Early maladaptive schemas (EMS) refer to negative beliefs and perceptions about oneself and relationships that originate in childhood and perpetuate psychological problems in adulthood.
Attachment theoryoriginally focused more on the emotional outcomes of early experiences but, over time, incorporated more cognitive elements like internal working models and scripts.
Attachment theory focuses on relational behavior, while schema theory focuses on conscious thoughts. The visible schemas can be seen as manifestations of the internal working models conceptualized in attachment theory.
Schema therapyproposes there are 18 early maladaptive schemas (EMS) that can be grouped into 5 higher-order domains, including: (1) disconnection rejection, (2) impaired autonomy, (3) impaired limits, (4) other-directedness, and (5) overvigilance/inhibition.
Schema therapy acknowledges attachment insecurity likely relates to endorsing maladaptive schemas, especially within the disconnection rejection domain.
Key Points
Rationale
Schema therapy proposes that EMS underlie many characterological issues that bring people into treatment. Research exploring links between adultattachment stylesand endorsement of certain EMS can provide insights into the cognitive architecture related to attachment insecurity.
Originally schemas were organized into 5 domains: disconnection/rejection, impaired autonomy/performance, impaired limits, other-directedness, and overvigilance/inhibition.
Existing research has typically only examined EMS in relation to broad “models of self and others” rather than exploring associations with specific adult attachment style dimensions (Brummet, 2007; De Paoli et al., 2017; Young et al., 2003).
No systematic review has quantified associations between attachment styles and schemas across domains using meta-analysis.
Method
Sample
Statistical Analysis
Results
Finds attachment anxiety relates to wider array of schemas than previously theorized:
Insight
Attachment theory offers an explanation for how early experiences shape internal working models about self and others. Schema therapy provides a framework for classifying and addressing the problematic beliefs and coping behaviors that may persist from those early experiences.
Quantifying the empirical links between adult attachment dimensions and maladaptive schema endorsement integrates these two theories in a novel way to advance clinical science and practice.
The findings illustrate potential value for therapists to assess clients’ attachment styles to formulate relevant schemas that may be driving presenting problems and tailor interventions accordingly.
The findings warrant future research on attachment-schema links in clinical groups and with interview measures. Research taking a micro and macro analysis approach could further unpack these associations.
Strengths
Limitations
Implications
Can help therapists case formulate and tailor interventions:
Differences in schema associations suggest presentation and coping may vary:
References
Primary reference
Karantzas, G. C., Younan, R., & Pilkington, P. D. (2023). The associations between early maladaptive schemas and adult attachment styles: A meta-analysis.Clinical Psychology: Science and Practice, 30(1), 1–20.https://doi.org/10.1037/cps0000108
Other references
Brummet, B. R. (2007). Attachment style, early maladaptive schemas, coping self-efficacy, therapy alliance and their influence on addiction severity in methadone-maintenance treatment [Doctoral dissertation, Fordham University].https://research.library.fordham.edu/dissertations/AAI3286413
De Paoli, T., Fuller-Tyszkiewicz, M., & Krug, I. (2017). Insecure attachment and maladaptive schema in disordered eating: The mediating role of rejection sensitivity.Clinical Psychology & Psychotherapy, 24(6), 1273–1284.https://doi.org/10.1002/cpp.2092
Johnson, B. N. (2023). Maladaptive schemas and attachment styles are two parts of the same iceberg: A commentary on Karantzas et al. (2022).Clinical Psychology: Science and Practice, 30(1), 24–25.https://doi.org/10.1037/cps0000126
Mercer, J. (2023). “Nothing either good or bad but thinking makes it so”: Commentary on “The association between early maladaptive schemas and adult attachment styles: A meta-analysis”.Clinical Psychology: Science and Practice, 30(1), 21–23.https://doi.org/10.1037/cps0000124
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003).Schema therapy: A practitioner’s guide. Guilford Press.
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Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
