Associations between features of eating disorders and the intensity and types of J. Young’s early maladaptive schemas in a group of young Poles
DOI:
https://doi.org/10.12923/2353-8627/2026-0002Keywords:
exploding head syndrome, parasomnias, sleep disordersAbstract
Introduction: Patients suffering from eating disorders (EDs) have attracted particular interest among researchers and clinicians due to the exceptionally high mortality rates observed in this population.The first symptoms of EDs typically appear during adolescence and early adulthood, which may indicate the crucial role of early life experiences in their development.The aim of the study was to examine the associations between the intensity of early maladaptive schemas and the presence of eating disorder features in a group of young adults in Poland.
Material and methods: The study included 231 participants: 75.5% women, 22.1% men. The mean age of the participants was 25.75(SD=7.79).Two questionnaires were used in the study:The Eating Attitudes Test (EAT-26) to assess eating disorder symptoms, and the Young Schema Questionnaire (YSQ-S3-PL) to measure the intensity of early maladaptive schemas.
Results: Differences in the intensity of early maladaptive schemas between individuals with and without eating disorder symptoms were found across all 18 schemas. The study participants reporting eating disorder symptoms scored higher on all analyzed variables and schema domains. Statistically significant correlations were identified between the EMS and specific eating habits, with the strongest associations observed for Bulimia and Food Preoccupation. The intensity of individual schemas was more strongly differentiated by gender among participants without eating disorder symptoms than among those reporting such symptoms.
Conclusions: 1. Individuals reporting symptoms of eating disorders display higher intensity of early maladaptive schemas compared to those not reporting such symptoms. 2. Specific maladaptive eating habits are associated with the intensity of EMS, allowing for the identification of distinct schema profiles linked to particular eating disorder symptoms.
References
1. Yu Z, Muehleman V. Eating disorders and metabolic diseases. Int J Environ Res Public Health. 2023;20(3):2446. doi: 10.3390/ijerph20032446
2. Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. Am J Clin Nutr. 2019;109(5):1402–13. doi: 10.1093/ajcn/nqy342
3. Calzo JP, Blashill AJ, Brown TA, Argenal RL. Eating disorders and disordered weight and shape control behaviors in sexual minority populations. Curr Psychiatry Rep. 2017;19(8):80. doi: 10.1007/s11920-017-0801-y
4. Hazzard VM, Loth KA, Hooper L, Becker CB. Food insecurity and eating disorders: a review of emerging evidence. Curr Psychiatry Rep. 2020;22(12):61. doi: 10.1007/s11920-020-01200-0
5. Murray SB, Nagata JM, Griffiths S, Calzo JP, Brown TA, Mitchison D, et al. The enigma of male eating disorders: a critical review and synthesis. Clin Psychol Rev. 2017;57:1–12. doi: 10.1016/j. cpr.2017.08.001
6. Pike KM, Dunne PE. The rise of eating disorders in Asia: a review. J Eat Disord. 2015;3(1):1–12. doi: 10.1186/s40337-015-0070-2
7. World Health Organization. *International Classification of Diseases, 11th Revision
8. Fichter MM, Quadflieg N. Long-term stability of eating disorder diagnoses. Int J Eat Disord. 2007;40(7 Suppl):S61–6. doi: 10.1002/eat.20443
9. Eddy KT, Dorer DJ, Franko DL, Tahilani K, Thompson-Brenner H, Herzog DB. Diagnostic crossover in anorexia nervosa and bulimia nervosa: implications for DSM-V. Am J Psychiatry. 2008;165(2):245–50. doi: 10.1176/appi.ajp.2007.07060951
