A new look at the schema therapy model: organization and role of early maladaptive schemas

This study reexamined the organization of Young’s 18 early maladaptive schemas and their hypothesized associations with experiences of need-thwarting parental experiences in childhood and the “vulnerable child” mode of emotional distress in adulthood. A large Danish sample (N = 1054) of 658 clinical- and 391 nonclinical adults completed measures of early maladaptive schemas, parenting styles, and the vulnerable child mode. We identified four higher-order schema domains as most appropriate in terms of interpretability and empirical indices (“Disconnection & Rejection”, “Impaired Autonomy & Performance”, “Excessive Responsibility & Standards”, and “Impaired Limits”). All four schema domains were differentially associated with conceptually relevant need-thwarting parental experiences. Apart from “Impaired Limits”, the schema domains meaningfully accounted for the association between need-thwarting parental experiences in childhood and emotional states of feeling like a “vulnerable child” in adulthood. We conclude that four domains of early maladaptive schemas are empirically and conceptually consistent with Young’s schema therapy model of personality pathology and longstanding emotional disorders. Findings warrant replication using different populations and if possible a prospective multi-method design. A scoring key for computing the four schema domains is provided.     

Schematherapie

Schema therapy is a cognitive behavioral therapy (CBT) development mainly for the treatment of personality disorders and other chronic mental disorders. It is characterized by an integration of cognitive, emotional and behavioral intervention methods derived from different therapeutic approaches with an emphasis on a specifically supportive therapeutic relationship. The original approach focused mainly on early maladaptive schemas. Current developments, however, concentrate on the concept of schema modes, describing different schema-associated emotional states. The schema mode approach is also used for specific case concepts for personality disorders. Effectiveness of schema therapy has been shown for borderline personality disorder. Current studies investigate the effectiveness of schema therapy for patients with other chronic mental conditions and as a group therapy approach. This paper provides an overview about case conceptualization and treatment, presents main research findings and discusses open questions and problems.     

Analysis of early representations and personality among victims of domestic violence

IntroductionThis exploratory study analyses the individual elements of the victims of domestic violence through life events, early dysfunctional representations and personality.ObjectivesThis research aims, firstly, to show the existence of early traumatic experiences for the victims of domestic violence. Secondly, it aims to measure the prevalence of early maladaptive schema and identify personality traits in these subjects. Finally, our aim is to highlight that depending on the violence carried out within the couple (reciprocal/unilateral), activated schemas and personality traits are different.MethodOur sample consists of 80 female subjects, non-abused women (n = 40) and victims of domestic violence (n = 40), of which 22 victims of unilateral violence and 18 victims of reciprocal violence. Participants filled out an initial questionnaire as well as the scales and self-report questionnaires as follows: Life events (Amiel-Lebigre, 1984); TCI (Cloninger et al., 1993); YSQ-S3 (Young et al., 2005). The data were subject to statistical analysis and were processed using the software SPSS 22.ResultsThe results show that the victims have experienced more early traumas than non-victims, that schemas (emotional deprivation, mistrust and abuse, subjugation, self-sacrifice) are more active. We note also different personality traits according to the different groups (victims/non-victims) and subgroups (reciprocal violence/unilateral violence).ConclusionOur study sheds light on the role of the individual elements of the victims on the perception of the relationship and on the process of engagement and disengagement of women in abusive relationships. Limits and expectations of the study are discussed.     

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.     

Changes in schemas of patients with severe borderline personality disorder: The Oulu BPD study

Borderline personality disorder (BPD) is a relatively common and severe psychiatric disorder that can impair quality of life in many ways. The aim of this study was to determine whether a combined treatment model for BPD patients, utilising major principles from schema‐focused therapy (SFT) and dialectical behavioral therapy (DBT), could be more effective in relieving early maladaptive schemas of BPD patients, compared to treatment as usual (TAU). This study is a part of the Oulu BPD study conducted at mental health care services run by Oulu city social and health care services. The study is a multisite, randomized controlled trial conducted over a one year period, involving two groups of patients with severe BPD: (1) Community Treatment By Experts (CTBE) patients (n = 18) receiving the combined treatment model, and 2) TAU patients (n = 27). The patients' schemas were assessed using the Young Schema Questionnaire (YSQ‐L3a) before and after one year of treatment. The results reveal that CTBE patients who attended the combined treatment model showed a statistically significant reduction in eight out of 18 early maladaptive schemas, while patients receiving treatment as usual did not demonstrate any significant changes in schemas. The cognitive therapeutic treatment model can be applied for clinical use in public mental health settings using existing professionals, and appears to produce positive changes in patients with BPD.     

