Personality and early maladaptive schemas: a five-factor model perspective

Early maladaptive schemas in autogenous and reactive subtypes of obsessive-compulsive disorder

AIMS

The aim of this study is to identify early maladaptive schemas in patients with obsessive-compulsive disorder (OCD) and to determine the use of these schemas in OCD autogenous and reactive subtypes.

METHODS

The study population included 40 healthy volunteers, and 90 patients diagnosed with OCD. The Yale-Brown Obsession-Compulsion Scale (Y-BOCS) was administered to the OCD group to determine the severity of the disorder, and the Y-BOCS Symptom Checklist was applied to determine the patients with autogenous (n = 37) and reactive (n = 53) subtypes of OCD. Young Schema Questionnaire-Short Form 3 (YSQ-SF3) scales were applied to all participants.

RESULTS

When autogenous and reactive subtype groups of OCD were compared with each other, the schema domains of disconnection (p = 0.004), high standards (p = 0.008), other-directedness (p < 0.001) and the schema dimensions of failure (p < 0.001), emotional deprivation (p < 0.001), defectiveness (p = 0.007), approval seeking (p = 0.007) and punishment (p = 0.001) were found to be more dominant in the autogenous group.

CONCLUSIONS

The findings of the study support that there are differences between autogenous and reactive subtypes of OCD in terms of dominant schemas. Therefore, its thought that the use of Schema Therapy methods in which schemas appropriate for subtypes are investigated in the treatment of OCD patients will contribute favorably to the treatment response.

The efficacy of schema therapy for personality disorders: a systematic review and meta-analysis

OBJECTIVE

Personality disorders (PDs) are prevalent and associated with functional impairment and psychological disability. Studies suggest that schema therapy (ST) may be an effective treatment for PDs. This review aimed to evaluate the efficacy of ST in treating PDs.

METHOD

We conducted a comprehensive literature search using PubMed, Embase, Web of Science, CENTRAL, PsycInfo, and Ovid Medline. We identified eight randomized controlled trials (587 participants) and seven single-group trials (163 participants).

RESULTS

Meta-analyses revealed that ST had a moderate effect size (g = 0.359) compared to control conditions in reducing symptoms of PDs. Subgroup analysis indicated that the effect of ST on different types of PDs varied slightly, and that group ST (g = 0.859) was more effective than individual ST (g = 0.163) in treating PDs. Secondary outcome analysis revealed a moderate effect size (g = 0.256) for ST compared to control conditions in improving quality of life, and ST was found to reduce early maladaptive schema (g = 0.590). Single-group trials analysis showed that ST had a positive effect on PDs (OR = 0.241).

CONCLUSION

ST appears to be an effective treatment for PDs, as it reduces symptoms and improves quality of life. This review provides support for the use of ST in the treatment of PDs.

Validity of a Revised Obsessive-Compulsive Personality Disorder (OCPD) Trait Profile and Its Relationship with Social Interaction Anxiety and Coping

There is evidence suggesting that the conceptualization and operationalization of Obsessive-Compulsive Personality Disorder (OCPD) is not satisfactory (Watters et al., 2019). In this study, we used an online sample (N = 1008) to investigate the construct validity of the PID-5 OCPD trait measure. Regression analyses supported our hypothesis that rigid perfectionism captured the core phenomenology of OCPD whereas restricted affectivity and intimacy avoidance were not conceptually related to the OCPD construct. Based on the biosocial theory for overcontrol (Lynch, 2018), we introduced anxiousness and workaholism to the PID-5 OCPD trait profile. In establishing the validity of the revised OCPD trait profile, we investigated, for the first time, the role of social interaction anxiety and maladaptive coping in OCPD. Our revised OCPD profile showed good validity and was characterized by marked social interaction anxiety and dysfunctional coping mechanisms. The findings may lead to a new conceptualization of OCPD which prioritizes deficits in social interaction and coping. We identify areas that need to be prioritized in the evaluation of OCPD by mental health professionals and offer avenues for new clinical research in the field.

Anger and psychological symptoms relationship: mediator role of maladaptive schemas

Trait anger is the strong predictor of various psychological symptoms like anxiety, depression, and hostility. Explaining how and why this relationship occurs is crucial to come up with more effective prevention and intervention strategies in the field. To this end, the current study aimed to reveal the mediating effect of early maladaptive schemas, which is the basic concept of schema therapy, on the relations of trait anger and psychological symptoms. Data was collected from 301 university students by using the measurement tools of Brief Symptom Inventory, Trait Anger Scale and Young Schema Scale. Findings revealed that trait anger positively predicted psychological symptoms. Secondly, a set of predictive models were prepared to detect the mediating effect of early maladaptive schemas. According to the analysis in the last stage, early maladaptive schemas fully mediated the relationship between trait anger and psychological symptoms.

