Maladaptive Schemas Research Articles

L’Attachement dans les Troubles Dépressifs Persistants chez l’adulte : une revue de la littérature

Persistent depressive disorders (PDD) are frequent and disabling and their therapeutic management remains poorly defined. Attachment theory highlights the effect of insecure representations of relationships in the development and maintenance of PDD. The aim of this literature review is to identify the main findings regarding the place of attachment in persistent depressive disorders (PDD) to show the interest of this framework as an explanatory model of PDD and to determine the usefulness of taking attachment into consideration in the therapeutic intervention for the treatment of PDD. The current treatment of PDD faces a high rate of either failure or partial remission. Almost half of depressed patients do not achieve remission or develop chronic residual symptoms. Although there is a specific therapy built for PDD (CBASP), there is currently no psychotherapy that has been sufficiently scientifically verified to be recommended for PDD. Interpersonal difficulties seem to play a major role in the maintenance of a depressive state: the difficulty in establishing a therapeutic relationship would explain why patients with PDD often show a poor therapeutic response to traditional psychotherapies, including cognitive behavioural therapy (CBT). In addition, some characteristics that make treatment difficult may be a consequence of childhood maltreatment, in particular emotional abuse, and neglect, that are risk factors for early depression with a chronic course. Furthermore, insecure attachment is a major risk factor of severity or persistence of psychopathological disorders. Conversely, secure attachment reduces the risk of developing these symptoms. Empirical research has shown links between insecure attachment and specific psychological disorders. Insecure attachment is associated with internalizing disorders, including depression, in childhood and in adulthood. Insecure attachment is clearly associated with depressive symptoms. This relationship is mediated by several variables such as self-esteem, disrupted social and relational skills depressive cognitions and early maladaptive schemas. Taken together, these findings suggest that attachment is an important risk factor in the development of psychopathology, in particular depressive disorders. Therefore, Bosmans suggests that the integration of attachment into psychotherapies would enhance their effectiveness. Attachment should therefore be considered as an important target of clinical intervention to treat the symptoms of PDD and there seems to be a need to develop this therapeutic approach to determine the extent to which a treatment protocol can focus specifically on attachment for chronically depressed patients. Studies of attachment psychotherapies consider attachment style both as a predictor of treatment outcome and as an indicator of therapeutic orientation. The patient's attachment representations and behaviours can influence the therapeutic process and the relationship with the therapist, which means identifying them to use specific strategies: therapeutic techniques relevant to one attachment style may be problematic for another. These considerations show the need for research that considers the relationship between PDD symptoms and patients’ attachment styles at the beginning of therapy to verify which attachment patterns are related to this specific pathology and to determine the influence of patients’ attachment patterns on the therapeutic process. Finally, innovative therapies such as Integrated Attachment Therapy, that consider attachment as the foundation of the therapeutic process, are being developed and form a new care offer that seems promising for the treatment of PDD.

Maladaptive Cognitive Schemas as Predictors of Disordered Eating: Examining the Indirect Pathway through Emotion Regulation Difficulties.

A scarcity of research has looked into the association of maladaptive core beliefs with dysfunctional eating patterns. Moreover, no prior study has considered the potential role of difficulties in negative emotion regulation when disentangling the complex correlations between early maladaptive schemas and disturbed eating habits. Our study aimed at exploring the distinct relationships between early maladaptive schemas and disordered eating, while investigating the indirect role of emotion regulation difficulties within these associations. We collected data from 982 Lebanese young adults (18–30 years old), distributed across the five Lebanese governorates, who completed the Eating Attitudes Test (EAT-26), the Young Schema Questionnaire—Short Form 3 (YSQ-SF3), and the Difficulties in Emotion Regulation Scale—16 Item Version (DERS-16). The results showed that the disconnection and rejection schema domain, under which the early maladaptive schema of mistrust was the most predictive of disordered/inappropriate eating attitudes. All the remaining maladaptive schema domains (i.e., the impaired autonomy/performance, impaired limits, other-directedness, and overvigilance/inhibition schema domains) exerted significant indirect effects on disordered eating attitudes through difficulties in emotion regulation. Our findings gave prominence to a potential intrinsic mechanism through which maladaptive cognitive schemas are linked to disordered eating behaviors, emphasizing the role of emotion dysregulation as a cardinal actor within this model. They sustain the surmise that cognitively and emotionally vulnerable individuals exhibit stronger propensities for inappropriate dietary patterns, as a means to offset their inner weakness. This study broadens the medical community’s insights into the underpinning processes behind eating disorder psychopathology and could therefore make a step towards the adoption of innovative therapeutic approaches that promote emotion regulation skills in the context of schema therapy.