童年期创伤对大学生抑郁的影响:早期适应不良图式和负性生活事件的作用

目的:考察早期适应不良图式、负性生活事件在童年期创伤与大学生抑郁间的影响机制。方法:采用童年期创伤问卷、Young图式问卷短版中文修订版、青少年生活事件量表及90项症状自评量表对1423名大学生进行调查,结果表明:(1)童年期创伤既可以直接正向预测大学生抑郁,也可以通过早期适应不良图式中的分离和拒绝、自主性及能力受损两大图式类别间接地正向预测大学生抑郁;(2)负性生活事件调节了早期适应不良图式在童年期创伤与抑郁间的中介作用     

Assessing Dissociative Symptoms and Dissociative Disorders in College Students in the Philippines

Experiences of childhood emotional maltreatment exert powerful yet heterogeneous effects on individuals, suggesting that other factors play a significant role in determining long-term adaptation. This study examined whether childhood emotional maltreatment, parental alcoholism, and gender predicted endorsement of early maladaptive schema domains. College students (N = 301) completed questionnaires assessing trauma exposure, parental alcoholism, maladaptive schemas, and posttraumatic symptoms. Analyses revealed that experiences of childhood emotional maltreatment predicted each of the four schema domains (i.e., disconnection, impaired autonomy, impaired limits, and exaggerated standards). Parental alcoholism moderated the relationship between childhood emotional maltreatment and the impaired autonomy schema domain. Gender moderated the relationships between childhood emotional maltreatment and the impaired autonomy and impaired limits schema domains. These findings support Young, Klosko, and Weishaar's (2003) Young, J. E., Klosko, J. S. and Weishaar, M. E. 2003. Schema therapy: A practitioner's guide, New York: Guilford.  [Google Scholar] hypotheses regarding early childhood trauma and early maladaptive schemas, and offer guidance to therapists working with survivors of childhood maltreatment.     

Attachment Quality and Psychopathological Symptoms in Clinically Referred Adolescents: The Mediating Role of Early Maladaptive Schema

This study investigated relationships between attachment insecurity, maladaptive cognitive schemas, and various types of psychopathological symptoms in a sample of clinically referred adolescents (N = 82). A mediation model was tested in which maladaptive schemas operated as mediators in the relations between indices of attachment quality and conduct, peer, and emotional problems. Results revealed partial support for the hypothesized mediation effect: the schema domain of disconnection/rejection acted as a mediator in the links between insecure attachment and peer problems and emotional problems. Further analysis of these effects revealed that different types of maladaptive schemas were involved in both types of psychopathology. Altogether, findings suggest that treatment of adolescent psychological problems may need to target the improvement of attachment relationships with peers and parents and the correction of underlying cognitive schemas.     

Global Maladaptive Schemas, Negative Life Events, and Psychological Distress

The relationship between maladaptive self-schemas, negative life events, and psychological distress was assessed. The model tested was based on Young's (J. Young, 1990) diathesis–stress conceptualization of maladaptive schemas, which are believed to represent the cognitive diathesis underlying Axis II personality pathology. Young's model predicts that schemas are chronically activated in individuals with maladaptive schemas. Therefore, the experience of salient negative life events is less likely to exacerbate the level of distress experienced by those having maladaptive schemas. A nonclinical sample (N = 93) was assessed using the Schema Questionnaire (SQ), a measure of maladaptive self-schemas, a measure of negative life events, and several measures of psychological distress. Support was found for this prediction indicated by a Schema × Negative Life Events interaction in which the distress level of High SQ participants was less affected by negative life events compared to Low SQ participants.     

Transactional Relationships among Cognitive Vulnerabilities, Stressors, and Depressive Symptoms in Adolescence

