Schema Change Without Schema Therapy: The Role of Early Maladaptive Schemata for a Successful Treatment of Major Depression

Abstract

Early maladaptive schemata (EMS) have repeatedly been shown to be associated with several psychopathological conditions, including depression. Schema therapy proposes interventions that aim at altering EMS. In the present study, we examined the effect of an integrative psychodynamic inpatient therapy without explicit focus on EMS in a sample with major depression. Forty-seven (38 female, 9 male) patients filled out the Symptom Checklist (SCL-90-R) and the Young Schema Questionnaire (YSQ) at the beginning and end of the treatment. Results revealed that EMS were significantly reduced in three out of five schema domains. Strong endorsement of EMS at the beginning of treatment tended to predict symptom reduction. More importantly, the reduction of symptom distress during treatment was strongly associated with a reduction in EMS of the schema domain Impaired Autonomy/Performance. We discuss that changes in EMS are highly relevant for changes in symptom distress but that EMS can not only be changed by schema therapy but also by other approaches, like psychodynamic therapy.