Specific Early Maladaptive Schemas Research Articles

The relationship between early maladaptive schemas and the functions of self-injurious behaviour in youth

ABSTRACT Objective There is emerging research demonstrating relationships between specific Early Maladaptive Schemas and self-injurious behaviour (SIB) in young people. Evidence also highlights the importance of conceptualising SIB in terms of its motivating function, differentiating between intrapersonal and interpersonal functions of the behaviour. Despite this, there is a relative absence of evidence linking schemas and functions of SIB. The current study sought to explore the relationship between schemas and motivations for self-injury in a community sample of young people with a history of self-injury. Method 125 Australian secondary and university students aged between 16 and 25 years who reported SIB history completed the Young Schema Questionnaire and the Inventory of Statements about Self-Injury. Results Multiple regression analyses found that the schemas of Abandonment/Instability and Entitlement significantly predicted intrapersonal functions of self-injury. In contrast, Insufficient Self-Control significantly predicted interpersonal functions. Defectiveness/Shame and Entitlement predicted self-injury with suicidal intent. Conclusions We discuss the findings regarding distinct patterns in the associations between schemas and the functions of self-injurious behaviour among youth with self-injury history. The present study also highlights how schemas may help to understand the motivations behind self-injury and assist clinicians in the assessment of risk for self-injury and suicide among youth, as well as to formulate plans for treatment and early intervention. KEY POINTS What is already known about this topic: Young people are motivated to self-injure for a variety of reasons, including to manage internal distress (intrapersonal) and influence their external environment (interpersonal). Alongside these motivating functions, vulnerability factors, such as childhood maltreatment and intense negative emotions, predispose a young person to self-injury when confronted with stress. Early maladaptive schemas are also increasingly being identified as vulnerability factors for self-injury, particularly Defectiveness/Shame and Abandonment/Instability. What this topic adds: Young people’s motivations to self-injure are influenced by their early maladaptive schemas. Young people who self-injure for intrapersonal motivations report schemas of Abandonment/Instability, those who self-injure for interpersonal motivations report an Insufficient self-control schema, and those who self-injure with some suicidal intent report schemas of Defectiveness/Shame. This highlights that the importance of understanding both the function and the schema when working with young people who self-injure. Youth whose self-injurious behaviour is interpersonally motivated may require interpersonal skill-building. For youth who self-injure for intrapersonal or suicidal motivations, a treatment such as schema therapy may be warranted.

Specific early maladaptive schemas differentially mediate the relations of emotional and sexual maltreatment to recent life events in youth with depression.

The current study provided a novel investigation of relations among particular types of childhood maltreatment (emotional vs. physical vs. sexual maltreatment), specific cognitive schema themes and the generation of dependent versus independent life events. Participants included 227 adolescents and emerging adults (74% female; aged 12-29) in a current episode of a unipolar depressive disorder drawn from three archival cross-sectional studies. Childhood maltreatment and life events from the past 6months were assessed using detailed contextual interviews with independent, standardized ratings. Emotional maltreatment was uniquely associated with schema themes of emotional deprivation and subjugation, and sexual maltreatment was uniquely associated with schema themes of abandonment, vulnerability and dependence/incompetence. Further, subjugation and abandonment cross-sectionally mediated the relations of emotional and sexual maltreatment, respectively, to greater dependent, but not independent, life events. Physical maltreatment was not associated with cognitive schemas or recent life events after accounting for its overlap with emotional and sexual maltreatment. Results suggest targets for cognitive intervention that may improve outcomes for youth with specific histories of emotional and sexual maltreatment.

Early maladaptive schemas and their relation to personality disorders: A correlational examination in a clinical population.

Personality disorder (PD) pathology has been linked to early maladaptive schemas (EMSs). Because of a large heterogeneity in study populations, sample size, statistical analyses and conceptualizations in the literature, the exact relationships between PDs and EMSs are still unclear. The current study examined the relationship between borderline, dependent, avoidant and obsessive–compulsive PDs, represented dimensionally as number of traits, and 15 different EMSs as measured by the Young Schema Questionnaire (YSQ). A total of N = 130 inpatients took part in the study (M age = 43.6, gender = 51.5% female). Stepwise regressions indicated that borderline, dependent, avoidant and obsessive–compulsive PD traits were partly characterized by specific EMSs and EMSs grouped as domains (i.e., other‐directedness domain for dependent PD and overvigilance for obsessive–compulsive PD) and that relations with a variety of domains and EMSs were overlapping for the PD dimensions (i.e., disconnection and rejection for both borderline and avoidant PDs). This suggests that PDs are reflected by a hybrid model of EMSs, with some EMSs and domains that relate to a broader vulnerability factor for PDs, and other domains that differentially relate to the independent PDs. Findings are informative for clinicians, as various EMSs per PD may be targeted in therapy.