Exploring the associations between early maladaptive schemas and impulsive and compulsive buying tendencies

The main purpose of this preliminary study was to investigate a potential relationship between early maladaptive schemas (EMSs) and impulsive and compulsive buying tendencies in a sample of young adults (college students). This research adds to the cognitive perspective of consumer behavior that the cognitive schemas putatively associated with early experiences may have a strong impact on impulsive and compulsive buying. Data was obtained from 365 participants in a cross-sectional study design. Participants completed an online survey with the following instruments: Young Schema Questionnaire; Impulsive Buying Tendency Measurement Scale; Richmond Compulsive Buying Scale; and Hospital Anxiety and Depression Scale. Using multiple linear hierarchical regressions, we confirmed that the domain of over vigilance and inhibition schemas was positively associated with impulsive and compulsive buying tendencies, while an opposite association was found for the domain of impaired limits. Being a female was also a predictor of impulsive buying and compulsive buying. The results were discussed in terms of the coping mechanisms to deal with negative emotions, as a way to obtain rewards, or as a way to escape painful self-awareness. Other mechanisms related to the internalization of perfectionist expectations and the propensity to shame were also explored.

Personality traits as mediators of the relationship between childhood trauma and depression severity in bipolar disorder: A structural equation model

BACKGROUND

Childhood trauma is negatively associated with depression severity in bipolar disorder; however, the underlying mechanisms remain unclear. We investigated whether personality traits (neuroticism, extraversion, openness, agreeableness, conscientiousness) mediate the relationship between childhood trauma and the severity of bipolar depression.

METHODS

Data from 209 individuals with bipolar disorder recruited for the Prechter Longitudinal Study of Bipolar Disorder were analysed. Using structural equation modelling, we examined the direct and indirect associations between childhood trauma (Childhood Trauma Questionnaire) and depression severity (Hamilton Depression Rating Scale) - with the personality traits (NEO Personality Inventory-Revised) as mediators.

RESULTS

The direct effect of childhood trauma on depression severity (standardised β = 0.32, 95% bootstrap confidence interval [CI] = 0.20-0.45, p < 0.001) and the indirect effect via neuroticism (standardised β = 0.03, 95% bootstrap CI [0.002, 0.07], p = 0.039) were significant; supporting a partial mediation model. The indirect effect accounted for 9% of the total effect of childhood trauma on depression severity (standardised β = 0.09, 95% bootstrap CI [0.002, 0.19], p = 0.046). The final model had a good fit with the data (comparative fit index = 0.96; root mean square error of approximation = 0.05, 90% CI = [0.02, 0.07]).

CONCLUSION

Personality traits may be relevant psychological mediators that link childhood trauma to a more severe clinical presentation of bipolar depression. Consequently, a person's personality structure may be a crucial operative factor to incorporate in therapeutic plans when treating individuals with bipolar disorder who report a history of childhood trauma.

Development and Validation of the Young Parenting Inventory (YPI-R3) for Measuring Past Deviant and Normal Variations in Parenting

Most measures of past parenting patterns have a restricted range of about two to three negative parenting constructs. The Young Parenting Inventory (YPI-R2) provides a more nuanced framework that measures a fuller spectrum of these negative parenting patterns and, therefore, holds the potential of being a more useful guide to parents and caretakers. The YPI-R2 is made up of six validated subscales. An additional four were identified but were not sufficiently robust to be included. The purpose of this study is to determine if these four scales can be strengthened through the development of additional items and be empirically validated. Using non-clinical, English-speaking community samples from Singapore (n = 592, 628) and Malaysia (n = 222, 229), these revised scales were tested using multiple exploratory factor analyses with fathers and mothers rated separately. After further scale refinement, the final model, which consisted of 10 subscales and 41 items, was then subjected to confirmatory factor analysis using 4 other non-clinical international samples with separate ratings for fathers and mothers—USA (n = 259, 281), South Africa (n = 318, 372), Nigeria (n = 328, 344) and India (n = 277, 289). The results show that the YPI-R3 with 10 subscales is a robust and cross-culturally acceptable model. Correlations and hierarchical multiple regression analyses showed that the YPI-R3 has good convergent validity and predictive capabilities with measures of psychopathology, personality traits, emotional distress, negative schemas and other distal measures of functioning in everyday life—gratitude, humor and satisfaction with life.

