Early Maladaptive Schema Factors, Chronic Pain and Depressiveness: a Study with 271 Chronic Pain Patients and 331 Control Participants

Abstract

Chronic pain and depression are coexisting entities with high simultaneous prevalence. Both are linked with early adversities. Early maladaptive schemas (EMS) can be seen as a reflection of these adversities. EMSs extensively indicate underlying psychic patterns and provide a good opportunity to detect covert processes and psychic shapes (latent factors), which create the basis of how people rate their schemas. The purpose of this study was to explore these latent, higher order schema factors (SF) and to find out how they are associated with pain intensity or depression in chronic pain patients and a control sample. The study subjects consisted of 271 first-visit pain patients and 331 control participants. Sociodemographic and pain data were gathered by questionnaire; 18 EMSs were measured with the Young Schema Questionnaire (short form) and depressiveness was measured with the Beck Depression Inventory, Version II. Exploratory factor and regression analyses were used. The chronic pain patient group showed two SFs. The first SF showed a shameful, defective, socially isolated, failure, emotionally inhibited, deprived, submissive and resigned pattern. The second SF showed a demanding, approval seeking, self-sacrificing and punitive pattern. SF1 predicted more than half of the depressiveness in the pain patient sample. A three-factor structure was found in the control sample, and SFs 1 and 3 together predicted almost one-third of depressiveness. The pain patient and the control groups had a different, higher order factor structure. We assume that SF1 in the pain patients reflected a rather serious, undefined early psychic trauma and was also associated with their depressiveness.

Early maladaptive schemas in patients with somatoform disorders and somatization

“…There are also associations between increased perceived stress and chronic pain (van Uum et al, 2008) as well as major depression (Staufenbiel, Penninx, Spijker, Elzinga, & van Rossum, 2013). Saariaho, Saariaho, Karila, and Joukamaa (2012) found a "pain predisposing and maintaining factor" that comprised the schemas "unrelenting standards" and "self-sacrifice" in their study on chronic pain patients. Self-sacrificing behaviour in somatoform patients may be associated with experiences of role reversal during childhood, which is known as parentification.…”

“…The highest performance expectations in combination with a high willingness to put one's own needs aside, as expressed in a self-sacrificing behaviour style, seem to be characteristic for patients with somatoform disorders. Saariaho, Saariaho, Karila, and Joukamaa (2012) found a "pain predisposing and maintaining factor" that comprised the schemas "unrelenting standards" and "self-sacrifice" in their study on chronic pain patients. Studies on fibromyalgia have shown that a perfectionistic and self-sacrificing lifestyle plays a crucial role in the development and persistence of fibromyalgia (Kivimaki et al, 2004;van Houdenhove, Neerinckx, Onghena, Lysens, & Vertommen, 2001;Wentz, Lindberg, & Hallberg, 2004).…”

The Latent Factor Structure of Young's Early Maladaptive Schemas: Are Schemas Organized Into Domains?

“…Because this model defined domains for only 15 schemas, the remaining three first‐order schema factors were allowed to freely correlate with each other and the second‐order domains. A two‐domain and a three‐domain model based on samples of adults with and without chronic pain were also fitted (Saariaho, Saariaho, Karila, & Joukamaa, ), as well as a model with a single global domain. Finally, bifactor models with and without correlations between the first‐order schema factors were examined.…”

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

“…Chronic pain disorder (CPD; comorbidity 3.7% [6]) fulfils this condition. Although there is a lack of comparisons between different Axis I disorders, a study on EMS in OCD versus healthy controls does exist [8], as well as comparisons of ED [9] and CPD [10] samples with controls. These studies found higher levels of EMS in clinical samples.…”