Early maladaptive schemas and borderline personality disorder features in a nonclinical sample: A network analysis.

Borderline personality disorder (BPD) is a challenging problem. Early maladaptive schemas (EMSs) are considered as important vulnerability factors for the development and maintenance of BPD. Literature suggests a complex relationship between BPD and EMSs. The current study employed network analysis to model the complex associations between central BPD features (i.e., affective instability, identity problems, negative relations, and self-harm) and EMSs in 706 undergraduate students. The severity of BPD symptoms was assessed using the Personality Assessment Inventory-Borderline subscale; the Young Schema Questionnaire-Short Form was used to assess EMSs. Results suggest that specific EMSs show unique associations with different BPD features. Interestingly, affective instability showed no unique associations with EMSs. Identity problems were uniquely associated with abandonment, insufficient self-control, dependence/incompetence, and vulnerability to harm/illness schemas. Negative relations in BPD showed unique connections with mistrust/abuse and abandonment. Finally, BPD self-harm was connected to emotional deprivation and failure. These findings indicate potential pathways between EMSs and specific BPD features that could improve our understanding of BPD theoretically and clinically.

Early maladaptive schemas in depression and somatization disorder

Cognitive theories of depression posit that early maladaptive schemas (EMSs) are key vulnerability factors for psychological disorders. In this study, we investigated specific EMSs as shared or distinct cognitive vulnerability factors for depression and somatization disorder. The sample consisted of patients with Major depressive disorder (N = 30) and Somatization disorder (N = 30) from a community hospital or a psychiatric clinic. Participants completed the Structured Clinical Interview for DSM-IV (SCID), the Beck Depression Inventory-II (BDI-II), and the short form of the Young Schema Questionnaire (YSQ-SF). Depressed patients exhibited significantly higher levels of all five schema domains and specific maladaptive schemas, including emotional deprivation, mistrust and abuse, social isolation and alienation, defectiveness and shame, failure, subjugation, emotional inhibition, and insufficient self-control or self-discipline. Moreover, depressed patients exhibited significantly higher levels of social isolation, emotional inhibition, as well as the overvigilance and inhibition domain when depressive symptom severity was controlled. Our results provide preliminary evidence that specific EMSs distinguish patients with depression and somatization. Suggestions for future research include the need to have a non-psychiatric control group, to evaluate the absolute role of EMSs in Somatization Disorder.

Associations Between Early Maladaptive Schemas and Mindful Attention-Awareness

Several authors have recently suggested the integration of mindfulness and mindfulness-based interventions into the schema therapy framework due to practical and theoretical compatibilities between these approaches. Preliminary research has demonstrated negative correlations between mindful attention-awareness and early maladaptive schemas, a key construct in schema therapy. However, little is known about the associations between early maladaptive schemas and mindfulness, particularly which specific early maladaptive schemas are related to mindful attention-awareness. This study examined the relationship between early maladaptive schemas, assessed with the Young Schema Questionnaire Short Form—Extended (YSQ-S2-Extended), and mindful attention-awareness, assessed with the Mindful Attention Awareness Scale (MAAS), in a community sample of Finnish adults (N = 215). Findings demonstrated that 17 out of 18 early maladaptive schemas were negatively correlated with mindful attention-awareness. In addition, three early maladaptive schemas, characterized by lack of self-control and avoidance of thoughts and emotions, were significantly related to low mindful attention-awareness in the linear regression. This study provides further empirical support for proposed associations between the presence of maladaptive cognitive schemas and a low ability to focus attention on experiences in the present in a mindful way. Future research is needed to study whether mindfulness-based interventions are beneficial in observing or reducing early maladaptive schemas and maladaptive coping strategies associated with them.

Exploration of trauma, dissociation, maladaptive schemas and auditory hallucinations in a French sample

ABSTRACTObjectives: The main goal of the present study was to explore the associations between several key variables that have been shown to partially mediate the link between specific trauma exposure and auditory hallucinations (AH), that is, maladaptive schemas and dissociation in the general population.Methods: In total, 425 voluntary participants were recruited from the general population and completed online the Childhood Trauma Questionnaire, the Young schema questionnaire, the Dissociative Experiences Scale, and the Launay–Slade Hallucination Scale. Data were analysed using Partial Least Squares Structural Equation Modelling.Results: Our model showed that: (1) sexual and emotional abuse impact on AH both through the effect of maladaptive schemas and dissociation; (2) physical abuse impact on AH only through the effect of dissociation. More specifically, we found that four maladaptive schemas impact on AH: Abandonment, Vulnerability, Self-sacrifice and Subjugation.Conclusions: Overall, our findings indicate that specific early maladaptive schemas may play a fundamental role in the association between exposure to trauma and auditory hallucination together with dissociation symptoms in the general population. Consequently, our study suggest considering maladaptive schemas as an important therapeutic target when working with individuals experiencing AH with or without a psychiatry disorder.

