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

BACKGROUND: Although 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. OBJECTIVE: We 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. METHOD: Participants completed measures of trauma, psychopathology, dissociation, self-esteem, and the Young Schema Questionnaire. RESULTS: It 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. CONCLUSIONS: Our 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 ARTICLE: Interpersonal 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.