Scrupulosity is treated as a particular presentation of the symptomatology characteristic for obsessive-compulsive disorder (OCD). However, typical treatment of OCD (e.g. cognitive-behavioral therapy) is less effective in the case of religious scruples. Recently, schema therapy has appeared as an alternative effective treatment in obsessive-compulsive symptomatology. The present study investigated the associations between early maladaptive schemas (EMSs) and scrupulosity in a non-clinical sample of 376 poles. The participants assessed their EMSs with the Young Schema Questionnaire 3 - Short Form and their scrupulosity with the Pennsylvania Inventory of Scrupulosity. We used network analysis to control for the EMS interconnectivity. We showed that accounting for the interactions within the EMSs, three schemas, namely, Punitiveness, Subjugation, and Enmeshment/Undeveloped Self, were positively correlated with scrupulosity. Given the central position of the Negativity/Pessimism schema in the examined network, we suggested that activation of this schema could be indirectly correlated to scruples via an escalation of activation to the Punitiveness, Subjugation, and Enmeshment schemas. The findings suggest that dependency and fear of rejection problems (present in Subjugation and Enmeshment EMSs) and over-compensation by perfectionism (present in Punitiveness EMS) could be addressed in the treatment of scruples.

Culture is a central theme across various theories and disciplines, influencing behavior and self-perception through interactions within social groups, families, and legal systems. This influence extends to the general population and particularly impacts sexual and gender minorities (SGMs), resulting in minority stress that contributes to mental health issues and the development of Early Maladaptive Schemas (EMSs). Adolescents within these groups face typical developmental stressors-such as hormonal changes and societal pressures-compounded by prejudice, increasing their vulnerability to depression, anxiety, stress, substance abuse, and eating disorders. Despite these challenges, Schema Therapy (ST) lacks comprehensive studies on the sociocultural aspects influencing EMS acquisition in SGM adolescents. This theoretical review aims to fill this gap by exploring the impact of society and culture on EMS development within SGM adolescents. We recognize the broad spectrum of cultural influences and emphasize the importance of cultural sensitivity and diversity. This review specifically addresses how societal and cultural dynamics impact SGM individuals, acknowledging that while ethnic or other cultural factors are not the focus of this paper, they merit future research. This manuscript will discuss central topics and their impact on LGBTQIA+ youth, including (1) the background (definition of culture, lack of studies on ST focusing on culture, and studies on adverse psychological outcomes), (2) minority stress theory and prejudice against sexual and gender diversity (distal and proximal stressors and sociocultural aspects), (3) EMSs and unmet emotional needs, (4) ST affirmative strategies (working with schema modes, imagery rescripting, chair work, and photo techniques), and (5) final considerations (limitations and research agenda).

This article describes the 1-year follow-up of a study into the effectiveness of Schema Therapy (ST) for borderline personality disorder (BPD) and comorbid alcohol use disorder (AUD). In the original study, 20 of these patients participated in a multiple baseline case series design study. The results of the original study were promising (a significant decrease of BPD and AUD symptoms). The present study is aimed at examining the longer term benefits of ST for BPD and comorbid AUD. One year after the cessation of the investigational therapy, 17 of the original participants agreed to participate in this follow-up study. T- or Wilcoxon signed rank tests were performed to compare 1-year follow-up to start of therapy (baseline). The results suggest that the main therapeutic improvements were generally preserved at 1-year follow-up. These findings add to the idea that integrated ST for BPD and comorbid AUD might be effective, also in the long term. A randomized clinical trial is indicated to substantiate this idea.

Background: Posttraumatic stress disorder (PTSD) is associated with high rates of cluster C personality disorders (PD), which may negatively affect PTSD treatment. It is unknown whether concurrent treatment for PTSD and comorbid PD leads to superior treatment effects, compared to standard trauma-focused treatment.Objective: The objective was to test the efficacy of adding personality disorder treatment (group schema therapy; GST) to individual trauma-focused treatment (imagery rescripting; ImRs).Method: A two-arm randomized clinical trial (1:1 allocation ratio) was conducted between 2018 and 2023 at two sites of a mental health institution in the Netherlands. Raters were blind to treatment allocation. Adult outpatients with PTSD and comorbid cluster C personality disorders were randomized to receive either ImRs (12-18 sessions) or ImRs + GST (12-18 ImRs + 52-58 GST). The main outcome was PTSD severity one year after start of treatment measured with the Clinician-Administered PTSD Scale for DSM-5.Results: Of 130 patients (mean [SD] age = 40.6 [11.2], 110 [85%] females), 66 were assigned to ImRs and 64 to ImRs + GST. At 12 months, there were large decreases in PTSD severity (dImRs = 2.42, 95%CI = 1.97-2.87; dImRs + GST = 2.44, 95%CI = 1.99-2.90), but there was no significant difference between conditions (d = 0.02, 95%CI = -0.33-0.36, p = .944). Reductions in personality disorder symptoms and all other secondary outcomes were observed in both conditions. There were no significant differences between conditions on any of the secondary outcomes at 12 months.Conclusion: The more intensive concurrent trauma-focused and personality disorder treatment (ImRs + GST) was not superior to trauma-focused treatment alone (ImRs) for patients with PTSD and comorbid CPD. This suggests that trauma-focused treatment is the preferred primary treatment in patients presenting with both internalizing personality disorder and PTSD, reserving the stepping up to more intensive psychotherapy aimed at the personality disorder as a second line of treatment.Trial registration: ClinicalTrials.gov identifier: NCT03833531.
Concurrent trauma-focused and personality disorder treatment was not superior to only trauma-focused treatment for patients with posttraumatic stress disorder (PTSD) and comorbid cluster C personality disorders.Large reductions in PTSD severity and medium-to-large reductions in all secondary outcomes, including personality disorder symptoms, were observed in both treatment arms.These findings are remarkable, given the higher therapy dosage and specialized treatment for personality disorder comorbidity in the combined treatment arm.

