Schema modes and their associations with emotion regulation, mindfulness, and self-compassion among patients with personality disorders

Abstract

Background The current study's goal was to examine the multivariate patterns of associations between schema modes and emotion regulation mechanisms in personality disorders. Schema modes are either integrated or dissociative states of mind, including intense emotional states, efforts to regulate emotions, or self-reflective evaluative thought processes. Exploring the multivariate patterns of a shared relationship between schema modes and emotion regulation strategies may lead to a better understanding of their associations and a deeper understanding of the latent personality profiles that organize their associations in a mixed personality disorder sample. Methods Patients who have personality disorders (N = 263) filled out five different self-report questionnaires, out of which four measured adaptive and maladaptive emotion-regulation strategies (Cognitive Emotion Regulation Questionnaire, Difficulty of Emotion Regulation Scale, Five Factor Mindfulness Questionnaire, Self-Compassion Scale), and the fifth one assessed schema modes (Schema Mode Inventory). We conducted canonical correlation analysis in order to measure the multivariate patterns of associations between the 26 emotion regulation and the 14 schema mode subscales. Results We found strong multivariate associations between schema modes and emotion regulation strategies. Collectively, the full model based on all canonical variate pairs was statistically significant using the Wilks’s Λ = .01 criterion, F (364,2804.4) = 3.5, p < .001. The first two canonical variate pairs yielded interpretable squared canonical correlation (Rc2) effect sizes of 74.7% and 55.8%, respectively. The first canonical variate pair represents a general personality pathology variable with a stronger weight on internalization than externalization, and bipolarity in terms of adaptive vs. non-adaptive characteristics. We labeled this variate pair "Adaptive/Non-Adaptive." The second canonical variate pair, labeled "Externalizing", represents externalizing schema modes and emotion regulation strategies. Conclusion Using a multivariate approach (CCA), we identified two independent patterns of multivariate associations between maladaptive schema modes and emotion regulation strategies. The Adaptive/Non-Adaptive general personality pathology profile and the Externalizing personality pathology profile may lead to a deeper understanding of personality disorders and help psychotherapists in their conceptualization in order to design the most appropriate interventions.

Stronger coupling of emotional instability with reward processing in borderline personality disorder is predicted by schema modes

“…Answers are rated on a 6-point Likert scale (from 1 – ‘Never’ or ‘Almost Never’ to 6 – ‘All of the time’). The Hungarian adaptation of the YSI was applied in previous studies (Salgó et al, 2021 ; Szalai, 2014 ).…”

“…Schema modes are organized into four categories: child modes, coping modes, parent modes, and the Healthy Adult mode. Modes can be adaptive (the Healthy Adult and the Happy Child mode) or maladaptive (every other mode) (for a short description of schema modes, see Table 1) (Salgó, Bajzát, & Unoka, 2021;Young, Klosko, & Weishaar, 2006).…”

Effects of Schema Therapy for Children and Adolescents on the Externalizing Behaviors of the Adolescents Referred to the Counseling Centers in Ahvaz, Iran

“…The effectiveness of schema therapy in mitigating externalizing behaviors could be justified by the fact that the traits of individuals with externalizing behaviors are associated with their distorted understanding of the world and a perceived unfair environment. This cognitive factor contributes to the emergence of disruptive behaviors (15). Researchers have also demonstrated a correlation between perceived unfairness and anger with other negative outcomes (26,27).…”

“…Nevertheless, it seems that a change in a 'deeper mode' is more effective and stable. Modes form more complex mechanisms such as somatic reactions, thoughts, feelings, and behaviors, thereby leading to a more global and stable change (15). In ST-CA, the mode model is primarily employed as it enables the use of a simpler language and more therapeutic diversity.…”

Effectiveness of Contextual Schema Therapy for Extreme Perfectionism and Emotion Regulation in Individuals with Perfectionism Disorder

“…Hemmati Sabet et al (20) demonstrated that employing cognitive therapy techniques helped patients learn to argue against incompatible perfectionism schemas and question their validity on a logical level. Furthermore, research findings suggest that the schema-based approach is effective for emotion regulation (21,22).…”