Early Maladaptive Schemas Research Articles

Suicidality in the Light of Schema Therapy Constructs, i.e., Early Maladaptive Schema and Schema Modes: A Longitudinal Study.

(1) Background: The search for new strategies to diagnose people at risk of suicide and to help them is highly significant in view of the still high rate of suicidality. Schema therapy and its core constructs, i.e., early maladaptive schemas (EMSs) and schema modes, correspond to both directions. (2) Methods: This study compared the severity of EMSs and schema modes in a clinical group of suicide risk, a clinical non-suicidal group, and a control group. Intragroup comparisons were also conducted between times of crisis and psychological stability. The evaluation was supported by controlling for the psychopathological symptoms presented, following the dimensional concept. (3) Results: The unquestionable relevance of the disconnection/rejection domain in suicidality has been proven. The importance of EMSs from other domains, especially during psychiatric crises, was confirmed. Among the schema modes, child and Punitive Parent modes proved to be the most significant. There were changes in coping modes but of a lesser effect size. The protective importance of the Healthy Adult and Happy Child modes was also proven. (4) Conclusions: The results provide an indication for practitioners about the EMSs and schema modes most associated with suicide risk. They can also serve as a framework for deepening the issue of identifying and preventing suicidality in schema therapy.

Investigation of the Relationship of Suicidal Ideation and Suicide Attempt History with Early Maladaptive Schemas in Individuals with Major Depressive Disorder

Objective: We aimed to examine the relationship between the presence of suicidal ideation and attempt history and maladaptive schemas in individuals with major depressive disorder.
 Materials and methods: The experimental group consisted of 28 individuals were diagnosed with major depressive disorder, had a history of suicide attempt and active suicidal ideation. 26 individuals who did not have active suicidal ideation and any history of suicide attempt constitute the control group. Sociodemographic data form, Beck Anxiety Scale, Beck Depression Scale, Beck Suicidal Ideation Scale and Young Schema Scale-Short Form-3 were administered to the participants.
 Results: The groups differed in terms of all scale scores (p

Assessing the relationship between early maladaptive schemas and interpersonal problems using interpersonal scenarios depicting rejection.

Early maladaptive schemas (EMSs) have been theorised to contribute to reoccurring interpersonal problems. This study developed a novel experimental paradigm that aimed to assess if EMSs moderate the impact of interpersonal situations on interpersonal responses by manipulating the degree of rejection in a series of interpersonal vignettes depicting acceptance, ambiguous rejection and rejection. In a sample of 158 first-year psychology students (27.2% male; 72.2% female; 0.6% other) participant responses to interpersonal scenarios were measured including degree of perceived rejection, emotional distress, conviction in varying cognitive appraisals consistent with attribution theory and behavioural responses to scenarios. Qualitative data was analysed using inductive content analysis and statistical analyses were conducted using multi-level mixed effect linear and logistic regression models using the software Jamovi. People reporting higher EMSs reported increased emotional distress (F(1, 156) = 24.85, p < .001), perceptions of rejection (F(1, 156) = 34.33, p < .001), self-blame (F(1, 156) = 53.25, p < .001), other-blame (F(1, 156) = 13.16, p < .001) and more intentional (F(1, 156) = 9.24, p = .003), stable (F(1, 156) = 25.22, p < .001) and global (F(1, 156) = 19.55, p < .001) attributions but no differences in reported behavioural responses. The results also supported that EMSs moderate the relationship between interpersonal rejection and perceptions of rejection (F(2, 1252) = 18.43, p < .001), emotional distress (F(2, 1252) = 12.64, p < .001) and self-blame (F(2, 1252) = 14.00, p < .001). Together these findings suggest that people with EMSs experience increased distress and select negative cognitions in situations where there are higher levels of rejection but that distress and negative cognitions are generally higher in people with EMSs irrespective of the situation.

Understanding the reparative effects of schema modes: an in-depth analysis of the healthy adult mode.