UNASSIGNED: Gold-standard approaches for chronic tinnitus involve hearing amplification measures and psychological therapy, where applicable. Whilst schema therapy is accumulating evidence as a transdiagnostically useful treatment framework, its applicability for patients with chronic tinnitus has not yet been examined. The present study (a) explores latent dimensions of psychological distress in a sample of chronic tinnitus patients, and (b) examines whether the schema mode model might explain these dimensions - thus constituting a potentially helpful conceptualization and treatment framework.
UNASSIGNED: N = 696 patients with chronic tinnitus completed the Tinnitus Questionnaire, Tinnitus Handicap Inventory, Hospital Anxiety and Depression Scale, Perceived Stress Questionnaire and ICD-10 Symptom Rating. As criterion, patients further completed the Schema Mode Inventory (SMI-r) - which assesses psychological constructs linked to negative self-beliefs (\"parent modes\"), primary emotions resulting from unmet psychological needs (\"child modes\"), and secondary emotional or behavioral attempts to reinstate or maintain psychological equilibrium (\"coping modes\"). A varimax-rotated principal axis factor analysis grouped the primary item pool. Factor scale scores were then correlated with the SMI-r.
UNASSIGNED: A three-factor solution explained 37.4% of variance and represented 78% of the included items. Following item content examination, the factors represented (1) General emotional distress, (2) Tinnitus-attributed emotional distress, and (3) Socio-audiological impairment. Factors 1|2 correlated highly (r = 0.70), Factors 2|3 moderately (r = 0.62). Linked to the schema mode model, Factor 1 correlated highly with the \"vulnerable child\" (r = 0.78), and moderately with the \"parent\", \"angry child\", and \"detached protector\" modes (0.53 < r < 0.65). Factor 2 correlated moderately with the \"vulnerable child\" (r = 0.53). Factor 3 was largely uncorrelated with SMI-r scores - although a low correlation with the \"detached protector\" warrants further examination.
UNASSIGNED: \"General\" and \"tinnitus-attributed\" emotional distress correlate highly - warranting holistic (not symptom-specific) psychological case conceptualization and treatment planning. Viewed from a schema mode perspective, the \"vulnerable child\" explains substantial variance across both dimensions. Consequently, autobiographically anchored, unmet emotional needs and emotional detachment constitute key treatment targets. Social-audiological impairment should be multimodally conceptualised and treated with hearing aids and psychological support measures, as applicable.

BACKGROUND: Schema therapy is promising for people with eating disorders, especially those unresponsive to cognitive behavioural therapy. Complex underlying psychological constructs include dysfunctional schemas and maladaptive modes. This study aimed to explore people living with eating disorders\' schema modes and their identification with and understanding of their high scoring modes.
METHODS: Sixteen women with enduring eating disorders without prior exposure to schema therapy completed the schema mode inventory for eating disorders short form (SMI-ED-SF), then participated in semi-structured interviews discussing their high scoring modes. Interviews were analysed by thematic analysis.
RESULTS: All participants scored above clinical concern on at least one maladaptive mode and many scored high on multiple modes, most commonly Demanding Mode, Vulnerable Child and Detached Self-Soother. Qualitatively, four themes emerged: 1) Adverse family environments related to (a) trauma and the vulnerable and angry child and (b) unrealistically high standards; 2) Mode effects on (a) everyday life and (b) disordered eating; 3) Modes are psychologically protective in (a) avoiding emotion by detachment and soothing, (b) people pleasing by compliance and surrender; 4) Help seeking including (a) barriers to recovery from an eating disorder, (b) dissatisfaction with interventions experienced to date, (c) schema therapy as a promising alternative.
CONCLUSIONS: Participants recognised and identified with their high scoring schema modes. After negative experiences with previous interventions, they considered schema therapy to be a promising alternative that could understand and work on their deeper psychological issues. This suggests that schema modes are a promising way of understanding and working with enduring eating disorders.
Maladaptive modes are important in Schema Therapy for eating disorders. They are momentary patterns of thought, feeling and behaviour, triggered by experiences to which people with eating disorders can be oversensitive. In a child mode the person may be inexplicably childish. A coping mode may involve detachment, surrender to others, or perfectionist overcompensation. A parent mode may involve unrealistic standards and demands. There are also two healthy modes of Healthy Adult and Happy Child, which are often lacking in people with eating disorders. In this study women with enduring eating disorders completed the schema mode inventory and then discussed their high scoring modes. Common maladaptive modes were vulnerable child, demanding parent mode and perfectionistic over-compensator. Participants identified with their high scoring modes and thought them useful for self-understanding, so schema therapy is a promising way of understanding the psychopathology underlying enduring eating disorders.