Early Maladaptive Schemas and the Accuracy of Facial Emotion Recognition: A Preliminary Investigation

Different developmental experiences related to deep-rooted beliefs about oneself and others may significantly affect individual social emotional competencies, such as the accuracy of facial emotion recognition and detection. This study presents a preliminary examination of the relationship between early maladaptive schemas (EMSs) and the accuracy of recognizing facial expressions showing basic emotions, neutral faces, and discrimination between neutral and emotional faces. The sample consisted of 138 psychology students (M = 20.33; SD = 1.33, 27 of the respondents were male). JACFEE and JACNeuF (Matsumoto & Ekman, 1988) were used as stimulus material for assessing the facial emotion recognition of seven basic emotions (anger, contempt, disgust, fear, sadness, happiness, and surprise) and neutral faces. The Young Schema Questionnaire - Short Form 3 (YSQ-S3; Young, 2005) was administered as a measure of EMSs. The findings demonstrate that all schema domains affect the accuracy of recognizing facial expressions showing negative emotions (anger, contempt, disgust, fear, and sadness). The Dependence/Incompetence, Entitlement/Grandiosity schemas were significant predictors for detecting neutral faces and discriminating between faces with and without emotion, while the Abandonment/Instability schema additionally proved significant for recognizing neutral faces. Limitations and suggestions for future elaboration are acknowledged.

A preliminary study: designing and validating projective images of Young's early maladaptive schema (EMS) domains

BACKGROUND

This study aims to design and validate ten projective images of Young's Early Maladaptive Schema (EMS) domains. For this purpose, two questions are to be addressed. (1) How is the factorial structure of the projective images of EMS domains? (2) Do the images designed in the domains of disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, and over-vigilance and inhibition have sufficient validity?

METHODS

This is an applied mixed-methods exploratory study, in which the statistical population consisted of psychologists from Tehran Province in the qualitative section (n = 8) as well as other individuals aged between 18 and 65 years (mean age = 33) from Qazvin in the quantitative section (n = 102) in 2018. The research questions were analyzed through principal axis factoring with a varimax rotation, confirmatory factor analysis, Pearson correlation coefficient, and Cronbach's alpha.

RESULTS

According to the results, ten images and five domains of Young's EMSs contribute to a simple structure. Accounting for 70.35% of the total variance of EMSs, the five dimensions include disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, and over-vigilance and inhibition.

CONCLUSIONS

The results indicated that the designed projective images yielded acceptable construct validity.

Neural meaning making, prediction, and prefrontal-subcortical development following early adverse caregiving

Early adversities that are caregiving-related (crEAs) are associated with a significantly increased risk for mental health problems. Recent neuroscientific advances have revealed alterations in medial prefrontal cortex (mPFC)-subcortical circuitry following crEAs. While this work has identified alterations in affective operations (e.g., perceiving, reacting, controlling, learning) associated with mPFC-subcortical circuitry, this circuitry has a much broader function extending beyond operations. It plays a primary role in affective meaning making, involving conceptual-level, schematized knowledge to generate predictions about the current environment. This function of mPFC-subcortical circuitry motivates asking whether mPFC-subcortical phenotypes following crEAs support semanticized knowledge content (or the concept-level knowledge) and generate predictive models. I present a hypothesis motivated by research findings across four different lines of work that converge on mPFC-subcortical neuroanatomy, including (a) the neurobiology supporting emotion regulation processes in adulthood, (b) the neurobiology that is activated by caregiving cues during development, (c) the neurobiology that is altered by crEAs, and (d) the neurobiology of semantic-based meaning making. I hypothesize that the affective behaviors following crEAs result in part from affective semantic memory processes supported by mPFC-subcortical circuitry that over the course of development, construct affective schemas that generate meaning making and guide predictions. I use this opportunity to review some of the literature on mPFC-subcortical circuit development following crEAs to illustrate the motivation behind this hypothesis. Long recognized by clinical science and cognitive neuroscience, studying schema-based processes may be particularly helpful for understanding how affective meaning making arises from developmental trajectories of mPFC-subcortical circuitry.

MM. The Relationships Between Early Maladaptive Schemas, Quality of Life and Self-care Behaviors in a Sample of Persons Living with HIV: The Potential Mediating Role of Cognitive Emotion Regulation Strategies

Introduction:

People who are living with HIV often experience physical as well as psychological challenges. Therefore, the aim of this descriptive, correlational study was to explore the potential mediating role of cognitive emotion regulation strategies in the relationships between early maladaptive schemas, quality of life, and self-care behavior in patients with HIV/AIDS.

