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

Abstract

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. K E Y W O R D S borderline, dimension, early maladaptive schemas, hybrid model, personality disorder 1 | INTRODUCTION Personality disorders (PDs) refer to pervasive, persistent and pathological patterns of perception and behaviour. These patterns deviate from expectations of the individuals' culture and manifest themselves in cognition, affectivity, interpersonal functioning and/or impulse control. Currently, 10 PDs are identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013) and indicated by at least four and up to nine features (i.e., 'frantic efforts to avoid real or imagined abandonment' or 'chronic feelings of emptiness' for borderline PD, p. 663). Various clinical interventions, including Interpersonal Reconstructive Therapy

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“…They also reported that those with numerous maladaptive schemas, who normally did not respond to ERP, would also benefit from it. Kunst et al [ 29 ] found that the over-vigilance and inhibition domain correlated with the obsessive–compulsive disorder. In addition, dos Santos Ribas et al [ 16 ] found a significant correlation between over-vigilance and inhibition domains (schemas of unrelenting standards, and hyper criticalness) in migraine patients from both genders.…”

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“…However, EMSs are not necessarily activated at every moment (H.M. Nordahl & Thimm, 2012). Typically, EMSs are activated by unpleasant and negative situations (Barazandeh et al, 2016) which can lead to negative mood states (such as depression and anxiety), interpersonal difficulties, dysfunctional reactions and emotional disorders (Flink et al, 2018;Kunst et al, 2020).…”

“…Likewise, when EMSs become active, they can lead to several cognitive and behavioural problems such as anger symptoms, neuroticism, social phobia, low academic achievement, substance abuse, addiction, interpersonal conflicts, and psychosomatic disorders (Estévez et al, 2019; Gómez‐Odriozola & Calvete, 2020; Kunst et al, 2020; Vasilopoulou et al, 2020). Lacking adaptive strategies with the negative affect inherent in EMSs, individuals have difficulties regulating negative emotions and, over time, might perceive them as intolerable (Eslampanah et al, 2020; Marengo et al, 2019).…”