Early Maladaptive Schemas and Dissociation in Adolescent PTSD: Examining Indirect Pathways

Responses to traumatic experiences and their relevance to psychopathology remain central topics in clinical research. This study examined the potential indirect effects of early maladaptive schemas (EMSs) and dissociative experiences in the association between trauma exposure and post-traumatic stress disorder (PTSD) symptom severity among adolescents. The sample comprised 70 Turkish adolescents aged 14-18 years (M = 16.3, SD = 1.2) with trauma histories meeting DSM-5 Criterion A for PTSD. Five EMS domains, assessed using the Young Schema Questionnaire, and four dissociative dimensions, measured by the Adolescent Dissociative Experiences Scale, were evaluated through a bootstrapped multiple indirect effects analysis. Current PTSD was identified in 60.0% of the sample; the most frequent index trauma was sexual abuse (47.1%), with 69.7% of these cases meeting PTSD criteria. The disconnection/rejection (β = 0.500, z = 2.400, p = 0.016) and other-directedness (β = 0.392, z = 2.290, p = 0.022) schema domains demonstrated significant indirect associations with PTSD symptom severity. Among dissociative dimensions, depersonalization/derealization (β = 0.430, z = 2.450, p = 0.014) also showed a significant indirect association. To the best of our knowledge, this is the first study to examine these indirect associations in an adolescent clinical sample. Although causal inferences cannot be drawn due to the cross-sectional design, findings highlight potential psychological pathways linking trauma to PTSD and may inform targeted early interventions for trauma-exposed youth.