The Effect of Schema Therapy on marital satisfaction - journal ...

ijcrb.webs.com 

INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS 

Abstract 

COPY RIGHT © 2012 Institute <strong>of</strong> Interdisciplinary Business Research 

APRIL 2012 

VOL 3, NO 12 

<strong>The</strong> <strong>Effect</strong> <strong>of</strong> <strong>Schema</strong> <strong>The</strong>rapy on marital satisfaction <strong>of</strong> couples with 

Obsessive-compulsive personality disorder (OCPD) 

Samaneh Mokhtari 6 , Dr. Fatemeh Bahrami 7 ,Zahra Padash 8 , Simin Hosseinian 9 , 

Mohammad Soltanizadeh 10 

<strong>The</strong> aim <strong>of</strong> this study is to determine the effect <strong>of</strong> schema therapy on marital satisfaction <strong>of</strong> 

couples with obsessive-compulsive personality disorder (OCPD) in Isfahan. <strong>The</strong> method is 

experimental with control and experimental group, pretest and posttest. <strong>The</strong> sample consist <strong>of</strong> 

20 couples referring counseling centers and were diagnosed as OCPD using clinical interview 

by psychiatrist and Millon Clinical Multiaxial Inventory-III. <strong>The</strong> participants were randomly 

assigned into two groups <strong>of</strong> schema therapy (experimental, n=10) and control group (control, 

n=10). <strong>The</strong>y responded to items <strong>of</strong> Millon Clinical Multiaxial Inventory-III (MCMI-III), 

ENRICH Marital Satisfaction Questionnaire, and Young <strong>Schema</strong> Questionnaire. <strong>The</strong> results 

<strong>of</strong> MANOVA showed that schema therapy decreased symptoms <strong>of</strong> OCPD (P




APRIL 2012 

VOL 3, NO 12 

Marriage satisfaction results from happiness and a good adjustment between the husband 

and wife about different aspects <strong>of</strong> life and it guarantees the strength <strong>of</strong> the family and a 

healthy relationship (Asgari, 2001). 

It seems to be two main theoretical approaches related to effective factors on marital 

satisfaction. In psychoanalytical theories, intrapersonal factors and in behavioral theories 

interpersonal factors are regarded. 

As a whole it can be said that factors such as age, education, children, marriage duration, 

couples' cooperation, interpersonal understanding, religious beliefs, financial matters, friends 

and relatives, sexual relationship, leisure time activities and housework, occupation, 

interpersonal skills, intimacy and self expression, cognitive factors, personality traits, mental 

disorders and psychological health are effective on marital satisfaction (Nazari, 2008; Greef 

and Malherb, 2001, Bouchard, Sabounn, lussier& Villeneure, 2009). 

One factor that has an important effect on interpersonal relationship including couples is 

personality pathology. Based on DSM-IV, a person with personality disorders is noticeably 

destructive in two domains <strong>of</strong> personal and interpersonal functioning. Personal domain means 

that what the client's view is and therefore what are his/her purposes in life and how to follow 

them? Interpersonal domain emphasizes on whether s/he can understand other's view and 

relate with them. Although there has been not much research on the simultaneity relationship 

between personal pathology and marital dysfunction, but South, Turkheimer and Oltmanns 

(2008) in a research on a sample <strong>of</strong> 82 married couples showed that personality disorder has 

had a significant correlation with marital satisfaction, verbal aggression, physical violence; 

and personality disorder determines 25% to 45% <strong>of</strong> the variation <strong>of</strong> marital adjustment. Since 

personality disorder individuals have problems in interpersonal functioning, <strong>The</strong>y also have 

various problems in adjustment and marital satisfaction. 

208




APRIL 2012 

VOL 3, NO 12 

One <strong>of</strong> the personality disorders that is diagnosed by perfectionism, moodiness, and 

extreme orderliness is the obsessive-compulsive personality disorder (OCPD). <strong>The</strong>se 

individuals have shortcomings in relationship patterns with their spouses, emotional 

expression and emotional limitation and they are usually very formal, unemotional and moral 

(Rosenhan and Seligman, 1995). Since, intimate relationship, self expression, positive 

emotions and praising each other are the necessary factors for marital satisfaction( Monroe, 

1990; Bouchard et al, 2009) obsessive-compulsive personality disorder (OCPD) is considered 

as one <strong>of</strong> the important effective factors on marital dissatisfaction. 

For marital satisfaction and adjustment, it is necessary to develop a constant effective 

relationship and for this purpose, the couple needs to share thoughts and emotions and to give 

positive reactions and gratitude to each other (Siliman, 2001). And at the same time poor 

interpersonal skills, unclear or conditional relationships, fault seeking and constant blaming, 

mind-reading and defiance, showing negative emotions repeatedly and on the other hand 

having little positive emotions, having negative thoughts and cognitive distortions could be 

lead to marital maladjustment and dissatisfaction (Gottman, 1993; Nakonezny,Shull and 

Rogers,1995). 

People who suffered from OCPD, have behavioral and emotional patterns such as 

repressing their own emotions, prejudice and stiffness in behavior, and over control on their 

own and other people's behavior. <strong>The</strong>se people have limited feelings and control on their own 

emotions and don't usually express them. <strong>The</strong>y also repress their own anger and hate (Millon, 

Grossman, Millon, Meagher and Ramnath, 2004). Regarding to the features <strong>of</strong> the obsessive- 

compulsive personality disorder (OCPD), this special patterns <strong>of</strong> expressing emotions and 

behavior cause to relationship problems and can lead to mental separation (Gottman, 1994). 

