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The association between early

maladaptive schema and personality
disorder traits in an offender
population
a ab
Flora Gilbert & Michael Daffern
a
Centre for Forensic Behavioural Science, School of Psychology
and Psychiatry, Monash University, Melbourne, Australia
b
Victorian Institute of Forensic Mental Health, Melbourne,
Australia
Published online: 28 Mar 2013.

To cite this article: Flora Gilbert & Michael Daffern (2013) The association between early
maladaptive schema and personality disorder traits in an offender population, Psychology, Crime &
Law, 19:10, 933-946, DOI: 10.1080/1068316X.2013.770852

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 Psychology, Crime & Law, 2013
Vol. 19, No. 10, 933
946, http://dx.doi.org/10.1080/1068316X.2013.770852

The association between early maladaptive schema and personality

disorder traits in an offender population
Flora Gilberta* and Michael Dafferna,b
a
Centre for Forensic Behavioural Science, School of Psychology and Psychiatry, Monash
University, Melbourne, Australia; bVictorian Institute of Forensic Mental Health,
Melbourne, Australia
(Received 1 March 2012; final version received 21 October 2012)
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Schema-focused therapy has become an increasingly popular treatment for

offenders with personality disorder (PD), although to date, there have been few
studies examining the association between early maladaptive schema (EMS) and
PD in forensic settings. Clarification of the relationship between EMS and PD in
offenders is, therefore, necessary for effective treatment delivery in this area. The
present study extended previous EMS research by investigating the relationship
between individual- and domain-level EMS and the DSM-IV PDs, in particular,
antisocial PD (ASPD) and borderline PD (BPD), in an offender population. A
sample of offenders (n 87) undergoing pre-sentence evaluation were assessed on
PD symptoms, EMS and depression, and correlation and regression analyses were
conducted to examine the associations between the EMS and the PD dimensions.
The results showed that the majority of PD dimensions were associated with
individual EMS and that these relationships were idiosyncratic in nature.
Relationships between ASPD symptoms and the Impaired Limits EMS domain
and between BPD symptoms and the Disconnection/Rejection EMS domain were
also identified. Overall, the results suggested that although Impaired Limits and
Disconnection/Rejection EMS are common among offenders with ASPD and
BPD, individually tailored assessment of the relationship between EMS and PD is
critical.
Keywords: personality disorder; schema; cognition; offenders; assessment

Offender populations invariably comprise large proportions of individuals with

personality disorder (PD); approximately half of all prisoners meet the criteria for
antisocial PD (ASPD) and one-third for borderline PD (BPD; Black et al., 2007;
Coid et al., 2009; O’Brien, Mortimer, Singleton, & Meltzer, 2003; Warren et al.,
2002). Although the high prevalence of PD among offenders is generally well
recognised, knowledge concerning treatment planning and delivery for offenders
with PD is presently limited. One promising development, however, has been the
introduction of interventions in forensic settings that specifically targeting PD such
as schema-focused therapy (Beckley & Gordon, 2010; Bernstein, Arntz, & de Vos,
2007), which may offer a more effective treatment pathway for a population that has
traditionally been considered challenging and less amenable to psychological
intervention (Bernstein et al., 2007).

