or less: physical health; (b) 1-4 years: psychological health; (c) 4-10 years: social relationships, wellbeing, and negative emotionality; and (d) more than 10 years: autonomy and self-acceptance. There are statistically significant differences by gender for the negative emotionality and physical health variables. Conclusion: Recovery from AUD is a long process that involves improvements in wellbeing and quality of life. Four stages can be described in this process, with the most pronounced changes occurring during the first 5 years of abstinence. However, AUD patients take more time to obtain similar scores to controls in several psychological dimensions.