Evidence in favor of schema therapy's effectiveness in treating personality disorders is growing. One of the central and recently popular concepts of schema therapy is schema modes [i.e., temporary emotional-cognitive-behavioral states resulting from the activation of early maladaptive schemas (EMSs)]. A key aspect herein is self-reparenting, i.e., a healing relationship between the healthy adult (HA, i.e., compassionate and healthy emotional states, and functional dealing with reality) and the child modes (i.e., representation of fragile and hurt feelings and dysfunctional coping). Through an in-depth qualitative analysis, we aimed to better understand the components of the HA that enable self-reparenting. Purposive sampling procedures were used to recruit eligible participants (n = 10) with relatively strong HA modes, as determined by high scores on positive affect and satisfaction with life measures and low scores on EMSs and psychopathological symptom measures. Semi-structured 45- to 60-min face-to-face interviews were conducted individually, in which individuals were asked to help the child modes reflected in the pictures. Interviews were then analyzed using deductive thematic analysis in MaxQDA. The analysis revealed three superordinate themes comprising of a total of 10 group themes: (1) bonding between HA and the vulnerable child modes ("Bond"); (2) balancing expression and inhibition of adult and child mode emotions ("Balancing"); and (3) opposing demanding and critical voices and maladaptive coping styles ("Battle"). Furthermore, a strong HA mode seems to have a reciprocal relationship with the child modes: the HA gives nurturance and protection to the child modes, and the child modes boost up the HA with spontaneity and happiness. In conclusion, emotional stability and resilience may be highest when HA-child mode interaction happens bidirectionally; when the child modes get reparented by the HA, and the HA is informed by the child modes.

Психологические убеждения и ранние дезадаптивные схемы у лиц, переживших травматический опыт

&lt;p&gt;&lt;strong&gt;Introduction.&lt;/strong&gt; This article describes the mutual influence of the phenomena of psychological assumptions, early maladaptive schemas (EMS), traumatic experience. The significance of this study is based to the need for psychologists to carry out practical work with the complexity and severity of the consequences of a person&amp;rsquo;s traumatic experience, specifics of beliefs and EMS. &lt;strong&gt;Purpose:&lt;/strong&gt; To study psychological assumptions and EMS, which are formed from childhood and increase the impact on the personality in connection with the traumatic experience reducing the adaptive capacity of the individual. &lt;strong&gt;Methods.&lt;/strong&gt; The article presents the results of a study of 45 people: females (31 participants) and males (14 participants), at the age 24&amp;ndash;40 years old (M = 33,9; SD = 5). The specificity of the manifestation of differences in psychological assumptions and EMS in individuals with high and low rates of trauma is described. The following methods were used: the questionnaire of traumatic situations (Life Experience Questionnaire &amp;ndash; LEQ), an adaptation of the WAS (World Assumptions Scale), the questionnaire for an adapted version of determining early maladaptive schemes by Jeffrey E. Young. &lt;strong&gt;Results and conclusions.&lt;/strong&gt; Differences in groups with high and low rates of traumatism were identified: the individuals who survived a traumatic experience are characterized by a higher level of EMS &amp;laquo;Abandonment/Instability&amp;raquo;, &amp;laquo;Social Isolation&amp;raquo;, &amp;laquo;Vulnerability&amp;raquo; and &amp;laquo;Negativity/Pessimism&amp;raquo;; persons with a low level of traumatism are characterized by the manifestation of conviction in the &amp;laquo;goodwill of the world&amp;raquo;. A relationship was found between the image of the &amp;laquo;Self&amp;raquo;, the basic belief about luck, a high level of trauma and EMS in people who had a traumatic experience.&lt;/p&gt;

The Structural Model of Early Maladaptive Schemas with Cardiac Health-Related Behaviors in General Population: The Mediating Role of Emotion Regulation and Self-compassion

The Structural Model of Early Maladaptive Schemas with Cardiac Health-Related Behaviors in General Population: The Mediating Role of Emotion Regulation and Self-compassion

Young Adults’ Romantic Disillusionment as a Function of Family-of-Origin Dynamics

This study examined associations among indulgent parenting, differentiation, early maladaptive schemas, and romantic disillusionment in an SEM model in a sample of 578 university ­students who were partnered or had been in a romantic relationship. Bootstrap tests of indirect effects were examined to rigorously establish mediation. Family-of-origin variables (indulgent parenting and indices of low differentiation) predicted participants’ early maladaptive schemas. Early maladaptive schemas predicted perceived partner entitlement, which in turn predicted disillusionment. No differences in model pathways were identified between women and men. The authors provide suggestions for future research and psychotherapy.

