Schema Modes Research Articles

Parental burnout and depression among Iranian mothers: The mediating role of Maladaptive Coping modes.

Depression in mothers impacts children negatively. Understanding the antecedents and the underlying mechanisms of depression is essential in helping clinicians target depressive symptoms effectively. This study investigated the relationship between parental burnout and depression in mothers and examined the mediation role of Maladaptive Coping modes. A total of 224 mothers participated in this study and completed the Parental Burnout Assessment scale, Patient Health Questionnaire, and items related to coping modes in Schema Mode Inventory. Data analysis with structural equation modeling revealed that depression and parental burnout were positively and significantly related. Bootstrap analysis showed that all coping modes except the Self-Aggrandizer mode act as mediators between parental burnout and depression in mothers. Detached Protector mode had the strongest indirect effect on depression. The results suggest Maladaptive Coping modes mediate the association between parental burnout and depression. The present finding provides evidence that Maladaptive Coping modes can be considered probable mediational mechanisms that relate depression to parental burnout in mothers and may serve as potential interventional targets.

Stronger coupling of emotional instability with reward processing in borderline personality disorder is predicted by schema modes.

Mood instability and risk-taking are hallmarks of borderline personality disorder (BPD). Schema modes are combinations of self-reflective evaluations, negative emotional states, and destructive coping strategies common in BPD. When activated, they can push patients with BPD into emotional turmoil and a dissociative state of mind. Our knowledge of the underlying neurocognitive mechanisms driving these changes is incomplete. We hypothesized that in patients with BPD, affective instability is more influenced by reward expectation, outcomes, and reward prediction errors (RPEs) during risky decision-making than in healthy controls. Additionally, we expected that these alterations would be related to schema modes. Thirty-two patients with BPD and thirty-one healthy controls were recruited. We used an established behavioral paradigm to measure mood fluctuations during risky decision-making. The impact of expectations and RPEs on momentary mood was quantified by a computational model, and its parameters were estimated with hierarchical Bayesian analysis. Model parameters were compared using High-Density Intervals. We found that model parameters capturing the influence of RPE and Certain Rewards on mood were significantly higher in patients with BPD than in controls. These model parameters correlated significantly with schema modes, but not with depression severity. BPD is coupled with altered associations between mood fluctuation and reward processing under uncertainty. Our findings seem to be BPD-specific, as they stand in contrast with the correlates of depressive symptoms. Future studies should establish the clinical utility of these alterations, such as predicting or assessing therapeutic response in BPD.

Mediating Role of Schema Modes in the Relationship Between Perceived Parenting Styles and Depression in Clinical and Non-Clinical Adult Samples

Bu çalışmada şema modlarının, ebeveynlik biçimleri ve depresyon arasındaki ilişkide aracı rolü yapısal eşitlik modellemesi kullanılarak sınanmıştır. Araştırmada klinik (N = 629, %71.1 kadın, %28.9 erkek; Ortyaş = 39.22) ve klinik olmayan yetişkin örneklemler (N = 589, %79.9 kadın, %20.1 erkek, Ortyaş = 28.25) kullanılmıştır. Bulgulara göre şema modları, klinik ve klinik olmayan örneklemlerdeki anne ve baba ebeveynlik biçimleri ile depresyon ilişkisine tümden aracılık etmektedir. İki örneklemin ölçme modelleri karşılaştırıldığında, anne ve baba ebeveynlik biçimleri, şema modları ve depresyon değişkenlerine ait ilişkilerin pozitif yönde ve anlamlı olduğu değerlendirilmiştir. İki örneklemin yapısal modellerinde ise baba ebeveynlik biçimleri ile şema modları arasındaki ilişkinin, anne ebeveynlik biçimleri ile şema modlarına kıyasla daha fazla kuvvetli olduğu görülmüştür. İki örneklem arasındaki farklı sonuçlara bakıldığında ise ölçme modellerinde klinik örneklemde anne ebeveynlik biçimleri depresyon ilişkisi düşük düzeydeyken klinik olmayan örneklemde orta düzeydedir. Ayrıca klinik örneklemde baba ebeveynlik biçimleri depresyon ilişkisi orta düzey, anne ebeveynlik biçimleriyle depresyon ilişkisinin düşük düzey olduğu görülmüştür. Bu çalışmada ulaşılan sonuçlar, depresyon tedavisinde ebeveynlik biçimlerinin göz önünde bulundurulduğu şema mod terapisinin yararlı olacağını düşündürmektedir.

