A Structural Model of Depression Based on Early Maladaptive Schemas, Resilience and Perceived Social Support with the Mediating Role of Self-Compassion and Hope in men and women with cancer

Document Type : Original Article


1 Ph.D.student. Department of Psychology, Semnan Branch, Islamic Azad University, Semnan, Iran

2 Assistant professor. Department of Psychology, Semnan branch, Islamic Azad University, Semnan, Iran

3 Assistant professor. Department of psychology, semnan university, semnan, Iran.

4 Assistant professor. Department of Psychology, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran


Aim: The aim of the present study was to investigate the depression prediction model based on early maladaptive schemas, resilience and perceived social support by considering the mediating role of self-compassion and hope in men and women with cancer. Methods: The research method was descriptive correlation. The statistical population in this study included all cancer patients referred to Imam Khomeini and Milad hospitals in Tehran. The sample size was 300 patients were selected based on inclusion and exclusion criteria. Research instruments included the Nef Self-Sufficiency Questionnaire (2003), Young's early maladaptive Schemas Questionnaire (1998), Connor-Davidson Resilience Questionnaire (2005), Zimet et al.'s Perceived Social Support Questionnaire (1988), Beck depression Scale (1961) And Snyder (1991) Hope Questionnaire. The collected data were analyzed by structural equation modeling. Results: The finding of data analysis showed that the depression prediction model based on initial maladaptive schemas, resilience and perceived social support, considering the mediating role of self-compassion and hope based on experimental data, has a good fit. Also, the direct and indirect effects of early maladaptive schemas, perceived resilience and social support were considered (p <0.05) regarding the mediating role of self-care and hope on the depression of cancer patients. Self-compassion directly affects the depression of cancer patients (p <0.05). Hope also directly affects the depression in cancer patients (p <0.05). Conclusion: According to the research results, in order for cancer patients to function properly, on the one hand, it is necessary to have modified maladaptive schemas, on the other hand, their treatment t should be based on improving resilience and perceived social support.


