Latent Profiles of Early Maladaptive Schemas and Their Associations With Suicide Risk Factors in Patients With Mood Disorders

Abstract

Purpose

Although early maladaptive schemas (EMSs) have been linked to suicidal ideation, their heterogeneous nature has not been fully explored in this relationship. This study sought to identify distinct latent profiles based on 18 EMSs in a clinical sample and examine how these profiles differ in relation to suicidal ideation and suicide risk factors, such as perceived burdensomeness, thwarted belongingness and fearlessness about death.

Method

Data from routine clinical assessments of 799 outpatients with mood disorders (aged 18–49 years, 513 female, 286 male, M_age = 28.71) were analysed. Latent profile analysis was performed to identify distinct EMS profiles, and their associations with suicide risk factors were examined using the Bolck–Croon–Hagenaars method.

Results

Five distinct EMS profiles emerged: Low, Below Average, Above Average, Specific Elevation and High Risk. The Specific Elevation profile demonstrated specifically elevated levels of social isolation/alienation, defectiveness/shame, failure, dependence/incompetence and insufficient self-control/self-discipline, while the levels of most other schemas were similar to the Above Average profile. The High Risk profile showed elevated levels across all schemas. Both the Specific Elevation profile and the High Risk profile exhibited the highest levels of perceived burdensomeness, thwarted belongingness and suicidal ideation, with no significant differences between them. Fearlessness about death did not differ among the profiles.

Conclusion

The identified EMS profiles offer unique utility in predicting perceived burdensomeness, thwarted belongingness and suicidal ideation. The specific schemas that showed elevation in the Specific Elevation profile may serve as promising targets for mitigating suicide risk in patients with mood disorders.