Early Maladaptive Schemas are Associated with Adolescents’ Substance and Behavioral Addictions

Early Maladaptive Schemas are Associated with Adolescents’ Substance and Behavioral Addictions

Supplemental Material for The Associations Between Early Maladaptive Schemas and Adult Attachment Styles: A Meta-Analysis

Supplemental Material for The Associations Between Early Maladaptive Schemas and Adult Attachment Styles: A Meta-Analysis

Emotion regulation as a mediator between early maladaptive schemas and non-suicidal self-injury in youth

Non-suicidal self-injury is commonly explained using an emotion regulation framework. Increasingly, early maladaptive schemas (EMS) are also used to conceptualise self-injury. However, there is an absence of research examining the relationship between EMS, emotion regulation, and self-injury. The current study attempted to address this gap by comparing youth with and without a history of self-injury on measures of emotion regulation difficulties and EMS, specifically Abandonment/Instability and Defectiveness/Shame. Specifically, we were interested in assessing whether difficulties in emotion regulation mediated the relationship between EMS and self-injury. Four hundred and three Australian secondary and university students aged between 16 and 25 years, completed measures of self-injury, EMS, and difficulties in emotion regulation. We found significant and positive relationships between Abandonment/Instability, Defectiveness/Shame and six emotion regulation difficulties. Young people with a self-injury history reported more difficulties in emotion regulation compared to those who had never self-injured. For each of the EMS, there was a direct effect on self-injury status, as well as an indirect effect via total emotion regulation difficulties. There was a significant indirect effect of Abandonment/Instability on self-injury via limited access to emotion regulation strategies. Results contribute to our understanding of mechanisms underlying the association between EMS and self-injury, that is, through emotion regulation difficulties. Results are discussed with reference to clinical implications, suggesting that targeting both EMS and emotion regulation difficulties may be appropriate when working with young self-injurers.

Effectiveness of Mindfulness Stress Reduction Program on Cognitive Flexibility and Early Maladaptive Schemas in Adults: Conscious Awareness, Cognitive Flexibility and Schemas

This study was prepared to examine the effect of mindfulness-based stress reduction program on cognitive flexibility and early maladaptive schemas in a group of young adults. The research was carried out with the participation of 18 young adults without a psychiatric diagnosis. The research process consists of eight weeks, with each week's session lasting two and a half hours. In addition to this, another session including a 6-hour day of silence was held. Before and after the study, the

Early Maladaptive Schemas and Self-Stigma in People with Physical Disabilities: The Role of Self-Compassion and Psychological Flexibility.

Self-stigmatizing thoughts may be rooted in one’s core beliefs, and in turn be associated with early maladaptive schemas (EMS). Psychological flexibility, an ability to distance and accept one’s thoughts, is reported to diminish EMS’s effect on well-being, while self-compassion, a mindful attitude towards one’s suffering, often reduces self-stigma. The objective of this study was to examine associations between EMS, self-stigma, psychological flexibility and self-compassion in individuals with disabilities, as they are at higher risk of experiencing self-stigma. Participants were 238 persons with disabilities. The Self-Stigma Scale, Young’s Schemas Questionnaire, the Self-Compassion Scale Short and the Acceptance and Action-II Questionnaire were used. Hierarchical regression and mediation analysis were used to establish (1) predictors and (2) potential mediators of self-stigma in people with disabilities. Hierarchical regression showed that EMS alone accounted for 39% of the variance explained by self-stigma, and with the addition of psychological flexibility—an additional 2% was explained. Parallel mediation analyses indicated that psychological flexibility partially mediated the relationship between EMS domains and self-stigma. It appears that psychological rigidity is related to self-stigma and should be addressed in treatment through evidence-based approaches such as Schema Therapy and Acceptance and Commitment Therapy to enhance individuals’ healthy life patterns, flexibility and self-compassion.

Psychological Consequences of Experiencing Violence in Childhood-The Role of Dissociation in the Formation of Early Maladaptive Schemas.

