رابطه طرحواره‌های ناسازگار با افسردگی و اضطراب اجتماعی در سالمندان

The ever-increasing growth of older population and its consequences have led aging to become a significant social issue in most societies. Old age is an unavoidable and critical period in human life, impacting all aspects of living. Therefore, this study aimed to determine the relationship of early maladaptive schemas (EMS) with depression and social anxiety in older adults. This was a descriptive-correlational study in which 150 individuals were selected through convenience sampling from all older adults aged 60 and over living in Tehran, Iran. The measures included Young’s 75-item EMS questionnaire, Yesavage et al.’s geriatric depression scale and Connor et al.’s social anxiety questionnaire. The data were analyzed using SPSS-28, indicating a significant direct relationship of early maladaptive schemas with both depression and social anxiety (p<0.05). The results of Pearson’s correlation test revealed that EMS of abandonment, emotional deprivation, social isolation, and failure had the strongest correlation with depression. While, EMS of perfectionism, defect/shame, social isolation, and vulnerability to harm were associated with social anxiety. Additionally, the results from multiple linear regression analysis showed that four EMS, namely abandonment, emotional deprivation, defect/shame, and emotional inhibition, were able to significantly predict depression, whereas three EMS, namely social isolation, defect/shame, and perfectionism, were proven to significantly predict social anxiety. It can be concluded that implementing preventive programs during childhood and adolescence to examine schemas and conducting comprehensive educational courses focused on schemas can serve as effective strategies for psychoeducation and improving well-being in old age.
EXTENDED ABSTRACT
 Introduction
Various variables related to depression and social anxiety in older adults have been examined in the research literature, with one of the most important being early maladaptive schemas (EMS_s). EMS_s are the deepest cognitive structures that encode and evaluate new information based on their pre-existing structures. They lie at the core of personality disorders, mood problems, and many chronic Axis I disorders. Operating outside of conscious awareness, EMS_s make individuals psychologically vulnerable to disturbances such as depression, anxiety, and dysfunctional relationships. Depression and anxiety also affect the quality of life of older adults as they age, particularly in response to life events. Although studies have explored the relationship of EMS with depression and social anxiety in older age, few have examined how this relationship unfolds and which specific schemas impact depression and social anxiety in this age group. Therefore, given the gaps in the research literature, the present study aims to investigate the relationship of EMS with depression and social anxiety in older adults.
Method
The present study employed a descriptive-correlational design. The statistical population of this study included all older adults aged 60 and above living in Tehran. Based on the predictive variables of the present study, a sample of 150 individuals (93 women and 57 men) was selected through convenience sampling. Inclusion criteria were (1) age 60 and above, (2) residing in Tehran, (3) at least middle school education, (4) participant consent and cooperation. Exclusion criteria included acute psychological or physical disorders, as reported by themselves, that might prevent participants from answering the questions or understanding their meaning. Participants completed Young’s 75-item EMS questionnaire, Yesavage et al.’s geriatric depression scale and Connor et al.’s social anxiety questionnaire. The questionnaires were in a printed format and distributed among older adults visiting counseling centers, health houses, and certain public places in District 5 of Tehran, using convenience sampling. Finally, the data obtained from the questionnaires were analyzed using Pearson’s correlation coefficient and multiple linear regression analysis in SPSS software version 28.
Results
Prior to data analysis, it was confirmed that the distribution of scores for all variables was normal, and the results indicated no correlation between errors and no multicollinearity among variables. To test the research hypotheses, Pearson’s correlation coefficient and multiple linear regression analysis were used. The results of the Pearson’s correlation coefficient showed a significant positive correlation between depression and EMS, as well as between social anxiety and EMS.
The model fit indices obtained were as follows: F (28.7) =p<.05, indicating a good fit for the regression model. R²=.427, showing that EMS explained 42.7% of the variance or changes in depression. The Durbin-Watson test value was 1.60, which falls within the acceptable range of 1.5 to 2.5, confirming the assumption of residual independence. Tolerance values>0.20 and VIF values<5 were tested, indicating no severe multicollinearity. Regarding social anxiety, F (28.7)=p<.05 also indicated a good fit for the regression model. R²=.427, showing that EMS explained 42.7% of the variance or changes in depression. The Durbin-Watson test value was 1.60, falling within the acceptable range of 1.5 to 2.5, confirming the assumption of residual independence. Tolerance values>.20 and VIF values<5 were tested, indicating no severe multicollinearity. The Pearson’s correlation coefficient results indicated that the relationship between EMS and depression was positive (m=47.62, p<.01), and the relationship between early maladaptive schemas and social anxiety was also positive (m=43.02, p<.01) and significant. Moreover, the correlation intensity analysis showed that the strongest correlation with depression was related to the EMS of abandonment (r=.56), emotional deprivation (r=.53), social isolation (r=.51), and failure (r=.49). The strongest correlation with social anxiety was related to the schemas of perfectionism (r=.53), defectiveness /shame (r=.47), social isolation (r=.47), and vulnerability to harm (r=.44).
Conclusion
The global population is rapidly moving towards aging. Therefore, older adults make up a significant portion of the population pyramids in both developed and developing countries. This stage of life is accompanied by a wide range of physiological and psychological changes, leading to an increase in the prevalence of mental disabilities during this period. The aim of the present study was to determine the relationship between EMSs and depression and social anxiety in older adults. According to the results, higher levels of EMSs were associated with increased depression in older adults. Specifically, among EMSs, abandonment, emotional deprivation, defectiveness/shame, and emotional inhibition were able to predict depression in older adults. Furthermore, higher levels of EMSs were related to increased social anxiety in older adults. Among EMSs, social isolation, defectiveness/shame, and perfectionism were able to predict social anxiety in older adults. The strongest impact was found in the relationship between the social isolation schema and social anxiety.
Ethical Consideration
Ethical Code
Educational Unit, Faculty of Humanities, Islamic Azad University, West Tehran Branch
Financial Support
This research did not receive any financial support.
Authors’ Contributions
N.M: Conceptualization, Software, Validation, Formal Analysis, Data Curation, Visualization; S.B: Methodology, Writing-Review & Editing, Project Administration; S.Gh: Conceptualization, Methodology, Writing-Orginal Draft
Conflict of Interest
The author had no conflicts of interest.
Acknowledgments
We extend our gratitude to the respected older adults for their participation in completing the questionnaires.
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