The predictive value of early maladaptive schemas in paranoid responses to social stress.

Social stress and negatively valenced cognitive representations of the self (self-schemas) play an important role in the formation of delusions. However, it has not been investigated whether and which self-schemas explain paranoid responses to social stress. Building on the framework of schema theory, the aim of this study was thus to investigate whether more pronounced early maladaptive schemas (EMSs) were associated with increased paranoid ideation after a social stress induction in patients with persecutory delusions (PD). Patients with PD (n=20) and healthy controls (n=40) were assessed for EMSs with the Young Schema Questionnaire. They were then exposed to a social stress situation in which they were socially excluded in a Cyberball paradigm. Prior to and after the social stress induction, paranoid symptoms were assessed. Patients with PD responded with a stronger increase in paranoia and revealed a significantly higher EMS total score compared to the healthy controls. As expected, higher increases in paranoia following the social stress were accounted for by higher EMS total scores. Exploratory analyses showed that particularly the specific EMSs Defectiveness/Shame and Enmeshment/Undeveloped Self were associated with the increase in paranoia. EMSs are associated with stress-related symptom increases in patients with PD. It thus seems worthwhile to further investigate the relevance of specific schemas for paranoia. The findings also suggest that addressing EMSs in psychological treatment of patients with PD holds potential.

Early Maladaptive Schemas in Bipolar Disorder Patients With and Without Suicide Attempts.

Patients with bipolar disorder (BD) are at an increased risk of attempted and completed suicide. To elucidate the beliefs and assumptions associated with suicidality in BD, the present study compared BD patients with and without a history of suicide attempt in terms of early maladaptive schemas (EMSs). The sample consisted of 49 remitted BD patients who completed the Young Schema Questionnaire-Short Version. Information on suicide attempts was obtained through interviews combined with medical records. Compared with BD patients without suicide attempts, the BD patients with suicide attempts scored significantly higher on 3 EMSs: social isolation, practical incompetence, and entitlement. The findings suggest that specific EMSs may be implicated in suicidal behaviors in BD. These results have implications for the assessment and treatment of suicidality in BD.

Early Maladaptive Schemas in Obsessive-Compulsive Disorder and Anxiety Disorders.

Purpose of this study is comparing early maladaptive schemas which are active in patients suffering from obsessive-compulsive disorder and anxiety disorders together, considering recent DSM-5 changes through which OCD has been placed in a separate and new diagnostic level. This research is a causal-comparative study. 151 persons were categorized in three groups of people suffering from OCD (50), suffering from anxiety disorders (50), and control group (51). Early diagnosis of disorders in two clinical groups were verified based on structured clinical interview for DSM )SCID-I) and Yale-Brown obsessive-compulsive scale (Y-BOCS). General health questionnaire (GHQ-28), the short versions of the Young schemas questionnaire (YSQ), and Padua inventory-Washington State University Revision (PI-WSUR) were also implemented. Findings revealed that mean scores of all schemas of those suffering from anxiety disorders, except for Self-Sacrifice, Unrelenting-Standards/Hypercriticalness, Entitlement/Grandiosity schemas, and mean scores of all early maladaptive schemas of those suffering from obsessive compulsive disorder are significantly higher than those of control group. OCD group had significantly higher scores in Emotional Deprivation, Mistrust/Abuse, and Defectiveness/Shame schemas than anxiety disorders group. Defectiveness/Shame and Vulnerability to Harm or Illness schemas can explain 38 percent of variance of obsessive compulsive symptoms. The dominant and specific early maladaptive schemas of OCD are Defectiveness/Shame, Mistrust/Abuse, and Emotional Deprivation Schemas. This study besides supporting the theory of early maladaptive schemas, suggests that interventions based on specific schemas can be useful methods in treatment of OCD and anxiety disorders.

Schémas précoces inadaptés, croyances addictives et styles défensifs chez des étudiants consommateurs de cannabis