*Corresponding author. Email: Flora.Gilbert@monash.edu

# 2013 Taylor & Francis
 934 F. Gilbert and M. Daffern

Schema theory (Young, 1990, 1994, 1999; Young, Klosko, & Weishaar, 2003)
draws upon early cognitive behavioural formulations of PD (e.g., Beck, Freeman, &
Associates, 1990), and proposes that attention to the broad organising principles that
individuals use to make sense of their life experiences (i.e., schema) should be central
to attempts to address the pervasive nature of PD. The term early maladaptive
schema (EMS) refers to those dysfunctional and pervasive themes regarding oneself
and other people that are developed during childhood or adolescence as a result of
unmet core human needs (e.g., safety) and maintained throughout the lifetime.
EMS is comprised of memories, emotions, cognitions and bodily sensations, and
the combined presence of EMS and maladaptive coping responses are theorised to
comprise the core of PDs (Rafaeli, Bernstein, & Young, 2011). Specifically, activation
of EMS triggers intense affect and frustration due to the perception that basic human
needs will not be met, with maladaptive behaviours and associated emotional states
becoming established as habitual responses to EMS activation. At present, 18 EMS
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(see Table 1; for a detailed definition of these EMS see Young et al., 2003) have been
identified and organised according to five domains of unmet or violated core needs
including (1) Disconnection/Rejection (safety, stability and nurturance), (2) Impaired
Autonomy/Performance (autonomy and competence), (3) Impaired Limits (internal
limits, responsibility towards others and long-term goal orientation), (4) Other-
Directedness (self-directedness) and (5) Overvigilance/Inhibition (spontaneity and
playfulness). Any EMS may theoretically contribute to the maintenance of PD
symptoms, although particular EMS combinations are proposed to have an association
with certain PDs of the Diagnostic and Statistical Manual of Mental Disorders, fourth
edition (DSM-IV-TR; American Psychiatric Association, 2000). With respect to those
PD’s prevalent amongst offenders, BPD is theorised to have a relationship with a wide
range of EMS, in particular, Abandonment, Mistrust/Abuse, Emotional Deprivation,
Defectiveness/Shame, Insufficient Self-Control, Subjugation and Punitiveness; in con-
trast, ASPD has yet to be linked to any specific EMS (Young et al., 2003).
Relatively little research has investigated the relationship between EMS and PD
in offenders. In the only published study, Specht, Chapman, and Cellucci (2009)
examined the relationship between the five EMS domains and the severity of BPD
and ASPD symptoms in 105 female prisoners. They found that BPD symptom
severity was positively related to the Disconnection/Rejection and Impaired Limits
domains, although portions of variance were shared, respectively, with depressive
symptoms and ASPD symptoms. Only the Impaired Limits domain was associated
with ASPD symptom severity.
However, several clinical and non-clinical studies substantiate a relationship
between certain EMS and those PDs frequently seen in offender populations. The
majority of the clinical literature has focused on BPD, consistently identifying a
relationship with EMS in the Disconnection/Rejection and Impaired Autonomy/
Performance domains, in particular, the Abandonment EMS (Ball & Cecero, 2001;
Jovev & Jackson, 2004; Nordahl, Holthe, & Haugum, 2005). Two non-clinical studies
also found relationships with these two EMS domains (Meyer, Leung, Feary, & Mann,
2001; Reeves & Taylor, 2007). Selected studies suggest greater variation in the range of
individual EMS associated with BPD. For example, Lawrence, Allen, and Chanen
(2011) found that BPD was positively related to Disconnection/Rejection and Impaired
Autonomy/Performance EMS domains as well as other EMS including Insufficient Self-
Control (Impaired Limits domain), Emotional Inhibition (Over-Vigilance/Inhibition
 Psychology, Crime & Law 935

Table 1. Means, standard deviations, ranges and alphas for PD and EMS.

Variable M SD Range a

SCID-II Axis II disorders

Paranoid 0.25 0.22 0.00
0.79 0.67
Schizoid 0.25 0.24 0.00
0.93 0.72
Schizotypal 0.21 0.20 0.00
0.83 0.66
Antisocial 0.42 0.24 0.00
1.00 0.70
Borderline 0.28 0.22 0.00
0.78 0.80
Narcissistic 0.21 0.19 0.00
0.83 0.67
Histrionic 0.12 0.15 0.00
0.69 0.66
Avoidant 0.20 0.24 0.00
0.86 0.81
Dependent 0.11 0.14 0.00
0.69 0.49
Avoidant 0.20 0.24 0.00
0.86 0.54
Obsessive
compulsive 0.21 0.17 0.00
0.81 0.74
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Early maladaptive schemas

Disconnection/Rejection domain 13.80 6.09 4.80
28.20 0.92
Abandonment 2.75 1.37 1.00
6.00 0.86
Mistrust/Abuse 3.18 1.48 1.00
6.00 0.86
Emotional deprivation 2.83 1.39 1.00
6.00 0.83
Defectiveness 2.57 1.44 1.00
6.00 0.89
Social isolation 2.90 1.48 1.00
6.00 0.88
Impaired Autonomy domain 12.66 4.65 5.00
22.75 0.83
Dependence 2.70 1.09 1.00
5.20 0.69
Vulnerability to harm 2.87 1.33 1.00
6.00 0.77
Enmeshment 2.08 0.91 1.00
5.20 0.63
Failure 2.59 1.22 1.00
6.00 0.82
Impaired limits domain 13.79 4.74 5.00
27.50 0.61
Entitlement 2.55 0.99 1.00
5.00 0.65
Insufficient self-control 2.97 1.24 1.00
6.00 0.79
Other-directedness domain 14.55 4.40 5.00
25.33 0.61
Subjugation 2.77 1.11 1.00
5.60 0.72
Self-sacrifice 3.46 1.18 1.00
6.00 0.78
Approval-seeking 2.64 1.11 1.00
5.40 0.74
Overvigilance/inhibition domain 16.08 5.11 6.00
29.00 0.82
Negativity 3.22 1.35 1.00
6.00 0.83
Emotional inhibition 2.97 1.34 1.00
6.00 0.81
Unrelenting standards 3.45 1.06 1.00
6.00 0.61
Punitiveness 3.34 1.25 1.00
6.00 0.78
Note: n85
87.