Refining the Experiential Component of Schema Therapy for Traumatised Populations: a New Continuum of Experiential Techniques

The schema therapy model is a potential new viable alternative for trauma-focused psychotherapy. This is because it employed a series of integrative and experiential techniques to resolve the unconscious impacts of past traumatic experiences. Additionally, its unique concepts of Early Maladaptive Schemas (EMS) and Schema Modes provided a new explanation for understanding trauma impacts. However, as schema therapy was not designed for trauma work, it does have certain limitations in its techniques, especially in its experiential component. In this theoretical paper, the identified limitations of the experiential techniques in schema therapy were addressed through assimilative integrating art therapy, dream-work and psychodynamic techniques. A new continuum of experiential techniques was created and integrated into schema therapy. This newly integrated schema therapy was named ‘trauma-focused schema therapy’ (Tf-ST). The six steps of assimilative integration were illustrated.

The alternative model of personality disorders or early maladaptive schemas? Usefulness for understanding borderline features in a non-clinical adult sample

Introduction and objective: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alternative model of personality disorders (AMPD) is currently under empirical verification for its usefulness and diagnostic accuracy. At the same time, numerous studies based on Young’s concept of maladaptive schemas are underway. The aim of the research was to compare the possibilities of explaining the severity of borderline features using both models. Materials and methods: The results obtained from 565 healthy adults, with women accounting for slightly more than 52%, aged 18–81 years (M = 37 years) were analysed. The Structured Clinical Interview for DSM-IV Axis II Personality Disorders – Personality Questionnaire (items for borderline personality disorder) (SCID-II, BPD part), Young Schema Questionnaire – Short Form (YSQ-S3) and Personality Inventory for DSM-5 (PID-5), Brief Form were used. Results: Regression analysis demonstrated that schemas account for about 39%, and personality traits for 53% of borderline trait variability, and their combined use increases this percentage to 55%. Structural modelling, in turn, indicated that only three schema domains are relevant for explaining borderline traits, but only indirectly. The direct effect schemas have on the personality dimensions from the AMPD model (only Impaired Autonomy has a significant direct effect on borderline). Contrary to the assumptions of the AMPD model, Negative Affectivity holds the slightest importance for the severity of borderline, while the greatest effect strength characterises Psychoticism. Conclusions: The dimensions of an alternative personality model have a direct relationship with BPD traits. The schemas explain personality traits (AMPD) but not the severity of the disorder itself.

Early maladaptive schemas, emotion regulation difficulties and alexithymia: A systematic review and meta-analysis.

Emotion regulation is an integral part of the schema therapy model. The aim of this systematic review and meta-analysis was to synthesize the evidence on the associations between early maladaptive schemas (EMSs), difficulties with emotion regulation and alexithymia. PsycINFO, PubMed and CINAHL Complete databases were searched on 28 May 2022 and 3 February 2023 in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Included studies were in English, in peer-reviewed journals and reported on the association between one or more of the 18 EMSs or five schema domains and emotion regulation difficulties or alexithymia. Methodological quality was assessed using the Appraisal Tool for Cross-Sectional Studies. Meta-analyses were conducted to examine difficulties with emotion regulation and alexithymia as correlates of each EMS and domain. A total of 19 studies published between 2008 and 2022 were included (Pooled N= 5957). Difficulties with emotion regulation were positively correlated with all 18 EMSs (range: entitlement r(7) =.28, 95% CI [.13, .42] to negativity pessimism r(5) =.53, 95% CI [.23, .74]) and schema domains (range: impaired limits r(5) =.34, 95% CI [.08, .56] to disconnection rejection r(5) =.44, 95% CI [.33, .73]). Alexithymia was positively correlated with the other-directedness domain (r(2) =.40, 95% CI [.09, .64]) and 16 of the 18 EMSs (range: unrelenting standards r(5) =.21, 95% CI [.12, .28] to emotional inhibition r(5) =.50, 95% CI [.34, .63]). The findings suggested that almost all 18 EMSs are implicated in emotion regulation difficulties and alexithymia, particularly those relating to unmet needs for attachment and autonomy.