Childhood experiences of violence can lead to severe psychological consequences. One of them is an increased risk of abnormal personality development. It can manifest as rigid negativistic beliefs about the self, others, and the surrounding world, which some specialists term early maladaptive schemas. The conducted study aims to provide a possible explanation of the role dissociation plays in the process of forming early maladaptive schemas. The study was conducted on 342 adult women whose biographies contained one or more episodes of potentially traumatic experiences of violence in childhood. Three questionnaires were used: Childhood Trauma Questionnaire, Dissociative Experiences Scale, Young Schema Questionnaire. The results show that experiences of violence are linked with dissociative disorders and the intensity of early maladaptive schemas. Mediation analysis confirmed that the relationship between experiencing violence and early maladaptive schemas is exacerbated by the presence of dissociative symptoms resulting from the violence experienced. The mediation analysis results suggest that if an experience of violence is followed by the emergence of dissociative symptoms, its impact on personality is more severe. This confirms earlier notions regarding the role that dissociative symptoms play in personality changes stemming from traumatic events.

Overprotective parenting experiences and early maladaptive schemas in adolescence and adulthood: A systematic review and meta-analysis.

Young's schema model identifies overprotection as a type of childhood experience associated with early maladaptive schemas. This review evaluated the evidence base examining overprotective parenting as a predictor of schema endorsement in adolescence and adulthood. A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines, and registered on PROSPERO (CRD42021258990). PsycINFO, CINAHL and PubMed databases were searched on 5 June 2021 for eligible studies reporting original data on unadjusted association(s) between overprotective parenting and schema endorsement in samples with a mean age of 12 years or older. Studies were excluded if they were not in English or peer reviewed or participants were exposed to an intervention. Meta-analyses using Meta-Essentials software examined the relationship between maternal and paternal overprotective parenting with Young's 18 schemas. An adapted version of the Appraisal tool for Cross-Sectional Studies (AXIS) was used to assess methodological quality. A total of 16 articles were included. Based on 36 meta-analyses (Pooled N = 1,496 to 3,218), several schemas demonstrated positive small correlations with maternal overprotective parenting (range: r = 0.15, 95% CI = 0.10, 0.19 [Entitlement] to r = 0.29, 95% CI = 0.13, 0.43 [Enmeshment]) and paternal overprotective parenting (range: r = 0.15, 95% CI = 0.10, 0.20 [Abandonment] to r = 0.24, 95% CI = 0.10, .36 [Enmeshment]). Considerable heterogeneity was detected, but subgroup analyses were not significant. Overall, recollections of overprotective parenting experiences were primarily associated with schemas relating to disconnection and rejection, and impaired autonomy and performance. However, the literature has thus far relied on retrospective measures of parenting, and longitudinal research is needed to establish causality.

Depresión y esquemas tempranos maladaptativos asociados al consumo de drogas en usuarios de una comunidad terapéutica intrapenitenciaria

Introduction: drug addiction is considered a public health problem and is associated with delinquency and violent behavior. Objective: to determine the relation between early maladaptive schemas, depression and drug use in persons deprived of liberty in intrapenitentiary treatment with the therapeutic community modality. Method: non-experimental and cross-sectional research in a population conformed by 114 male users deprived of liberty. The instruments used were the Beck Depression Inventory and early maladaptive schemas and drug use questionnaires. Results: the schemas that correlated with drug use in persons deprived of liberty were failure, subjugation, sacrifice, insufficient discipline and grandiosity, and those that increased the risk of drug use were dependence/incompetence (RR = 3.375, I = .418, S = 27.227), vulnerability (RR = 3.375, I = .418, S = 27.227), failure (RR = 2.500, I = .306, S = 20.453) and unattainable standards (RR = 2.294, I = .279, S = 18.860). Discussion and conclusions: it was found that early maladaptive schemas in the prison population are related to and increase the risk of drug use, therefore these results have applications for the prevention and treatment of drug use in persons deprived of liberty.

Turkish Adaptation of the Dusseldorf Illustrated Schema Questionnaire for Children: Psychometric Properties and Relationship with Childhood Difficulties.