domain) and Subjugation (Other-Directedness domain). In a sample of psychiatric

outpatients, Thimm (2011) found that BPD was positively associated with only
Mistrust/Abuse and Insufficient Self-Control EMS. Inconsistency in the findings in this
area suggests complexity in the relationship between BPD and EMS, and is also
consistent with the tendency for BPD to be associated with a wide range of
psychopathology and various treatment needs (Zanarini et al., 1998).
Fewer studies have examined the relationship between EMS and ASPD, and the
available findings are inconsistent. In the earliest study, Ball and Cecero (2001)
examined the association between PD symptom severity and Five Factor Model
 936 F. Gilbert and M. Daffern

personality traits, EMS and presenting problems in a sample of methadone-

maintained outpatients. They found that ASPD severity was positively associated
with three specific EMS: Mistrust/Abuse, Vulnerability to Harm and Emotional
Inhibition. Associations with Entitlement and Insufficient Self-Control were also
expected based on theoretical conceptualisations of the disorder (Beck et al., 1990),
however, these relationships were not significant. Other studies have found a lack of
significant relationships between ASPD and the individual EMS (Nordahl et al.,
2005; Thimm, 2011). To account for these findings, it has been proposed that EMS
may be less central to certain PDs, including ASPD (Nordahl et al., 2005).
Diagnoses of paranoid PD (PPD) and narcissistic PD (NPD) are also over-
represented amongst offenders (Coid, 2002; Roberts & Coid, 2010; Warren et al.,
2002), although EMS research for these PDs is limited. For PPD, a positive
relationship with the Mistrust/Abuse EMS has been identified (Carr & Francis, 2010;
Nordahl et al., 2005; Reeves & Taylor, 2007; Thimm, 2011), and Nordahl et al. (2005)
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found broader associations with the Disconnection/Rejection and Impaired Autono-

my/Performance EMS domains. For NPD, Young et al. (2003) propose that high
scores on Entitlement, Insufficient Self-Control and Unrelenting Standards and low
scores on all other EMS are typically obtained as a result of the predominantly
overcompensating and avoidant response styles of individuals with NPD. Only
partial support for this pattern has been observed, with Entitlement EMS linked to
NPD in both psychiatric outpatients (Thimm, 2011) and student samples (Reeves &
Taylor, 2007; Zeigler-Hill, Green, Arnau, Sisemore, & Myers, 2011).
The present study aimed to extend previous research (Specht et al., 2009) by
investigating the relationship between EMS and PD symptoms in a sample of
offenders. While the focus was on ASPD and BPD, the relationship between EMS
and symptoms of the eight other DSM-IV PDs was also examined given the lack of
previous research in this area. By exploring the associations between EMS and the
various PDs, the study aimed to gain insight into a particular area of dysfunction
that is largely overlooked via application of the DSM-IV PD criteria alone. Improved
understanding of the relationship between EMS and PD traits is likely to enhance
treatment planning and delivery of psychological interventions for offenders with
PD.
Based on the results of Specht et al. (2009) and the findings emerging from
previous EMS studies, it was hypothesised that (1) greater severity in ASPD
symptoms would be associated with higher scores on the Impaired Limits EMS
domain and (2) greater BPD severity would be associated with higher scores on the
Disconnection/Rejection, Impaired Limits and Impaired Autonomy/Performance EMS
domains, (3) PPD severity would be positively related to Disconnection/Rejection and
Impaired Autonomy/Performance domain EMS and the strongest of these relation-
ships would be with Mistrust/Abuse EMS and (4) NPD severity would be related to
few EMS although would be positively associated with the Entitlement EMS.

