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Cited by 6Child Abuse and TraumaPsychoanalysis and Psychopathology ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Early maladaptive schemas from child maltreatment in depression and psychotherapeutic remediation: a predictive coding framework

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Ramamurthy, Gita, Chen, Alan·2025·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2025.1548601PMC PMC12069367
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Abstract

Schemas are affective-cognitive conceptual models of self, others and the world, derived from life experience. Predictive Coding theory proposes schema are created from perceptual input as follows: Based on previous similar experiences, the brain generates schema, with “predictions,” expectations of future sensory experiences. Discrepancy between predicted versus actual experience produces a “prediction error.” Exposure to prediction errors considered more certain than the predictions of a schema prompts the hippocampus to update and revise the schema. Hypothesized underlying mechanisms include memory reconsolidation, extinction and pattern separation. Depression is characterized by negative schemas predicting helplessness, hopelessness and worthlessness. Early maladaptive schemas, from childhood, are implicated in mediating the greater risk of depression from childhood maltreatment. Prominent examples include the Defectiveness/Shame self-schema, predicting a flawed, unlovable self and the Social Isolation/Alienation schema, predicting isolation. Predictive Coding offers the following biopsychosocial hypothesis explaining how childhood maltreatment promotes depressogenic early maladaptive schema, and how psychotherapy can help: Schema can be difficult to change because of an attention/memory bias away from schema-incongruent information that generate prediction errors prompting schema revision. Childhood maltreatment exacerbates this learning bias. Maladaptive coping styles associated with childhood maltreatment, decrease exposure to experiences contradicting depressogenic schema. Biological changes from childhood maltreatment, including inflammation, interfere with hippocampal updating of schema. Finally, impaired socio-occupational function, associated with childhood maltreatment, reinforces depressogenic schema. By targeting factors associated with childhood maltreatment, which reinforce depressogenic early maladaptive schema or diminish prediction errors, psychotherapy can facilitate revision of depressogenic schema.

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Crossref · 10.3389/fpsyt.2025.1548601

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  • When considered alongside predictive coding theory, the ecological momentary assessment findings suggest that the high accessibility and frequency of digital interventions could provide users with more opportunities to encounter schema-disconfirming experiences in everyday contexts.

    “When these findings are considered alongside predictive coding theory, they suggest that the high accessibility and frequency of digital interventions could provide users with more opportunities to encounter schema-disconfirming experiences in everyday contexts.”

    From Schema-Informed Digital Mental Health Intervention for Maladaptive Cognitive-Emotional Patterns: Randomized Controlled Trial (2025) · cites this paper as [14]

    The paper’s “Psychotherapy revises EMS” section says that attention to schema-incongruent information may boost prediction errors involved in revising maladaptive schemas. That supports the predictive-coding premise, but the paper does not address ecological momentary assessment or whether the accessibility and frequency of digital interventions create more everyday opportunities for such experiences. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • The mechanism of prediction error and psychological updating underlies many traditional therapies such as CBT, ACT, and schema therapy, which create moments of disconfirmation to shift entrenched beliefs.

    “This mechanism underlies many traditional therapies such as CBT, acceptance and commitment therapy (ACT), and schema therapy, which create moments of disconfirmation to shift entrenched beliefs [14].”

    From Schema-Informed Digital Mental Health Intervention for Maladaptive Cognitive-Emotional Patterns: Randomized Controlled Trial (2025) · cites this paper as [14]

    In “Psychotherapy revises EMS,” the paper links CBT and schema therapy to updating maladaptive schemas and describes prediction error as important to that process. “Psychotherapy targets elements of self-reinforcing feedback loops” says ACT counters avoidant coping and a maladaptive schema, but does not specifically say ACT creates prediction errors. The paper presents these pathways as hypotheses, whereas the claim states the mechanism as established. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • When individuals encounter experiences that violate their expectations, prediction errors may prompt psychological updating.

    “When individuals encounter experiences that violate their expectations, for example, receiving acceptance when rejection is anticipated, prediction errors may prompt psychological updating.”

    From Schema-Informed Digital Mental Health Intervention for Maladaptive Cognitive-Emotional Patterns: Randomized Controlled Trial (2025) · cites this paper as [14]

  • Predictive coding models help explain how change in early maladaptive schemas is possible.

    “From a theoretical standpoint, predictive coding models help explain how such change is possible [14].”

    From Schema-Informed Digital Mental Health Intervention for Maladaptive Cognitive-Emotional Patterns: Randomized Controlled Trial (2025) · cites this paper as [14]

  • Early maladaptive schemas can be understood as internal models that guide perception by minimizing prediction error.

    “Early maladaptive schemas can be understood as internal models that guide perception by minimizing prediction error.”

    From Schema-Informed Digital Mental Health Intervention for Maladaptive Cognitive-Emotional Patterns: Randomized Controlled Trial (2025) · cites this paper as [14]

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Research works printed but not linked: 5

  1. [9]McQuaid JR Thase ME. Mood Disorders: Psychotherapy. In: Kaplan and Sadocks Comprehensive Textbook of Psychiatry, Tenth Edition. Wolters Kluwer Health, Philadelphia (2017).
  2. [22]Brockman RN Simpson S Hayes C Wijngaart Rvd Smout M. From Core Emotional Needs to Schemas, Coping Styles, and Schema Modes The Conceptual Model of Schema Therapy. In: Cambridge Guide to Schema Therapy (Cambridge Guides to the Psychological Therapies). Cambridge University Press. Kindle Edition, Melbourne, Australia (2023). p. 1– 15.
  3. [86]Brockman RN Simpson S Hayes C van der Wijngaart R Smout M. Research Supporting the Schema Therapy. In: Cambridge Guide to Schema Therapy (Cambridge Guides to the Psychological Therapies). Cambridge University Press. Kindle Edition, Cambridge, UK (2023). p. 16– 38.
  4. [158]Beck AT John RA Shaw BF Gary E DeRubeis Robert J Hollon SD. Integrating Cognitive Techniques. In: Cognitive Therapy of Depression. Guilford Publications. Kindle Edition, New York (2024). p. 95– 119.
  5. [159]Brockman RN Simpson S Hayes C van der Wijngaart R Smout M. Intervention Strategies for Schema Healing 3 Experiential Techniques. In: Cambridge Guide to Schema Therapy (Cambridge Guides to the Psychological Therapies). Cambridge University Press. Kindle Edition, New York, NY (2023). p. 150–84.

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Authors
Ramamurthy, G., & Chen, A.
Affiliations
  • SUNY Upstate Medical University (US)
  • University of Southern California (US)
Corresponding author
Ramamurthy, Gita
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2025-04-29
Volume
16
Pages
1548601-1548601
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2025.1548601
PMC
PMC12069367
OpenAlex
W4409957848
Cited by
5
References
163
Citations by year
2026: 4 · 2025: 1
FWCI
1.10
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
early maladaptive schemas, child abuse, depression, predictive coding, prediction error, memory reconsolidation, extinction, pattern separation, hippocampus, attentional bias, inflammation, biopsychosocial model

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