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Role and treatment of early maladaptive schemas in Vietnam veterans with PTSD

Cockram, David McEwan (2009) Role and treatment of early maladaptive schemas in Vietnam veterans with PTSD. Professional Doctorate thesis, Murdoch University.

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The first study examined the role of perceived adverse parenting and early maladaptive schemas in the development of PTSD in Australian and New Zealand Vietnam war-veterans (N = 220). Veterans diagnosed with PTSD scored higher on the Young Schema Questionnaire and had higher scores on the Measure of Parental Style (MOPS) than veterans not diagnosed with PTSD. Only three childhood negative events were associated with PTSD: witnessing domestic violence; mother unemployed; and living with a stepfather. These variables may relate to research on negative family environment being associated with PTSD, whereas schemas may relate to parenting. The finding of strong relationships between negative life events data and adverse parenting endorses the MOPS as a valid instrument.

Admission to hospital in Vietnam was the only war variable related to PTSD. Schemas mediated the negative parenting - PTSD link, and the Vietnam War experience - PTSD link. The results suggest that early maladaptive schemas have an important role in the development or maintenance of PTSD in Vietnam veterans.

The second study measured at baseline, termination and three months the early maladaptive schemas, PTSD, anxiety, depression, and relationships of war-veterans (n = 54) participating in a PTSD group treatment program that included schema-focused therapy. Scores on the PTSD Check List, the Hospital Anxiety and Depression Scale, and 17 schemas decreased significantly after treatment. The Abbreviated Dyadic Adjustment Scale and the Assessment of Quality of Life scores indicated that the veterans’ current relationships improved. Partners of veterans also experienced enhanced relationships. All gains were maintained at three-month follow-up. The five schema domains were associated with an improvement in PTSD symptoms, with gains on the impaired autonomy domain being associated with 26.3% of the changes in PTSD. Change scores for the schema treatment were compared to a similar earlier manualised CBT program. Pre-treatment measures were similar in both groups. Nevertheless, PTSD and anxiety improved significantly more for the schema-focused therapy group. Although the second study was not a randomised control comparison, both studies support the feasibility of schema-focused therapy to assist veterans with PTSD.

Item Type: Thesis (Professional Doctorate)
Murdoch Affiliation(s): School of Psychology
Supervisor(s): Drummond, Peter and Lee, Chris
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