A next generation of the schema therapy model of personality pathology: A cross-cultural and international study protocol

F Freideriki Carmen Mamali M Marleen Rijkeboer D Dylan Molenaar S Sophie A. Rameckers M Marta Panzeri A Arnoud Arntz C Christopher W. Lee R Robert Brockman D Daniela Ho Tan M Muhammad Kamruzzaman Mozumder T Tarun Kanti Gayen D Dmitry Dyakov Y Yuliya Stabrouskaya A Amirov Gatam V Vladislav Lobanovich S Sofiya Kanavina V Veronika Romanovich O Olkhouka Artsiom Andreevich N Natallia Tkhoryk A Aliaksandra Shabaikovich E Eva Dierckx E Els Pauwels K Kristina Eggermont F Fabiola Rodrigues Matos R Renan Puléo Barela L Lilian Queiroz Frossard I Irina S. Lazarova K Krista Peneva A Atanaska Katrandjieva A Anna St. Lazarova Y Yawen Zhu B Baozhen Lyu Y Yuhan Liu L Libo Li (College of Chemistry and Chemical Engineering, State Key Laboratory of Clean and Efficient Coal Utilization) H Hongxia Qin X Xiaowei Guo X Xin Hu S Songhao Zhang O Olivia Y. T. Ma A Aled L. Y. Tang S Stine Bjerrum Moeller I Ida-Marie T. P. Arendt B Bo Bach J Jacob Meline G Géraldine Tapia K Katia M’bailara K Ketevan Abdushelishvili A Archil Begiashvili N Natia Badrishvili A Ana Gvinianidze L Lana Akopashvili I Irma Khabazi J Johannes Kopf-Beck C Cosima Leithne F Fritz Renner S Samy Egli S Sarah M. Quaatz I Ioannis A. Malogiannis E Eleni Giannoulis G Gregoris Simos Z Zsolt Unoka L Lajos Simon V Viktoria Simon M Manjula Munivenkatappa P Paulomi Matam Sudhir T Tavleen Kaur Kohli A Apoorva Shrivastava A Arpita Alok Misra A Anisha Khanna J John Philip Louis N Naomi Maurilla Santoso T Theresia Indira Shanti L Laurentius Sandi Witarso M Maryam Hedayati A Adeleh Samimi S Saade Malekasgar B Barbara Basile I Ilona Krone A Agnese Orupe J Julija Gecaite-Stonciene J Justina Pociunaite H Huey Jing Renee Tan E Edward Chan V Veerathayalani Heimkumar N Nadia Kadri S Saadia Karroumi F Fatima Zahra Chentaf N Naima Ezzahiri H Hind Rachidi S Soukaina Bouchebti H Hind Bouidar W Wydad Hikmat F Fouzia Chroukate Z Zainaib Ennaciri J Jens C. Thimm V Veronica Lorentzen J Jarosław M. Michałowski A Agnieszka E. Popiel D Dorota Mącik W Weronika Maria Browarczyk M Maria do Céu Salvador A Ancuța Elena Păduraru S Suzana E. Semeniuc P Paula I. Stroian I Irina Șubredu A Alexandra Yaltonskaya D Darya Maryasova O Olga Titova N Natalia Gegel N Natalia Gorodentseva M Maria Skryabina A Alena Plichko O Olga Pavlova S Svetlana Prokaeva V Viktoryia Malashchanka H Hui Ling Michelle Neo D Dan J. Stein W Waseem Hawa J Jean-Pierre Hartmann E Eunhee Lee Y Younghee Song R Rocío Gómez-Juanes E Esther Calvete J Jordi Cid R Ralph E. Schmidt S Stephanie Homan C Chaiyun Sakulsriprasert D Darunee Phukao R Ratipan Thawornwutichat W Welika Mamoon A Anuk Chandraungs N Nanthaka Supreeyaporn N Nathan Bachrach M Marije Keulen-de Vos J Jill Lobbestael E Eline Dorrestijn J Julie Krans D Duygu Yakin D Deniz Baştak A Aliye Canan Taşlioğlu Sayiner B Başak İnce S Stephanie Tasilaridis M Mine Ergelen F Fiona C. Kennedy C Christopher D. J. Taylor M Michael B. First (Department of Psychiatry, Columbia University) G George Lockwood Z Zachary Appenzeller A Alice R. Norton E Elizabeth Seeley-Wait M Maree J. Abbott K Karina L. Allen S Surilena Hasan S Sergio Alejandro Morales Hernández A Abdelrahman Mohamed Sharaf F Florian Alexander Ruths

