Early maladaptive schemas and ICD-11 CPTSD symptoms: Treatment considerations

Lee Greenblatt-Kimron, Thanos Karatzias, Maya Yonatan, Adi Shoham, Philip Hyland, Menachem Ben-Ezra, Mark Shevlin

Research output: Contribution to journalArticlepeer-review


Objectives: Early maladaptive schemas (EMS) can result from adverse interpersonal traumatic experiences. The ICD-11 updated the concept of disorders following traumatic experiences with the new disorder of complex post-traumatic stress disorder (CPTSD). There is now a need to develop and test interventions for CPTSD. An essential step in identifying interventions that are particularly relevant to the treatment of CPTSD is to explore psychological constructs associated more closely with CPTSD compared to PTSD. The current study explored the associations of EMS with PTSD and CPTSD. Design: The sample consisted of 603 adults (mean age = 41.65, SD = 13.8), recruited through social media and e-mails, and who responded to an online questionnaire. Methods: Participants completed measures of demographic, traumatic life events, EMS, PTSD and CPTSD symptoms. Results: Overall, results suggest that participants with CPTSD present with higher schema elevations across all schemas compared to those with PTSD or no diagnosis. Secondly, the schemas of emotional deprivation, abandonment/instability, social isolation/alienation, defectiveness/shame, enmeshment/undeveloped self, subjugation, emotional inhibition and insufficient self-control/self-discipline were significantly associated with the symptom clusters of CPTSD. Finally, results indicate that different schemas form significant associations with the individual symptom clusters of CPTSD. Conclusions: Although results require replication in clinical samples, initial findings suggest that specific EMS may be important psychological correlates of CPTSD symptoms. Wider treatment considerations of these findings are discussed.

Original languageEnglish
Pages (from-to)117-128
Number of pages12
JournalPsychology and Psychotherapy: Theory, Research and Practice
Issue number1
StatePublished - Mar 2023


  • complex post-traumatic stress disorder
  • early maladaptive schemas
  • post-traumatic stress disorder


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