Methods
Participants
Participants were 78 male and 9 female offenders (n87) referred to a community
forensic mental health service for pre-sentence psychological or psychiatric
 Psychology, Crime & Law 937

assessment, in circumstances where mental health issues or problematic behaviours

were considered to be pertinent to the sentencing process. Their mean age was 33.4
years (SD 10.7, range: 19
64). The exclusion criteria included individuals who
were unable to speak English without the aid of an interpreter, had an intellectual
disability, or who were experiencing pervasive psychotic symptomatology that
prevented them from completing the assessment (n 4). According to the
Structured Clinical Interview for Axis I Disorders, patient edition (First, Spitzer,
Gibbon, & Williams, 2007), rates of Axis I disorders were: substance use disorder
(n 58, 67%), mood disorder (n 48, 55%), anxiety disorder (n 40, 46%),
adjustment disorder (n13, 15%) and psychotic disorder (n12, 14%).
The data collection occurred between June 2009 and December 2010; partici-
pants were systematically assessed from consecutive referrals received by the service
over this period and were administered the relevant measures irrespective of their
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participation in the research. Participants underwent a clinical interview with

doctoral level research assistants as part of their pre-sentence evaluation; upon
completion of the interview each participant was invited to provide consent for the
information obtained to be used for research purposes. Thirteen individuals declined
to participate in the research.
The sample had committed a diverse range of criminal offences, the most
common offence categories were acts intended to cause injury (n 26, 29.9%), sexual
assault and related offences (n20, 23%), theft (n8, 9.2%) and harassment
offences (n 7, 8.0%). The majority also had a prior criminal history (n 52, 60%).
The socio-demographic characteristics of the sample, study exclusion criteria and
detailed methodology were reported in a previous study (Gilbert, Daffern, Talevski,
& Ogloff, forthcoming). This research comprised part of a larger project that was
approved by the Victorian Institute of Forensic Mental Health and the Monash
University Standing Committee on Ethics in Research Involving Humans.

Materials
The Structured Clinical Interview for Axis II Disorders (SCID-II; First, Gibbon,
Spitzer, Williams, & Benjamin, 1997) was used to assess the 10 DSM-IV Axis II PDs.
The SCID-II is a widely used measure for the clinical assessment of PD and its
validity in establishing these diagnoses is well recognised (Farmer & Chapman,
2002). With regard to categorical diagnoses, 44% of participants (n 38) met criteria
for one or more PD, the rates were as follows: ASPD (n20, 23%), BPD (n14,
16%), PPD (n 10, 12%), Schizoid (n 9, 10%), Avoidant (n5, 6%), NPD (n 4,
5%), Schizotypal (n 3, 3%), Obsessive
Compulsive (n2, 2%) and Dependent (n
1, 1%). Twenty-two per cent of participants (n 19) met criteria for two or more
PDs; the most common combination was ASPD and BPD (n 8, 9%). In addition to
diagnostic status, dimensional scores corresponding to PD symptom severity were
calculated. This approach has been shown to improve the inter-rater reliability of the
SCID-II (e.g., Lobbestael, Leurgans, & Arntz, 2011) and provided ratings of PD
symptom severity for the entire sample. To calculate dimensional scores, in
accordance with the procedure reported by Specht et al. (2009) the scores for each
PD criteria were recoded so that 1 (absent) 0; 2 (sub-threshold) 0.5; and
 938 F. Gilbert and M. Daffern

3 (threshold) 1. These scores were then summed across all relevant items, and the
totals were then divided by the number of diagnostic criteria for each category.
EMS was quantified using the Young Schema Questionnaire-Short Form, Version
3 (YSQ-SF, Version 3; Young, 2005). The YSQ-SF contains 90 items and requires
individuals to rate each item on a 6-point Likert scale from 1 (completely untrue of
me) to 6 (describes me perfectly). Mean EMS scores, reflecting the average score
across the number of items on each scale (range: 1
6), were then calculated. Several
studies indicate that the YSQ-SF has similar psychometric properties to the longer
version of the YSQ (Stopa, Thorne, Waters, & Preston, 2001; Welburn, Coristine,
Dagg, Pontefract, & Jordan, 2002). The YSQ-SF also has adequate discriminant
validity (Oei & Baranoff, 2007) and internal reliability (Stopa et al., 2001); however,
the validity of the YSQ-SF has yet to be examined in relation to offender
populations. In the current research, the YSQ-SF demonstrated good internal
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reliability, with 14 EMS demonstrating Cronbach’s alpha value more than 0.72.
However, four EMS had alphas between 0.61 and 0.69 (Enmeshment, Dependence/
Incompetence, Entitlement and Unrelenting Standards).
Previous studies have found that depressive symptoms can bias responding on the
YSQ (Stopa & Waters, 2005; Welburn et al., 2002). To examine the effect of
depression on responses to the YSQ-SF in the present study, clinical diagnostic
information for depression was assessed using the relevant modules of the Structured
Clinical Interview for Axis I Disorders, patient edition (First et al., 2007). Participants
were rated as experiencing depression if they met the criteria for a major depressive
episode, dysthymic disorder, depressive disorder not otherwise specified or adjust-
ment disorder with depressed mood at the time of assessment.