In the developmental history <strong>of</strong> these individuals being forced to do what other people 

impose is very common (Choca and Van Denberg, 1997). <strong>The</strong> parenting styles that most 

209




APRIL 2012 

VOL 3, NO 12 

notably associated with the disorder are consistently, strict, authoritarian, and over controlling 

styles. In their childhood, these children were likely taught to be overly responsible for their 

behaviors, and trained to feel shameful and worthless if not compliant. Sperry and Carlson 

(1996) hypothesized that ―the parental injunction to which they were most likely exposed was 

‗You must do and be better to be worthwhile‘‖ (Laksman, 2007). 

Cognition approaches consider the role <strong>of</strong> irrational core beliefs or maladaptive schemas 

as important factor in the forming <strong>of</strong> obsessive compulsive personality disorder (Millon, 

Grossman, Millon, Meagher and Ramnath, 2004). <strong>The</strong> obsessive compulsive personality 

disorder (OCPD) correlate to dysfunctional cognition schemas towards responsibility and its 

thoughts deal with schemas such as blame, punishment, guilt and shame. <strong>The</strong>se schemas are 

predefined in their memories that <strong>of</strong>ten impose their structures to the new information 

(Rheaume, Ladouceur, Freestone and Lerarte, 1995). <strong>The</strong>y also have low desire to healthy 

behavioral responses so that they experience impulsive behaviors and high worry( Arntz, 

Weertman, Salt, 2001). 

<strong>The</strong>re are different approaches concerning how to cure people suffering from personality 

disorders including obsessive compulsive personality disorder (OCPD). To name just a few 

we can mention: Psychoanalyses based on transference psychotherapy (Kernberg and 

Klarkin, 1999), behavioral psychotherapies such as Dialectical Behavior therapy (Linehan, 

1993) and also treatments based on cognitive approaches such as cognitive therapy (Beck and 

Freeman, 1990; Freeman and Fusco, 2004), rational-emotional therapy (Ellis,2001), 

contrastive-cognitive therapy (Sharf,2002), cognition Revolutional therapy (Lyoti,2002; 

Oldham, Gabbard and Gain, 2001; Arntz, Klokman and Siesweda, 2005) and also medicine 

therapy (Joyice, 2003). 

210




APRIL 2012 

VOL 3, NO 12 

One <strong>of</strong> the various types <strong>of</strong> cognitive therapy that is actually the developed form <strong>of</strong> the 

traditional cognitive behavioral therapy and focuses more on relationship therapy, emotional 

experiences and early life experiences is the schema focused therapy (Young, 1999). 

<strong>Schema</strong> therapy is based on a cognitive–integrative conceptualization <strong>of</strong> personality 

disorders using a broader and more eclectic approaches than the usual cognitive therapy 

approaches, integrating various theoretical formulations (Young, 1994; Arntz, 1994; Young, 

Klosko, & Weishaar, 2003; quoting from Nordhal and Nyster, 2005). 

A schema condition is an organizational manner <strong>of</strong> thinking, feeling and behaving based 

on a group <strong>of</strong> schemas and each group <strong>of</strong> schema conditions is relatively independent <strong>of</strong> the 

others (Arntz, Klokman and Siesweda, 2005). Early Maladaptive <strong>Schema</strong>s (EMS) are broad, 

pervasive themes or patterns that develop during childhood or adolescence and grown into 

older age and are inefficient to a high degree (Young, 1999). 

<strong>Schema</strong> therapy combines techniques from cognitive, behavioral, psychoanalytical, 

existentialism and humanistic therapies. Although the basic frame in this therapy is based on 

cognition, it has been affected a lot by object relations and attachment approaches. Unlike 

different types <strong>of</strong> cognitive therapies that focus on the present state <strong>of</strong> the person, schema 

therapy approach focuses on self-destroying thoughts, feelings and behaviors that were 

developed in childhood and are repeated in his life (Bernstain, 2005;quoting from 

Strack,2005) and is developed for patients resistant to treatment such as personality disorders, 

chronic depressions and anxiety disorders. <strong>Schema</strong> therapy has four main interventions, 

including:1) Cognitive Interventions,2) Experiential Interventions,3) Interpersonal 

Interventions,4) Behavioral Interventions. <strong>Schema</strong> therapy procedure is divided into two 

main phases: a) Conceptualization and Evaluation, b) Change schema (Young, Klosko and 

Weishaar, 2003). 

211




APRIL 2012 

VOL 3, NO 12 

<strong>The</strong> several researches concerning the efficiency <strong>of</strong> this schema therapy have been done. 

Although these research don't study the efficiency <strong>of</strong> the schema therapy for the obsessive 

compulsive personality disorder, but they can be used as a pro<strong>of</strong> for its effectiveness on 

personality disorders. Nordhal and Nyster (2005) have reported schema therapy as effective 

on reducing the symptoms <strong>of</strong> borderline personality disorders. Nordhal, Holth and Shaugum 

(2005) also, did a study about the effectiveness <strong>of</strong> moderating <strong>of</strong> schema on reducing the 

symptoms <strong>of</strong> personality disorder. <strong>The</strong>y also perceived that moderating <strong>of</strong> schema can predict 

the amount <strong>of</strong> the reduction <strong>of</strong> symptoms in this type <strong>of</strong> disorders. <strong>The</strong> results <strong>of</strong> the research 

done by Kellogg and Young (2006), Farrell, Shaw and Webber (2009), and Nadort, (et al, 

2009), are also consistent on the functional <strong>of</strong> schema therapy. <strong>The</strong>re have been few 

researches about marital satisfaction and its connection with personality disorder especially 

the obsessive compulsive personality disorder and the early maladaptive schemas. In 

Gottman's research (1993), it was showed that expressing emotions has an important role on 

couple closeness (Zadhoosh, 2007). Whisman(1999) showed in a research done on a sample 

<strong>of</strong> 2538 married couples that marital dissatisfaction can be related to any kind <strong>of</strong> mental 

disorder. South, Turkheimer and Oltmanns (2008), also showed in a research on a sample <strong>of</strong> 

82 married couples that there is a negative relation between marital satisfaction and 

personality disorders. Shafiee, ( et al, 2006), also perceived in a sample <strong>of</strong> 245 married 

couples that marital satisfaction has a negative relationship with depression, anxiety disorder 

and the obsessive compulsive disorder. Also in the study <strong>of</strong> Naderi (2007) it was denoted that 

concerning perfectionism and marital conflicts there is a significant difference between the 

families who refer to family courts and normal families. 