Formulation of the Extramarital Relationships Model Based on Early Maladaptive Schemas Mediated by Sensation-seeking in Men

Background and Objective: The existence of extramarital relationships is one of the main causes of family breakdown and divorce. The current study aimed to formulate an extramarital relationship model based on early maladaptive schemas mediated by sensation-seeking in men. Materials and Methods: This descriptive-correlational study was conducted based on structural equation modeling. The statistical population included all men with extramarital relationships visiting a counseling center in the west of Tehran (Hamkadeh) from March to September 2021. The sample for this study included 250 men with extramarital relationships within the age range of 28-45 who were selected via the convenience sampling method. Data gathering was carried out using the marital infidelity questionnaire of Yeniceri and Kökdemir (2006), Young's early maladaptive schema questionnaire (1998), and the Zuckerman Sensation-seeking questionnaire (2006). Structural equation modeling was used for data analysis. Results: The results indicated that the assumed research model is fitted over the empirical data (RMSEA=0.056). The coefficient of a direct path between early maladaptive schemas and marital intimacy (β=0.28) was significant at 0.05 level. The indirect coefficient of early maladaptive schemas to extramarital relationships through flexibility was significant (P=0.001). Conclusion: The early maladaptive schemas were correlated with extramarital relationships mediated by sensation-seeking. Therefore, it can be stated that the reduction of early maladaptive schemas and sensation-seeking will effectively mitigate extramarital relationships.

Evaluation of Patients Diagnosed with Generalized Anxiety Disorder in Terms of Early Maladaptive Schemas

Aim: It has been reported that individuals with generalized anxiety have many interpersonal problems and these problems occur through schemas such as emotional inhibition, shyness, subjugation, self-sacrifice and intervention. In light of this information, the purpose of this study was to compare individuals with generalized anxiety disorder (GAD) and healthy controls in terms of early maladaptive schemas (EMSs).&#x0D; Material and Methods: This research involved 92 participants aged 18 to 55, including 48 GAD patients and 44 healthy controls. Sociodemographic data form, Young Schema Questionnaire-Short Form-3 (YSQ-S3), Generalized Anxiety Disorder 7-item scale (GAD-7), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered to the participants. The study was approved by the ethics committee (KÜTF KAEK NO:2023.02.16).&#x0D; Results: The patients' average age was 38.19±11.29, and 83.3% of them (n=40) were women. The average age of healthy controls was significantly lower, however, neither group differed significantly in terms of education or marital status. The mean GAD-7 score of the patients was 6.26±6.81. Emotional deprivation (p=0.024), pessimism (p

Early maladaptive schemas in sex offenders versus the characteristics of offences against sexual freedom

This study examines the relationship between early maladaptive schemas (EMS) and the characteristics of offences committed by sex crime convicts. The research uses data collected from 102 convicts. The Polish version of Young’s Schema Questionnaire (YSQ-S3-PL) was used to gauge the severity of EMS. The author’s self-made questionnaire used for making extracts from prison records, coupled with Beisert’s Violence Scale (2012), was employed to study the characteristics of the offences committed by the criminals under study. A correlation was found between the characteristics of the committed criminal acts (choice of victim, the CSO’s modus operandi, sexual violence involved) and the type and severity of each EMS. Relevant for CSOs in the context of their criminal acts are 4 domains out of 5 and 11 EMSs out of 18. The findings suggest that EMS contribute to criminal sexual behaviour. It may be important and useful to consider these structures when constructing models of preventive measures and planning therapeutic or proactive interventions. As a result, it would seem that convicted sexual offenders (CSO’s) require a customised approach including therapeutic models designed to address the specific maladaptive schema.

Resilience and Strategic Emotional Intelligence as Mediators between the Disconnection and Rejection Domain and Negative Parenting among Female Intimate Partner Violence Victims.

(1) Background: The exposure of children to intimate partner violence (IPV) is associated with a wide range of negative effects on children's development, where as parenting practice is considered to be one of the key factors mediating and mitigating this. Studies have found mixed results regarding the impact of female IPV victimization on maternal parenting practice; however, the most frequently tested hypothesis suggests that the cumulative stress of the IPV experience may emotionally deregulate the mother, contributing to an increased risk of neglected and abusive parenting practices. Little is still known about the factors determining the observed differences in maternal parenting practices among IPV victims. Thus, in our study, we use mediation models to provide preliminary results exploring the role of resilience and strategic emotional intelligence in the relationship between women's disconnection and rejection (D/R) schema domain and maternal parenting practice among IPV victims. (2) Methods: A total of 48 female survivors of IPV and 48 age-matched women with no prior experience of IPV completed a set of tests examining parenting practices, the D/R domain, resilience and emotional intelligence. (3) Results: IPV victimization was associated with significantly higher rates of negative parenting practices. The D/R domain was found to be a significant predictor of parental autonomy attitude and level of parental competence, and these relationships were fully mediated by resilience with strategic emotional intelligence and resilience, respectively. (4) Conclusions: The results shed light on the under-researched relationship between early maladaptive schemas and parenting behavior in the context of IPV. The implications for clinical practice and further research can be drawn based on the study findings.

