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Trauma Exposure

Maladaptive Schemas and Posttraumatic Stress Disorder Symptom Severity: Investigating the Mediating Role of Posttraumatic Negative Self-Appraisals among Patients in a Partial Hospitalization Program

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Pages 322-338 | Received 26 Jan 2021, Accepted 31 Jul 2021, Published online: 21 Oct 2021
 

ABSTRACT

Maladaptive schemas have been linked with increased posttraumatic stress disorder (PTSD) symptoms. Posttraumatic negative self-appraisals (i.e., posttraumatic shame and self-blame) have also been empirically supported as contributors to PTSD symptom severity following traumatic events. These associations are well known; however, the pathways between maladaptive schemas and PTSD symptoms remain largely unclear. The present study aimed to examine the mediating effects of posttraumatic negative self-appraisals (shame and self-blame) on the association between maladaptive schemas and PTSD symptom severity in patients completing a partial hospitalization program. Patients (N = 98) completed measures of early maladaptive schemas, posttraumatic shame, posttraumatic self-blame, and PTSD symptom severity at intake. Posttraumatic negative self-appraisals mediated the association between maladaptive schemas and PTSD symptom severity. When we examined the specific mediating effects of shame and blame – rather than negative self-appraisals overall – shame was a significant mediator (b = .153, 95% CI [.031, .296]), but not blame (b = .038, 95% CI [−.083, .204]). Further, posttraumatic shame mediated the association between two of the four schema domains – disconnection & rejection (b = .092, 95% CI [.030, .201]) and impaired autonomy & performance (b = .047, 95% CI [.002, .124]) – and PTSD symptom severity. These findings highlight the importance of posttraumatic shame in the association between maladaptive schemas and PTSD symptom severity. Theoretical and practical implications are discussed.

Disclosure statement

No potential conflict of interest was reported by the author(s).

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