Early maladaptive schemas in adult survivors of interpersonal trauma: foundations for a cognitive theory of psychopathology

Abstract

BackgroundAlthough the association between psychological trauma and early maladaptive schemas (EMS) is well established in the literature, no study to date has examined the relationship of EMS to PTSD and psychopathologies beyond depression and anxiety in a sample of adult survivors of interpersonal trauma. This information may be useful in helping our understanding on how to best treat interpersonal trauma.ObjectiveWe set out to investigate the association between EMS and common forms of psychopathology in a sample of women with a history of interpersonal trauma (n=82). We have hypothesised that survivors of interpersonal trauma will present with elevated EMS scores compared to a non-clinical control group (n=78). We have also hypothesised that unique schemas will be associated with unique psychopathological entities and that subgroups of interpersonal trauma survivors would be present in our sample, with subgroups displaying different profiles of schema severity elevations.MethodParticipants completed measures of trauma, psychopathology, dissociation, self-esteem, and the Young Schema Questionnaire.ResultsIt was found that survivors of interpersonal trauma displayed elevated EMS scores across all 15 schemas compared to controls. Although the pattern of associations between different psychopathological features and schemas appears to be rather complex, schemas in the domains of Disconnection and Impaired Autonomy formed significant associations with all psychopathological features in this study.ConclusionsOur findings support the usefulness of cognitive behavioural interventions that target schemas in the domains of Disconnection and Impaired Autonomy in an effort to modify existing core beliefs and decrease subsequent symptomatology in adult survivors of interpersonal trauma.Highlights of the articleInterpersonal trauma survivors are distinguished primarily by a generalised elevation of their maladaptive schemas, rather than a unique schema profile comprised of specific schemas.A strong profile was formed in the domains of 'Disconnection' and 'Impaired Autonomy', where both presented with strong associations with psychopathological entities.CBT interventions should target schemas such as 'Vulnerable to Harm', to alleviate mental health distress in people with interpersonal trauma.

Coming to terms with oneself: a mixed methods approach to perceived self-esteem of adult survivors of childhood maltreatment in foster care settings

“…Results showed significantly lower emotional SE in adult IM survivors compared to the norm sample [ 38 ]. Although the observed effect was small, this finding is consistent with previous research reporting low emotional SE in other clinical samples [ 51 , 52 ]. Thus, we assume that experiencing IM negatively affects self-related associations and emotions, and supports our first hypothesis.…”

The Mediating Role of Early Maladaptive Schemas in the Relationship between Childhood Traumatic Events and Complex Posttraumatic Stress Disorder Symptoms in Older Adults (>64 Years)

“…The authors proposed a minimum number of participants to achieve 0.8 power depending on the magnitude of the estimated effect sizes for the 'a' and 'b' mediation pathways. Previous research (Foa, Ehlers, Clark, Tolin, & Orsillo, 1999;Karatzias et al, 2016;Wright, Crawford, & Del Castillo, 2009) has indicated large effect sizes for the 'a' and 'b' pathways. Based on these findings, a sample size of 36 was deemed appropriate.…”

“…Research examining the relative contribution of schema domains in PTSD severity has indicated a stronger association between schemas within the Disconnection and Impaired Autonomy domains and PTSD (Harding, Burns, & Jackson, 2012;Karatzias, Jowett, Begley, & Deas, 2016;Price, 2007).…”

“…The relationship between EMS and PTSD has been researched in the adult populations (Karatzias, et al, 2016), however, no studies have investigated the role of EMS in the development of CPTSD symptoms in older adults (> 64 years of age).…”

“…The study also sought to investigate the mediating role of second order schema factors in this association. It was hypothesized that EMS would mediate the relationship between childhood trauma and CPTSD severity, and based on previous research (Harding et al, 2012;Karatzias et al, 2016;Price, 2007), it was hypothesized that the second order schema factors of Disconnection and Impaired Autonomy would be significant mediating factors.…”