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Am J Mens Health. 2018 Mar;12(2):202-209. doi: 10.1177/1557988317742230. Epub 2017 Nov 17.

Predicting the Risk of Opioid Use Disorder Based on Early Maladaptive Schemas.

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1 Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran.
2 Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran.
3 Doctoral School of Health Sciences, University of Pécs, Hungary.
4 Nursing and Midwifery College, Sabzevar University of Medical Sciences, Sabzevar, Iran.
5 Department of Epidemiology and Biostatistics, Sabzevar University of Medical Sciences, Sabzevar, Iran.
6 McGill University, Montreal, QC, Canada.


Substance use is a globally devastating social problem. Early maladaptive schemas (EMSs) are inefficient mechanisms leading directly or indirectly to psychological distress. The current study aimed to assess the role of EMSs in predicting opioid use disorder. The cross-sectional study was conducted in 2013 in Bojnurd at northeast of Iran on 60 male opioid users who received Methadone Maintenance Treatment (MMT) and 60 control males. The opioid users were selected randomly from MMT clinics and control subjects were selected and matched with opioid users using demographic variables. The subjects completed the Young Schema Questionnaire-Short Form (YSQ-SF). Except for SS (self-sacrifice), EG (entitlement/grandiosity), US (unrelenting standards), and FA (Failure to Achieve), the mean of other maladaptive schemas in the opioid user group were significantly higher than that of the control group, adjusted for multiple comparisons. Multivariate analysis of variance (MANOVA) indicated significant differences in maladaptive schemas between the two groups. Logistic regression identified that Emotional Deprivation, Mistrust/Abuse, and Unrelenting Standards can predict opioid use. As a result, the risk of opioid-related disorders in people with higher YSQ-SF scores in these schemas is higher. The findings conclude that the existence of underlying EMS may constitute a vulnerability factor for developing opioid use disorders later on in life. Provided the vast amount of scientific literature in evidence-based treatments focusing on EMSs, maladaptive schemas and related core beliefs can be detected and treated in adolescence to prevent the enactment of the schema and psychological distress likely to induce opioid use.


Young Schema Questionnaire; early maladaptive schemas; opioid use disorder

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