The Role of Early Maladaptive Schemas and Emotional Knowledge in Predicting Employees’ Illness Anxiety

The present study was conducted to investigate the role of early maladaptive schemas and emotional knowledge in predicting employees’ anxiety. The current research is of a descriptive-correlation type. The statistical population included all employees of companies (Aida Nar, Arshida, Sobh Farda and Avijeh) in Tehran from October to January 2021. Using available sampling method, 135 people were selected. The respondents filled in Young &amp; Brown, 1994 (1994) schema questionnaire, Grant et al.’s (2002) emotional awareness, and Ahadi and Pasha’s hypochondriasis questionnaire (2001), and finally, regression analysis was used to analyze the data. The obtained findings showed that initial maladaptive schemas and emotional knowledge can predict employees’ illness anxiety (p&lt;0.05). Accordingly, disconnection area (β = -0.37), disrupted constraint area (β = -0.24), autonomy area (0.10), Emotional self-awareness (β = 0.05), other areas of orientation (β = 0.04) and area of autonomy (β = 0.10) had the highest coefficient of influence in predicting illness anxiety, respectively. According to the results of this research, early maladaptive schemas and emotional knowledge can predict illness anxiety; hence, counselors and psychologists should prioritize early maladaptive schemas and emotional knowledge in the study of anxiety.

Social Anxiety from an Attachment Theory Perspective: The Mediating Role of Early Maladaptive Schema Domains and Rejection Sensitivity

Social anxiety is a common problem. Several factors play a role in the development and maintenance of social anxiety. Since relationship with parents is specifically an important factor, it is important to examine social anxiety from an attachment theory perspective. Studies indicate that early maladaptive schemas and rejection sensitivity may play a role in the relationship between attachment pattern and psychological distress. Therefore, the aim of the present study is to examine the mediating role of early maladaptive schema domains and rejection sensitivity in the relationship between internal working models of attachment and social anxiety. The sample of the study consisted of 557 university students (199 male, 358 female) between the ages of 17-27 (M = 20.69, SD = 1.79). Liebowitz Social Anxiety Scale, Relationship Scales Questionnaire, Young Schema Questionnaire-Short Form 3, and Rejection Sensitivity Questionnaire were administered to the participants. Results of the mediation analysis with Bootstrapping showed that Impaired Autonomy schema domain and rejection sensitivity mediated the relationships between attachment self-model and social anxiety. Moreover, schema domains of Impaired Autonomy, Impaired Limits and Unrelenting Standards, and rejection sensitivity mediated the relationship between attachment other-model and social anxiety. The current study may contribute to the literature by providing an understanding of how the relationship between attachment and social anxiety may emerge. Clinicians aiming to increase clients’ functionality and quality of life should/could focus on their clinical practice on the above early maladaptive schema domains and rejection sensitivity.

What role do early life experiences play in eating disorders? The impact of parenting style, temperament and early maladaptive schemas.

Given that most eating disorders develop in adolescence and early adulthood, early life experiences are said to play a key role in the aetiology of eating disorders. There are well-documented relationships between early maladaptive schemas and eating disorders, early maladaptive schemas and temperament and temperament and perceived parenting style. The present study aimed to test a hypothesis that perceived parenting style predicts temperament, which predicts early maladaptive schemas, which predict eating disorder symptoms in young people. An online survey measured perceived parenting style, temperament, early maladaptive schemas and eating disorder symptoms in 397 people with disordered eating between the ages of 18 and 29. Path analysis was used to investigate the relationship between these elements. The results found support for this hypothesis. Perceived maladaptive parenting ratings for mothers were a stronger predictor of temperament, and only two temperament factors were adequate predictors of early maladaptive schemas. Overall, the present study found preliminary support for a linear relationship where perceived parenting style predicts temperament, which predicts early maladaptive schema levels, which predicts eating disorder symptoms. The present study was the first to propose and test this model; however, further research is required to confirm the nature and extent of this relationship.

