Early maladaptive schemas, emotion regulation difficulties, and alexithymia : A systematic review and meta-analysis

Journal article


Pilkington, Pamela D., Karantzas, Gery C., Faustino, Bruno and Pizarro-Campagna, Elizabeth. (2023). Early maladaptive schemas, emotion regulation difficulties, and alexithymia : A systematic review and meta-analysis. Clinical Psychology and Psychotherapy. pp. 1-14. https://doi.org/10.1002/cpp.2914
AuthorsPilkington, Pamela D., Karantzas, Gery C., Faustino, Bruno and Pizarro-Campagna, Elizabeth
Abstract

Background
Emotion regulation is an integral part of the schema therapy model. The aim of this systematic review and meta-analysis was to synthesize the evidence on the associations between early maladaptive schemas (EMSs), difficulties with emotion regulation and alexithymia.

Method
PsycINFO, PubMed and CINAHL Complete databases were searched on 28 May 2022 and 3 February 2023 in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Included studies were in English, in peer-reviewed journals and reported on the association between one or more of the 18 EMSs or five schema domains and emotion regulation difficulties or alexithymia. Methodological quality was assessed using the Appraisal Tool for Cross-Sectional Studies. Meta-analyses were conducted to examine difficulties with emotion regulation and alexithymia as correlates of each EMS and domain.

Results
A total of 19 studies published between 2008 and 2022 were included (Pooled N = 5957). Difficulties with emotion regulation were positively correlated with all 18 EMSs (range: entitlement r(7) = .28, 95% CI [.13, .42] to negativity pessimism r(5) = .53, 95% CI [.23, .74]) and schema domains (range: impaired limits r(5) = .34, 95% CI [.08, .56] to disconnection rejection r(5) = .44, 95% CI [.33, .73]). Alexithymia was positively correlated with the other-directedness domain (r(2) = .40, 95% CI [.09, .64]) and 16 of the 18 EMSs (range: unrelenting standards r(5) = .21, 95% CI [.12, .28] to emotional inhibition r(5) = .50, 95% CI [.34, .63]).

Conclusions
The findings suggested that almost all 18 EMSs are implicated in emotion regulation difficulties and alexithymia, particularly those relating to unmet needs for attachment and autonomy.

Keywordsearly maladaptive schemas; emotion regulation; alexithymia; meta-analysis; schema domains; systematic review
Year2023
JournalClinical Psychology and Psychotherapy
Journal citationpp. 1-14
PublisherJohn Wiley & Sons Ltd
ISSN1099-0879
Digital Object Identifier (DOI)https://doi.org/10.1002/cpp.2914
PubMed ID37735142
Scopus EID2-s2.0-85171777299
Open accessPublished as ‘gold’ (paid) open access
Page range1-14
Publisher's version
License
File Access Level
Open
Output statusIn press
Publication dates
Online21 Sep 2023
Publication process dates
Accepted05 Sep 2023
Deposited05 Oct 2023
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