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

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. 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. Participants completed measures of trauma, psychopathology, dissociation, self-esteem, and the Young Schema Questionnaire. 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. 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. 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. 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.尽管已有大量文献证实心理创伤与早期适应不良图式（early maladaptive schemas, EMS）之间存在关联，但截至目前，尚无研究在人际创伤成年幸存者样本中探讨EMS与创伤后应激障碍（post-traumatic stress disorder, PTSD）以及抑郁、焦虑之外的其他精神病理障碍的关联。此类信息有助于我们深化对人际创伤最优治疗方案的理解。本研究旨在纳入有人际创伤史的女性样本（n=82），探讨EMS与各类常见精神病理障碍的关联。我们提出如下假设：与非临床对照组（n=78）相比，人际创伤幸存者的EMS得分会显著升高。此外我们还假设：特定图式将与特定精神病理亚型相关联，且本研究的人际创伤幸存者样本中存在不同亚组，各亚组的图式严重程度升高模式存在差异。所有参与者完成了创伤、精神病理、解离、自尊相关量表以及杨氏图式问卷（Young Schema Questionnaire）的测评。研究结果显示，与对照组相比，人际创伤幸存者在全部15种图式上的得分均显著升高。尽管不同精神病理特征与图式之间的关联模式看似相当复杂，但本研究中，"脱离与自主功能受损（Disconnection and Impaired Autonomy）"领域的图式与所有精神病理特征均存在显著关联。本研究结果支持，针对"脱离与自主功能受损"领域图式的认知行为干预，可帮助人际创伤成年幸存者修正其核心信念并减轻后续症状。人际创伤幸存者的主要特征是其适应不良图式呈现广泛性升高，而非由特定图式构成的独特图式模式。"脱离"与"自主功能受损"领域形成了显著的图式特征，二者均与精神病理亚型存在强关联。认知行为干预（CBT）应针对诸如"易受伤害（Vulnerable to Harm）"这类图式，以缓解人际创伤人群的心理健康困扰。人际创伤幸存者的主要特征是其适应不良图式呈现广泛性升高，而非由特定图式构成的独特图式模式。"脱离"与"自主功能受损"领域形成了显著的图式特征，二者均与精神病理亚型存在强关联。认知行为干预（CBT）应针对诸如"易受伤害（Vulnerable to Harm）"这类图式，以缓解人际创伤人群的心理健康困扰。