Early maladaptive schemas in trichotillomania and skin-picking disorder: their relationships with symptom severity and subtypes

TL;DR

The study explores how early maladaptive schemas relate to symptom severity and subtypes in trichotillomania and skin-picking disorder.

Contribution

It identifies EMSs as transdiagnostic and associated with symptom severity in TTM and SPD.

Findings

No significant differences in EMS severity between TTM, SPD, and OCD patients.

Several EMSs were positively linked to symptom severity and picking/pulling styles in TTM and SPD.

Assessing EMSs may improve understanding of TTM and SPD patients' issues.

Abstract

Higher levels of early maladaptive schemas (EMSs) have been associated with increased symptom severity and worse treatment outcomes in several mental disorders, but little is known about the role of EMSs in trichotillomania (TTM) and skin-picking disorder (SPD). The current study therefore aimed to explore the relationship of EMSs with symptom severity and subtypes in patients with TTM and SPD, as well as to compare their baseline EMS levels to those of a group of patients with obsessive‒compulsive disorder (OCD).

The Young Schema Questionnaire–Short Form (YSQ-SF), along with measures of disorder-specific symptoms and subtypes, was administered to patients with TTM (n = 120), SPD (n = 75), and OCD (n = 88) prior to treatment. Potential between-group differences in EMSs were explored with ANCOVA, with age and illness duration as covariates. Disorder- and subtype-specific patterns were explored with correlational analysis.

No significant baseline differences in EMS severity were found between TTM, SPD, and OCD patients, thereby corroborating EMSs’ transdiagnostic function in mental disorders. Several EMSs were significantly positively associated with self-reported and clinician-rated symptoms and picking/pulling styles of TTM and SPD, with some indications of diagnosis-specific association patterns.

These results suggest that EMSs are common among individuals with TTM and SPD and that assessment of these schemas may enhance clinicians’ understanding of TTM and SPD patients’ presenting problems.