بهشتی، ابراهیم.، و حاجبی، مجید. (1397). رابطه تاب‌ آوری و عمل به باورهای دینی با اضطراب و افسردگی در سربازان. مجله طب نظامی، 20(3):341-333.
تقدیسی، مریم.، و منصوری، احمد. (1398). مدل یابی رابطه بین فرایندهای نگرانی با نشانه‌های افسردگی و بی‌خوابی مراقبان افراد مبتلا به سرطان. تحقیقات علوم رفتاری، 17(4): 630-618.
حسین پور فیضی، محمدعلی.، آذرفام، پروین.، آدمپور زارع، مینا.، و پولادی، ناصر. (1396).شیوع سرطان پستان در آذربایجان شرقی از شهریور 1385 لغایت شهریور 1388 در مقایسه با شهریور 1388 لغایت شهریور 1391. مجله پزشکی دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تبریز، 130: 36-50.
صنعتگر، رایحه.، و اسماعیلی, مریم. (1399). اثر بخشی بازی درمانی گروهی بر پذیرش اجتماعی و امید در کودکان مبتلا به سرطان. خانواده درمانی کاربردی، 1(2): 125-140
کاکاوند، علیرضا.، نظری، فاطمه.، و مشهدی فراهانی، ملکه. (1394). رابطه طرح‌واره‌های ناسازگار اولیه با شیوه‌های فرزندپروری مادران و اختلال‌های بیرونی‌شده فرزندان‌شان. فصلنامه روانشناسی کاربردی، 9(2): 135-115.
لطفی حقیقت، امیر.، منیرپور، نادر.، و ضرغام حاجبی، مجید. (1400). مدل ساختاری درماندگی خانواده در بیماران مبتلا به سرطان بر اساس طرحواره های ناسازگار اولیه و راهبردهای مقابله ای با نقش میانجی هم وابستگی خانواده. خانواده درمانی کاربردی، 2(3): 511-534
محمدی، فهیمه.، دوکانه­ای فرد، فریده.، و حیدری، حسن. (1398). اثربخشی معنا درمانی بر شفقت بر خود و امید به زندگی در زنان مبتلا به افسردگی. سنجش و پژوهش در مشاوره کاربردی، ۱ (۲): ۱۸-۱
مقدم، فرانک.، و نامور، هومن. (1398). نقش سبک زندگی و آشفتگی روانشناختی در ناتوانی کارکردی بیماران مبتلا به سرطان سینه. سنجش و پژوهش در مشاوره کاربردی، 2(1): 19-34
یانگ، جفری.، کلوسکو، ژانت.، و ویشار، مارجوری. (2003). طرحواره درمانی: راهنمای کاربردی برای متخصصان بالینی. ترجمه حسن حمید پور و زهرا اندوز (1386). تهران:‌ انتشارات ارجمند.
Andrews, P. W., Maslej, M. M., Thomson Jr, J. A., & Hollon, S. D. (2020). Disordered doctors or rational rats? Testing adaptationist and disorder hypotheses for melancholic depression and their relevance for clinical psychology. Clinical Psychology Review, 101927.
Bade BC, Dela Cruz CS. (2020) Lung Cancer: Epidemiology, Etiology, and Prevention. Clin Chest Med; 41(1): 1-24.
Booth, N. R., McDermott, R. C., Cheng, H.-L., & Borgogna, N. C. (2019). Masculine gender role stress and self-stigma of seeking help: The moderating roles of self-compassion and self-coldness. Journal of Counseling Psychology. Advance online publication.
Bozikas, V., & Parlapani, E. (2016). Resilience in patients with psychotic disorder. Psychiatrike= Psychiatriki27(1), 13.
Boyle, M. (2018). Art Therapy for Major Depression: Positive Psychology and the Therapeutic Alliance.
Brown, S. L., Hughes, M., Campbell, S., & Cherry, M. G. (2020). Could worry and rumination mediate relationships between self‐compassion and psychological distress in breast cancer survivors?. Clinical Psychology & Psychotherapy27(1), 1-10.
Byrne, B. M. (2010). Structural equation modeling with AMOS: Basic concepts, applications, and programming. Routledge.
Conceição, E. M., Fernandes, M., de Lourdes, M., Pinto-Bastos, A., Vaz, A. R., & Ramalho, S. (2020). Perceived social support before and after bariatric surgery: association with depression, problematic eating behaviors, and weight outcomes. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity25(3), 679-692.
Conley, E.,y Andersen, D. (2019). Health professional cultural competence reduces the psychological and behavioral impact of negative healthcare encounters. Cultural Diversity and Ethnic Minority Psychology. 13(5), 432-440.
David, V. A., & Enache, R. G. (2020). Depression in cancer patients. Technium Social Sciences Journal12, 150-159.
Dunn, B. D., & Roberts, H. (2016). Improving the capacity to treat depression using talking therapies: Setting a positive clinical psychology agenda.
Erim, D. O., Bensen, J. T., Mohler, J. L., Fontham, E. T., Song, L., Farnan, L., ... & Gaynes, B. N. (2019). Prevalence and predictors of probable depression in prostate cancer survivors. Cancer125(19), 3418-3427.
Evans, S. E., Steel, A. L., & DiLillo, D. (2013). Child maltreatment severity and adult trauma symptoms: Does perceived social support play a buffering role? Child Abuse & Neglect, 37(11), 934-943.
Fervaha, G., Izard, J. P., Tripp, D. A., Rajan, S., Leong, D. P., & Siemens, D. R. (2019, April). Depression and prostate cancer: a focused review for the clinician. In Urologic Oncology: Seminars and Original Investigations (Vol. 37, No. 4, pp. 282-288). Elsevier.
Fradelos, E. C. (2019). Connecting the dots: understanding the relationship between religiosity, psychological resilience and depression in breast cancer patients. Progress in Health Sciences9(1), 98-104.
