Cited by 223Personality Disorders and PsychopathologyAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

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A new look at the schema therapy model: organization and role of early maladaptive schemas

Bach, Bo, Lockwood, George, Young, Jeffrey E.·2018·Cognitive Behaviour Therapy

DOI 10.1080/16506073.2017.1410566

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Abstract

Bo Bacha** http://orcid.org/0000-0002-5744-1769, George Lockwoodb & Jeffrey E. Youngca Center of Excellence on Personality Disorder, Psychiatric Research Unit, Region Zealand, Denmarkb Schema Therapy Institute Midwest, Kalamazoo Center, Kalamazoo, MI, USAc Department of Psychiatry, Columbia University, New York, NY, USA* Corresponding author. Emails: bbpn@regionsjaelland.dk** bobachsayad@gmail.com Center of Excellence on Personality Disorder, Psychiatric Research Unit, Slagelse Psychiatric Hospital, Fælledvej 6, Bygning 3, 4200 Slagelse, DenmarkAbstractThis study reexamined the organization of Young’s 18 early maladaptive schemas and their hypothesized associations with experiences of need-thwarting parental experiences in childhood and the “vulnerable child” mode of emotional distress in adulthood. A large Danish sample (N = 1054) of 658 clinical- and 391 nonclinical adults completed measures of early maladaptive schemas, parenting styles, and the vulnerable child mode. We identified four higher-order schema domains as most appropriate in terms of interpretability and empirical indices (“Disconnection & Rejection”, “Impaired Autonomy & Performance”, “Excessive Responsibility & Standards”, and “Impaired Limits”). All four schema domains were differentially associated with conceptually relevant need-thwarting parental experiences. Apart from “Impaired Limits”, the schema domains meaningfully accounted for the association between need-thwarting parental experiences in childhood and emotional states of feeling like a “vulnerable child” in adulthood. We conclude that four domains of early maladaptive schemas are empirically and conceptually consistent with Young’s schema therapy model of personality pathology and longstanding emotional disorders. Findings warrant replication using different populations and if possible a prospective multi-method design. A scoring key for computing the four schema domains is provided.

