The impact of early maladaptive schemas on anxiety and depression among early-stage breast cancer patients
Direct and mediated pathways through illness representations
Bibliographic Data
| ID | 21579706 |
|---|---|
| Authors | Spyridoula Karveli (0000-0003-1676-6353, National and Kapodistrian University of Athens, corresponding author), Evangelos C Karademas (0000-0003-0802-5213, University of Crete), Fiorita Poulakaki (0000-0001-6028-1295, Athens Medical Center), Zoe Antonopoulou (Athens Medical Center), Nikolaos Arkadopoulos (0000-0002-0355-0417, National and Kapodistrian University of Athens), Christos Markopoulos (0000-0002-8241-0817, National and Kapodistrian University of Athens) |
| Year | 2025 |
| Pages | 1-16 |
| Publication date | 2025-08-12 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Psychology & Health (JOURNAL) |
| Journal identifiers | ISSN: 0887-0446 • E-ISSN: 1476-8321 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/08870446.2025.2546410 |
| PMID | 40792657 |
| OpenAlex | W4413106710 |
| Language | EN |
| References cited | 36 |
Background Illness representations and Early Maladaptive Schemas (EMSs) play a significant role in shaping emotional self-regulation processes. EMSs are trait-like structures that constitute vulnerability factors associated with psychopathology in adulthood. Adverse life events, such as a breast cancer (BC) diagnosis, are assumed to trigger these EMSs. The present study examined, in a sample of BC patients, whether EMSs are related to anxiety/depression, directly as well as indirectly, through illness representations.Methods The study employed a prospective design, and newly diagnosed BC patients (N = 95; mean age = 50.4) completed self-report questionnaires within 4 wk (T0), 4 months (T1), and 12 months (T2) after surgery. The Young Schema Questionnaire‐Short Form (YSQ-S3), the Brief Illness Perception Questionnaire (Brief IPQ), and the Hospital Anxiety and Depression Scale (HADS) were used.Results Path analysis revealed a statistically significant direct effect of T0 Vulnerability to Harm on T2 anxiety (β = 0.23, p = 0.014). Vulnerability to Harm also predicted anxiety and depression through emotional representations (β = 0.16 and 0.13, respectively, p < 0.01). A direct effect of the Enmeshment EMS was also observed on anxiety (β = 0.21 p = 0.010).Conclusion Vulnerability to Harm and Enmeshment EMSs both fall under the “impaired autonomy/performance” domain, reflecting lower self-esteem, diminished ability to function independently, and heightened fear. Recognizing these dispositional factors early is crucial for preventing long-term distress. The finding that illness representations mediated the relationship only for the Vulnerability to Harm EMS suggests a unique relationship between this schema and how individuals perceive their illness, likely due to its relevance to the illness experience
Anxiety · Developmental psychology · Distress · Hospital Anxiety and Depression Scale · Psychiatry · Psychopathology · Cancer survivorship and care · Childhood Cancer Survivors' Quality of Life · Clinical Psychology · Family Support in Illness · Psychology
| Highly cited | No |
|---|