Methods:

In the first half of 2017, patients with HIV/AIDS (N=240) were recruited from an HIV clinic in Tehran, Iran. A self-report questionnaire included the Young Schema Questionnaire-Short Form (YSQSF), Short Form Health Survey (SF-36), short form of Cognitive Emotion Regulation Questionnaire (CERQ), and a self-care behaviors questionnaire. The data analysis involved using advanced statistical techniques for structural equation modeling.

Results:

There were significant, inverse relationships between all five areas of early maladaptive schemas and positive cognitive emotional regulation strategies, self-care behaviors, and quality of life. Also, there were significant, positive relationships between all five areas of early maladaptive schemas and negative cognitive and emotional regulation strategies.

Conclusion:

The findings suggest that practical interventions to reduce maladaptive responses may result in healthier outcomes for persons living with HIV.

Construction and validation of the Lebanese fear of relationship commitment scale among a representative sample of the Lebanese population

PURPOSE

To describe the generation and validation of the Lebanese fear of relationship commitment scale (LFRC) and factors associated with FRC in a representative sample of the Lebanese population.

DESIGN AND METHODS

This cross-sectional study, conducted between January and May 2018, enrolled 568 single community dwelling participants.

RESULTS

The scale items converged over a solution of four factors, explaining 50.46% of the variance (Cronbach's α = 0.789). Higher social phobia (β = 0.073) and higher general trust score (β = 0.393) were associated with higher FRC, whereas higher self-esteem (β = -0.275) was associated with lower FRC.

PRACTICE IMPLICATIONS

The LFRC-17 is a valid and reliable measure of fear of relationship commitment and a highly efficient tool both for research and clinical practice. It gathers social, physical, and psychological aspects related to gamophobia.

Thinking about feeling: Using trait emotional intelligence in understanding the associations between early maladaptive schemas and coping styles

OBJECTIVES

Maladaptive interpersonal schemas can trigger distressing emotions and drive dysfunctional behaviour that leads to difficulties in interpersonal relationships and perpetuates the original maladaptive schemas. This study sought to identify patterns of association between trait emotional intelligence (TEI), early maladaptive schemas (EMS), and coping styles in a non-clinical sample. Emotionality profiles were hypothesized to be associated with EMS severity and poorer coping, as early experiences can shape an individual's self-perceptions through reinforcement by maladaptive responses.

DESIGN

Cross-sectional study with 142 undergraduate students.

METHODS

We obtained self-reports of TEI, coping styles, and EMS.

RESULTS

Disengagement coping was strongly correlated with EMS severity (r = .565, p < .01). TEI was negatively correlated with EMS (r = -.660, p < .01) and Disengagement (r = -.405, p < .01). Emotionality, Impaired Autonomy, and Overvigilance partially mediated the relationship between Disconnection and Emotion-Focused Disengagement. Self-Control fully mediated the relationship between Impaired Limits and Problem-Focused Disengagement.

CONCLUSIONS

The findings suggest that lower TEI is associated with the likelihood for maladaptive coping in response to EMS. The preference for certain coping styles associated with a particular domain of EMS may be explained by an individual's perceived metacognitive ability to regulate their stress and emotions. When individuals' needs for love, safety, and acceptance from others are not met, there might be poorer perceived self-efficacies in Emotionality and the tendency to cope through emotional avoidance. Individuals with difficulties establishing internal limits are more likely to respond with problem avoidance, possibly due to deficient distress tolerance. Longitudinal studies with a clinical population are warranted to replicate these findings.

PRACTITIONER POINTS

Clinicians will likely find it helpful to consider their clients' TEI to facilitate more individualized formulation and treatment planning, by considering whether related emotional regulation problems might be innate or a deficit in skills Implies the need to do more basic emotional regulation work to supplement and strengthen the established imagery work in schema therapy (ST).

From Emotional Intelligence to Self-Injuries: A Path Analysis in Adolescents With Conduct Disorder

Objective: Self-harm acts are highly prevalent among adolescents with conduct disorder. It has been shown that low level of emotional intelligence (EI) might be related to a higher risk of self-injuries. However, the exact mechanisms underlying this association are still unclear. The purpose of this study was to explore whether psychopathological symptoms and selected psychological processes mediate the association between EI and self-harm risk in adolescents with conduct disorders. Method: Out of 162 adolescents with conduct disorder approached for participation, 136 individuals (aged 14.8 ± 1.2 years, 56.6% females) were enrolled and completed the questionnaires evaluating the level of EI, depression, anxiety, impulsiveness, empathy, venturesomeness, self-esteem, and disgust. Results: Individuals with a lifetime history of self-injuries had significantly higher levels of depression, anxiety and impulsivity as well as significantly lower levels of EI and self-esteem. Higher levels of EI were associated with significantly higher levels of self-esteem, venturesomeness and empathy as well as significantly lower levels of depression, anxiety and impulsivity. Further analysis revealed that trait and state anxiety as well as self-esteem were complete mediators of the association between EI and self-harm risk. Conclusions: Our findings indicate that anxiety and self-esteem might mediate the association between EI and a risk of self-injuries in adolescents with conduct disorder. However, a cross-sectional design of this study limits conclusions on the direction of causality. Longitudinal studies are needed to test validity of our model.