Abstract

Background Personality disorders are highly prevalent worldwide imposing substantial personal and social challenges. Schema Therapy is an effective psychotherapeutic approach for personality pathology and other complex characterological problems. New scientific insights prompted a re-evaluation of its theoretical underpinnings leading to a reformulated Schema Therapy theory. Furthermore, the assumed cross-cultural universality of the Schema Therapy model has not been tested. Aims This project has two primary aims: (1) To develop revised instruments based on the reformulated theory that are psychometrically sound and valid across diverse cultures and languages. (2) To validate the Schema Therapy-related constructs and their inter-relationships across cultures. Methods New draft versions of the Young Schema Questionnaire, Schema Coping Inventory, and Schema Mode Inventory were developed. Before dissemination, these instruments will undergo rigorous psychometric evaluation to refine item sets and ensure linguistic and conceptual consistency. A minimum of 100 adult mental health patients and 100 non-patients from each participating country will complete the revised instruments. Sociodemographic and mental health-related variables will also be assessed. Statistical analyses will evaluate (a) internal consistency, (b) unidimensionality, (c) cross-cultural invariance, (d) factorial validity (if possible), and (e) known-group validity. Malfunctioning items will be deleted, and subscales will be shortened, if possible, targeting internal consistency of ≥.80. Expected outcomes This study is expected to yield optimized versions of the three instruments aligned with the reformulated theory. These findings will inform subsequent international studies to further assess the structural and cross-cultural validity of the revised scales. The resulting empirically validated scales will be openly accessible, facilitating worldwide utilization. Discussion This protocol outlines the first international study based on the reformulated theory, aiming to extend the psychopathological coverage and enhance the cross-cultural application of evidence-based treatments for personality pathology. Results will be disseminated through peer-reviewed publications and conference presentations. Potential limitations are discussed.

Article Details

Journal PLoS ONE
Volume / Issue Vol. 21, Issue 6
Published June 12, 2026
Pages e0332723
ISSN 1932-6203
Publisher Public Library of Science

Journal Info

PLoS ONE

Public Library of Science

ISSN: 1932-6203 Open Access Health Sciences

Authors (156)

F

Freideriki Carmen Mamali

M

Marleen Rijkeboer

D

Dylan Molenaar

S

Sophie A. Rameckers

M

Marta Panzeri

A

Arnoud Arntz

C

Christopher W. Lee

R

Robert Brockman

D

Daniela Ho Tan

M

Muhammad Kamruzzaman Mozumder

T

Tarun Kanti Gayen

D

Dmitry Dyakov

Y

Yuliya Stabrouskaya

A

Amirov Gatam

V

Vladislav Lobanovich

S

Sofiya Kanavina

V

Veronika Romanovich

O

Olkhouka Artsiom Andreevich

N

Natallia Tkhoryk

A

Aliaksandra Shabaikovich

E

Eva Dierckx

E

Els Pauwels

K

Kristina Eggermont

F

Fabiola Rodrigues Matos

R

Renan Puléo Barela

L

Lilian Queiroz Frossard

I

Irina S. Lazarova

K

Krista Peneva

A

Atanaska Katrandjieva

A

Anna St. Lazarova

Y

Yawen Zhu

B

Baozhen Lyu

Y

Yuhan Liu

L

Libo Li

College of Chemistry and Chemical Engineering, State Key Laboratory of Clean and Efficient Coal Utilization