UNASSIGNED: There are significant temporal and financial barriers for individuals with personality disorders (PD) receiving evidence-based psychological treatments. Emerging research indicates Group Schema Therapy (GST) may be an accessible, efficient, and cost-effective PD intervention, however, there has been no synthesis of the available evidence to date. This review therefore aimed to investigate the efficacy of GST for PDs by systematically synthesizing available literature.
UNASSIGNED: Five electronic databases were screened with resulting studies subjected to a specific eligibility criteria, which yielded fourteen relevant studies. Characteristics were extracted and methodological quality rigorously assessed.
UNASSIGNED: Strong support was evidenced for GST\'s ability to reduce Cluster B and C symptomology, particularly for Borderline and Avoidant PD. GST appeared to improve global symptom severity, quality of life and functional capacity, as well as treatment targets such as schemas and modes.
UNASSIGNED: Although not without limitations and a moderate risk of bias, the current body of evidence supports GST as a potential solution to current service deficits in economical and evidence-based care for individuals with PD. Implications for treatment and future research are discussed.

UNASSIGNED: Despite the growing interest in the early maladaptive schemas, the progress in understanding their impacts is decelerated by a lack of clear understanding of their structure. Different composite scores are calculated without a solid ground or a clarified meaning. Here we explain that the schema variance can be theoretically decomposed into three components: schema-specific, domain-specific due to the unmet core needs, and the common variance we call general susceptibility; each can differentially correlate with other substantive variables. Using this framework, we empirically examine the structure of schemas and their relationships to facial emotion recognition, a crucial ability that can widely affect our social interactions.
UNASSIGNED: A sample of adults completed an emotion recognition task and the Young Schema Questionnaire. Using different factor models, the specific and shared variance across schemas was analyzed. Then, the relation of these variance components to facial emotion recognition was explored.
UNASSIGNED: A general factor explained 27%, 40%, and 64% of the total variance in items, schemas, and domains, respectively. Partialling out the common variance, there was little domain-specific variance remained. Regarding facial emotion recognition, they were not correlated with specific schemas; however, the general susceptibility factor was correlated with anger recognition.
UNASSIGNED: The variance decomposition approach to schemas, which uses the bifactor model, may offer a clearer way to explore the impacts of schemas. While domain scores are widely used, their reliability, validity, and meaning are questionable. The generic factor, which is consistently extractable from empirical data, requires further attention.

Research suggests that individuals who commit crimes often exhibit various early maladaptive schemas (EMSs). EMSs are a broad and pervasive theme or pattern consisting of memories, emotions, cognitions, and bodily sensations concerning oneself and one\'s relationships with others. Furthermore, EMSs play a crucial role in the onset and maintenance of different types of offending behaviors, highlighting the need to implement schema therapy (ST) for perpetrators. Therefore, the present systematic review assesses the effectiveness of ST for individuals who committed crimes. Four databases (PubMed, Scopus, Web of Science, and Scielo) were searched for studies examining the effectiveness of ST for individuals who committed crimes. Seventeen studies were identified, but only 15 met the criteria for inclusion. Results showed that ST can lead to beneficial effects in EMSs, schema modes, personality symptoms, and risk factors to commit crimes (e.g., cognitive distortions). However, the studies, besides being scarce, revealed some methodological limitations. ST is a promising therapy for individuals who committed crimes, despite the studies\' methodological shortcomings, which prevent us from drawing more firm conclusions. Although promising, more research is needed to enhance our understanding of the impact of ST therapies in forensic settings.

UNASSIGNED: The relationship between entertainment preferences and personality traits has previously been addressed in a few studies. However, there are no studies evaluating this relationship within the scope of the schema theory. We planned to evaluate the relationship between early maladaptive schemas (EMS) and music and movie preferences. In this study, the research team created a survey on the 8 most preferred film and music categories in social media platforms in Turkey.
UNASSIGNED: A sociodemographic data form and the Young Schema Questionnaire - Short Form 3 were applied to 389 participants. Our findings emphasize the relationship between EMS, schema domains, and entertainment preferences.
UNASSIGNED: In particular, we found significant effects of the Disconnection and Rejection, Impaired Autonomy and Performance, and Impaired Limits schema domains. Even after controlling for age and gender, we found interesting relationships.
UNASSIGNED: Early maladaptive schemas have important effects on entertainment preferences. A better understanding of these relationships can provide us with more information on the reflections of personality on daily life.