Statistical analyses
Descriptive statistics for the 10 PD dimensional scores and 18 EMS have been
reported previously (Gilbert et al., forthcoming; Gilbert, Daffern, Talevski, & Ogloff,
2013), although restated here to frame the results of the current study. Bivariate
correlational analyses were first conducted to investigate the associations between
the individual EMS and PD dimensions. Given the large number of comparisons a
more conservative significance level of p B0.001 was applied for these analyses to
reduce the likelihood of Type I errors. Multivariate hierarchical regression analysis
was then used to examine how the EMS were related to ASPD and BPD symptom
severity across the entire sample (n 85); based on the large number of individual
EMS this analyses was conducted at the EMS domain level. Bivariate correlations
between the five EMS domains and ASPD/BPD symptoms were first calculated;
associations that were significant at p B0.05 were then included in the subsequent
regression analyses. Since ASPD and BPD severity were strongly inter-related (r
0.61, p B0.001), ASPD was included as a covariate for the BPD model and vice versa
(Model 1). The effect of gender on ASPD and BPD severity and the five EMS
domain scales was investigated using independent samples t-tests. These results were
non-significant at p B0.05 and gender was consequently not included as an
additional covariate. A second set of regression analyses was conducted in which
the effect of depression on the relationships between the EMS domains and ASPD/
 Psychology, Crime & Law 939

BPD symptoms was examined, whereby the EMS domains were entered as before in
the first step, and in the second step, depression was entered (Model 2).

Results
Descriptive data (means, standard deviations, ranges and internal consistencies
[Cronbach’s alpha]) for the PD dimensions and individual EMS are reported in Table
1. The most prevalent PD symptoms were those of ASPD, followed by BPD, PPD
and Schizoid PD. For the 18 individual EMS, scores were highest on Self-Sacrifice,
Unrelenting Standards, Punitiveness, Negativity/Pessimism and Mistrust/Abuse.
Thirty-one participants (36%) were experiencing depression at the time of
assessment. To explore how the EMS domains were broadly related to depressive
symptomatology, a series of independent samples t-tests were conducted that
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revealed differences between depressed and non-depressed participants on

Disconnection/Rejection (M 16.97, SD 5.43 vs. M11.87, SD 5.78), t(83) 
4.01, pB0.001; Impaired Autonomy/Performance (M14.52, SD 4.25 vs. M
11.37, SD 4.43), t(83)  3.21, p0.002; Impaired Limits (M 16.00, SD 4.51
vs. M12.32, SD 4.36), t(82)  3.68, pB0.001; and Overvigilance/Inhibition
(M17.72, SD 4.35 vs. M15.11, SD 5.34), t(83)  2.30, p0.024;
although there were no differences on Other-Directedness (M15.60, SD4.27
vs. M13.85, SD 4.44), t(83)  1.78, p0.080.
The relationships between the 18 individual EMS scales and 10 PD symptom
severities are presented in Table 2. All identified relationships were in the positive
direction; the PD symptoms yielding the strongest associations with individual EMS
were avoidant PD (AvPD), PPD and BPD. ASPD severity was positively related only
to the Insufficient Self-Control EMS, while NPD was not associated with any of the
EMS. The Social Isolation EMS was most consistently related to the various PD
dimensions (five of ten PDs), followed by Mistrust/Abuse (four of ten PDs),
Dependence, Negativity and Emotional Inhibition (three of ten PDs). The associations
between ASPD and BPD symptoms and the five EMS domains were next examined
(Table 3). ASPD symptom severity was positively related to three EMS domains:
Impaired Limits, Impaired Autonomy/Performance and Disconnection/Rejection, while
BPD severity was positively related to all domains with the exception of Other-
Directedness.
Multivariate hierarchical regression analyses were then used to examine the
association between ASPD and BPD severity and the EMS domains (see Model 1,
Table 4). For the ASPD model, only the Impaired Limits domain (b0.439, p
0.001) emerged as an independent predictor of ASPD severity after the two other
relevant domains were controlled for, with this model accounting for 15%
(R2adj ¼ 148, p 0.001) of the variance in ASPD severity. Furthermore, Impaired
Limits remained significantly related to ASPD severity after BPD severity was
accounted for (b0.275, p 0.020). For the BPD model, after the relevant EMS
domains were entered, Disconnection/Rejection (b 0.419, p 0.013) and Impaired
Limits (b 0.289, p0.027) were found to be significant predictors of BPD, and the
model accounted for 20% of the variance in BPD severity (R2adj ¼ 204, pB0.001).
Only the Disconnection/Rejection remained a significant predictor (b 0.302, p
0.035) of BPD severity after ASPD severity was added, however.
 940 F. Gilbert and M. Daffern

