The Predictive Role of Schema Modes and Difficulties in Emotion Regulation in Corona Disease Anxiety

Document Type : Original Article


1 Master Student of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran

2 Master Student of General Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran

3 Assistant Professor, Department of Psychology, Semnan University, Semnan, Iran


Introduction: The aim of this study was to predict corona disease anxiety based on difficulies in difficulties in emotion regulation and schema mode.
Method: The design of the present research was correlational.The statistical population of the study included all
students in Mashhad who were members of virtual social networks. Among the community, 238 volunteered to answer the questionnaires. For data collection the Corona Disease Anxiety Scale (CDAS), the Graz and Roemer difficulties in emotion regulation scale (DERS), the Schema Mode Questionnaire
(SMQ) was used, and data was analysed by Pearson correlation
test and multiple linear regression analysis
Results: The results of this research indicate that the combination of difficulties in emotion regulation and schema mode components predicit corona disease anxiety. The components of impulse control and emotional uncertainty from the subscales of difficulties in emotion regulation were significantly associated with corona disease anxiety.

Conclusion: In sum, according to the findings of the present study, it is possible to make effective interventions in emotion regulation and schema mode for prevention of coron disease anxiety.


1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P. A novel coronavirus from patients with pneumonia in China, 2019. New England journal of medicine. 2020; 727-733.
2. Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, Hu Y, Tao ZW, Tian JH, Pei YY, Yuan ML. A new coronavirus associated with human respiratory disease in China. Nature. 2020; (579): 265-9.
3. World Health Organization. World Health Organization coronavirus disease 2019 (COVID-19) situation report.
4. Laddu DR, Lavie CJ, Phillips SA, Arena R. Physical activity for immunity protection: Inoculating populations with healthy living medicine in preparation for the next pandemic. Progress in cardiovascular diseases. 2020; (64):102-4.
5. Pfefferbaum B, North CS. Mental health and the Covid-19 pandemic. New England Journal of Medicine. 2020; (6):510-2.
6. Luo M, Guo L, Yu M, Wang H. The psychological and mental impact of coronavirus disease 2019; (COVID-19) on medical staff and general public–A systematic review and meta-analysis. Psychiatry research. 2020, (290): 113-190.
7. Maunder R, Hunter J, Vincent L, Bennett J, Peladeau N, Leszcz M, Sadavoy J, Verhaeghe LM, Steinberg R, Mazzulli T. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. Cmaj. 2003; (10):1245-51.
8. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA network open. 2020; (3): 1-12.
9. Chen Y, Zhou H, Zhou Y, Zhou F. Prevalence of self-reported depression and anxiety among pediatric medical staff members during the COVID-19 outbreak in Guiyang, China. Psychiatry research. 2020; (288):11-30.
10. Salari M, Zali A, Ashrafi F, Etemadifar M, Sharma S, Hajizadeh N, Ashourizadeh H. Incidence of anxiety in Parkinson's disease during the coronavirus disease (COVID‐19) pandemic. Movement Disorders. 2020; (10):1096-95.
11. Cao J, Wei J, Zhu H, Duan Y, Geng W, Hong X, Jiang J, Zhao X, Zhu B. A study of basic needs and psychological wellbeing of medical workers in the fever clinic of a tertiary general hospital in Beijing during the COVID-19 outbreak. Psychotherapy and psychosomatics. 2020; (30): 1-3.
12. Nishiura H, Jung SM, Linton NM, Kinoshita R, Yang Y, Hayashi K, Kobayashi T, Yuan B, Akhmetzhanov AR. The extent of transmission of novel coronavirus in Wuhan, China, 2020; (9):1-5.
13. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. International journal of antimicrobial agents. 2020; (55):1-9.
14. Stanton R, To QG, Khalesi S, Williams SL, Alley SJ, Thwaite TL, Fenning AS, Vandelanotte C. Depression, anxiety and stress during COVID-19: associations with changes in physical activity, sleep, tobacco and alcohol use in Australian adults. International journal of environmental research and public health. 2020; (11):40-65.
15. Bajema KL, Oster AM, McGovern OL, Lindstrom S, Stenger MR, Anderson TC, Isenhour C, Clarke KR, Evans ME, Chu VT, Biggs HM. Persons evaluated for 2019 novel coronavirus—United States, January 2020. Morbidity and mortality weekly report. 2020; (69):166.
16. Roy D, Tripathy S, Kar SK, Sharma N, Verma SK, Kaushal V. Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic. Asian journal of psychiatry. 2020; (51):1-9.
17. Fillenbaum GG, Blay SL, Mello MF, Quintana MI, Mari JJ, Bressan RA, Andreoli SB. Use of mental health services by community-resident adults with DSM-IV anxiety and mood disorders in a violence-prone area: Sao Paulo, Brazil. Journal of affective disorders. 2019; (250):145-52.
18. Melnyk BM. Reducing healthcare costs for mental health hospitalizations with the evidence-based COPE program for child and adolescent depression and anxiety: a cost analysis. Journal of Pediatric Health Care. 2020; (34):117-21.
19. Gross JJ, editor. Handbook of emotion regulation. Guilford publications; 2013-p50-110.