Dusseldorf Illustrated Schema Questionnaire for Children (DISC) measures early maladaptive schemas (EMS) in childhood. EMS are emotional and cognitive rules and patterns formed in childhood and adolescence because of unmet emotional needs which are maintained throughout life and negatively affect one’s potential. The first aim of the current study is to adapt DISC to the Turkish language and examine its psychometric properties to facilitate preventive intervention during early childhood. The second aim of the study is to investigate the relationship between schemas and childhood difficulties. The sample consisted of 771 (419 females, 352 males) children of first graders (8-year-old) to twelfth graders (14-year-old) from 54 of the 81 cities in Turkey. Cronbach’s α value for the total of 36 items was calculated as .89 and α values for subscales ranged between .42 and .83. The test–retest reliability coefficient of the total of the scale was .79 at 1 month and subscales’ test–retest values ranged between .31 and .91. Confirmatory factor analysis showed a good fit for the purported 18-factor model of the original DISC in the Turkish version within a sample of children from diverse socio-economic and cultural backgrounds from Turkey. The Turkish version of the DISC indicated a reliable and valid instrument to assess maladaptive schemas in children.

Cognitive distortions of sexual victimizers of children and adolescents: associations with experiences in the family of origin, early maladaptive schemas, self-esteem and selfefficacy

Introduction: Cognitive distortions of child sexual offenders have been researched because they might be the foundation for tort conduct.
 Objective: the aim of this study was to analyze cognitive distortions in individuals convicted for statutory rape against children and/or teenagers and verify connections with their family of origin, early maladaptive schema, self-esteem, and self-efficacy, as well as to assess the predictive power of these variables in the occurrence of cognitive distortions.
 Method: this was a descriptive, correlational and explanatory research performed with 49 men currently serving time without parole. The following instruments were administered: Family Background Questionnaire, Young Schema Questionnaire, General Self-Efficacy Scale, Rosenberg Self-Esteem Scale, as well as a documentary review of the legal proceedings of the participants.
 Results: the study revealed connections between cognitive distortions and substance abuse by the father (r=0,417; p=0,034), as well as vulnerability to harm (r=0,416; p=0,008), defectiveness (r=0,405; p=0,013), and grandiosity (r=0,339; p=0,040) schema. The vulnerability to harm scheme was the only predictive variable for cognitive distortions, accounting for 73,4 % of the variance.
 Conclusion: importance of analyzing cognitive distortions in child sexual victimizers and the possibility of schema therapy as an alternative treatment.

Predicting problematic smartphone use based on early maladaptive schemas by using machine learning classification algorithms

Predicting problematic smartphone use based on early maladaptive schemas by using machine learning classification algorithms

Loneliness is associated with maladaptive schema modes in patients with persistent depressive disorder

ObjectivesThough loneliness represents a public health concern, this complex unpleasant feeling is commonly neglected in psychiatric care and may constitute a new treatment target in clinical groups particularly prone to feeling lonely and socially isolated, e.g., persistent depressive disorder (PDD). Schema modes encompass a set of distinct cognitive-affective patterns that may contribute to loneliness and social isolation. Aim of this study was to examine the interplay between subjective loneliness and objective social network size with schema modes in patients with PDD as well as healthy controls (HC). MethodSixty-two PDD patients (DSM-5; 35 female, Mage = 40.5, SD = 12.4) and 71 HC (60 female, Mage = 28.1, SD = 10.1) were assessed cross-sectionally using the following self-report measures: UCLA Loneliness Scale, Social Network Index (SNI), and Schema-Mode-Inventory, revised version (SMI-r). Correlational and multiple linear regression analyses were performed. ResultsPDD patients reported significantly higher scores of loneliness and maladaptive schema modes and a smaller social network than HC. Loneliness was significantly positively associated with the modes Vulnerable Child, Detached Protector, Bully and Attack, and Punitive Parent, and negatively with Contented Child and Healthy Adult in both groups. In contrast, social network size was only positively associated with the Contented Child mode. ConclusionLoneliness is highly prevalent in PDD and in contrast to social network size associated with maladaptive schema modes. Therapeutically addressing these schema modes with specific techniques may represent a mechanism-based intervention for patients suffering from loneliness and should be investigated in clinical trials.