Schema therapy in the diagnosis of eating disorder: features of early maladaptive schemas

The article is devoted to the study of early maladaptive schemas in patients with eating disorders. Patients with eating disorders represent a heterogeneous group, with a variety of mental pathologies, most often represented by patients’ personal characteristics. The present study analyzes deeper impairments in communication with close ones at an early age, predisposing to the onset of mental pathology. On the basis of the Psychiatric Clinical Hospital No. 1 named after N. A. Alekseev, 131 patients diagnosed with anorexia nervosa and bulimia nervosa were examined. In the course of the study, the Young Schema Questionnaire (YSQ-S3R) was utilized. Non-adaptive schemas were identified in the domain «disconnection and rejection» in all patients with eating disorders. In the patients with bulimia nervosa, the early schemas in the impaired autonomy domain were most pronounced, in contrast to the patients with anorexia nervosa. The schema of insufficient self-control in the impaired limits domain was also detected in these patients, while in the patients with anorexia nervosa, this indicator was not manifested. The hypervigilance and inhibition domain was manifested by maladaptive schemas in both groups, with the negativity schema expressed in patients with bulimia nervosa. The domain of focus on others is characteristic of all patients with eating disorders. A comparative analysis of the indicators of early maladaptive schemas in patients with anorexia nervosa and bulimia nervosa and the results of a group of healthy people was carried out. In the healthy group, the expressed early maladaptive schemas were not observed. Violations in satisfying basic needs at an early age can be triggers in the mechanism of development and maintenance of eating disorders and personality pathology in this group of patients.

Early maladaptive schemas are associated with self-injury thoughts and behavior in adolescents

BackgroundEarly maladaptive schemas (EMSs) and self-harm have been firmly linked in adults, but research on these associations in adolescents remains scarce. Additionally, the links between EMSs and functions of self-injury has not been previously studied in this age group. Thus, the aim of the present study was to investigate the associations of EMSs with self-harm thoughts and behavior, as well as with self-harm functions, among adolescents in specialized health care.MethodsThe participants were recruited from first-visit 12-22-year-old adolescent patients entering specialized mental health care or pediatric care. For 118 participants, complete data were available for the Young Schema Questionnaire Short Form 2-Extended (YSQ) when entering care and the Ottawa Self-Injury Inventory Functions scale (OSI-F) one year later. YSQ was used to measure the participants’ EMSs and OSI-F their self-harm thoughts and behavior. The associations of EMSs and self-harm were investigated in three groups: no self-harm, self-harm thoughts only, and both self-harm thoughts and behavior. The associations of EMSs with self-injury behavior functions were assessed in four categories: Internal Emotional Regulation, External Emotional Regulation, Social Influence, and Sensation Seeking. Additionally, EMSs’ associations with addictive features of self-injury behavior were assessed. The magnitudes of effect sizes of differences between the self-harm groups were evaluated with Cliff’s Delta. The associations of EMSs with self-injury functions were analyzed with general linear modeling and with self-injury addictive features using logistic regression.ResultsThe differences between the self-harm groups were significant for the majority of the EMSs. The stronger the EMSs were, the more severe the manifestations of self-harm. The effect sizes ranged from small to large depending on the EMS. Considering self-injury functions, Internal Emotional Regulation was associated with Self-Sacrifice EMS (p = 0.021), and External Emotional Regulation both with Abandonment (p = 0.040) and Unrelenting Standards (p = 0.012) EMSs. Being addicted to self-injury was associated with Abandonment (p = 0.043) and Dependence (p = 0.025) EMSs.ConclusionsThe present study shows that significant associations between EMSs and both self-harm thoughts and behavior exist also in adolescents. Stronger EMSs are linked to more severe self-harm. Knowledge of these associations may help to improve the understanding and treatment of adolescents suffering from self-harm.

The effectiveness of individual schema therapy in older adults with borderline personality disorder: A multiple-baseline case series design.

The aim of this study was to explore the effectiveness of schema therapy (ST) in older adults with borderline personality disorder (BPD). Multiple baseline case series design with five BPD patients, with a mean age of 66. After a baseline phase with random length, patients received weekly ST sessions for a year, followed by follow-up sessions during 6months. Participants rated the credibility of negative core beliefs weekly; various secondary outcome measures were assessed every 6months (severity of BPD, early maladaptive schemas, schema modes, personality functioning, maladaptive personality traits, psychological distress and quality of life), and BPD diagnosis was assessed before baseline and after follow-up. Data were analysed with mixed regression analyses and paired t-tests. Results revealed that ST led to a significant decrease in credibility of negative core beliefs, with high effect sizes. All participants remitted from their BPD diagnosis. This is the first study exploring the effectiveness of ST for BPD in older adults, and it suggests that ST can be a powerful intervention for this group of patients.