Table 2. Correlation matrix of the EMS and PD symptom severities for 87 offenders.

Pa Sz St AS Bo Hi Na Av De OC

Disconnection/rejection
Abandonment 0.27 0.13 0.32 0.13 0.33 0.06 0.12 0.42* 0.35 0.03
Mistrust/abuse 0.54* 0.28 0.42* 0.30 0.46* 0.02 0.08 0.43* 0.24 0.03
Emotional 0.33 0.20 0.22 0.16 0.30 0.03 0.02 0.60* 0.31 0.02
deprivation
Defectiveness 0.38* 0.29 0.28 0.16 0.36 0.08 0.04 0.65* 0.16 0.06
Social isolation 0.49* 0.38* 0.53* 0.27 0.41* 0.10 0.19 0.51* 0.19 0.23
Impaired autonomy
Dependence 0.40* 0.36 0.37 0.33 0.39* 0.02 0.14 0.42* 0.29 0.12
Vulnerability to 0.46* 0.29 0.36 0.21 0.36 0.06 0.05 0.43* 0.21 0.05
Harm
Enmeshment 0.07 0.05 0.16 0.04 0.01 0.12 0.01 0.15 0.16 0.04
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Failure to 0.32 0.34 0.31 0.21 0.31 0.08 0.02 0.57* 0.22 0.16
Achieve
Impaired limits
Entitlement 0.19 0.16 0.03 0.31 0.22 0.04 0.32 0.06 0.01 0.27
Insufficient 0.31 0.24 0.21 0.39* 0.46* 0.11 0.28 0.32 0.28 0.26
Self-control
Other-Directedness
Subjugation 0.33 0.17 0.32 0.24 0.34 0.13 0.04 0.48* 0.40* 0.03
Self-Sacrifice 0.03 0.04 0.05 0.05 0.04 0.03 0.10 0.21 0.25 0.11
Approval- 0.07 0.02 0.05 0.12 0.12 0.13 0.07 0.18 0.10 0.06
seeking
Overvigilance/Inhibition
Negativity 0.44* 0.26 0.31 0.21 0.41* 0.06 0.01 0.47* 0.30 0.10
Emotional 0.38* 0.41* 0.26 0.18 0.33 0.04 0.01 0.61* 0.20 0.20
Inhibition
Unrelenting 0.07 0.17 0.04 0.02 0.07 0.08 0.01 0.22 0.11 0.29
Standards
Self- 0.20 0.22 0.16 0.11 0.04 0.06 0.04 0.47* 0.15 0.23
punitiveness
Note: Pa, Paranoid; Sz, Schizoid; St, Schizotypal; AS, Antisocial; Bo, Borderline; Na, Narcissistic; Hi,
Histrionic; Av, Avoidant; De, Dependent; OC, Obsessive
compulsive.
* p B0.001.

A second set of regression analyses were conducted to examine the effect of EMS
domains on ASPD and BPD while controlling for depression (see Model 2, Table 4).
After the entry of depression, for the ASPD model, the Impaired Limits domain
remained significantly related to ASPD symptom severity (b0.408, p0.003),
while for the BPD model, the Disconnection/Rejection domain (b 0.354, p 0.039)
significantly predicted BPD severity.

Discussion
The present study explored the relationship between EMS and PD severity in an
offender population; a particular focus was on ASPD and BPD traits due to their
high prevalence amongst offenders. The research generated several findings that
 Psychology, Crime & Law 941

Table 3. Correlation matrix of the five EMS domains and ASPD, BPD severity.