Schema therapy with cognitive behaviour day-treatment in patients with treatment-resistant anxiety disorders and obsessive-compulsive disorder: an uncontrolled pilot study

Treatment resistance in patients with anxiety disorders and obsessive-compulsive disorder (OCD) might be caused by dysfunctional personality traits or, more specifically, early maladaptive schemas (EMSs) and schema modes, that can be treated with schema therapy (ST). To explore possible effectiveness of ST-CBT day-treatment in patients with treatment-resistant anxiety disorders and OCD in an uncontrolled pilot study. Treatment-resistant patients with anxiety disorders or OCD (n = 27) were treated with ST-CBT day-treatment for 37 weeks on average including 11.5 therapy hours per week. The Symptom Questionnaire-48, Young Schema Questionnaire-2 and Schema Mode Inventory were completed before and after treatment. General psychopathology, EMSs and schema modes significantly improved after treatment. Spearman's correlations between pre- to post-treatment difference scores of general psychopathology, EMSs and schema modes were significant and high. The level of pre-treatment EMSs and schema modes did not predict post-treatment general psychopathology. Symptom reduction was strongly correlated with improvement of EMSs and schema modes. Stronger pre-treatment EMSs and schema modes did not hinder improvement of symptoms. ST-CBT day-treatment is promising for patients with treatment-resistant anxiety disorders and OCD. Further controlled research is needed to substantiate evidence for schema therapy in patients with treatment-resistant anxiety disorders and OCD.

The relationship of early maladaptive schemas and schema modes with violence risk in persons acquitted by reason of insanity

The legal term “insanity defense” is used to describe people who commit a crime under the influence of a mental disorder. The assessment of the violence risk posed by such individuals is complex, and in global practice, it is typically conducted by a multiprofessional team. How- ever, in Russian practice, psychological evaluation is not carried out since it is believed that psychological drivers lose their significance in the presence of a mental disorder. The article describes the results of a study on the relationship between early maladaptive schemas and schema modes with violence risk in persons acquitted by reason of insanity. Measurements were taken from 58 male patients at the St. Petersburg Psychiatric Hospital, a specialized fa- cility with intensive supervision, ranging in age from 18 to 61 years. These measurements included the level of severity of early maladaptive schemas (assessed using the Young Schema Questionnaire — Short Form Revised), the level of severity of dysfunctional schema modes (evaluated through the Schema Mode Inventory), and the level of violence risk (measured using the Historical Clinical Risk Management Scales — HCR-20 V2). The results obtained using Spearman’s rank correlation coefficient and the Benjamini — Hochberg procedure lead to the conclusion that a weak reliable relationship exists between the schema “Insufficient Self-Control” and the level of violence risk in persons acquitted by reason of insanity. Con- sequently, it is inferred that this schema can be considered a psychological driver of violence risk. The conducted research is the first of its kind in Russia.

Schema mode inventory in cases of aggressive behavior: A systematic review

Schema mode inventory in cases of aggressive behavior: A systematic review

Prospect of using schema therapy in working with sex offenders.

The search for effective methods of treating sex offenders is essential in order to reduce the risk of their subsequent sexual offences. This article presents Jeffrey Young's concept of Schema Therapy with a discussion on the appropriateness of its use in the treatment of those who engage in problematic sexual behaviour directed against sexual freedom. Such behaviours are prohibited by law and are connected to committing crimes set out in Chapter XXV of the Penal Code (including rape, exploitation of helplessness, abuse of dependence relation, sexual act with a minor under 15 years of age). The article presents the main assumptions of schema therapy. Then, with reference to the main assumptions of this therapeutic approach, a theoretical model of schema therapy in the context of violent sexual behaviour is proposed and discussed. The authors also attempted to analyze the mechanism of formation and perpetuation of deviant criminal behaviors in the context of key constructs of this approach, such as: early maladaptive schemas, schema modes, and coping styles. As Schema Therapy has proven to be effective in treating chronic personality aspects of disorders, often underlying the sexual pathology of the sex offenders, this approach seems to be a promising trend for such a difficult population of people.

Schema therapy for personality disorders in autistic adults: Results of a multiple case series study.

To our knowledge, treatment of personality disorder (PD) comorbidity in autistic adults is understudied and is still in its infancy. We investigated the effectiveness of schema therapy (ST) for autistic adults with PD. A multiple case series design with 12 adults (aged 19-62 years) was used with baseline, exploration, ST (with cognitive behavioural and experiential techniques) and follow-up conditions. Participants rated dysfunctional core beliefs (primary outcome) weekly during baseline and treatment and monthly during follow-up. Schema modes, general mental health symptoms, social responsiveness, PD traits and common Axis-I mental disorders were assessed. Mixed model analyses indicated significant effects of ST with medium to large effect sizes for dysfunctional core beliefs, functional schema modes, PD traits, general mental health symptoms and social responsiveness. Results remained stable during follow-up. The results of this study indicate that ST might be effective in decreasing dysfunctional core beliefs, PD traits and general mental health symptoms and in increasing functional schema modes and social responsiveness. Improvements persisted over time. ST seems effective in treating PD in autistic individuals.