According to literature and researches, one <strong>of</strong> the important effective factors on marital 

satisfaction is a personality disorder such as the obsessive compulsive personality disorder 

and whereas the obsessive compulsive personality disorder (OCPD) is known by 

212




APRIL 2012 

VOL 3, NO 12 

dysfunctional cognitive schemas, This research aimed to study the effects <strong>of</strong> schema therapy 

on marital satisfaction in married couples suffering from OCPD, by correcting and changing 

the dysfunctional core beliefs or the early maladaptive schemas (EMS). 

Method 

Participants 

<strong>The</strong> participants who entered the study were 20 couples who referred themselves to Isfahan 

counseling centers. Age <strong>of</strong> participants ranged from 23 to 40 years (M=27.6, SD=5.1, years). 

Age <strong>of</strong> their partners ranged from 21 to 45 years (M=45, SD=29.6, years). Length <strong>of</strong> 

marriage ranged from 1 year to 15 years (M=5.37, SD=4.04, years). Fifty percent <strong>of</strong> couples 

hadn't any child, 37.5 percent had one child and 12.5 percent had two children. 

Procedures 

All the participants were randomly chosen from five counseling centers in Isfahan, using the 

cluster random sampling. <strong>The</strong> inviting poster was provided that informed clients about OCPD 

symptoms. Clients who considered themselves as having the symptoms <strong>of</strong> the obsessive 

compulsive personality disorder and perfectionist behavior and were willing to take part in 

this educational-treatment workshop were enrolled. <strong>The</strong>n, based on a diagnostic interview 

according to the DSM-IV-R standards by psychiatrist and using Millon Clinical Multiaxial 

Inventory-III (MCMI-III), from among all the volunteers, a group <strong>of</strong> married couples who 

had the symptoms <strong>of</strong> the obsessive compulsive personality disorder (OCPD) were chosen. 

<strong>The</strong>n, in a simple random sampling twenty people were recruited and were randomly 

assigned into two groups <strong>of</strong> experimental and control. It is worth mentioning that the 

condition for entering <strong>of</strong> subjects was to be at least <strong>of</strong> 18 years age and to have at least 

diploma educational degree. Also excluding conditions were, people who suffering from 

psychotic disorders or the patients has an acute, relatively severe, untreated Axis I disorder 

requiring immediate attention and the patient who is currently abusing alcohol or other drugs 

213




APRIL 2012 

VOL 3, NO 12 

at a moderate to severe level, and also, if their presenting problems to be situational or does 

not seem to be related to a life pattern or schema. <strong>The</strong> participants didn‘t know that they are 

in a research situation while, the therapist knew. <strong>The</strong> y participated in 12 therapeutic sessions. 

<strong>The</strong> attrition rate was zero. <strong>The</strong> people in waiting list participated in therapeutic sessions 

after the research. Due to follow treatment integrity the therapist was the person who planned 

the package <strong>of</strong> therapy. <strong>The</strong>re were no data reduction and the participants‘ satisfaction was 

assessed during the sessions on a continuum form 0 (totally dissatisfied) to 100 (totally 

satisfied). <strong>The</strong> participants were informed that all <strong>of</strong> their information are secret. 

Measures 

<strong>The</strong> data attained using 3 questionnaires including as follow: 

1- <strong>The</strong> Millon Clinical Multiaxial Inventory-III (MCMI-III, Millon 1994) was used in 

order to study the problems and also the symptoms <strong>of</strong> the obsessive-compulsive 

personality disorder at first. This is a self-report scale <strong>of</strong> 175 yes/no questions that 

evaluates 14 personality clinical patterns and 10 clinical symptoms and has 4 validity 

scales. <strong>The</strong> scale number 7 in this questionnaire evaluates the obsessive-compulsive 

personality disorder. In a research done by Sharifi (2002), the Cronbach alpha 

coefficients alpha was <strong>of</strong> 0/85 to 0/97. <strong>The</strong> questionnaire also demonstrated good 

discriminate validity on all scales (Sharifi, 2002). 

2- <strong>The</strong> Enriching and Nurturing Relationship Issues, Communication and Happiness 

Questionnaire (ENRICH), has 115 items and is scored using the Likert scale. This 

questionnaire is made <strong>of</strong> 12 subscales. <strong>The</strong> first scale has 5 items and the others have 

10 items. <strong>The</strong> subscales are included: idealistic distortion, marital satisfaction, 

personality issues, communication, conflict resolution, financial management, leisure 

activities, sexual relationship, children and parenting, family and friends, equalitarian 

roles and religious orientation. This questionnaire was measured according to Iranian 

214




APRIL 2012 

VOL 3, NO 12 

norms and its validity and reliability was approved by Asrar and Haghshenas (2005). 

In Mahdavian's research (1997), the reliability was 0.94 using the retesting method. 