ObjectivesPrevious research suggested that cannabis addiction in young adults might be associated with dysfunctional schemas, cannabis-related beliefs and psychological defense mechanisms. To extend this previous research, the aim of the present study was to evaluate levels of activation of (a) early maladaptive schemas of Young, (b) cannabis-related beliefs based Beck's cognitive model of substance abuse (anticipatory, relief-oriented, permissive beliefs) and (c) defensive styles of Bond (mature, neurotic, immature) in a sample of cannabis users (no-problematic use, abusers, dependants) and healthy control subjects. Participants and methodsOne hundred and ninety-nine undergraduate students were enrolled. Participants were divided into four groups: Cannabis-dependent users (n=24, mean age: 20.05 years; SD=2.29), cannabis abusers (n=40, mean age: 20.4 years; SD=2.13), cannabis no-problematic users (n=52, mean age: 19.9 years; SD=1.8) and healthy control subjects (n=83, mean age: 20.1 years; SD=1.66). Participants were invited to complete seven questionnaires assessing (1) alcohol use disorders (Alcohol Use Disorders Identification Test [AUDIT]), (2) cannabis use disorders (Mini International Neuropsychiatric Interview [MINI]), (3) early maladaptive schemas (Young Schemas Questionnaire [YSQ-S2]), (4) cannabis-related beliefs (Beliefs Questionnaire for Drug Addiction – Cannabis Version), (5) defensive styles (Defense Style Questionnaire [DSQ-40]), (6) anxiety (Beck Anxiety Inventory [BAI]), (7) depression (Beck Depression Inventory – Second Edition [BDI-II]), ResultsCompared to healthy control subjects, cannabis no-problematic users and cannabis abusers, the cannabis-dependent users obtained significantly higher levels for (1) global score of fifteen early maladaptive schemas; (2) five early maladaptive schemas (Emotional Deprivation, Abandonment, Mistrust/Abuse, Insufficient Self-Control and Subjugation); (3) global score of positive cannabis-related beliefs and relief-oriented beliefs; (4) two immature psychological defense mechanisms (Autistic fantasy, Projection). ConclusionThe present study confirms the results of previous research and suggests that cannabis dependence is associated with specific early maladaptive schemas and cannabis-related beliefs. We discuss theoretical and clinical implications of these findings.

An Examination of Early Maladaptive Schemas among Substance Use Treatment Seekers and their Parents

Early maladaptive schemas, which are cognitive and behavioral patterns of viewing oneself and the world that result in substantial distress, are gradually being documented as important vulnerabilities for substance abuse. Unfortunately, there is limited research on early maladaptive schemas among substance abusers and their family members. Research on this topic may carry important implications for family-focused substance use interventions. The current study examined similarities and differences in early maladaptive schemas among a sample of substance abuse treatment seeking adults (n = 47) and at least one parent (n = 58). Results demonstrated that the substance abusers scored higher than their parents on 17 of 18 early maladaptive schemas, with most differences falling into the large effect size range. There were some similarities in the specific early maladaptive schemas endorsed by both groups despite substance abusers scoring higher on all schemas. Implications of these findings for future research and family-focused substance use treatment programs are discussed.

Early maladaptive schemas in depressed patients: Stability and relation with depressive symptoms over the course of treatment

Early maladaptive schemas (EMSs) are hypothesized to be stable, trait-like, enduring beliefs underlying chronic and recurrent psychological disorders. We studied the relation of EMSs with depressive symptom severity and tested the stability of EMSs over a course of evidence-based outpatient treatment for depression in a naturalistic treatment setting. The sample consisted of depressed outpatients (N=132) treated at a specialized mood disorders treatment unit in The Netherlands. Participants completed measures of depressive symptom severity and maladaptive schemas before treatment and 16-weeks after starting with treatment. Specific maladaptive schemas (failure, emotional deprivation, abandonment/instability) were cross-sectionally related to depressive symptom severity. Moreover, the schema domain impaired autonomy & performance at pre-treatment related positively to depression levels at the 16-week follow-up assessment, whereas the schema domain overvigilance & inhibition at pre-treatment related negatively to depression levels at the follow-up assessment when controlling for pre-treatment depression severity. Finally, all EMSs demonstrated good relative stability over the course of treatment. Our results suggest that specific EMSs are related to depressive symptom severity in clinically depressed patients, that specific schema domains predict treatment outcome, and that schemas are robust to change over time, even after evidence-based outpatient treatment for depression.

Early maladaptive schemas and personality disorder symptoms: An examination in a non‐clinical sample

Objective.This study aimed to examine the overall and specific relationship between early maladaptive schemas (EMSs) and personality disorder (PD) symptoms in a non‐clinical sample.Design.While a notable previous study has examined the relationship between EMSs and PD symptoms after statistically controlling for gender and within‐cluster PD symptoms, they did not control for comorbid axis I and inter‐cluster PD symptoms. Hence, we redressed this methodological problem by statistically controlling for these conditions in a series of multiple regressions.Methods.In a sample of 178 non‐clinical participants, we obtained self‐reports of PD symptoms, depression, anxiety, eating disorder, and EMSs.Results.Results of a series of multiple regressions found that EMSs significantly predicted all PD symptoms apart from borderline and antisocial PDs and our hypotheses were largely consistent with hypotheses for cluster A and C PDs. We also found that specific EMSs differentially predicted PD subtypes even after controlling for other PD symptoms, depression, anxiety, and eating disorder symptoms.Conclusion.This study supports the contention that PDs are related to EMSs and there are specific relationships between particular EMSs and particular PDs.