The relationship between schemas and quality of life of HIV patients: Role of social connectedness as a mediator

As the AIDS epidemic has unfolded, it has caused adverse psychosocial and economic consequences, disrupting the personal and familial lives of the infected individuals and society in general. The present study attempted to study the relationship between schemas and the quality of life among HIV individuals. The study also incorporated the role of social connectedness as a mediator. For data collection, HIV patients (n = 30) were taken using convenient sampling from the specialized HIV clinic in Rahimyar Khan, Pakistan. The information was gathered using the Urdu versions of the following standardized instruments: the Schema Mode Inventory, the WHOQOL-HIV BREF, and the Social Connectedness Scale-Revised. The results showed a strong relationship between individuals’ schemas and their quality of life. Maladaptive schemas negatively predict the quality of life, while social connectedness positively predicts the quality of life, and maladaptive schemas negatively predict social connectedness. The mediation analysis established that social connectedness fully mediates the relationship between self-esteem and social anxiety. The study also provided an understanding of the positive role of social connectedness as a mediator in enhancing the quality of life of HIV patients.

Comparison of the effectiveness of schema mode cards and the effectiveness of strength-based counseling on resilience in conflicted couples

Comparison of the effectiveness of schema mode cards and the effectiveness of strength-based counseling on resilience in conflicted couples

An exploratory investigation of schema modes in social anxiety disorder: Empirical findings and case conceptualization.

Current "gold standard" treatments for social anxiety disorder (SAD) are limited by the limited emphasis of key etiological factors in conceptualization, and many individuals with SAD experience residual symptoms posttreatment. Hence, the novel application of the Schema Therapy Mode Model may provide a helpful framework for extending clinical understanding and treatment options for SAD. This exploratory study aimed to investigate the presence and pattern of schema modes among SAD individuals. Forty individuals with SAD completed questionnaire measures of symptomatology, social anxiety-relevant cognitions, schema modes, childhood trauma, and parental style. Key maladaptive schema modes identified in SAD were Vulnerable Child, Punitive Critic, Demanding Critic, Compliant Surrender, and Detached Self-Soother. Outcomes provide the basis for a proposed schema mode case conceptualization for SAD and are hoped to provide a rationale for testing the applicability of Schema Therapy as a novel treatment for SAD. Key limitations are discussed.

Parts of the Self, Schema Modes, Alters, and Narrative and Pre-Narrative Selves: Understanding and Working With Multiplicity

The account of Kelly's therapy (Edwards, 2022b), and the commentaries by Singer (2022) and Margolin (2022), each, in different ways, highlight the significance of multiplicity, and the importance of understanding it, for the practice of psychotherapy. For several decades, many approaches to therapy have recognized and provided guidelines working with this multiplicity (Hermans & DiMaggio, 2004; Kellogg & Young, 2006; Lazarus & Rafaeli, in press; Rowan & Cooper, 1999; Schwartz, 1997; Stiles, 2011; Teasdale, 1999; Watkins & Johnson, 1982). Schema therapy is an integrative therapy that draws freely on these historical traditions, while offering its own distinctive framework for using multiplicity in case conceptualization for a wide variety of clinical phenomena (Edwards, 2022a). Examination of processes within cases treated within this framework provides the opportunity to further develop and synthesise clinically grounded theory, and, as Edwards (2022b) argued, it is increasingly possible for that practice to be grounded in a scientific understanding of the systems of memory and learning that underlie the client’s experience, drawing on the significant advances in our understanding of autobiographical memory systems. This article continues to explore this idea by responding to the commentaries on the case study of Kelly by Singer and Margolin.

Metaverse as a possible tool for reshaping schema modes in treating personality disorders.

Personality disorders (PD) are usually treated with face-to-face sessions and/or digital mental health services. Among many schools of therapies, schema therapy stands out because rather than simply targeting the symptoms of PD, it cordially targets the cause of PD and heals the early maladaptive schema, thus is exceptionally good at soothing emotional disturbances before enacting cognitive restructuring, resulting in long-term efficacy. However, according to Piaget’s genetic epistemology, the unmet needs lie in the fact that the schemata that determine the adaptive behavior can only be formed in the interaction with the real world that the patient is living in and reconsolidated by the feedback from the object world upon the patient’s newly-formed behavior. Therefore, in order to reshape the patient’s schema modes to support adaptive behavior and regain emotional regulation capabilities of the healthy adult, one may have to reconstruct the object world surrounding the patient. Metaverse, the bestowed successor to the Internet with the cardinal feature of “the sense of full presence,” can become a powerful tool to reconstruct a new object world for the patient with the prescription of a psychotherapist, so as to transform the treatment techniques in schema therapy into the natural autobiographical experiences of patients in the new object world, thus gradually reshape the patient’s schema modes that can ultimately result in an adaptive, and more inclusive, interaction with the real world. This work describes the underlying theory, the mechanism, the process, and ethical considerations of such promising technology for the not-too-far future.