The latent structure of the Young Schema Questionnaire-Short Form

Objective:

The current study aimed to examine the latent structure of a web-based, Brazilian Portuguese version of the Young Schema Questionnaire-Short Form (YSQ-SF).

Method:

The sample consisted of 15,557 adult participants – 4,702 men and 10,855 women – with age ranging from 18 to 60 years. Confirmatory factor analysis was used to test the a priori conceptual 15-factor model presumed to underlie the YSQ-SF item set.

Results:

Most items displayed high levels of reliability (factor loadings greater than 0.7) and low liability to random measurement error (residual variances below 0.02), indicating that the a priori YSQ-SF factor structure is adequate.

Discussion:

These findings offer empirical evidence supporting YSQ-SF construct validity and, consequently, its application in adults.

Schema therapy conceptualization of personality functioning and traits in ICD-11 and DSM-5

PURPOSE OF REVIEW

Schema therapy conceptualizes personality disorders in terms of modes and underlying schemas. This article reviews the literature on schema therapy conceptualization of personality disorder functioning and traits, and proposes how these findings apply to novel personality disorder classification in ICD-11 and the DSM-5 Alternative Model of Personality Disorders (AMPD).

RECENT FINDINGS

Maladaptive schemas and modes are generally associated with personality dysfunction and traits in conceptually coherent ways. The healthy adult mode, a transdiagnostic core concept in schema therapy, corresponds to the ICD-11 and DSM-5-AMPD features of core personality functioning. Modes and underlying schemas substantially overlap with specific ICD-11 and DSM-5-AMPD traits, which denote individual themes and styles of personality dysfunction.

SUMMARY

The dimensional personality disorder framework in ICD-11 and DSM-5-AMPD is largely compatible with the schema therapy model. The ICD-11 and DSM-5-AMPD provide a scientifically derived and theory-free framework for all practitioners, which may be connected to clinical theory of schema therapy in a coherent manner. Level of personality functioning can be conceptualized as healthy adult functioning (e.g. sense of identity, self-worth, emotion regulation, intimacy, and fulfillment), which inform intensity of treatment. Trait qualifiers can be conceptualized by associated modes (e.g., compliant surrender) and underlying schemas (e.g. abandonment), which inform focus and style of treatment.

Development and Validation of the Positive Parenting Schema Inventory (PPSI) to Complement the Young Parenting Inventory (YPI) for Schema Therapy (ST)

The factor structure of an initial item pool of 207 positive parenting items was investigated (Manila; n = 520, 538) to develop the Positive Parenting Schema Inventory. Single group and multigroup confirmatory factor analyses of the Positive Parenting Schema Inventory showed invariance of the factor structure in six out of the seven levels on two other independent samples (Eastern, Indonesia; n = 366, 383; Western, the United States; n = 204, 214). Good values for reliability were obtained for its seven subscales (50 items) using coefficient omegas (.71 to .95). Evidence of validity based on test content, response processes (item responses to desired inferences), internal structure (exploratory and confirmatory factor analyses), relations to other variables (correlations with other instruments), and consequences of testing (correlations with positive schemas) were demonstrated. A core tenet of schema therapy theory was supported in that recall of past positive parenting patterns were associated with current levels of positive schemas.

Validation of the Young Schema Questionnaire-Short Form in a Flemish Community Sample

The Young Schema Questionnaire (YSQ, Young, 1994) was developed to assess Early Maladaptive Schemas (EMS), which account for the dysfunctional beliefs in individuals with personality disorders or maladaptive personality traits. This study aims to investigate the factor structure, the reliability and the validity of the original YSQ - Short Form (Young & Brown, 1998; YSQ-SF, 15 EMS) as well as an extension including 16 EMS, based on the 16 factor structure of the YSQL2 (Young & Brown, 1998) in a community sample. The sample consisted of 672 participants (51% females; M _age-total = 44.34; SD _age-total = 16.24). Results show evidence for both the 15 and 16 factor solution of the YSQ-SF with good internal consistency coefficients for the different scales. Significant gender differences were observed for Self-Sacrifice (females higher) and Entitlement (men higher), along with different patterns of correlations between age and Insufficient Self-Control (r = -.19), Enmeshment (r = -0.16) and Self-Sacrifice (r = .13). Furthermore, Big Five personality traits were significantly associated with several schema scales. In sum, we can conclude that both the YSQ-SF15 and 16 are valid instruments to assess EMS among a Flemish community sample. However, given the unique additive value of the 16^th EMS (Social Undesirability) in predicting lower scores on Extraversion and Openness, the use of the YSQ-SF16 could be favored.