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“The authoritarian parenting style uses methods of discipline that contribute decisively to the vulnerability of personality and aggressive/intimidating behavior or victimization (Bach et al., 2018).”
Method
Anger and psychological symptoms relationship: mediator role of maladaptive schemas
Özmen, A. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1183618 · Cited by 7
“They are psychological constructs that individuals believe to be unconditionally true for them, for the world, and for others (Bach et al., 2018; Farrel and Shaw, 2018).”
Background
Personality and motivation of physical activity in adolescent girls: effects of perceived parental support and social physical anxiety
Fathirezaie, Z., Bădicu, G., Yağın, F. H., Aghdasi, M. T., Sani, S. H. Z., Abbaspour, K., Ballı, Ö. M., Entezar, S., & Ardigò, L. P. (2024) · BMC Public Health · doi:10.1186/s12889-024-18060-5 · Cited by 7
“For example, a study by Bach et al. [22] found that a father’s need thwart-ing behaviors can lead to an increased risk of emotional disorders among their children.”
Background
Predicting psychological need satisfaction and frustration from early maladaptive schemas and DSM-5 and ICD-11 personality traits
Thimm, J. C. (2024) · Current Psychology · doi:10.1007/s12144-024-05889-7 · Cited by 11
“…(negative beliefs about one’s ability to function independently and perform successfully), impaired limits (beliefs about grandiosity and the lack of self-control), and exaggerated responsibility and standards (early mal-adaptive schemas involving high internal standards) (Bach et al., 2018 ).”
Exploring Exercise Addiction, Self-Esteem, and Early Maladaptive Schemas: A Cross-Sectional Study Among Female University Students
Olave, L., Díez, I. I., Macía, P., Momeñe, J., Estévez, A., Muñiz, J. A., & Peñacoba, C. (2025) · Healthcare · doi:10.3390/healthcare13040422 · Cited by 8
“In this regard, it has been noted that Impaired Limits and Over-Vigilance are less associated with self-esteem because they focus more on externalized behaviors (e.g., lack of boundaries) or rigid coping strategies (e.g., perfectionism) [101].”
Early Maladaptive Schemas as Core Therapeutic Targets in Eating Disorders and Obesity: A Schema Therapy–Informed Network Analysis
Aloi, M., Rania, M., Carbone, E. A., de Filippis, R., D’Onofrio, E., Rotella, L., Quirino, D., Simpson, S., & Segura‐Garcìa, C. (2025) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70153 · Cited by 7
The Influence of Early Maladaptive Schemas on Recovery and Psychological Capital in Borderline Personality Disorder Clients: Findings From Rural Dwelling Sample
Atta, M. H. R., Abdelrazek, M. N., Rahman, A. A. A. O. A., & Eweida, R. S. (2024) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.13148 · Cited by 8
Assessing self-schema content: The relationship of psychological needs to early maladaptive schemas, rejection sensitivity, and personality traits
Scott, W. D., Tyser, J., Penningroth, S. L., & Strauch, C. (2021) · Self and Identity · doi:10.1080/15298868.2021.1895882 · Cited by 8
“Similarly, schema therapy views the frustration of basic psychological needs for relatedness to others, competence, autonomy, and self-control as responsible for the development of early maladaptive schemas (Bach et al., 2018).”
BackgroundResultInfluential
Connecting DSM‐5 and ICD‐11 trait domains with schema therapy and dialectical behavior therapy constructs
Tracy, M., Sharpe, L., Bach, B., & Tiliopoulos, N. (2022) · Personality and Mental Health · doi:10.1002/pmh.1574 · Cited by 7
Self-citation
Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis
Aazh, H., Langguth, B., & Danesh, A. A. (2018) · International Journal of Audiology · doi:10.1080/14992027.2018.1514470 · Cited by 7
Evaluation of Early Maladaptive Schemas and Adult Attachment Profiles in Patients Diagnosed with Major Depressive Disorder and Examination of Their Relationship with Disease Variables
Özaslan, E. A., Türkili, S., & Acar, Ş. T. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm14010170 · Cited by 5
“Dysfunctional schemas that fail to meet core needs are referred to as early maladaptive schemas [9].”
Psychological predictors of eating Behavior: The role of maladaptive schemas and emotion regulation across BMI, gender, and age groups
Obara-Gołębiowska, M. (2025) · Appetite · doi:10.1016/j.appet.2025.108243 · Cited by 9
Effect of Two Couple Therapies, Acceptance and Commitment Therapy and Schema Therapy, on Forgiveness and Fear of Intimacy in Conflicting Couples
سبحانی, ف. ف., Shiroudi, S. G., & Khodabakhshi‐Koolaee, A. (2021) · Practice in Clinical Psychology · doi:10.32598/jpcp.9.4.746.3 · Cited by 6
RESPONSIBILITY OF THE EMPLOYERS AND EMPLOYEES IN HUNGARY: THE IMPORTANCE OF HYGIENE DURING THE PANDEMIC
Poór, J., Szalai, S. V. M., Jenei, S., & MOLNÁR, J. (2021) · Acta Oeconomica Universitatis Selye · doi:10.36007/acta.2021.10.2.7 · Cited by 6
A bibliometric analysis of the quantitative schema therapy literature
Pilkington, P. D., & Karantzas, G. C. (2024) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2963 · Cited by 12
A Model of Core Emotional Needs and Toxic Experiences: Their Links with Schema Domains, Well-Being, and Ill-Being
Louis, J. P., Lockwood, G., & Louis, K. M. (2024) · Behavioral Sciences · doi:10.3390/bs14060443 · Cited by 6
“Given the trend in the research, it was hypothesized that a four-category model of unmet needs by Bach et al. [27] associated with toxic experiences would emerge as the most robust.”
BackgroundMethodResultInfluentialSelf-citation
Dysfunctional Parenting and Psychological Symptomatology: An Examination of the Mediator Roles of Anger Representations in the Context of the Schema Therapy Model
Gülüm, İ. V., & Soygüt, G. (2020) · Psychological Reports · doi:10.1177/0033294120971762 · Cited by 6
“(2003) defined 18 different schemas and, related, 5 schema domains based on the conceptualization of core emotional needs (Bach et al., 2018; Lockwood & Perris, 2012).”
Background
A preliminary study: designing and validating projective images of Young’s early maladaptive schema (EMS) domains
Siahmoshtei, J., Delāvar, A., & Borjali, A. (2021) · BMC Psychology · doi:10.1186/s40359-021-00514-9 · Cited by 6
“[5] reported four schema domains in the Danish community in an empirical and conceptual sense based on Young’s schema therapy model, personality pathology, and chronic emotional disorders.”
Background
The Cyberball task in people after obesity surgery: preliminary evaluation of cognitive effects of social inclusion and exclusion with a laboratory task
Meneguzzo, P., Tenconi, E., Collantoni, E., Longobardi, G., Zappalà, A., Vindigni, V., Favaro, A., & Pavan, C. (2021) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-021-01297-z · Cited by 6
Early Maladaptive Schemas and the Accuracy of Facial Emotion Recognition: A Preliminary Investigation
Panić, D., Mitrović, M., & Ćirović, N. (2022) · Psychological Reports · doi:10.1177/00332941221075248 · Cited by 6
“To this end, it should be noted that the psychometric structure of schemas is invariant across clinical and non-clinical samples (Bach et al., 2017; Saggino et al., 2018).”
Background
Early maladaptive schemas and perceived impact of COVID-19: the moderating role of sex and gambling