1 2 3 4 5 6 7

(1) Disconnection/Rejection

(2) Impaired Autonomy 0.72*

(3) Impaired Limits 0.55* 0.63*

(4) Other-Directedness 0.61* 0.60* 0.44*

(5) Overvigilance/Inhibition 0.76* 0.73* 0.48* 0.64*

(6) ASPD 0.25** 0.22** 0.42* 0.19 0.10

(7) BPD 0.44* 0.32* 0.41* 0.19 0.29** 0.61*

Note: n85.
* p B0.001; ** pB0.05.

appear to warrant further investigation of the EMS
PD relationship among

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offenders. First, support was obtained for the hypothesised relationship between
ASPD and the Impaired Limits EMS domain. This association appeared robust, with
Impaired Limits demonstrating a unique relationship with ASPD symptom severity

Table 4. Hierarchical regression analyses of EMS domains on ASPD and BPD severity.

Model 1 Model 2

Predictor DR2adj b DR2adj b

ASPD Severity Step 1 0.148***

Disconnection/Rejection
0.088


Impaired Autonomy
0.115


Impaired Limits
0.439***


Step 2 0.242*** 0.004
Disconnection/Rejection
0.123
0.049
Impaired Autonomy
0.037
0.111
Impaired Limits
0.275*
0.408**
BPD Severity
0.562**


Depression


0.133
Total R2adj 0.390**
0.152**

BPD Severity Step 1 0.204**



Disconnection/Rejection
0.419*


Impaired Autonomy
0.103


Impaired Limits
0.289*


Overvigilance/Inhibition
0.090


Step 2 0.225*** 0.013

Disconnection/Rejection
0.302*
0.354*
Impaired Autonomy
0.099
0.112
Impaired Limits
0.063
0.252
Overvigilance/Inhibition
0.053
0.057
ASPD severity
0.527**

Depression


0.166
Total R2adj 0.429*** 0.217***

Note: n85.
*p B0.05; **pB0.01.
 942 F. Gilbert and M. Daffern

after the effects of the other EMS domains, BPD severity and depression were taken
into account. These findings correspond to those reported in the only previous study
of EMS and PD in offenders (Specht et al., 2009); however, they are novel since the
present sample was comprised largely of male offenders. EMS in the Impaired Limits
domain correspond to deficiencies in respecting the rights of and cooperating with
others, making commitments and setting or meeting realistic personal goals (Rafaeli
et al., 2011), and the relationship with ASPD symptoms may reflect the reluctance of
these individuals to take responsibility for their own behaviour. The finding is also in
accordance with those of Polaschek, Calvert, and Gannon (2009), who found that an
‘I get out of control’ implicit theory was commonly held by violent offenders; this
perception of poor self-regulation might be underpinned by a combination of
biological, genetic factors and learning experiences.
The finding that ASPD severity was related to Insufficient Self-Control is
inconsistent with the findings of Nordahl et al. (2005) and Thimm (2011), who did
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not find associations between ASPD and EMS. They also diverge from the findings
of Ball and Cecero (2001), who found a relationship between ASPD severity and
Mistrust/Abuse and Vulnerability to Harm. This result should therefore be treated
with caution; particularly, EMS may not predominate in people with ASPD,
highlighting the need for idiographic assessment.
The hypotheses for BPD were partially supported, with BPD severity related to
two individual Disconnection/Rejection EMS (Mistrust/Abuse, Social Isolation) as
well as Insufficient Self-Control, Dependence and Negativity EMS. These findings are
consistent with the results of those studies that have found relationships between
BPD and a wide range of EMS (e.g., Lawrence et al., 2011; Meyer et al., 2001).
However, in the present study only the Disconnection/Rejection domain was uniquely
associated with BPD symptoms after controlling for the effect of the other domains
and the symptoms of ASPD, a finding that was consistent with Specht et al. (2009),
and seem to suggest that, as in other populations, EMS related to violations of basic
needs such as safety, security and nurturance (Rafaeli et al., 2011) are a core
component of BPD in offenders.
The expectation that PPD severity would be related to EMS in the Disconnection/
Rejection and Impaired Autonomy/Performance domains was also supported.
Additionally, the strongest relationship identified was that with the Mistrust/Abuse
EMS. This finding adds to the previous body of research in both clinical (e.g.,
Thimm, 2011) and non-clinical populations (e.g., Reeves & Taylor, 2007) indicating
that PPD is associated with significantly higher Mistrust/Abuse EMS, a core belief
that corresponds to the definitional criteria for PPD (e.g., ‘suspects . . . others are
exploiting, harming or deceiving’, American Psychiatric Association, 2000, pp. 694).
In addition, PPD severity was more broadly related to a total of seven of the 18 EMS
described by Young et al. (2003), suggesting complexity in the relationship between
PPD symptoms and EMS. With respect to NPD, the expectation that NPD severity
would be positively associated with Entitlement EMS was not supported. Further-
more, this PD lacked relationships with any of the other 18 EMS. This profile was
consistent with Young et al.’s (2003) propositions regarding the overcompensating
and avoidant response style of individuals with NPD.
A final key finding was that EMS profiles were variable across the 10 PDs.
Selected PDs including BPD, AvPD and PPD, were associated with a range of EMS,
whereas others such as Histrionic and NPD lacked a strong association. EMS studies
 Psychology, Crime & Law 943