3- <strong>The</strong> Young <strong>Schema</strong> Questionnaire – long form (YSQ is a self-report measure to 

Treatment 

assess schemas. Patients rate themselves on how well each item describes them on a 

6-point Likert scale. <strong>The</strong> maximum and minimum <strong>of</strong> the scores is from zero to five 

and the top mark indicates the high quantity <strong>of</strong> the early maladaptive schemas. This 

questionnaire studies the early maladaptive schemas in 18 different areas. That are 

included: 1)Emotional Deprivation, 2)Abandonment/Instability, 3)Mistrust/Abuse, 

4)Social Isolation/Alienation, 5)Defectiveness/Shame, 6)Failure, 

7)Dependence/Incompetence, 8) Vulnerability to Harm or Illness, 9) 

Enmeshment/Undeveloped Self, 10)Subjugation, 11)Self-Sacrifice, 12)Approval- 

Seeking/Recognition-Seeking, 13)Entitlement/Grandiosity, 14) Insufficient Self- 

Control/Self-Discipline, 15) Negativity/Pessimism, 16) Emotional Inhibition, 

17)Unrelenting Standards/Hypercriticalness, 18) Punitiveness. In Yousefi‘s research 

(2009) the Cronbach alpha coefficient was 0.91(Yousefi, 2009). 

Before receiving the interventions, the experimental and control groups filled in the 

questionnaires. <strong>The</strong> two groups were assessed again by the same measures after 12 

therapeutic sessions. <strong>The</strong> sessions were held 2 hours. 

215



Table 1 presents the format and aims <strong>of</strong> the session for experimental group. 

Table 1: <strong>The</strong> aim and content <strong>of</strong> each session 


APRIL 2012 

VOL 3, NO 12 

Row Content Aim 

1 Elementary session Recognition the OCPD according to the DSM-IV -R standard and Millon Clinical Multiaxial 

2 First session: initial 

evaluation and 

assessment 

3 Second session: 

Presentation <strong>of</strong> 

schemas, and that 

role on behavior 

4 Third session: 

imagery assessment 

5 Fourth session: 

coping styles 

assessment 

6 Fifth session: 

therapeutic strategic 

for defectiveness/ 

shame schema 

7 Sixth session: 


for unrelenting 

standards/ hyper 

criticalness 

8 Seventh session: 


for emotional 

inhibition 

9 Eighth session: 


for negativity/ 

pessimism 

10 Ninth session: 


for self-sacrifice 

11 Tenth session: 


for enmeshment / 

undeveloped self 

12 Eleventh session: 


for vulnerability to 

harm or illness 

13 Twelfth session: 

Ending session 

Inventory-III (MCMI-III) 

<strong>The</strong> break <strong>of</strong> ice, revisal on structure and provision <strong>of</strong> sessions, Educating psychological 

awareness 

Educational pattern <strong>of</strong> ABC, automatic thought, Core beliefs and maladaptive schema , the 

origins <strong>of</strong> schema: core emotional needs, early life experience & emotional temperament 

Presentation <strong>of</strong> inner child and a rational for imagery, Education to letter to parents. 

Educating 3 mechanism schema perpetuation and 3 coping styles (surrender, avoidance, over 

compensator) 

Typical Presentation <strong>of</strong> the schema, understand the childhood origins <strong>of</strong> schema, increase the 

couple‘s sense <strong>of</strong> self-esteem, correct the ―defect‖ in person life and marriage life, willing to enter 

relationships, put human flaws into a realistic perspective, Becoming more open with couple and 

people and stop trying to hide so many parts <strong>of</strong> themselves, and they no longer exhibit behaviors 

that surrender to, avoid, or overcompensate. 

Typical Presentation <strong>of</strong> the schema, challenge their perfectionism and using <strong>of</strong> ―cost–benefit 

analyses‖, understand the childhood origins <strong>of</strong> schema, reduce their unrelenting standards and 

hyper criticalness via: try to accomplish less, and to accomplish it les perfectly, have more <strong>of</strong> a 

balance in their lives between accomplishment and pleasure, Less critical <strong>of</strong> themselves and 

couples, less demanding and more accepting <strong>of</strong> human imperfection, and are less rigid about rules. 

Typical Presentation <strong>of</strong> the <strong>Schema</strong>, understand the childhood origins <strong>of</strong> schema, become more 

emotionally expressive and spontaneous, expressing the emotions that suppressed, learn to show 

anger in appropriate ways, engage in more activities for fun, express affection, and talk about their 

feelings with couples, stop controlling the people around them such as couple, humiliating couples 

for expressing normal emotions, and feeling shame about their own emotions. 

Typical Presentation <strong>of</strong> the <strong>Schema</strong> ,understand the childhood origins <strong>of</strong> schema, predict the future 

more objectively and positively by technique ―illusory glow‖, move away from the extreme 

negative end toward a more moderate position, no longer focused so obsessively on trying to avoid 

making mistakes, focus more on fulfilling emotional needs and following their natural 

inclinations. 

Typical Presentation <strong>of</strong> the schema, understand the childhood origins <strong>of</strong> schema, teach couples 

that all people have an equal right to get their needs met, recognize that they have needs that are 

not being met, decrease the couple‘s sense <strong>of</strong> over responsibility, encourages couples to attend to 

their own needs, to let other people meet their needs, to ask for what they want more directly, and 

to be more vulnerable instead <strong>of</strong> appearing strong more <strong>of</strong> the time. 

Typical Presentation <strong>of</strong> the schema, understand the childhood origins <strong>of</strong> schema, help members 

express their spontaneous, natural selves—their unique preferences, opinions, decisions, talents, 

and natural inclinations—rather than suppressing their true selves, centering <strong>of</strong> their own lives, 

setting the boundaries with the parental figure and have a full sense, stop avoiding and establish 

connections with others that are neither too distant nor too enmeshed <strong>of</strong> their own identity. 