The transactional cognitive vulnerability to stress model Hankin & Abramson (Psychological Bulletin, 127:773–796, 2001) extends the traditional diathesis-stress model by proposing that the relationships among cognitions, depressive symptoms, and stressors are dynamic and bidirectional. In this study three different pathways among these variables were assessed simultaneously: (1) cognitive vulnerabilities and stressors as predictors of depressive symptoms (vulnerability model), (2) depressive symptoms and cognitive vulnerabilities as predictors of stressors (stress generation model), and (3) depressive symptoms and stressors as predictors of cognitive vulnerabilities (consequence model). A fully cross-lagged design panel was employed with 1,187 adolescents (545 girls and 642 boys, Mean Age?=?13.42 years) who were assessed at two time points separated by 6 months. They completed measures of cognitive vulnerabilities (maladaptive schema domains and negative inferential style), stressors, and depressive symptoms. Inferential style and schemas of the disconnection and rejection domain predicted prospective increases in depressive symptoms. Initial levels of depressive symptoms and most cognitive vulnerabilities predicted greater stress generation. Initial levels of stressors and depressive symptoms predicted an increase in negative inferential style and maladaptive schema domains over time. These bidirectional relationships were mostly similar for boys and girls, although there were a few gender differences. The findings support a transactional model with reciprocal relationships among stress, depressive symptoms, and cognitive vulnerabilities. Transactional implications for depression interventions among adolescents are discussed.     

Maladaptive Parenting,Temperament, Early Maladaptive Schemas,and Depression: A Moderated Mediation Analysis

According to the Schema Therapy Model, maladaptive parenting styles interact with a child’s unique temperament in the development of early maladaptive schemas (EMSs), which in turn increase one’s risk for developing pathology. However, few authors have examined the comprehensive model. The purpose of this study was to assess the indirect effect of perceived parenting styles on depressive symptoms through EMSs. Furthermore, a series of moderated mediation analyses were conducted to examine whether the indirect effect varies as a function of temperament. A total of 403 undergraduate students completed measures of perceived parenting experiences, temperament, EMSs, and depressive symptoms. Results indicated that the schema domains of disconnection/rejection and impaired autonomy mediated the relationship between perceived parenting styles and depressive symptoms. Moderation of the indirect effect was only found in two of the twelve tested models. This study lends partial support to the Schema Therapy model and also offers a new way of looking at the interactive nature of the constructs.     

Cognitive Schemas as Mediating Variables of the Relationship Between the Self-Defeating Personality and Depression

The current investigation was designed to examine particular maladaptive cognitive schemas as mediating variables of the relationship between the self-defeating personality and depression. A total of 82 mildly to severely depressed adult outpatients, referred for counseling and psychotherapy services, were assessed in terms of self-defeating personality and maladaptive cognitive schema characteristics. Results indicated that 57% of the variance within depression, measured by the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979), was accounted for by the self-defeating personality and five maladaptive cognitive schemas: abandonment/instability; defectiveness/shame; failure; subjugation; and vulnerability to harm. Further, mediation analyses indicated that abandonment/instability and defectiveness/shame statistically mediated the relationship between the self-defeating personality and depression. Results are discussed in light of contemporary theories of depression.     

Defense mechanisms: An approach from the perspective of personal construct psychology

The psychoanalytic concept of defense mechanisms was theoretically and empirically approached from the perspective of personal construct psychology, in an attempt to investigate its cognitive components. Thirty neurotic clients of the Psychotherapeutic Center in Stuttgart, Federal Republic of Germany, were investigated by means of the Questionnaire for Defense Categories (Ehlers & Peter, 1989) and the Repertory Grid Test (Kelly, 1955). Tight construing, extremity of emotional evaluation, construal of the symptom as having positive implications, and construed similarity between certain aspects of the self were observed in clients who frequently used the defense mechanisms denial, rationalization, and turning against the object.     

The role of early maladaptive schemas in predicting exposure and response prevention outcome for obsessive-compulsive disorder

This is the first study that explores whether early maladaptive schemas are related to treatment outcome for patients with obsessive-compulsive disorder (OCD). The sample consisted of 88 outpatients with a diagnosis of OCD who completed exposure and response prevention treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory and Young Schema Questionnaire – Short Form were administered before and after treatment. Regression analyses using post-treatment Y-BOCS as the dependent variable indicated that higher scores on the abandonment schema at pre-treatment were related to poor outcome and explained 7% of the variance in symptoms at post-treatment. Higher scores on the self-sacrifice schema at pre-treatment were related to good outcome and explained 6% of the variance in obsessive-compulsive symptoms at post-treatment. During treatment, only changes in the failure schema were significantly related to good outcome and explained 18% of the variance in symptoms at post-treatment.     

