Early Maladaptive Schemas and Schema Modes in clinical disorders: A systematic review

Psychol Psychother. 2023 Sep;96(3):716-747. doi: 10.1111/papt.12465. Epub 2023 Apr 7.

Abstract

Purpose: Although schema therapy has been predominantly applied to treat personality disorders, interest into its application in other clinical disorders is growing. Central to schema therapy are Early Maladaptive Schemas (EMS) and Schema Modes. Since existing EMS and Schema Modes were primarily developed in the context of personality disorders, their relevance for clinical disorders is unclear.

Methods: We conducted a systematic review of the presence of EMS and Schema Modes in clinical disorders according to DSM criteria. Per disorder, we evaluated which EMS and Schema Modes were more pronounced in comparison with clinical as well as non-clinical control groups and which EMS and Schema Modes were most highly endorsed within the disorder.

Results: Although evidence concerning EMS was scarce for several disorders, and only few studies on Schema Modes survived inclusion criteria, we identified meaningful relationships and patterns for EMS and Schema Modes in various clinical disorders.

Conclusions: The present review highlights the relevance of EMS and Schema Modes for clinical disorders beyond personality disorders. Depending on the theme of the representation, EMS act as vulnerabilities both across diagnoses and for specific disorders. Thus, EMS and resulting Schema Modes are potential, valuable targets for the prevention and treatment of clinical disorders.

Keywords: Early Maladaptive Schemas; Schema Modes; clinical disorders; psychopathology; schema therapy; systematic review.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Adaptation, Psychological*
  • Humans
  • Personality Disorders* / therapy
  • Surveys and Questionnaires