Typical Presentation <strong>of</strong> the schema, understand the childhood origins <strong>of</strong> schema, get couples to 

lower their estimations <strong>of</strong> the likelihood <strong>of</strong> catastrophic events and to raise their evaluations <strong>of</strong> 

their ability to cope, convince members to stop avoiding and overcompensating for the schema, 

and to face most <strong>of</strong> the situations they fear. 

Summation <strong>of</strong> sessions, Getting feedback <strong>of</strong> treatment and posttests, give gifts to members 

216



Findings 


APRIL 2012 

VOL 3, NO 12 

Table 2: Means and standard deviations for pre and post test <strong>of</strong> the OCPD, EMS and marital 

satisfaction scores in experimental and control groups 

variables 

adjust 

means 

Experimental Group Control Group 

Pre-test Post-test Pre-test Post-test 

standard 

deviations 

adjust 

means 

standard 


adjust 

means 

standard 


adjust 

means 

217 

standard 


OCPD 18.50 3.162 11.51 4.143 19.45 1.488 22 1.185 

Negativity/Pessimism 42.96 14.55 29.16 12.56 45.65 20.16 46.47 16.07 

Defectiveness/Shame 26.12 9.01 16.00 6.39 25.10 7.23 24.29 5.527 

Vulnerability to Harm or Illness 20.12 2.29 8.00 6.54 23.87 2.23 22.26 8.93 

Enmeshment/Undeveloped Self 18.87 1.72 10.75 5.496 15.27 1.597 17.91 4.676 

Self- Sacrifice 40.88 21.22 27.00 11.84 45.51 13.54 42.75 16.42 

Emotional Inhibition 22.12 7.39 11.25 6.670 25.12 12.79 21.50 8.106 

Unrelenting 

40.62 13.94 26.75 10.039 45.75 10.64 41.97 12.33 

Standards/Hypercriticalness 

Entitlement/Grandiosity 32.32 8.48 21.46 6.299 36.21 8.126 37.25 9.254 

Idealistic distortion 14.50 2.777 18.00 1.85 13.50 2.250 13.25 2.503 

Marital satisfaction 30.70 4.580 32.00 3.070 29.97 3.796 27.00 3.796 

Personality issues 26.00 2.828 27.62 2.386 27.48 3.862 27.37 3.862 

Communication 28.75 2.187 30.00 3.585 26.85 6.837 27.18 6.730 

Conflict resolution 23.87 7.199 30.00 4.242 27.50 6.546 25.75 6.546 

Financial management 27.73 5.861 31.12 3.758 34.00 5.237 33.00 5.233 

Leisure activities 24.85 4.023 29.25 2.121 27.37 5.012 25.50 5.018 

Sexual relationship 30.62 4.867 36.12 3.642 29.75 8.908 30.37 8.908 

Children and Parenting 23.39 6.365 26.64 3.710 27.30 5.119 24.12 5.114 

Family and Friends 25.37 3.159 27.75 3.327 23.25 5.257 22.37 5.257 

Equalitarian roles 24.87 6.010 25.00 7.708 27.25 5.800 24.52 5.805 

Religious orientation 24.50 5.580 28.75 7.440 12.133 5.757 24.12 5.757 

Total marital satisfaction mark 30.16 32.314 343.27 27.479 317.36 39.56 305.58 39.59 

N=10, 

<strong>The</strong> table 2 shows, the means <strong>of</strong> OCPD in the pretest in the experimental group were 

18.5 (SD = 3.162) and in the control group 19.75 (SD =1.488), while in the post test the 

means in the experimental group were 11.51 (SD = 4.143) and in the control group were 22 

(SD =1.185). Also, the means and standard deviations <strong>of</strong> the EMS in the pre test and post test 

in the experimental group were different. While the reduction <strong>of</strong> the means in the control 

group were not much different. <strong>The</strong> table 2 shows the means and standard deviations <strong>of</strong> the 

marital satisfaction in experimental and control groups.



Table 3 

<strong>The</strong> analysis <strong>of</strong> MANOVA in relation to the effect <strong>of</strong> <strong>Schema</strong> therapy on OCPD, EMS and 

marital satisfaction 


APRIL 2012 

VOL 3, NO 12 

Variables SS df MS F Sig. <strong>Effect</strong> size Observed power 

OCPD 102.56 1 102.56 19.015 0.002 0.896 0.995 

Negativity/Pessimism 741.369 1 741.369 6.985 0.041 0.602 0.805 

Defectiveness/Shame 168.828 1 168.828 17.251 0.008 0.741 0.896 

Vulnerability to Harm or Illness 227.690 1 227.690 17.019 0.007 0.791 0.924 

Enmeshment/Undeveloped Self 202.551 1 202.551 14.323 0.012 0.787 0.902 

Self- Sacrifice 879.268 1 879.268 16.471 0.009 0.701 0.885 

Emotional Inhibition 403.589 1 403.589 10.666 0.011 0.711 0.821 

Unrelenting Standards/Hypercriticalness 325.126 1 325.126 8.623 0.025 0.671 0.812 

