Early maladaptive schemas,emotion regulation,coping with stress,quality of life,and psychological symptoms in psoriasis disease

Abstract

This study examined relationships between Early Maladaptive Schemas (EMS), emotion regulation, coping styles, and psoriasis outcomes in Istanbul, Turkey. Participants included 100 psoriasis patients (ages 25–45) and 107 healthy controls. Data were analyzed using structural equation modeling. Psoriasis patients scored significantly higher on six schemas: Emotional Deprivation, Approval Seeking, Pessimism, Self-Sacrifice, Punitiveness, and Unrelenting Standards (Cohen’s d = 0.42–0.89). They also demonstrated greater emotion regulation difficulties and reduced adaptive coping. Mediation analyses revealed that maladaptive emotion-focused coping fully mediated relationships between EMS and quality of life deterioration (β = .11, 95% CI (.04, .19]) and psoriasis severity (β = .08, 95% CI [.02, .15]). Pessimism and Punitiveness schemas, impulse control difficulties, and maladaptive emotion-focused coping predicted general psychological symptom severity (measured by validated scales) (R² = .46). Findings suggest maladaptive emotion-focused coping as a key mechanism linking schemas to psoriasis outcomes, supporting integrated dermatological and psychological interventions.