The Influence of Early Maladaptive Schemas on Sex Differences in the Development of PTSD Symptomatology

The relationship between gender, trauma, Early Maladaptive Schemas (EMS), and PTSD symptomatology was examined in a non-clinical sample of college students. Participants were administered self-report measures and clinical interviews to assess for PTSD and EMS. Women were found to report significantly more PTSD symptomatology than men. Participants who met the cutoff score on the PCL for a diagnosis of PTSD scored significantly higher on all 18 EMS than those who did not meet the cutoff score. Women were significantly higher than men on the EMS of failure, mistrust-abuse, vulnerability, negativity-pessimism, abandonment, subjugation, self-sacrifice, and approval-seeking. Bootstrapping mediation analyses were conducted to examine whether the 18 EMS mediated the relationship between trauma and PTSD, controlling for gender. Mistrust-abuse, vulnerability to harm or illness, unrelenting standards, abandonment, subjugation, and self-sacrifice emerged as significant mediators. In the multiple mediation model, only the EMS of abandonment emerged as unique. A second test of multiple mediation was performed to assess the extent to which EMS mediated the relationship between gender and PTSD symptomatology. There was significant overall mediation by the presence of mistrust-abuse, failure, vulnerability, negativity-pessimism, abandonment, subjugation, and self-sacrifice, though vulnerability emerged as unique. All EMS are associated with PTSD symptomatology, but only specific EMS mediated the relationship between trauma, gender, and PTSD. Many of these EMS are higher in women, possibly making them more vulnerable to the disorder. Clinical implications and directions for future research are discussed.