Entitlement/Grandiosity 119.991 1 119.991 7.447 0.048 0.659 0.798 

Idealistic distortion 25.285 1 25.285 18.173 0.005 0.752 0.941 

Marital satisfaction 85.027 1 85.027 6.747 0.035 0.668 0.847 

Personality issues 1.161 1 1.161 0.290 0.609 0.046 0.074 

Communication 98.368 1 98.368 16.168 0.004 0.821 0.906 

Conflict resolution 87.844 1 87.844 35.581 0.001 0.856 0.998 

Financial management 1.787 1 1.787 0.329 0.857 0.052 0.078 

Leisure activities 49.432 1 49.432 7.059 0.036 0.666 0.840 

Sexual relationship 61.504 1 61.504 14.115 0.009 0.705 0.872 

Children and Parenting 2.463 1 2.463 0.205 0.667 0.033 0.067 

Family and Friends 6.050 1 6.050 2.136 0.194 0.263 0.235 

Equalitarian roles 30.627 1 30.627 1.315 0.295 0.180 0.163 

Religious orientation 2.023 1 2.023 0.083 0.783 0.014 0.057 

Total marital satisfaction mark 1938.124 1 1938.124 75.129 0.000 0.926 1.000 

<strong>The</strong> results <strong>of</strong> co-variation analysis in the table 3, after controlling covariate variables (pre 

test, age, education, job, age <strong>of</strong> marriage, the number <strong>of</strong> children, income and gender) that 

have a significant relationship with the obsessive compulsive personality disorder revealed 

218




APRIL 2012 

VOL 3, NO 12 

that schema therapy has led to the reduction <strong>of</strong> the symptoms among the married people who 

suffering from the obsessive compulsive personality disorder (P




APRIL 2012 

VOL 3, NO 12 

Past researches also showed that cognitions such as relationship attributions and beliefs, 

and assumptions and should, have been identified as robust correlates <strong>of</strong> relationship (e.g., 

marital) satisfaction (Chatav and Whisman, 2009). 

One <strong>of</strong> the communication beliefs that has a strong relationship with the obsessive 

compulsive personality disorder is ―shoulds‖ that is known with doing things perfectly, hard 

work and orderliness. It seems that this personality pattern has problems such as spending too 

much time for being subtle, inflexible, and perfectionism for self and also in relationship with 

other people such as spouse. Also difficulty in feeling and emotional expressing and limited 

emotions can cause to marital dissatisfaction. <strong>Schema</strong>s also have an important role in 

thoughts, feelings, behaviors and relationships with others. <strong>Schema</strong>s are structures or 

frameworks that screen, code, examine motives and are resistant to change to a high degree 

<strong>of</strong> cognition and have a deep effect on individual's emotional and feelings (Riso, Dutoit, Stein 

and Young, 2007). Maladaptive or dysfunctional schemas as enduring, unconditional, 

negative beliefs about oneself, others, and the environment which organized one‘s past 

experiences and continue and deform in our present life and over time, these deep beliefs 

about self and others become dysfunctional to a significant degree and highly resistant to 

change in individuals with personality disorders (Young,1999). Maladaptive schemas affect 

different aspects <strong>of</strong> life including marriage. From this point <strong>of</strong> view, the present findings are 

the same as the findings <strong>of</strong> Clifton (1995), Stiles (2004), Andouz and Hamidpour (2006), Ãli, 

Seif and Khosravi (2000) and also Young's theory (1990) that is <strong>of</strong> the belief that maladaptive 

schemas have an important role on individual's adulthood life. 

Cognitive techniques play an important role in schema therapy .<strong>Schema</strong> therapy can 

balance people's marriage expectations and correct factors that can lead to unreasonable 

thoughts, misunderstandings, focusing on the cognitive patterns <strong>of</strong> these people and 

correcting their thoughts by modifying maladaptive schemas such as unrelenting standards, 

220




APRIL 2012 

VOL 3, NO 12 

emotional inhibition and defectiveness. <strong>Schema</strong> therapy with cognitive strategies will ask 

about the advantages and disadvantages <strong>of</strong> this lifestyle so that the ―healthy side‖ <strong>of</strong> the 

person's personality is developed. Beck (1995), states that an important indicator for working 

on cognition is the change <strong>of</strong> emotions. In a way that the person experiences again the very 

same emotional state that he experienced at the time <strong>of</strong> his problems. A change <strong>of</strong> emotions 

can be created through imaging, role playing, etc. and it causes "hot" cognition that has an 

important role in cognitive strategies (Whisman and Ubelacker, 2007). 

<strong>The</strong> schema therapy approach tries to make the internal child <strong>of</strong> the person and his 

ignored needs talk to his healthy internal adult using some experimental techniques so that 

the person can help himself and satisfy his own emotional needs in a way that there is no 

more unreasonable expectation in his marriage and he does not need to attain social and 

emotional validation through others. <strong>Schema</strong> therapy also creates changes in the person's 

consistency behavioral patterns so that it can correct the causes <strong>of</strong> thought strengthen using 

behavioral techniques. 

Behavioral approaches can help to alternative coping styles. Although cognitive 

behavioral approaches use behavioral processes to improve behavioral patterns, but schema 

therapy seems more effective on chronic problems as it focuses on cognitions and emotions 

first, and then on the more schema-driven behavior patterns. <strong>The</strong>rapeutic relationship that is a 

vital component <strong>of</strong> schema assessment and change has taken a great deal <strong>of</strong> attention in this 

treatment method. It can be said that therapeutic relationship will help the client perception 

and acceptation his problem and this is the beginning <strong>of</strong> the acceptance <strong>of</strong> maladaptive 

schemas and dysfunctional thoughts and therefore he won't resist the treatment. <strong>The</strong> schema 

therapy approach believes that the combination <strong>of</strong> the four processes <strong>of</strong> cognition, emotional, 

behavioral and therapy relationship can correct and balance dysfunctional thoughts and 

maladaptive schemas that show themselves as dysfunctional patterns <strong>of</strong> behavior and 

221




APRIL 2012 

VOL 3, NO 12 

relationship, in a better way compared to when just one process is used. As people suffering 

from the obsessive compulsive personality disorder have groups <strong>of</strong> problems such as 

dysfunctional thoughts, controlling behavior, limited emotional relationship, controlled 

emotional expressing and lack <strong>of</strong> trust in the efficiency <strong>of</strong> therapeutic relationship in their 

married life, schema therapy seems to be a better approach for changing and correcting 

beliefs because <strong>of</strong> its comprehensiveness in techniques. 