Early maladaptive schemas as mediators between childhood maltreatment and later psychological distress among Chinese college students

The aim of the current study was to examine whether early maladaptive schemas (EMSs) mediate the association between different kinds of childhood maltreatment and later psychopathology and the effect of different kinds of childhood maltreatment on psychological distress in later life. A total of 1102 college students from two local universities participated in the study; their average age was 20.46 ± 1.13 years. The participants completed the Childhood Trauma Questionnaire (CTQ), the Early Maladaptive Schemas Scale (EMSs), the Zung Self-Rating Depression Scale (SDS), and the Zung Self-Rating Anxiety Scale (SAS). Later psychological distress had a significant positive correlation with childhood EMSs, and almost all of the variables measuring childhood maltreatment had a significant positive correlation with EMSs. Structural equation modeling and mediation analyses were conducted based on Bootstrap estimations; the mediation analyses demonstrated the utility of EMSs as the mechanism through which childhood maltreatment has an indirect effect on later psychological distress. Moreover, the study found that emotional abuse had the strongest overall effect of all five types of child maltreatment on later psychological distress, followed in order of magnitude by emotional neglect, physical neglect, sexual abuse, and physical abuse.

The Relation of Dysfunctional Cognitive Schemas and Personality Dimensions in Generalized Anxiety Disorder

Objective: This study investigated whether differences exist in the structural personality dimensions and eighteen maladaptive cognitive schemas among in- and out-patients (Clinical Group) diagnosed with Generalized Anxiety Disorder (GAD) and people from the general population without any psychiatric diagnostic (Control Group).

Methods: The Generalized Anxiety Disorder (GAD) sample (N = 100) included 35 (35%) men and 65 (65%) women, with a mean age of 36.4 years (SD = 10.86; age range 18-69). The control sample (N = 100), included 28 (28%) men and 72 (72%) women, with a mean age of 27.1 years (SD = 9.8; age range 19-60). Data were simultaneously analyzed with one-way multivariate analysis of covariance (MANCOVA) to measure the effect of group membership on personality dimensions and on dysfunctional cognitive schemas, controlling for participants' age. Next, univariate analyses of covariance (ANCOVAs) were done on each item with covariate-adjusted post-hoc comparisons.

Results: The results indicate that the Clinical Group participants had unfavorable scores on all five personality dimensions (i.e., Openness, Extraversion; Conscientiousness; Agreeability; and Emotional Stability - Neuroticism) and for almost all of the dysfunctional cognitive schemas in comparison with participants in the Control Group.

Conclusions: These results have general implications in understanding Generalized Anxiety Disorder (GAD) clients and their personality characteristic's profile and dysfunctional/maladaptive cognitive schemas.

Effects of the Schema Therapy and Mindfulness on the Maladaptive Schemas Hold by the Psoriasis Patients with the Psychopathology Symptoms

BACKGROUND

This study aimed to compare the effects of the schema along with mindfulness-based therapies in the psoriasis patients.

MATERIALS AND METHODS

This semi-experimental study with post- and pre-tests was conducted on the psoriasis patients in the Dermatology Clinic of the Isfahan Alzahra Hospital, Iran using the convenience sampling in 2014. The patients had a low general health score. The experimental groups included two treatment groups of schema-based (n = 8) and mindfulness (n = 8). Both groups received eight 90-min sessions therapy once a week; they were compared with 8 patients in the control group. To evaluate the psoriasis patients' maladaptive schema, Young schema questionnaire was used. Data were analyzed through the covariance analysis test.

RESULTS

There was a significant difference between the schema-based therapy and mindfulness groups with the control group. There was also a significant difference between the schema-based therapy groups consisting of the defeated schema, dependence/incompetence schema, devotion schema, stubbornly criteria schema, merit schema, restraint/inadequate self-discipline schema, and the control group. Moreover, a significant difference existed between the maladaptive schema of mindfulness therapy group and the controls. There was a significant difference concerning the improvement of the psychopathologic symptoms between the mindfulness therapy group and the control group.