Childhood trauma, posttraumatic stress disorder symptoms, early maladaptive schemas, and schema modes: a comparison of individuals with obesity and normal weight controls

BackgroundPrevious research on the psychological mechanisms of obesity has primarily focused on acute psychopathology. However, there is limited literature on the role of more complex and entrenched psychological processes in weight management. The current study aimed to expand previous research by examining more enduring psychological constructs, including early maladaptive schemas (EMS), schemas modes, and trauma.MethodsParticipants (N = 125) comprised adults with normal weight (n = 40) and obesity (n = 85) from community and clinical settings in Australia. Eligible participants completed a series of self-report questionnaires via Research Electronic Data Capture (REDCap). Two, separate, one-way multivariate analysis of variance (MANOVA) were conducted to examine group differences on the outcome variables.ResultsFindings indicated a significant effect of group on EMS and schema modes, V = .51, F(32, 92) = 2.97, p < .001, partial η2 = .51. Follow-up univariate tests revealed that individuals with obesity endorsed significantly more maladaptive schemas and schema modes and significantly less healthy schema modes than individuals with normal weight. In addition, results demonstrated a significant effect of group on childhood trauma and posttraumatic stress disorder (PTSD) symptoms, V = .19, F(6, 118) = 4.70, p < .001, partial η2 = .19. Subsequent univariate tests and chi-square analyses indicated that individuals with obesity reported significantly more childhood trauma as well as significantly more PTSD symptoms within the last month than normal weight individuals.ConclusionThis was the first study to compare EMS and schema modes in treatment-seeking individuals with obesity and normal weight controls using the short form version 3 of the Young Schema Questionnaire and revised, 118-item, Schema Mode Inventory. Overall, findings revealed that individuals with obesity experience more complex and enduring psychological difficulties than normal weight individuals. Increased assessment and targeted treatment of these underlying mental health concerns may contribute to a more holistic conceptualisation of obesity and could improve the long-term success of weight management.

Suicidal ideation and suicide attempts among university students in South Korea during the COVID-19 pandemic: the application of interpersonal-psychological theory and early maladaptive schema.

BackgroundThis study examined the application of interpersonal-psychological theory and early maladaptive schema of suicidal ideation and suicide attempts in South Korean university students.MethodsIn this cross-sectional study, data from 367 university students were surveyed using the Interpersonal Needs Questionnaire, Early Maladaptive Schema, Suicide Ideation Scale, and the Acquired Capability for Suicide Scale. Data were collected between June 21 and July 21, 2021.ResultsUniversity students’ interpersonal needs and early maladaptive schema were significantly associated with suicidal ideation, and influencing suicide attempts. The acquired capability for suicide moderated the relationship between suicidal ideation and attempts.ConclusionsIn suicide prevention programs for university students, it is critical to consider their interpersonal needs and early maladaptive schema, and the acquired capability for suicide, to prevent suicidal ideation and attempts among them.

The mediating role of maladaptive cognitive schemas regarding the relationship between parenting styles and chronic pain in adolescents: a structural equation modelling approach

BackgroundAlthough there is a growing body of evidence linking parenting styles to health outcomes, little emphasis has been dedicated to how parenting styles affect chronic pain in adolescents. Given the high prevalence of chronic pain in adolescents and taking into consideration the complexity of chronic pain and the factors affecting it, further research is needed to better understand the processes through which parenting styles affect adolescents’ pain. The purpose of the present study was to explore the mediating role of maladaptive schemas in the association between different parenting styles and chronic pain.Method1302 adolescents aged 12 to 21 in Shiraz, Iran, were randomly selected to participate in this study. To identify adolescents with chronic pain, screening questions based on the 11th revision of the International Classification of Diseases were used. Buri’s Parental Authority Questionnaire (PAQ), and Young’s Schema Questionnaire-Short Form (YSQ-SF) were used to assess the parenting styles and maladaptive cognitive schemas, respectively. The structural equation modeling approach was carried out to evaluate the direct, indirect, and total effects of different parenting styles on chronic pain.ResultsThe results in the SEM models revealed that disconnection/ rejection (β = − 0.043, 95%CI = − 0.07 to − 0.02), impaired autonomy/ performance (β = − 0.01, 95%CI = − 0.02 to -0.003), over-vigilance/inhibition (β = − 0.007, 95%CI = − 0.01 to − 0.008), and impaired limits schemas (β = − 0.004, 95%CI = − 0.006 to − 0.002) significantly mediated the protective effects of the authoritative parenting style on chronic pain. It was also found that the mediating effects of disconnection/ rejection (β = 0.01, 95%CI = 0.01 to 0.02), and over-vigilance/ inhibition (β = 0.002, 95%CI = 0.001 to 0.02) existed in the relationship between the authoritarian style and chronic pain. The permissive style may also affect chronic pain through disconnection/ rejection (β = 0.004, 95%CI = 0.001 to 0.01), other-directedness (β = 0.01, 95%CI = 0.005 to 0.015), and impaired limits schemas (β = 0.05, 95%CI = 0.04 to 0.06).DiscussionThe findings of the present study showed that maladaptive cognitive schemas play a mediating role in the relationship between parenting styles and chronic pain in adolescents. It seems that the interventions that target the effective communication between the parents and the adolescents can be considered as an important part in the chronic pain management in adolescents.