The effects of psychological education in schema modes on academic emotions the students with emotional and behavioral disorders

The effects of psychological education in schema modes on academic emotions the students with emotional and behavioral disorders

Comparison of the effectiveness of schema mode cards and the effectiveness of cognitive processing therapy on problem solving in conflicted couples

Comparison of the effectiveness of schema mode cards and the effectiveness of cognitive processing therapy on problem solving in conflicted couples

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.

Emotional States Encountered by Law Enforcement Officers: an Initial Test of the Schema Mode Concept in Police Actions

Working with extreme mood states is a regular challenge for law enforcement officers. In their encounters during police actions, they very often face manifestations of anger and aggression, as well as vulnerable states such as ones involving fear, helplessness, or humiliation. In this study, we investigated whether officers could reliably identify emotional states in the persons they encountered, using the Schema Therapy concept of “schema modes.” Although the mode concept has been extensively validated in the field of forensic mental health, this is its first application to police work. Twenty-seven police officers working for two different German police headquarters were asked to report about a recent operation involving a person showing intense emotional states. After receiving a short training in using the iModes, cards that facilitate working with modes, they retrospectively rated the presence and intensity of the schema modes of the persons whom they encountered. Two experts in Schema Therapy independently rated the same scenarios, using the Mode Observation Scale (MOS). Intraclass correlations showed moderate to excellent levels of agreement between the officers’ and experts’ mode-ratings. Modes involving anger (70%), aggression (70%), indirect hostility (44%), and arrogance/grandiosity (41%) were the most prevalent, while modes involving vulnerable emotions were less common. It can be concluded that police officers can reliably assess different modes in encountered persons, even without extensive training. This initial study suggests that the mode concept has applicability to police work and merits additional study for its potential for de-escalation and conflict management in police contexts.

A Feasibility Study of Group Schema Therapy with Psychomotor Therapy for Older Adults with a Cluster B or C Personality Disorder

ABSTRACT Objectives Schema group therapy is an effective treatment for personality disorders, but its focus on cognitive techniques may be a limitation for older adults. This article describes the rationale and initial evaluation of a group schema therapy protocol enriched with psychomotor therapy (GST+PMT) for older adults in geriatric mental health care. Methods Within an observational feasibility study, we evaluated the effect of a 26-week GST+PMT program in 19 outpatients aged 60–70 years with a cluster B or C personality disorder on the Young Schema Questionnaire, Schema Mode Inventory and Manchester Short Assessment of Quality of Life. Cohen’s d effect-sizes were calculated between baseline (T0), mid-treatment (T1) and end-of-treatment (T2). Results Medium to large pre-post effect-sizes (T0-T2) were found for all outcome measures. Most improvement of schema modes occurred between T0-T1, and of schemas and quality of life between T1-T2. Conclusions Group schema therapy enriched with PMT is feasible in later life and its effect might be mediated by targeting schema modes. Future research would be helpful, including larger samples and controlled studies. Clinical Implications For older adults suffering from personality disorders B or C verbal schema group therapy enriched with non-verbal PMT may be an effective treatment.

The Relationship Between Early Maladaptive Schemas and Non-suicidal Self-injury: A Systematic Review

Background: Non-suicidal self-injury (NSSI) is a maladaptive strategy mainly regulating emotions in youth and adolescents. Early maladaptive schemas (EMSs) were identified to affect NSSI. This review aimed to provide a synthesis of the literature on the relationship between EMS and NSSI. Methods: A systematic review was conducted via the electronic databases PsycINFO, PubMed, Science Direct, and Google Scholar. The inclusion criteria were (i) the study examined the relationship between EMSs and NSSI, (ii) full texts were available in the English language, and (iii) the study was a piece of published empirical quantitative research. The authors also evaluated the risk of bias assessment. Results: Ten studies were investigated. The relationship between EMS and NSSI was identified from different points of view. The results confirmed a developmental model of NSSI and shame that focuses on the function of this behavior to regulate emotions (especially shame) in individuals with a predisposition for emerging EMS and schema modes. A major limitation of this review is the absence of longitudinal research. Conclusion: It is important to address EMSs and modes that lead to NSSI engagement in both preventive and therapeutic interventions.