CONCLUSIONS

This study showed similar effects of both the schema and mindfulness-based therapies on the maladaptive schemas in improving the psoriasis patients with the psychopathologic symptoms.

Life Event Stress and Binge Eating Among Adolescents: The Roles of Early Maladaptive Schemas and Impulsivity

This study examined the relationships between life event stress, early maladaptive schemas, impulsivity and binge eating among adolescents and investigated the effects of early maladaptive schemas and impulsivity on the relationship between life event stress and binge eating. Specifically, we examined a moderated mediation model in which early maladaptive schemas mediated this relationship and impulsivity moderated the mediation effect. Life event stress, early maladaptive schemas, impulsivity and binge eating were investigated in a sample of 2172 seventh-, eighth- and tenth-grade middle and high school students (mean age = 14.55 years, standard deviation = 1.29). The results indicated that adolescents with greater life event stress, more early maladaptive schemas and higher levels of impulsivity displayed more severe binge eating. In addition, early maladaptive schemas mediated the relationship between life event stress and binge eating, while impulsivity moderated this relationship. Furthermore, impulsivity also moderated the mediation effect of early maladaptive schemas; as impulsivity levels increased, the strength of the association between life event stress and early maladaptive schemas increased. This study illustrates the importance of understanding individual differences and their effects on the relationship between life event stress and binge eating. Copyright © 2015 John Wiley & Sons, Ltd.

How Do DSM-5 Personality Traits Align With Schema Therapy Constructs?

DSM-5 offers an alternative model of personality pathology that includes 25 traits. Although personality disorders are mostly treated with psychotherapy, the correspondence between DSM-5 traits and concepts in evidence-based psychotherapy has not yet been evaluated adequately. Suitably, schema therapy was developed for treating personality disorders, and it has achieved promising evidence. The authors examined associations between DSM-5 traits and schema therapy constructs in a mixed sample of 662 adults, including 312 clinical participants. Associations were investigated in terms of factor loadings and regression coefficients in relation to five domains, followed by specific correlations among all constructs. The results indicated conceptually coherent associations, and 15 of 25 traits were strongly related to relevant schema therapy constructs. Conclusively, DSM-5 traits may be considered expressions of schema therapy constructs, which psychotherapists might take advantage of in terms of case formulation and targets of treatment. In turn, schema therapy constructs add theoretical understanding to DSM-5 traits.

[The 5 mental dimensions identified in early maladaptive schemas statistical analysis of Young's schema questionnaire (YSQ-s3)]

INTRODUCTION

Schemas represent a stable vision of oneself. Young's schema questionnaire-s3 (YSQ-s3) presents 90 perceptions of oneself, specifying 18 early maladaptive schemas (EMS). We studied the intensity and inter-relations of these 18 EMS and how they pool together into a specific domain.

METHOD

Two hundred and ninety four subjects (294 patients from a French private practice in psychiatry and 12 volunteers) filled in a French version of the YSQ-s3. Item scores range from 1 to 6. Only the scores of 4 "true for me during most of my life" or higher were kept for the statistical analysis. Data analysis was conducted using descriptive statistics, principal component analysis (PCA) and hierarchical clustering analysis (HCA).

RESULTS

The EMS mean scores ranged from 3.4 to 12.9 and standard deviations from 5.9 to 9.7. EMS score correlations range from 0.009 to 0.55. The principal component analysis (PCA), that provides linear combinations of each EMS score, yields only one meaningful component. Indeed, the screen plot that provides the eigen values associated with each principal component, suggests keeping only the first component. This component presents a size-effect and represents the "global scores intensity". The hierarchical clustering analysis (HC) fits the 18 EMS in 5 domains (r(2) = 0.4): (1) "avoidance" (with 3 EMS: emotional deprivation, social isolation/alienation, emotional inhibition), (2)"give" (with 1 EMS: self-sacrifice), (3) "take" (with 3 EMS: entitlement/grandiosity, insufficient self-control/self-discipline, approval-seeking/recognition-seeking) (4) "awareness" (with 8 EMS: abandonment/instability, mistrust/abuse, defectiveness/shame, dependence/incompetence, vulnerability to harm or illness, enmeshment/undeveloped self, failure, subjugation) (5) "faith" (with 3 EMS: negativity/pessimism, unrelenting standards/hyper-criticalness, punitiveness). When the HC analysis is applied to the population (n = 294), it yields 6 classes of patients. The mean score of the 5 domains, described above, can describe these classes.