H

Hongxia Qin

X

Xiaowei Guo

X

Xin Hu

S

Songhao Zhang

O

Olivia Y. T. Ma

A

Aled L. Y. Tang

S

Stine Bjerrum Moeller

I

Ida-Marie T. P. Arendt

B

Bo Bach

J

Jacob Meline

G

Géraldine Tapia

K

Katia M’bailara

K

Ketevan Abdushelishvili

A

Archil Begiashvili

N

Natia Badrishvili

A

Ana Gvinianidze

L

Lana Akopashvili

I

Irma Khabazi

J

Johannes Kopf-Beck

C

Cosima Leithne

F

Fritz Renner

S

Samy Egli

S

Sarah M. Quaatz

I

Ioannis A. Malogiannis

E

Eleni Giannoulis

G

Gregoris Simos

Z

Zsolt Unoka

L

Lajos Simon

V

Viktoria Simon

M

Manjula Munivenkatappa

P

Paulomi Matam Sudhir

T

Tavleen Kaur Kohli

A

Apoorva Shrivastava

A

Arpita Alok Misra

A

Anisha Khanna

J

John Philip Louis

N

Naomi Maurilla Santoso

T

Theresia Indira Shanti

L

Laurentius Sandi Witarso

M

Maryam Hedayati

A

Adeleh Samimi

S

Saade Malekasgar

B

Barbara Basile

I

Ilona Krone

A

Agnese Orupe

J

Julija Gecaite-Stonciene

J

Justina Pociunaite

H

Huey Jing Renee Tan

E

Edward Chan

V

Veerathayalani Heimkumar

N

Nadia Kadri

S

Saadia Karroumi

F

Fatima Zahra Chentaf

N

Naima Ezzahiri

H

Hind Rachidi

S

Soukaina Bouchebti

H

Hind Bouidar

W

Wydad Hikmat

F

Fouzia Chroukate

Z

Zainaib Ennaciri

J

Jens C. Thimm

V

Veronica Lorentzen

J

Jarosław M. Michałowski

A

Agnieszka E. Popiel

D

Dorota Mącik

W

Weronika Maria Browarczyk

M

Maria do Céu Salvador

A

Ancuța Elena Păduraru

S

Suzana E. Semeniuc

P

Paula I. Stroian

I

Irina Șubredu

A

Alexandra Yaltonskaya

D

Darya Maryasova

O

Olga Titova

N

Natalia Gegel

N

Natalia Gorodentseva

M

Maria Skryabina

A

Alena Plichko

O

Olga Pavlova

S

Svetlana Prokaeva

V

Viktoryia Malashchanka

H

Hui Ling Michelle Neo

D

Dan J. Stein

W

Waseem Hawa

J

Jean-Pierre Hartmann

E

Eunhee Lee

Y

Younghee Song

R

Rocío Gómez-Juanes

E

Esther Calvete

J

Jordi Cid

R

Ralph E. Schmidt

S

Stephanie Homan

C

Chaiyun Sakulsriprasert

D

Darunee Phukao

R

Ratipan Thawornwutichat

W

Welika Mamoon

A

Anuk Chandraungs

N

Nanthaka Supreeyaporn

N

Nathan Bachrach

M

Marije Keulen-de Vos

J

Jill Lobbestael

E

Eline Dorrestijn

J

Julie Krans

D

Duygu Yakin

D

Deniz Baştak

A

Aliye Canan Taşlioğlu Sayiner

B

Başak İnce

S

Stephanie Tasilaridis

M

Mine Ergelen

F

Fiona C. Kennedy

C

Christopher D. J. Taylor

M

Michael B. First

Department of Psychiatry, Columbia University

G

George Lockwood

Z

Zachary Appenzeller

A

Alice R. Norton

E

Elizabeth Seeley-Wait

M

Maree J. Abbott

K

Karina L. Allen

S

Surilena Hasan

S

Sergio Alejandro Morales Hernández

A

Abdelrahman Mohamed Sharaf

F

Florian Alexander Ruths