The Mediating Role of Early Maladaptive Schemas in the Relationship between Childhood Traumatic Events and Complex Posttraumatic Stress Disorder Symptoms in Older Adults (>64 Years)

Abstract

The current study investigated the mediating role of Early Maladaptive Schemas (EMS) in the association between childhood trauma and Complex PTSD (CPTSD) symptom severity in a clinical sample of 42 older adults (>64 years). It was found that EMS total score mediated the relationship between childhood trauma and CPTSD symptom severity. Two second order schema factors (Disconnection; Impaired Autonomy) also had a mediating role in this relationship. Results provide preliminary support for the utility of interventions targeting EMS, particularly in the domains of Disconnection and Impaired Autonomy, in order to alleviate CPTSD symptoms. Future research is required to replicate these results within larger samples and to examine the efficacy of schema and cognitive interventions within trauma exposed older adults.

Keywords:

• childhood trauma
• schemas
• CPTSD
• older adults

Acknowledgements

The authors would like to thank Mr Sandy McAfee, former Consultant Clinical Psychologist in NHS Lothian for his support in the initial stages of the research.

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

This work was prepared in part fulfillment of the degree of Doctorate in Clinical Psychology, funded by NHS Education for Scotland.

Notes on contributors

Eleni Vasilopoulou

Eleni Vasilopoulou is a third-year student in the Doctorate in Clinical Psychology at the University of Edinburgh. Research interests include examining factors associated with the development and severity of Posttraumatic Stress Disorders (PTSD) and Complex PTSD. Current research has focused on factors affecting posttraumatic response and presentation in older adults.

Thanos Karatzias

Professor Karatzias, is the Director of Research in the School of Health & Social Care at Edinburgh Napier University, UK and Clinical & Health Psychologist at the Rivers Center for Traumatic Stress, Edinburgh, UK. He is the former Chair of the British Psychological Society Scotland Working Party for Adult Survivors of Sexual Abuse (BPSSS) and he was a member of the Committee of the British Psychological Society (BPS) Crisis, Disaster & Trauma Section. In collaboration with national and international research partners he has developed a special interest in the effects and treatment of psychological trauma on physical and mental health; on prison populations; and on people with learning disabilities. The last few years he works in the area of Complex PTSD.

Philip Hyland

Dr Philip Hyland is a Senior Lecturer at the Department of Psychology, Maynooth University. His primary research area is traumatic stress studies. He is particularly interested in understanding how to most accurately describe and measure psychological responses to trauma; the psychosocial risk factors for different types of traumatic response; and the long-term outcomes of traumatic exposure. Recent research has predominately focused on evaluating the validity of the new descriptions of PTSD and CPTSD in ICD-11. Dr Hyland is the Deputy Statistical Editor of the Journal of Traumatic Stress, and most recently, established the International Trauma Consortium, a global collaboration of researchers and clinicians who wish to advance the science and practice of psychotraumatology.

Hannah Wallace

Dr Hannah Wallace completed her BSc in Applied Psychology at Liverpool John Moores University in 2007 and went on to study for her Doctorate in Clinical Psychology at the University of Edinburgh shortly after this. Dr Wallace was a 4 year specialist aligned trainee with the Lothian Older People’s Psychology Service. She graduated in 2014 and has worked in a specialist Older People’s Psychology Service in Lothian since. Dr Wallace has specialist interests in complex trauma and neuropsychology.

Azucena Guzman

Dr Azucena Guzman is a Chartered Clinical Psychologist and Lecturer in Health and Ageing at the University of Edinburgh, with 14 years of clinical and research experience in the field of neurodegenerative conditions.