DISCUSSION

These 5 domains do not completely fit Young's five "primary infantile needs" domains. Only 2/3 of the EMS are correctly attributed to the "primary infantile needs" domains. The 5 domains seem closely related to the 5 dimensions of the NEO-PI-R or to the 5 domains of personality disorders (criteria b) described in the DSM-5. In our understanding the dimensions "avoidance, give, take" represent 3 types of relationship to others (on behavioral level). The dimension "awareness" represents the fears and losses (on the emotional level) and "faith" represents beliefs and consciousness (on the cognitive level). The intensity of the 5 domains inside each class of patients could guide the clinical interpretation, specifically for personality disorders.

Emotional abuse as a predictor of early maladaptive schemas in adolescents: contributions to the development of depressive and social anxiety symptoms

The schema therapy model posits that maltreatment generates early maladaptive schemas (EMSs) that lead to the development of emotional disorders throughout the life span. The model also stipulates that temperament moderates the influence of maltreatment on EMSs. This study examines (a) whether emotional abuse perpetrated by parents and peers, both alone and interactively with temperament, predicts the worsening of EMSs; and (b) whether EMSs in turn predict an increase in depressive and social anxiety symptoms in adolescents. A total of 1,052 adolescents (Mage=13.43; SD=1.29) were assessed at three time points, each of which was separated by 6 months. The subjects completed measures of emotional abuse by parents and peers, neuroticism, extraversion, EMSs, depressive symptoms, and social anxiety. The findings indicate that emotional bullying victimization and neuroticism predict a worsening of all schema domains over time. Contrary to expectations, there was no significant interaction between temperament dimensions and emotional abuse. The results confirmed the mediational hypothesis that changes in EMSs mediated the predictive association between bullying victimization and emotional symptoms. This study provides partial support for the schema therapy model by demonstrating the role of emotional abuse and temperament in the genesis of EMSs.

The relation between antisocial and borderline personality symptoms and early maladaptive schemas in a treatment seeking sample of male substance users

Individuals with substance use disorders are more likely to have antisocial and borderline personality disorder than non-substance abusers. Recently, research has examined the relations between early maladaptive schemas and personality disorders, as early maladaptive schemas are believed to underlie personality disorders. However, there is a dearth of research on the relations between early maladaptive schemas and personality disorders among individuals seeking treatment for substance abuse. The current study examined the relations among early maladaptive schemas and antisocial and borderline personality within in a sample of men seeking substance abuse treatment (n = 98). Results demonstrated that early maladaptive schema domains were associated with antisocial and borderline personality symptoms. Implications of these findings for substance use treatment and research are discussed.

KEY PRACTITIONER MESSAGE

Antisocial (ASPD) and Borderline (BPD) personality disorder symptoms are prevalence among individuals seeking substance abuse treatment. Early maladaptive schemas are believed to underlie the development of ASPD and BPD symptoms, and are also prevalence among individuals seeking substance use treatment. Findings from the current study suggest that specific early maladaptive schema domains predict ASPD and BPD symptoms in a substance abuse treatment seeking sample of adult males. The treatment of ASPD and BPD among men seeking substance use treatment may want to focus on early maladaptive schemas.

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

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

Schema therapy, motivational interviewing, and collaborative-mapping as treatment for depression among low income, second generation Latinas

US-born Latinos report significantly more depression than foreign-born Latinos in the US, and Latinas have twice the rate of depression than Latino men. The purpose of this pilot study was to test the feasibility of an innovative, short-term program of Schema Therapy (ST) combined with Motivational Interviewing (MI) techniques to reduce depression and increase resilience among second generation Latinas of low income in the US. In addition to blending ST and MI strategies with a focus on resilience, a novel technique called collaborative-mapping was a crucial strategy within treatment. Scheduling for sessions was flexible and patients had unlimited cell phone access to the therapist outside of sessions, although few used it. A mixed linear regression model for BDI-II scores of 8 women who completed all eight 2-h sessions demonstrated that the treatment significantly decreased BDI-II scores during the course of treatment (p = .0003); the average decreasing rate in BDI-II scores was 2.8 points per visit. Depression scores remained sub-threshold for 12 months after treatment completion. Resilience scores significantly increased after treatment completion and remained high at all follow-up visits through 1 year (p < .01). Thus, this short term, customized intervention was both feasible and effective in significantly decreasing depression and enhancing resilience for this sample with effects enduring one year after treatment. This study is the first to combine ST and MI in therapy, which resulted in an appealing, desirable, and accessible depression treatment for this severely understudied, underserved sample of low income, second generation Latinas in the US.