The Effectiveness of Schema Therapy on Depression and Cognitive Emotion Regulation in Adolescents with Psychosomatic Disorders
Keywords:
psychosomatic patients, schema therapy, depression, cognitive emotion regulation, adolescentsAbstract
Objective: This study aimed to determine the effectiveness of schema therapy in reducing depression and improving cognitive emotion regulation among adolescents with psychosomatic disorders.
Methods and Materials: This quasi-experimental study used a pre-test, post-test, and two-month follow-up design with a control group. The statistical population included adolescents with psychosomatic disorders who referred to specialized psychology clinics in Hamedan. Thirty participants were selected through convenience sampling and randomly assigned to an experimental group and a control group, with 15 participants in each group. The experimental group received schema therapy in ten 90-minute sessions, whereas the control group received no psychological intervention during the study period. Data were collected using the Depression Scale and the Cognitive Emotion Regulation Questionnaire. Data analysis was conducted using SPSS version 26 through repeated-measures two-way analysis of variance after checking the assumptions of normality, homogeneity of variance, sphericity, and equality of covariance matrices.
Findings: The results showed a significant between-group effect for depression (F = 4.688, p = 0.033, η² = 0.27) and cognitive emotion regulation (F = 15.703, p = 0.024, η² = 0.204). The within-group effect of time was also significant for depression (F = 24.416, p < 0.001, η² = 0.67) and cognitive emotion regulation (F = 36.997, p < 0.001, η² = 0.785). Moreover, the group-by-time interaction effect was significant for depression (F = 60.000, p < 0.001, η² = 0.71) and cognitive emotion regulation (F = 66.011, p < 0.001, η² = 0.653), indicating the effectiveness of schema therapy across post-test and follow-up stages.
Conclusion: Schema therapy appears to be an effective psychological intervention for reducing depression and enhancing cognitive emotion regulation in adolescents with psychosomatic disorders. By targeting early maladaptive schemas and modifying dysfunctional cognitive-emotional patterns, this approach can contribute to improved psychological functioning in this population.
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References
Aghabagheri, H., Mohammadkhani, P., Omrani, S., & Farahmand, V. (2012). The effectiveness of mindfulness-based cognitive group therapy on increasing subjective well-being and hope in patients with MS. Journal of Clinical Psychology, 4(1), 21-31.
Bakos, D. S., Gallo, A. E., & Wainer, R. (2015). Systematic review of the clinical effectiveness of schema therapy. Contemporary Behavioral Health Care, 1, 1-7. https://doi.org/10.15761/CBHC.1000104
Bamelis, L. L. M., Evers, S. M. A. A., Spinhoven, P., & Arntz, A. (2014). Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders. American Journal of Psychiatry, 171(3), 305-322. https://doi.org/10.1176/appi.ajp.2013.12040518
Farrell, J. M., Shaw, I. A., & Webber, M. A. (2009). A pilot study of group schema therapy for borderline personality disorder: A randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 40(2), 317-328. https://doi.org/10.1016/j.jbtep.2008.07.001
Faustino, B., Vasco, A. B., Silva, A. N., & Marques, T. (2020). Relationships between emotional schemas, mindfulness, self-compassion and unconditional self-acceptance on the regulation of psychological needs. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(2). https://doi.org/10.4081/ripppo.2020.442
Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in psychiatric treatment, 15(3), 199-208. https://doi.org/10.1192/apt.bp.107.005264
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.
Isazadeh, F., Heydari, S., Aghajanbaglou, S., & Saffarinia, M. (2020). The effectiveness of schema therapy on stress, social adjustment, and psychological coherence of women with cancer. Journal of Modern Psychology, 14(2), 85-102.
Jamali, S., Najafi, M., Ghoreishi, F., & Rahimian, E. (2021). The effectiveness of acceptance and commitment therapy on suicidal thoughts and psychological flexibility of patients with bipolar disorder. Psychological studies, 17(1), 7-22.
Karami Mohajeri, Z., Karbalaei Harfeteh, F., Khalatbari, J., & Fardin, M. (2025). The effectiveness of integrating schema therapy and acceptance and commitment therapy on subjective well-being and body image concern of women with breast cancer. Journal of Psychological Science, 24(145), 197-220.
Karimi Mohajeri, Z., Karbalaee Harfteh, F., Khalatbari, J., & Fardin, M. (2025). The effectiveness of integrating schema therapy and acceptance and commitment therapy on subjective well-being and body image concerns in women with breast cancer. Journal of Psychological Sciences, 24(145), 197-220. https://psychologicalscience.ir/browse.php?a_id=2564&sid=1&slc_lang=en
Kelly, A. C., Zuroff, D. C., & Shapira, L. B. (2009). Soothing oneself and resisting self-attacks: The treatment of two intrapersonal deficits in depression vulnerability. Cognitive therapy and research, 33(3), 301-313. https://doi.org/10.1007/s10608-008-9202-1
Khanjani, M., Shahidi, S., Fathabadi, J., Mazaheri, M., & Shokri, O. (2014). Factor structure and psychometric properties of the short form (18 items) of Ryff's cognitive emotion regulation scale in male and female students. Thought and Behavior in Clinical Psychology, 9(32), 27-36.
Körük, S., & Özabacı, N. S. (2018). Effectiveness of schema therapy on the treatment of depressive disorders: A meta-analysis. Current Approaches in Psychiatry, 10(4), 452-470.
MacBeth, A., & Gumley, A. (2012). Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical psychology review, 32(6), 545-552. https://doi.org/10.1016/j.cpr.2012.06.003
Mamdouhi, Z., Safargholi, H., Houshmandi, S., Damirchi, S., & Tabakhzadeh, N. (2023). The effectiveness of compassion therapy on cognitive emotion regulation of female students of Islamic Azad University, Islamshahr branch. Journal of Applied Psychology, 12(3), 45-58.
Mansouri Karyani, R., Bassak Nejad, S., Mehrabizadeh Honarmand, M., & Majdi Nasab, N. (2022). The effectiveness of compassion-focused acceptance and commitment therapy on psychological flexibility and psychological distress of patients with multiple sclerosis. Iranian Journal of Psychiatry and Clinical Psychology, 28(2), 222-235.
Neff, K. D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and identity, 2(2), 85-101. https://doi.org/10.1080/15298860309032
Nikan, A., Torabi, A., Mohseni Nasab, Z., Bahadori, A., Javanmard, Z., & Hosseini Rad, M. (2023). Comparison of the effectiveness of schema therapy and mindfulness-based cognitive therapy on stress, resilience, emotion regulation, and cognitive emotion regulation of cardiovascular patients. Research in Psychological Health, 17(1), 46-60.
Rafiei, F., Soleimani, M., & Seyedfatemi, N. (2011). Providing a model for the participation of patients with chronic diseases in nursing care. Koomesh journal, 12(3), 293-304.
Renner, F., Arntz, A., Peeters, F., & Huibers, M. (2016). Schema therapy for chronic depression: Results of a multiple single case series. Cognitive therapy and research, 40(4), 482-496. https://doi.org/10.1007/s10608-016-9750-3
Thimm, J. C. (2017). Relationships between early maladaptive schemas, mindfulness, self-compassion and psychological distress. International Journal of Psychology & Psychological Therapy, 17(1), 1-15.
Tirch, D. D., Leahy, R. L., Silberstein, L. R., & Melwani, P. S. (2012). Emotional schemas, psychological flexibility, and anxiety: The role of flexible response patterns to anxious arousal. International Journal of Cognitive Therapy, 5(4), 380-391. https://doi.org/10.1521/ijct.2012.5.4.380
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. Guilford Press.