10. Castellini G, Lo Sauro C, Mannucci E, Ravaldi C, Rotella CM, Faravelli C, et al. Diagnostic crossover and outcome predictors in eating disorders according to DSM-IV and DSM-V proposed criteria: a 6-year follow-up study. Psychosom Med. 2011;73(3):227–36. doi: 10.1097/PSY.0b013e31820a1838
11. Chesney E, Goodwin GM, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry. 2014;13(2):153–60. doi: 10.1002/wps.20128
12. Crow SJ. Terminal anorexia nervosa cannot currently be identified. Int J Eat Disord. 2023;56(7):1329–34. doi: 10.1002/eat.23957
13. Crow SJ, Peterson CB, Swanson SA, Raymond NC, Specker S, Eckert ED, et al. Increased mortality in bulimia nervosa and other eating disorders. Am J Psychiatry. 2009;166(12):1342–6. doi: 10.1176/appi.ajp.2009.09020247
14. Amiri S, Khan MAB. Prevalence of non-suicidal self-injury, suicidal ideation, suicide attempts, suicide mortality in eating disorders: a systematic review and meta-analysis. Eat Disord. 2023;31(5). doi: 10.1080/10640266.2023.2196492
15. Soullane S, Israël M, Steiger H, Chadi N, Low N, Dewar R, et al. Association of hospitalization for suicide attempts in adolescent girls with subsequent hospitalization for eating disorders. Int J Eat Disord. 2023;56(12):2171–80. doi: 10.1002/eat.24052
16. National Institute for Health and Care Excellence. Eating disorders: recognition and treatment. NICE guideline NG69. London: NICE; 2017.
17. Joshua PR, Lewis V, Simpson S, Kelty SF, Boer DP. What role do early life experiences play in eating disorders? The impact of parenting style, temperament and early maladaptive schemas. Clin Psychol Psychother. 2024;31(1):e5124. doi: 10.1002/cpp.2904
18. Huckstepp TJ, Allen A, Maher AL, Houlihan C, Mason J. Factor structure of the Young Positive Schema Questionnaire in an eating disorder sample. Eat Weight Disord. 2023;28(1):41. doi: 10.1007/s40519-023-01549-0
19. Maher A, Cason L, Huckstepp T, Stallman H, Kannis-Dymand L, Millear P, et al. Early maladaptive schemas in eating disorders: a systematic review. Eur Eat Disord Rev. 2022;30(1):3–20. doi: 10.1002/erv.2866
20. Young JE, Klosko JS, Weishaar ME. Schema Therapy: A Practitioner's Guide. New York: Guilford Press; 2003.
21. Arntz A, Jacob G. Schema Therapy in Practice. Sopot: Gdańskie Wydawnictwo Psychologiczne; 2016.
22. Gerges S, Hallit S, Malaeb D, Obeid S. Maladaptive cognitive schemas as predictors of disordered eating: examining the indirect pathway through emotion regulation difficulties. Int J Environ Res Public Health. 2022;19(18):11620. doi: 10.3390/ijerph191811620
23. Kellogg SH, Young JE. Schema therapy for borderline personality disorder. J Clin Psychol. 2006;62(4):431–8. doi: 10.1002/jclp.20240
24. Basile B, Tenore K, Mancini F. Early maladaptive schemas in overweight and obesity: a schema mode model. Heliyon. 2019;5(9):e02361. doi: 10.1016/j.heliyon.2019.e02361
25. Waller G, Meyer C, Ohanian V. Psychometric properties of the long and short versions of the Young Schema Questionnaire: core beliefs among bulimic and comparison women. Cogn Ther Res. 2001;25(2):891–913. doi: 10.1023/A:1026487018110
26. Roediger E, Archonti C. Transference and therapist-client chemistry in the treatment of eating disorders. In: Simpson S, Smith E, editors. Schema Therapy for Eating Disorders. New York: Routledge; 2020. p. 221–41.
27. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4. doi: 10.1001/jama.2013.281053
28. The Belmont Report. Ethical principles and guidelines for the protection of human subjects of research. Belmont: The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; 1979.