Estévez, A., Macía, L., Diego, G. A., & Herrero, M. (2023) · Current Psychology · doi:10.1007/s12144-023-05337-y · Cited by 6
“Finally, Aloi et al. (2020) concluded that gamblers presented higher rates in the “impaired autonomy and performance” and “impaired limits” schema domains (see Bach et al., 2018).”
Early Adaptive Schemas and Sexual Wellbeing in Women: Exploring Differences in Menopausal Status
Allen, A., & Tully-Wilson, C. (2023) · International Journal of Applied Positive Psychology · doi:10.1007/s41042-023-00100-x · Cited by 5
“Young (2003) described how schema form in early childhood and adolescence, depending on whether emotional needs such as attachment, autonomy, and emotional expression are satisfied, leading to early adaptive schema;, or impeded, leading to early maladaptive schemas (Bach et al., 2018; Oliveira & Nobre, 2013; Young et…”
Early Maladaptive Schemas and Online Pornography Use: A Cross-Sectional Study
Vieira, C. H., Kuss, D. J., & Griffiths, M. D. (2025) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-025-01463-9 · Cited by 5
“This is in line with the Impaired Limits schema domain, which is characterised as an inability to maintain or understand appropriate internal and interpersonal limits and a lack of respect and responsibility to others (Young et al., 2003).”
Influential
Advances in research and adaptive expressions of entitlement: a mini review
George‐Levi, S. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1689011 · Cited by 5
“…trait and a context-dependent belief shaped by environmental factors, and in the schema model, which conceptualizes entitlement as a self-regulatory process rooted in early experiences and activated when perceptions of fairness, self-worth, or control are threatened (Bach et al., 2018).”
Early Maladaptive Schemas and Celebrity Worship: The Mediating Role of Sense of Coherence and Difficulty in Emotion Regulation
Fazelirad, H., Mohammadkhani, S., Mafakheri, A., Arezoumandi, Z., & Griffiths, M. D. (2025) · Psychiatric quarterly · doi:10.1007/s11126-025-10151-9 · Cited by 4
“However, a more recent factor analysis conducted by Bach et al. [4] suggested that a four-domain model of schemas might be more valid and empirically sound (i.e., ‘discon-nection and rejection’, ‘impaired autonomy and performance’, ‘excessive responsibility and standards’, and ‘impaired limits’).”
Cuestionario de esquemas de Young CEY-S3: Propiedades psicométricas en una muestra chilena mixta
Quiñones, Á., Ramírez, P., Cid, J., Roberto Melipillán, A., Ugarte, C. A., & Florenzano, R. U. (2018) · Terapia psicológica · doi:10.4067/s0718-48082018000300144 · Cited by 5
Çocukluk dönemi mutluluk ve huzur anılarının bilişsel şemalar ve psikolojik semptomlarla ilişkisi
Yılmaz, H. (2019) · Erken Çocukluk Çalışmaları Dergisi · doi:10.24130/eccd-jecs.1967201932116 · Cited by 5
Profiles and transitions of non-suicidal self-injury with addictive features in adolescents: Predictive role of maladaptive cognitive schemas
Zhou, Q., Liang, Y., & Liu, X. (2025) · Journal of Behavioral Addictions · doi:10.1556/2006.2025.00065 · Cited by 4
“Maladaptive schemas are categorized into four domains: (1) disconnection and rejection; (2) impaired autonomy and performance; (3) excessive responsibility and standards; and (4) impaired limits (Bach, Lockwood, & Young, 2018).”
Influential
The predictive roles of self-compassion, perceived social support, and psychological flexibility in early maladaptive schemas among college students: an exploration based on latent profile analysis
Zhang, S., Liu, Q., Jia, M., Zhang, Q., & Zhang, L. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1619308 · Cited by 4
The Multiple Perspectives Approach to Understanding Sexual-Economic Exchange
Meskó, N. (2025) · Archives of Sexual Behavior · doi:10.1007/s10508-025-03259-3 · Cited by 6
“Often referred to as core beliefs or early maladaptive schemas, these cognitive structures develop in response to unmet emotional needs during childhood, such as secure attachment, self-regulation, emotional expression, and realistic boundaries (Bach et al., 2018).”
A new model for basic needs: comparison of the second order factorial structures of young schema questionnaire and its relationship with symptoms of psychopathology
Karaosmanoğlu, H. A., Karaca, B. K., Aytaç, M., & Küçükseymen, Z. C. A. (2024) · Current Psychology · doi:10.1007/s12144-024-06157-4 · Cited by 4
“In the current study, this single fac - tor loaded on the overvigilance domain, whereas in Bach et al. ( 2017a ), Pessimism was a main factor in the disconnection domain, and it was suggested that it also had a place Informed consent Informed consent was obtained from all individual participants…”
Influential
Examining the Effects of Ostracism and Overinclusion in the Eating Disorder Binge Spectrum: Evidence From a Controlled Cyberball Task
Meneguzzo, P., Mico, A. D., Collantoni, E., Meregalli, V., Tenconi, E., & Favaro, A. (2025) · European Eating Disorders Review · doi:10.1002/erv.70007 · Cited by 4
The relationship between early maladaptive schemas and attachment
Lukáč, J., & Popelková, M. (2020) · Pomáhajúce profesie · doi:10.17846/pp.2020.3.1.5-19 · Cited by 6
Working in the Dark? Exploring the Relationship Between the Dark Triad and Early Maladaptive Schemas
Ray, S. J., & Fritzon, K. (2024) · Trends in Psychology · doi:10.1007/s43076-024-00374-3 · Cited by 4
“Unrelenting Standards and Punitiveness EMSs belong in the Excessive Responsibility and Standards EMS domain (Bach et al., 2018) and are hypothesized to develop within a family origin that is strict and punitive and emphasizes adherence to the rules (Young et al., 2003).”
Influential
“Longing to be cared about and cared for” Exploring Experiences of Trauma Therapy and Views on Future Trauma Therapy (Including Digital) for Young People in Rural Northern Sweden
Wallin, L., Lundqvist, U., Svedin, C. G., & Dennhag, I. (2024) · Children and Youth Services Review · doi:10.1016/j.childyouth.2024.107953 · Cited by 3
Adaptive Schema Domains: Validation and Higher-Order Structure of the Young Positive Schema Questionnaire in a Sample of Flemish Emerging Adults
Coenye, J., Verbeken, S., Goossens, L., Louis, J. P., & Beyers, W. (2025) · Journal of Personality Assessment · doi:10.1080/00223891.2025.2478032 · Cited by 3
“In the development of the YPSQ, Louis et al. (2018) developed their 14 schemas based on the revised model (Bach et al., 2018) and proposes a four domain solution for EAS: Connection/Acceptance, Healthy Autonomy, Reasonable Limits, Healthy & Realistic Standards.”
Influential
Attachment styles, maladaptive cognitive schemas, and relationship satisfaction: A multilevel analysis of romantic relationships
Ginalska, K., & Cichopek, A. (2025) · Personality and Individual Differences · doi:10.1016/j.paid.2025.113380 · Cited by 3
The relationship between childhood trauma, early maladaptive schema and alexithymia: a multi-group path model of clinical and non-clinical samples
Zhang, Q., Liu, Q., Jia, M., Zhang, S., Zhang, L., & Cong, Z. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1754917 · Cited by 3
“Within this schema domain, individuals come to believe that their needs for belonging, love, care, safety, and stability cannot be met in any relationship, which predisposes them to higher levels of alexi-thymia (Bach et al., 2018).”