Gómez-Odriozola, J., & Calvete, E. (2020). Longitudinal Bidirectional Associations Between Dispositional Mindfulness, Maladaptive Schemas, and Depressive Symptoms in Adolescents. MINDFULNESS.
Hong JF, Zhang W, Song YX, Xie LF, Wang WL.(2015). Psychological distress in elderly cancer patients. Int J Nurs Sci.2: 23-7.
Hou.,& Lam. (2014). Effects of paclitaxel on mechanical sensitivity and morphine reward in male and female C57Bl6 mice. Experimental and Clinical Psychopharmacology, 24(6), 485–495.
Huang G, Wu Y, Zhang G, Zhang P, Gao J (2011). Analysis of the psychological conditions and related factors of breast cancer patients. The Chinese German Journal of Clinical Oncology; 9(1):53-7.
Huang, J., Wang, X., Li, W., & An, Y. (2019). The relationship between conscientiousness and posttraumatic stress disorder among young Chinese firefighters: The mediating effect of perceived social support. Psychiatry Research, 273, 450-455.
Jean, C. Y., & Syrjala, K. L. (2017). Anxiety and depression in cancer survivors. Medical Clinics101(6), 1099-1113.
Kimura T, Egawa S. (2018). Epidemiology of prostate cancer in Asian countries. Int J Urol; 25(6): 524-531.
Kripke, D. F. (2016). Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit. F1000Research5.
Liao MN, Chen SC, Lin YC, Chen MF, Wang CH, Jane SW (2013). Education and psychological support meet the supportive care needs of Taiwanese women three months after surgery for newly diagnosed breast cancer: A non-randomized quasi-experimental study. International journal of nursing studies; 51:390-9.
Neff KD.(2003). The development and validation of a scale to measure self-compassion. Self Identity. 2(3):223-50.
Peoples, A. R., Garland, S. N., Pigeon, W. R., Perlis, M. L., Wolf, J. R., Heffner, K. L., ... & Morrow, G. R. (2019). Cognitive behavioral therapy for insomnia reduces depression in cancer survivors. Journal of Clinical Sleep Medicine15(1), 129-137.
Przezdziecki A, Sherman KA, Baillie A, Taylor A, Foley E, Stalgis-Bilinski K.(2013). My changed body: breast cancer, body image, distress and self-compassion. Psychooncology;22(8):1872-9.
Richardson, C. M., Trusty, W. T., & George, K. A. (2020). Trainee wellness: self-critical perfectionism, self-compassion, depression, and burnout among doctoral trainees in psychology. Counselling Psychology Quarterly33(2), 187-198.
Rueger, S. Y., Malecki, C. K., Pyun, Y., Aycock, C., & Coyle, S. (2016). A meta-analytic review of the association between perceived social support and depression in childhood and adolescence. Psychological Bulletin142(10), 1017.
Schaap, G. M., Chakhssi, F., & Westerhof, G. J. (2016). Inpatient schema therapy for nonresponsive patients with personality pathology: Changes in symptomatic distress, schemas, schema modes, coping styles, experienced parenting styles, and mental well-being. Psychotherapy, 53(4), 402-412.
Thompson, T., Pérez, M., Kreuter, M., Margenthaler, J., Colditz, G., & Jeffe, D. B. (2017). Perceived social support in African American breast cancer patients: Predictors and effects. Social Science & Medicine192, 134-142.
Todorov, N., Sherman, K. A., Kilby, C. J., & Breast Cancer Network Australia. (2019). Self‐compassion and hope in the context of body image disturbance and distress in breast cancer survivors. Psycho‐oncology28(10), 2025-2032.
Trompetter, H. R., de Kleine, E., & Bohlmeijer, E. T. (2017). Why does positive mental health buffer against psychopathology? An exploratory study on self-compassion as a resilience mechanism and adaptive emotion regulation strategy. Cognitive therapy and research41(3), 459-468.
Wilson, J. M., Weiss, A., & Shook, N. J. (2020). Mindfulness, self-compassion, and savoring: Factors that explain the relation between perceived social support and well-being. Personality and Individual Differences, 152, 1-8.
Young, J., & Martin, R. (2010). Schema Therapy. In K.S. Dobson (Ed), Handbook of Cognitive-Behavioral Therapies (pp 317-346). New York: The Guilford Press.
Zhang D.H., & He, H.L. (2010). Personality traits and life satisfaction: A Chinese case study. Social Behavior and Personality, 38(8), 1119-1122.
Zhang, L., Huang, W., Fan, H., Liu, Y., Cao, Y., & Chen, Y (2020). Correlation Analysis of Early Maladaptive Schema and Clinical Symptoms, Personality Characteristics and Defense Mechanism of Depression Patients.
Zhu, L., Wang, J., Liu, S., Xie, H., Hu, Y., Yao, J., ... & Fleer, J. (2020). Self-Compassion and Symptoms of Depression and Anxiety in Chinese Cancer Patients: the Mediating Role of Illness Perceptions. Mindfulness11(10), 2386-2396.