29. Oettingen J, Chodkiewicz J, Mącik D, Gruszczyńska E. Polish adaptation and validation of the Young Schema Questionnaire 3 Short Form (YSQ-S3-PL). Psychiatr Pol. 2018;52(4):707–18. doi: 10.12740/PP/OnlineFirst/76541
30. Rogoza R, Brytek-Matera A, Garner DM. Analysis of the EAT¬26 in a non-clinical sample. Arch Psychiatry Psychother. 2016;18(2):54–8. doi: 10.12740/APP/63647
31. Maher AL, Allen A, Mason J, Houlihan C, Wood AP, Huckstepp T. Exploring the association between early adaptive schemas and self-reported eating disorder symptomatology. Clin Psychol Psychother. 2023;30(1):152–65. doi: 10.1002/cpp.2789
32. Aloi M, Rania M, Carbone EA, de Filippis R, Quirino D, D’Onofrio E, et al. Early maladaptive schemas mediate the relationship between childhood trauma and interpersonal problems in eating disorders. Clin Psychol Psychother. 2025;32(2):e70052. doi: 10.1002/cpp.70052
33. Foran AM, O'Donnell AT, Muldoon OT. Stigma of eating disorders and recovery-related outcomes: a systematic review. Eur Eat Disord Rev. 2020;28(4):385–97. doi: 10.1002/erv.2735
34. Puhl R, Suh Y. Stigma and eating and weight disorders. Curr Psychiatry Rep. 2015;17(3):552. doi: 10.1007/s11920-015-0552¬6
35. Faustino B, Vasco AB. Relationships between emotional processing difficulties and early maladaptive schemas on the regulation of psychological needs. Clin Psychol Psychother. 2020;27(6):804–13. doi: 10.1002/cpp.2464
36. Pugh M. A narrative review of schemas and schema therapy outcomes in the eating disorders. Clin Psychol Rev. 2015;40:64–82. doi: 10.1016/j.cpr.2015.04.003
37. Brown JM, Selth S, Stretton A, Simpson S. Do dysfunctional coping modes mediate the relationship between perceived parenting style and disordered eating behaviours? J Eat Disord. 2016;4(1). doi: 10.1186/s40337-016-0123-1
38. Hinrichsen H, Waller G, Dhokia R. Core beliefs and social anxiety in the eating disorders. Eat Weight Disord. 2007;12(1):e14–8. doi: 10.1007/BF03327776
39. Pauwels E, Dierckx E, Schoevaerts K, Claes L. Early maladaptive schemas in eating disordered patients with or without non-suicidal self-injury. Eur Eat Disord Rev. 2016;24(5):399–405. doi: 10.1002/erv.2460
40. Espeset EM, Gulliksen KS, Nordbø RH, Skårderud F, Holte A. The link between negative emotions and eating disorder behaviour in patients with anorexia nervosa. Eur Eat Disord Rev. 2012;20(6):451–60. doi: 10.1002/erv.2183
41. Molina L, Orue I, Calvete E. Maladaptive schemas as an explanation for gender differences in eating disorder symptoms in adolescents. Rev Psicol Clin Niños Adolesc. 2023;10(2):1–7.
42. Henderson ZB, Fox JRE, Trayner P, Wittkowski A. Emotional development in eating disorders: a qualitative metasynthesis. Clin Psychol Psychother. 2019;26(4):440–57. doi: 10.1002/cpp.2365
43. McIntosh VVW, Jordan J, Carter JD, Frampton CMA, McKenzie JM, Latner JD, et al. Psychotherapy for transdiagnostic binge eating: a randomized controlled trial of cognitive-behavioural therapy, appetite-focused cognitive-behavioural therapy, and schema therapy. Psychiatry Res. 2016;240:412–20. doi: 10.1016/j. psychres.2016.04.080
44. Joshua PR, Lewis V, Kelty SF, Boer DP. Is schema therapy effective for adults with eating disorders? A systematic review into the evidence. Cogn Behav Ther. 2023;52(3):1–20. doi: 10.1080/1650 6073.2022.2158926
45. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: APA; 2013.
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