Authors: Bach, B., Lockwood, G., & Young, J. E.
Affiliations: Region Zealand (DK)
Schema Therapy Institute Midwest, Kalamazoo Center, Kalamazoo, MI, USA
Columbia University (US)
Corresponding author: Bach, Bo
ORCID: Bach, Bo
Venue: Cognitive Behaviour Therapy
Publisher: Informa UK Limited
Published: 2017-12-19
Volume: 47
Issue: 4
Pages: 328-349
ISSN: 1650-6073 (ISSN-L)
1651-2316
DOI: 10.1080/16506073.2017.1410566
OpenAlex: W2779355268
Cited by: 222
References: 54
Citations by year: 2026: 19 · 2025: 51 · 2024: 36 · 2023: 36 · 2022: 23 · 2021: 23 · 2020: 15 · 2019: 11 · 2018: 8
FWCI: 11.51
Type: journal article
Language: en
Open access: closed
Locations: Cognitive Behaviour Therapy (publishedVersion)
PubMed (publishedVersion)
Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: schema therapy, early maladaptive schemas, parental experiences, personality pathology, emotional distress, disconnection and rejection, impaired limits
MeSH terms: Adolescent, Adult, Aged, Anxiety, Denmark, Depression, Female, Humans, Male, Middle Aged, Parent-Child Relations, Parents, Personality Disorders, Surveys and Questionnaires, Stress, Psychological, Case-Control Studies, Parenting, Personal Autonomy, Young Adult

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A new look at the schema therapy model: organization and role of early maladaptive schemas

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