222



References 


APRIL 2012 

VOL 3, NO 12 

Ãli, Sh., Seif, S. Khosravi, Z. (2008). Link between early schemas and opinion to marriage in 

Ferdosi University collegian. <strong>The</strong> 3th National Congress <strong>of</strong> Family Pathology. Tehran, 

Iran. 

Andouz, Z. & Hamidpour, H. (2006).<strong>The</strong> effect <strong>of</strong> early maladaptive schema, attachment 

style and marital satisfaction in couples. <strong>The</strong> 2th National Congress <strong>of</strong> Family Pathology. 

Tehran, Iran. 

Arntz, A., Klokman, J. & Siesweda, S. (2005). An experimental test <strong>of</strong> the schema mode 

model <strong>of</strong> borderline personality disorder. Journal <strong>of</strong> Behavior therapy and Experimental 

Psychiatry. 36, 226- 239. 

Arntz, A., Handriks, T., Keune, N. (1999). Avoidant personality disorder and implicit schema 

congruent information processing bias- A pilot study with a pragmatic inference task. 

Behavior Research and <strong>The</strong>rapy. 37(7),619 

Arntz, A., Weertman, A., Salet, S. (2011). Interpretation bias in cluster-C and borderline 

personality disorder. Behavior Research and <strong>The</strong>rapy. 49(8),472. 

Bouchard, Sebastien., Sabounn, Stephanie., Lussier, Yvan,. Villeneuve, Evens. (2009). 

Relationship quality and stability in couples when one partner suffers from borderline 

personality disorder. Journal <strong>of</strong> marital and family therapy.35(4).446-456. 

Asgari, H. (2001). <strong>The</strong> role <strong>of</strong> mental health in marriage and life and divorce. Tehran: 

G<strong>of</strong>tegou press. 

Asrar, S. & Haghshenas, H. (2005). Marital satisfaction questionnaire validity and reliability 

for group <strong>of</strong> couples with marital problem in Shiraz. Congress <strong>of</strong> Psychiatry and 

Psychology Researches in Iran. Tehran, Iran. 

Chatav, Y. & Whisman, M. A. (2009).Partner <strong>Schema</strong>s and Relationship Functioning: A 

States <strong>of</strong> Mind Analysis. Journal <strong>of</strong> Behavior <strong>The</strong>rapy 40, 50-56. 

Choca, J.P. & Van Denberg, E. (1997). "Interpretive guide to the American Clinical 

Multiaxial inventory (2 nd ed)". Washington, DC: American Psychological Association. 

Clifton, J. A. (1995). <strong>The</strong> effect <strong>of</strong> parenting style, attachment, and early maladaptive schema 

on adult romantic relationship. Dissertation. Abstracts International, 56 (10-B), 57- 91. 

Farrell, J. M., Shaw, I.A., & Webber, M. A. (2009). A <strong>Schema</strong>- focused approach group 

Psychotherapy for Outpatients with Borderline Personality Disorder: A controlled trial. 

Journal <strong>of</strong> Behavior <strong>The</strong>rapy and Experimental Psychiatry. 40 (2). 317- 328. 

Gottman, J.M. (1994). What predicts divorce? <strong>The</strong> relationship between marital processes 

and marital outcomes. Hillsdale, NJ: Erlbaum. 

Gottman, J.M. (1993). A theory <strong>of</strong> marital dissolutions and stability. Journal <strong>of</strong> Family 

Psychology.7. 57-75. 

Greef, P. A. & Malherb, L. H. (2001). Intimacy and Marital Satisfaction in spouse. Journal <strong>of</strong> 

sex and marital therapy. 27. 247- 257. 

Joyce et al. (2003). Polymorphisms <strong>of</strong> DRD4 and DRD3 and risk <strong>of</strong> avoidant and obsessive 

personality traits and disorders. Psychiatry Research. 119(2):1- 10. 

Kellogg, S. H. & Young, J. H. (2006). <strong>Schema</strong> <strong>The</strong>rapy for Borderline Personality Disorder. 

Journal <strong>of</strong> clinical psychology. 62(4), 445-458. 

Laksman, Z. (2007). An Examination <strong>of</strong> clinicians' emotional reactions as diagnostic 

indicator for axis II obsessive- compulsive personality disorder. Doctoral Dissertation <strong>of</strong> 

Psychology <strong>of</strong> the Adler School. 

Mahdavian, F. (1997). <strong>The</strong> influence <strong>of</strong> communication training on marital satisfaction and 

mental health. Unpublished Clinical Psychology M.A Dissertation. University <strong>of</strong> Iran 

psychiatry Institute. Tehran, Iran. 

223




APRIL 2012 

VOL 3, NO 12 

Monroe, R. Paula. (1990). A study <strong>of</strong> marital problems, marital satisfaction. Dissertation <strong>of</strong> 

PH.D Psychotherapy. <strong>The</strong> University <strong>of</strong> Tulsa. 

Millon, T., Grossman, S., Millon, C., Meagher, S., & Ramnath, R. (2004). Personality 

Disorder in Modern Life (second edition). John Wiley & Sons, Ltd. 

Nadort, M., Arntz, A., Smit, J. H., Giesen-Bloo, J., Eikelenboom, M., Spinhoven, Ph., 

Asselt, T. V., Wensing, M., & Dyck, R.V. (2009). Implementation <strong>of</strong> outpatient schema 

therapy for borderline personality disorder with versus without crisis support by the 

therapist outside <strong>of</strong>fice hours: A randomized trial. Behavior Research and <strong>The</strong>rapy, 47. 

