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A new look at the schema therapy model: organization and role of early maladaptive schemas
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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“Because these underlying structures are recognized as contributing to psychological suffering, many therapeutic approaches target them to foster long-term change [10-13].”
From Schema-Informed Digital Mental Health Intervention for Maladaptive Cognitive-Emotional Patterns: Randomized Controlled Trial (2025) · cites this paper as [10]
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“Schema-linked difficulties, such as perfectionism, rejection sensitivity, social withdrawal, and anxious overcontrol, are well-known contributors to long-term distress and functional impairment if left unaddressed [10].”
From Schema-Informed Digital Mental Health Intervention for Maladaptive Cognitive-Emotional Patterns: Randomized Controlled Trial (2025) · cites this paper as [10]
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“Schema domains have recently been reorganized (Bach et al., 2018; Yalcin et al., 2020) into four domains based on factor analyses.”
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“Based on the unmet core emotional needs, Young et al. (2006) identified 18 schemas organized into four domains (Bach et al., 2018) summarized below (see appendix A of Bach et al., 2018, for full list of schemas and definitions).”
Metadata
- 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
- 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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