A Comparison of Schemas, Schema Modes and Childhood Traumas in Obsessive-Compulsive Disorder, Chronic Pain Disorder and Eating Disorders

Abstract

Background: In this study, we investigated early maladaptive schemas (EMS), schema modes and childhood traumas in patients suffering from obsessive-compulsive disorder (OCD) in contrast to patients with other Axis I disorders. Based on cognitive theories on OCD, our main research question was whether schemas belonging to the domain of ‘impaired autonomy and performance' are more prevalent in OCD than in both eating disorders (ED) and chronic pain disorder (CPD). Sampling and Methods: EMS, schema modes and traumatic childhood experiences were measured in 60 patients with OCD, 41 with ED, 40 with CPD and 142 healthy controls. To analyze differences between the groups, MANCOVAs were conducted followed by deviation contrasts. Depression level, age and gender were considered as possible covariates. Results: OCD patients scored higher on 4 EMS, 2 of which belong to the domain ‘impaired autonomy and performance'. ED patients had higher scores in the EMS ‘emotional inhibition' and CPD patients on the Childhood Trauma Questionnaire subscale ‘physical neglect'. Conclusions: These results suggest that there might be typical schema patterns associated with OCD and ED. We can also conclude that a higher prevalence of traumatic experiences does not necessarily coincide with more EMS and schema modes.

Do dysfunctional coping modes mediate the relationship between perceived parenting style and disordered eating behaviours?

“…[6, 30]). Although the Self-Aggrandiser mode also functions as a form of overcompensation, this mode was endorsed at a relatively low level and only weakly correlated with eating behaviours, consistent with previous findings [45, 49]. …”

“…Further, there is preliminary, though limited, empirical support for the application of the schema model to ED populations [29, 40, 41]. Specifically, research has linked EMS and schema processes to ED pathology, and ED populations have been found to score higher on EMS [22, 25, 52] and schema modes [45, 49] than non-clinical populations. Preliminary studies suggest that the Compliant Surrenderer, and two avoidant coping modes, Detached Self-Soother and Detached Protector, appear to be higher in the ED population than in non-clinical populations [45] and other clinical groups [49].…”

Early maladaptive schemas in patients with somatoform disorders and somatization

“…Schemas are the deepest level of cognition. The overall score of the Young Schema Questionnaire (YSQ) indicates a general psychopathology; however, specific schema patterns are observed for different diagnoses of mental illness, for example, elevated EMS "approval seeking/recognition seeking" and "entitlement/grandiosity" in bipolar disorders (Hawke & Provencher, 2012); "abandonment," "dependence," "vulnerability," and "insufficient self-control" in patients with obsessive-compulsive disorders (Voderholzer et al, 2014); and "failure" in bulimic patients (Waller et al, 2001). On the basis of clinical experience, Young and colleagues conceptualized 18 different EMSs (Young, Klosko, & Weishaar, 2003).…”

The Effects of Schema Therapy on Emotional Self-Awareness, Vulnerability, and Obsessive Symptoms Among Patients with Obsessive-Compulsive Disorder

“…For instance, OCD patients mainly have the emotional inhibition, emotional deprivation, and vulnerability schemas, while the most common maladaptive schema among patients with depression, anxiety, and eating disorders is abandonment, which is indicative of unfulfilled needs such as safety, trust, and empathy (8,9). In addition, patients with obsessional neurosis mainly have the social isolation, emotional inhibition, vulnerability, and mistrust schemas (10,11).…”

“…Therefore, emotional self-awareness deficit, characterized by inability to correctly recognize and express emotions, can significantly contribute to the development of mental disorders (10)(11)(12). The most severe type of emotional selfawareness deficit is alexithymia (or emotional silence).…”