Nakonezny. P., Shull. R & Rodgers. (1995). <strong>The</strong> effect <strong>of</strong> no fault divorce law on the divorce 

rate across the 50 states and its relation to income, education, religiosity. Journal <strong>of</strong> 

Marital and Family, 57, 488. 

Nazari, A. M. (2007). Brief therapy and family therapy. Tehran: Moalem press. 

Nordhal, H. M. & Nysuter, T.E. (2005). "<strong>Schema</strong> therapy for patients with borderline 

personality disorder: A single case series". Journal <strong>of</strong> Behavior therapy and Experimental 

Psychiatry. 36, 254- 264. 

Nordhal, H. M., Holthe, H. & Shaugum. J. A.(2005). Early maladaptive schema in patients 

with or without personality disorder-close schema modification predicts symptomatic 

relief?. Clinical Psychology and Psychotherapy, 12. 142- 149. 

Oldham, K.A., Gabbard, G. & Gain, M. (2001). Practice guideline for the treatment <strong>of</strong> 

patients with BPD. American Journal <strong>of</strong> Psychology, 158 (SUPPI). 

Pascal, A., Christine, A. & Jean, L. (2008). Development and Validation <strong>of</strong> Cognitive 

Inventory <strong>of</strong> subjective distress. International Journal <strong>of</strong> Geriatric Psychiatry. Chichester, 

23, 1175-82. 

Rheaume, J., Ladouceur, R., Freestone, M. H. & Lerarte, M. (1995). Inflated responsibility in 

obsessive- compulsive disorder. Behavior Research and therapy, 33. 159- 169. 

Riso, L.P., Dutoit, P.L., Stein, D. J. & Young, J.E. (2007). Cognitive schema and core beliefs 

in Psychological problems scientist- practitioner guide. Washington D.C, USA: 

American Psychological Association. 

Rosen- Granden, J. R., Meyers, J. E. & Hattie, J. A. (2004). <strong>The</strong> relationship between marital 

characteristics, marital interaction processes and marital satisfaction. Journal <strong>of</strong> 

counseling & development, 82 (1). 68-85. 

Rosenhan, D.L. & Seligman, M.B.P. (1995). Abnormal Psychology (third edition). New 

York: W.W.Norton. 

Siliman, B. (1998). Patterns <strong>of</strong> adjustment, first three years. Marriage enrichment & domestic 

violence information, Retrieved March 2001 from the world wide web: http:// 

www.uwyo.edu/ ag/ ces/family/ Ben/ marriage/ stage patterns.htm. 

South, S. C., Turkheimer, Eric. & Oltmanns, Thomas F. (2008). "Personality disorder 

symptom and marital functioning". Journal <strong>of</strong> Consulting and Psychology. 76 (5). 769. 

Stiles, O.E. (2004). Early Maladaptive <strong>Schema</strong>s and intimacy in Young adult's romantic 

relationships. Unpublished Dissertation Proqest Information and Learning Company. 

Retrieved from www. Proqest. Com. 

Strack, S. (2005). Handbook <strong>of</strong> Personality and Psychopathology. New Jersey, USA: John 

Wiley & Sons, Inc. 

Shafee, A. R., Azar, M., Janbozorgi, M., Nouhi, S. & Hoseini, R. (2007). <strong>The</strong> correlation <strong>of</strong> 

women‘s pathology and marital satisfaction. Quarterly Journal <strong>of</strong> Pajoohandeh. 12 (6). 

483-490. 

Sharifi, A. A. (2002). A guide for the Millon Clinical Multiaxial Inventory III. Ravansanji 

Publishing. Tehran. Iran. 

224




APRIL 2012 

VOL 3, NO 12 

Taniguchi, S.T., Freeman, P.A., Taylor, S. & Malcarne, B. (2006). A study <strong>of</strong> married 

couples‘ perception <strong>of</strong> marital satisfaction in outdoor recreation. Journal <strong>of</strong> Experimental 

Education.28 (3). 253 -256. 

Whisman, M.A. (1999). Marital dissatisfaction and psychiatric disorders. Journal <strong>of</strong> 

Abnormal Psychology. 108(4). 701-706. 

Whisman, M.A. & Ubelacker, L,A,.(2007). Maladaptive schema and core beliefs in treatment 

and research with couples. In Riso, L.P., Toit, P.L.D., Stein, D. J., & Young , J.E 

Cognitive <strong>Schema</strong>s and Core beliefs. Psychological problems. Washington: American 

Psychological Association. 

Yoosefi, N., Etemadi, A., Ahmadi, A. Bahrami, F., Fatehizade, M. & Beshlideh, K. (2009). 

Validating <strong>of</strong> Early Maladaptive <strong>Schema</strong> Scale (EMSs). Unpublished Doctoral 

Dissertation. University <strong>of</strong> Isfahan. Isfahan. Iran. 

Young, J.E. (1999). Cognitive therapy for personality disorder. Sarasota, FF: Pr<strong>of</strong>essional 

Resources Press. 

Young, J.E., Klosko, J. S. & Weishoar, M.E. (2003). <strong>Schema</strong> therapy: a practioner‘s guide. 

New York: A Division <strong>of</strong> Guilford Publications, Inc. 

Zadhoosh, S. (2008). <strong>The</strong> comparison <strong>of</strong> the effectiveness <strong>of</strong> religious oriented cognitive 

behavior group therapy and classic cognitive behavior group therapy on the woman 

quality <strong>of</strong> marital relationship and satisfaction. Unpublished Psychology M.A 

Dissertation. University <strong>of</strong> Isfahan. Iran. 

225

The Effect of Schema Therapy on marital satisfaction - journal ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?