TERAPIA CENTRATĂ PE SCHEME ÎN BORDERLINE CU ISTORIC DE ABUZ EMOŢIONAL: ANALIZA EFICIENŢEI

Abstract

Introducere. Tulburarea de personalitate borderline este frecvent corelată cu expunerea precoce la abuz emoţional, factor etiologic major în formarea schemelor cognitive timpurii dezadaptative. Acestea se exprimă prin instabilitate afectivă, relaţionare disfuncţională şi autoevaluare negativă persistentă. Scop. Scopul cercetării a fost de a analiza eficienţa terapiei centrate pe scheme în reducerea simptomatologiei borderline la pacienţii cu istoric documentat de abuz emoţional în copilărie. Material şi metode. A fost realizat un studiu bibliografic a literaturii din perioada 2018-2024 bazele de date PubMed şi Google Scholar. Au fost selectate articole ce au evaluat terapia centrată pe scheme asupra simptomelor TPB şi schemelor disfuncţio-nale post-traumă. Criteriile de selecţie au inclus validitatea metodologică şi relevanţă clinică. Rezultate. Studiile analizate au raportat o reducere semnificativă a simptomelor tulburărilor de personalitate borederline, în special a impulsivităţii şi relaţiilor instabile, măsurate prin scale standardizate, precum Borderline Symptom List(BSL-23),cu reducerea de 30-45% (p < 0,05). S-a observat o restructurarea graduală a schemelor de tip,defectivitatea/ruşine”, „abandon” şi „neîncredere”, evaluată prin Yong Schema Questionnaire (YSQ), cu scăderea semnificative dupa 6-12 luni. Eficienţa terapiei centrate pe scheme a fost superioară tratamentelor standard în intervenţii medii şi lungiconform testelor t si ANOVA (p < 0,05). Concluzii. Terapia centrată pe scheme s-a dovedit eficientă în abordarea simptomelor TPB asociate traumelor emoţionale, precum impulsivitatea şi instabilitatea emoţională. Prin restructurarea profundă a schemelor dezadaptative, s-a observat o îmbunătăţire a funcţionării emoţionale şi relaţionale a pacienţilor.

Introduction. Borderline personality disorder is frequently associated with early exposure to emotional abuse, a major factor in the development of early maladaptive cognitive schemas. These manifest through affective instability, dysfunctional interpersonal relations, and persistent negative self-evaluation. Objective. The aim of the research was to analyze the effectiveness of Schema Therapy in reducing borderline symptomatology in patients with a documented history of emotional abuse during childhood. Material and methods. A bibliographic study of the literature from 2018-2024 was conducted using the PubMed and Google Scholar databases. Relevant articles were selected that evaluated the effects of Schema Therapy on BPD symptoms and dysfunctional trauma-relates schemas. Selection criteria included methodological validity and clinic applicability. Results. The analyzed studies reported a significant reduction in borderline personality disorder symptoms, partic-ulary impulsivity and unstable relationships, as measured by standardized scales such as the Borderline Symptom List (BSL-23), showing a reduction of 30-45% (p < 0,05). A gradual restricting of maladaptive schemas such as „defectiveness/shame”, „abandonment”, and „mistrust” was observed, assessed using the Young Schema Questionnaire (YSQ), with significant decreases after 6-12 months. The efficacy of schema-focused therapy was superior to standard treatments in medium- and long-term interventions, according to t-test and ANOVA (p < 0,05). Conclusion. Schema-focused therapy has proven effective in addressing BPD symptoms associated with emotional trauma, such as impulsivity and emotional instability. Through the deep restricting of maladaptive schemas, improvements were observed in patients emotional and relational functioning.