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The Role of Early Maladaptive Schemas in Pain and Depression in Chronic Pain Patients: A Structural Equation Modelling

Fatemeh Rezaei* and Nasrin Alsadat Hosseini Ramaghani

Individuals with chronic pain frequently display comorbid depression. Depression and chronic pain may be related
to childhood maltreatment and early distress. Early maladaptive schemas (EMSs)designed to assess early distress.
EMSs are at the core of personality pathology and psychological distress. The main objective of this study was to test
the hypothesis that depression mediates the relationship between EMSs and pain. One hundred chronic pain patients
completed Young’s Schema Questionnaire, McGill Pain Questionnaire and depression subscale of Hospital Anxiety
and Depression Scale. We estimated two structural models; second model fitted the clinical sample well (chi2= 19.2; p=
.31). In this model a latent variable (general maladaptive schema) was explored is directly associated with depression
(β=0.39; p<0.01); Also depression is associated with the pain (β= -.57; p<0.01); General maladaptive schema had an
indirect effect on pain that was mediated by depression (β= -.35; p<0.01).The results of the study suggested that early
emotional maltreatment plays an important role in depression and pain in chronic pain patients. The model can help to
adequate and establish targets for the psychological treatments included in multidisciplinary programs for this disorder.