大学生早期适应不良图式、焦虑与拖延的关系

为探讨大学生早期适应不良图式、焦虑与拖延的关系, 并考察焦虑在早期适应不良图式与拖延之间的中介效应, 采用一般拖延量表、Young图式问卷—简版、状态—特质焦虑问卷和自编一般人口学情况调查表, 对广东一高校559名大学生进行调查研究。研究结果发现:(1)"分离和拒绝"、"自主性和能力不足"、"缺乏自控/自律不足"图式均能显著正向预测焦虑和拖延;(2)特质焦虑能显著正向预测拖延, 而状态焦虑对拖延无显著预测作用;(3)特质焦虑在"分离和拒绝"、"自主性和能力不足"、"缺乏自控/自律不足"图式与拖延之间起部分中介作用。     

图式治疗理论与实践

由于传统认知行为疗法治疗人格障碍面临许多问题和挑战,Young在认知行为疗法的基础上创建了图式治疗。图式治疗关注患者的早期适应不良图式和适应不良的应对方式,并通过一系列治疗策略,帮助患者改变早期适应不良图式,形成更健康的行为方式。图式治疗是在传统认知行为疗法的基础上,结合依恋理论、客体关系理论、格式塔理论和建构主义理论的整合治疗模型,其整合的优势为今后的发展带来很大空间     

The effects of relational structure on analogical learning

Relational structure is important for various cognitive tasks, such as analogical transfer, but its role in learning of new relational concepts is poorly understood. This article reports two experiments testing people’s ability to learn new relational categories as a function of their relational structure. In Experiment 1, each stimulus consisted of 4 objects varying on 2 dimensions. Each category was defined by two binary relations between pairs of objects. The manner in which the relations were linked (i.e., by operating on shared objects) varied between subjects, producing 3 logically different conditions. In Experiment 2, each stimulus consisted of 4 objects varying on 3 dimensions. Categories were defined by three binary relations, leading to six logically different conditions. Various learning models were compared to the behavioral data, based on the theory of schema refinement. The results highlight several shortcomings of schema refinement as a model of relational learning: (1) it can make unreasonable demands on working memory, (2) it does not allow schemas to grow in complexity, and (3) it incorrectly predicts learning is insensitive to relational structure. We propose schema elaboration as an additional mechanism that provides a more complete account, and we relate this mechanism to previous proposals regarding interactions between analogy and representation construction. The current findings may advance understanding of the cognitive mechanisms involved in learning and representing relational concepts.     

Sources of Emotional Maltreatment and the Differential Development of Unconditional and Conditional Schemas

Schema theory posits that experiences of maltreatment result in the early development of maladaptive schemas (EMS; Young, Klosko, & Weishaar, 2003, Schema therapy: A practitioner's guide, The Guilford Press: New York, NY). EMS are organized by conditionality; unconditional schemas are theorized to develop early in childhood predominantly in response to experiences of parenting and conditional schemas are theorized to develop later in life in response to other relationships. Despite this distinction, minimal previous research has investigated their differential development. The current study examined the relative contributions of parental and other (peer and intimate partner) emotional maltreatment (EMT) in the differential development of unconditional and conditional schemas. Ninety-seven undergraduate students retrospectively reported their maltreatment experiences using the Lifetime Experiences Questionnaire and completed the Young Schema Questionnaire to measure EMS. Consistent with hypotheses, parental EMT was the strongest predictor of unconditional schemas. Unexpectedly, parental EMT also emerged as the strongest predictor of conditional schemas. Theoretical and clinical implications of these findings are discussed.     

Unique Contributions of Positive Schemas for Understanding Child and Adolescent Life Satisfaction and Happiness

Much research has examined negative cognitive schemas as associates of psychopathology. Although some research has established relations between positive cognitive schemas and psychopathology, little research has examined positive cognitive schemas in the context of well-being among children and adolescents. In the current study, contributions of positive schemas to two indicators of well-being, namely happiness and life satisfaction, were examined. Specifically we examined how positive schemas predict well-being beyond negative schemas, whether age and gender moderate the relations between positive schemas and well-being, and the contributions of specific positive schema themes to well-being. 282 child and adolescent boys (n = 122) and girls (n = 160) aged 8–18 (M = 13.37, SD = 2.18), completed measures of positive schemas, negative schemas, life satisfaction, and happiness. Results indicated that positive schemas related to life satisfaction and happiness beyond negative schemas, supporting the importance of examining positive schemas in models of well-being. Positive schemas were more strongly tied to happiness in older adolescents versus younger children, but the relations between positive schemas and life satisfaction did not vary as a function of age. Gender effects indicate that the relation between positive schemas and life satisfaction and happiness was stronger for females than for males. When the relative contributions of positive schema themes (i.e., trust, worthiness, optimism, success, self-efficacy) were explored in the prediction of life satisfaction and happiness, worthiness emerged as the strongest predictor. Results emphasize the importance of considering positive schemas in models of well-being among children and adolescents.