Does Cognitive Therapy Change the Early Maladaptive Schemas in Individuals with Alcohol Dependence? Evidence from a Randomized Controlled Trial.

Although early maladaptive schemas (EMSs) have been suggested as potential vulnerability markers for alcohol dependence (AD), there is less emphasis on addressing these schemas in substance abuse treatment programs. We thus aimed to examine the change in schemas in response to cognitive therapy in individuals with AD. In this an open-label randomized controlled study, individuals with alcohol dependence syndrome (ADS, n = 84) were randomized to the intervention group (n = 45), which received six cognitive therapy sessions combined with treatment as usual (TAU), or the control group (n = 39), which was on TAU only. Participants were assessed on the measures of EMSs, alcohol use severity, and perceived stress at baseline and posttreatment. The intervention group showed significant improvement in 5 out of 18 EMSs, that is, emotional deprivation, defectiveness, self-sacrifice, unrelenting standard, and negativity, compared to the control group, at the end of the treatment. There was a significant between-group effect for perceived stress but not for alcohol use severity. EMSs can be changed with cognitive therapy in individuals with AD and could be a crucial area to address in treatment programs. Further studies with long-term follow-up are warranted. The trial was registered with the Clinical Trials Registry-India (CTRI/2015/12/006441) on December 17, 2015.

Development and Validation of the Adaptive Schema Questionnaire.

Schemas help with the organization and interpretation of information. Adaptive schemas indicate positive predisposing thinking patterns in an individual. This study aimed to develop a psychometrically robust tool to assess adaptive schema in a nonclinical sample. This research comprises two independent studies. Study I was multiphased. In Phase I (n = 70), 36 open-ended items were generated following the Young schema therapy model and qualitatively analyzed. This facilitated the generation of 144 items in Phase II (n = 152) which were evaluated for content validity and subjected to rigorous item analysis. Exploratory factor analysis was performed in Phase III (n = 751). Confirmatory factor analysis was conducted in Study II (n = 244). Exploratory factor analysis resulted in a six-factor solution comprising 25 items. These factors correspond to the six adaptive themes, namely, adequate, secured, self-reliant/autonomous, resistant, successful, and self-assured. The newly developed Adaptive Schema Questionnaire demonstrated adequate reliability (α = 0.86). Significant correlations between the obtained factors and Early Maladaptive Schemas, depression, big five personality factors, and positive and negative effects established the concurrent validity. Confirmatory factor analysis indicated acceptable goodness of fit for the obtained model. The developed Adaptive Schema Questionnaire is a reliable and valid instrument with promising utility in psychotherapy and research context.

Provide Structural Models of Psychological Problems Based on the Field of Exclusion and Exclusion With the Role of a Tool That Wants To Experience and Feel Alone

Background and Aim: This study presented a structural model of psychological problems based on the exclusion and negative spontaneous thoughts with the role of non-experimental mediators and feelings of loneliness. Materials and Methods: The present study was correlational, and the statistical population included all people with psychological symptoms who were referred to the clinics of Qom Counseling Center. Results: The research sample was the Psychological Problems Questionnaire (Lovibond, P. F. Lovibond, S. H. 1995), the Early maladaptive Schemas Questionnaire (Young, J. E. 1990) and the feeling of loneliness (Russell, 1996) and the Acceptance and Editing Questionnaire 2 (Bavand et al., 2011). Completed. The test results showed that the research model fit path analysis well. Conclusion: The study results of the mediating role of loneliness showed that the mediating role confirms both feelings of loneliness and experience, and therefore shows the role of mediation between rejection and experiential harm. Cuts with problems ¬. Have psychological (p