Banca de DEFESA: SÍLVIA MARIA PEREIRA DA SILVA

EARLYL MALADAPTIVE SCHEMAS AND SCHEMATIC MODES IN PATIENTS WITH MAJOR DEPRESSION WITH AND WITHOUT 

SUICIDAL IDEATION

initial maladaptive schemas; schema modes; depression; suicidal ideation

Suicide is a complex, multicausal phenomenon that occurs in all classes or age groups. Presenting as
suicidal ideation, attempted suicide, and suicide itself, require proper clinical assessment and risk
monitoring. The present research aimed to understand suicidal ideation from Jeffrey E. Young's Schema
Therapy and its concepts on Initial Maladaptive Schemas and Schematic Modes. In this context, early
childhood experiences with caregivers shape the understanding of self and the world, and will influence
future interpersonal relationships. The main objective of this paper, was to perform a systematic review
of articles from the last decade; and to investigate Initial Maladaptive Schemas and Schematic Modes
in a sample of 61 depressive patients, with and without suicidal ideation. The results are presented in
the format of two articles. In the first article, a systematic review of national and international articles
from the last 10 years was performed. Seven articles were selected for the final sample. The results
indicated that there is no consensus. However, overall, schemas such as Social Isolation/Alienation,
Defectiveness/shame, Distrust/abuse, and Hoarding/ grandiosity were most prevalent in these patients.

It was concluded that there is a need for further research on the topic. In the second article, a cross-
sectional study was conducted with 61 depressed patients, with (n=31) and without (n=30) suicidal

ideation. Participants completed questionnaires on sociodemographic data, DSM-5 Structured Clinical
Interview of Disorders, Beck-II Depression Inventory, Young's Schema Questionnaire, and Schema
Modes Inventory. Patients with suicidal ideation had a higher level of depressive symptom severity.
Moreover, they had comparatively higher scores on the Schemas Subjugation, Defectiveness/shame,
Social Isolation, Abandonment, Punitive Posture, Inflexible Patterns, and Entanglement. In both groups,
there was a high prevalence of the vulnerable child mode. And also, it was noted that patients with
suicidal ideation have three times more activation of the angry child and internalized dysfunctional
critical/punitive parent modes. In contrast, depressed patients without suicidal risk had higher scores in
the happy child and healthy adult modes. Therefore, Schema Therapy may be beneficial in assessing
and treating suicidal tendency in depressed patients. Future research is needed to expand on the results.