have typically adopted a range of methodologies, and the present findings contribute
to the assumption that the relationship between EMS and PD is not easily
characterised and that it may well be problematic to make assumptions regarding
the EMS that underlie each PD. It has been noted that that the behavioural
adaptation of individuals with the same EMS may markedly differ depending on
their coping style (Rafaeli et al., 2011). For example, one individual may react angrily
and then behave aggressively when the Mistrust/Abuse EMS is activated; another
person may become distressed and self-harm.
The implications of these findings are that idiographic assessment and
formulation are required prior to treatment, determining the relevance of specific
EMS to each individual. The YSQ presents as a useful tool for this process,
enabling scrutiny of the relationship between an individual’s EMS and offending
behaviours. Results of an assessment using the YSQ can then be interpreted in
collaboration with the client to establish a shared understanding of their EMS and
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the way in which they generate problematic behaviours. Clinical assessment of

coping responses and the relationship between activated schema and aggression
and other violent behaviour is also likely to be helpful. A further implication is that
for clinicians involved in the treatment of individuals or groups where there is a
high prevalence of ASPD traits, schema-focused interventions would benefit from
targeting beliefs associated with Impaired Limits, similarly, for BPD, interventions
should target Disconnection/Rejection beliefs.
The results of the present study should be interpreted in light of several limitations.
First, the sample size was modest. Although comparable to those of other EMS studies
(e.g., Nordahl et al., 2005), it may be that moderate or small EMS
PD relationships
could have been detected with a larger sample. In addition, the sample comprised a
large proportion of individuals who did not meet the criteria for categorical diagnoses
of PD. There may be more notable differences in EMS
PD relationships among
those with more severe PD and there is a need for more research in this area. In
relation to the assessment process, the effect of response styles on the way in which
participants answered the YSQ:SF was difficult to determine. Specifically, indivi-
duals may have lacked insight into their beliefs or, alternatively, may have utilised
coping strategies to defend against conscious awareness of their EMS. It is presently
unclear how this issue might have been rectified given the lack of research in this
area. Finally, the proportion of females in the sample was small (n9). Although it
was considered necessary to include female participants given the relatively small
sample size overall and the lack of previous research to indicate differences between
the genders with respect to the association between EMS and PD, it is unclear whether
the results of the present study may be generalised to females. Future studies will need
to examine gender differences in EMS profiles with respect to the various PDs.
With respect to future avenues for research, attention has recently increasingly
focused on the concept of schema modes, that is, alternating patterns of thinking,
feeling and behaviour that variously underlie PD (e.g., Lobbestael, Arntz, &
Sieswerda, 2005). Utilisation of the Schema Mode questionnaire (Young et al.,
2007) might also assist in clarifying the operation of EMS in offender
populations, and further research in this area is warranted. Replication of the
present study in larger samples and in incarcerated offenders would also be
particularly beneficial, as well as more comprehensive investigation of the
relationship between ASPD traits and EMS. Another promising avenue for
 944 F. Gilbert and M. Daffern

future research would be to examine how EMS specifically relates to offending

behaviour; qualitative research may help to elucidate individuals’ responses and
coping mechanisms for activated EMS.
In summary, the present study replicated and extended previous research testing
the assumption that certain maladaptive cognitions are related to PD. Those PDs
seen in forensic populations are characterised by hostility, lack of remorse, poor
control of emotions and anger and irritability, and the present results assist in
elucidating the core beliefs underpinning these disorders. Nonetheless, the relation-
ship between EMS and PD appears complex and requires further investigation to
fully discern the utility of schema-focused approaches to the assessment and
treatment of offenders with PD.

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