20. Inwood E, Ferrari M. Mechanisms of change in the relationship between self‐compassion, emotion regulation, and mental health: A systematic review. Applied Psychology: Health and Well‐Being. 2018; (10):215-35.
21. Mousavi SF, Reyhaneh R. The prediction of posttraumatic growth based on memorials symptoms and rumination in women with cancer. Journal of Health Psychology. 2018; (26):146-59. [persian]
22. Gross JJ, John OP. Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology. 2003; (85):348-62.
23. Tugade MM, Fredrickson BL. Regulation of positive emotions: Emotion regulation strategies that promote resilience. Journal of happiness studies. 2007; (8):311-33.
24. Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: A meta analytic review. Clinical psychology review. 2010; (30):217-37.
25. Szczygieł D, Buczny J, Bazińska R. Emotion regulation and emotional information processing: The moderating effect of emotional awareness. Personality and Individual differences. 2012; (52):433-7.
26. Grezellschak S, Lincoln TM, Westermann S. Cognitive emotion regulation in patients with schizophrenia: Evidence for effective reappraisal and distraction. Psychiatry research. 2015; (229):434-9.
27. Restubog, Simon Lloyd D., Anna Carmella G. Ocampo, and Lu Wang. "Taking control amidst the chaos: Emotion regulation during the COVID-19 pandemic. 2020; (119):1-9.
28. Gross JJ. Emotion regulation: taking stock and moving forward. Emotion. 2013; (13):359-369.
29. Yap K, Mogan C, Moriarty A, Dowling N, Blair‐West S, Gelgec C, Moulding R. Emotion regulation difficulties in obsessive‐compulsive disorder. Journal of clinical psychology. 2018; (74):695-709.
30. Mazloomzadeh, Mohammadreza, et al. Relationship between Corona virus anxiety and health anxiety: Mediating role of emotion regulation difficulty. Journal of Clinical Psychology, 2021.‏ [Persian]
31. Ejei J, Gholamali LM, Erami H. Comparison Of Emotional Regulation In Substance Abusers And Normal Subjects. J Psychol. 2015; (74):137-46.
32. Lobbestael J, Van Vreeswijk MF, Arntz A. An empirical test of schema mode conceptualizations in personality disorders. Behaviour research and therapy. 2008; (46):854-60.
33. Lobbestael J, Arntz A, Sieswerda S. Schema modes and childhood abuse in borderline and antisocial personality disorders. Journal of behavior therapy and experimental psychiatry. 2005; (36):240-53.
34. Roediger E, Stevens BA, Brockman R. Contextual schema therapy: An integrative approach to personality disorders, emotional dysregulation, and interpersonal functioning. New Harbinger Publications; 2018; p10-60.
35. Gewelt SE. Early Maladaptive Schemas in Anxiety Disorders-An Investigation of Schemas' Relation to Symptoms in a Complex Sample (Master's thesis); 2017.
36. Cámara M, Calvete E. Early maladaptive schemas as moderators of the impact of stressful events on anxiety and depression in university students. Journal of Psychopathology and Behavioral Assessment. 2012; (34):58-68.
37. Young JE, Klosko JS, Weishaar ME. Schema therapy: A practitioner's guide. guilford press; 2003. Translate: Hamidpour H, Andouz Z.
38. Alipour A, Ghadami A, Alipour Z, Abdollahzadeh H. Preliminary validation of the Corona Disease Anxiety Scale (CDAS) in the Iranian sample. Quarterly Journal of Health Psychology. 2020; (32):163-75.
39. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment. 2004; (26):41-54.
40. Gratz KL, Rosenthal MZ, Tull MT, Lejuez CW, Gunderson JG. An experimental investigation of emotion dysregulation in borderline personality disorder. Journal of abnormal psychology. 2006; (115):850-855.
41. Besharat MA, Difficulties in Emotion Regulation Scale. Thought & Behavior in Clinical Psychology.2018; (47): 89-92
42. Besharat MA, Bazzazian S. Psychometric properties of the Cognitive Emotion Regulation Questionnaire in a sample of Iranian population. Journal of Shahid Beheshti School of Nursing & Midwifery. 2014; (84):61-70.
43. Lobbestael J, Arntz A, Sieswerda S. Schema modes and childhood abuse in borderline and antisocial personality disorders. Journal of behavior therapy and experimental psychiatry. 2005; (36):240-53.
44. Hanaei N, Mahmood Alilou M, Bakhshi Pour Roudsari A, Akbari I. Mentalities sketches, experience of child abuse and attachment styles with borderline personality disorder. Clinical Psychology and Personality. 2015; (13):101-20.
45. Campbell-Sills L, Barlow DH. Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. Handbook of emotion regulation. 2007; (2):542-59.
46. Hofmann SG, Sawyer AT, Fang A, Asnaani A. Emotion dysregulation model of mood and anxiety disorders. Depression and anxiety. 2012; (29):409-16.
47. Kord B, Mohammadi M. Predicting of Students' Anxiety on the basis of Emotional Regulation Difficulties and Negative Automatic Thoughts. Education Strategies in Medical Sciences. 2019; (12):130-4.
48. Kord B, Karimi S. The prediction of emotional regulation based on the students' Self-Compassion and body image. Journal of Educational Psychology Studies. 2017; (28):207-30. (Persian)
49. Roemer L, Lee JK, Salters-Pedneault K, Erisman SM, Orsillo SM, Mennin DS. Mindfulness and emotion regulation difficulties in generalized anxiety disorder: Preliminary evidence for independent and overlapping contributions. Behavior therapy. 2009; (40):142-54.
50. Neumann A, van Lier PA, Gratz KL, Koot HM. Multidimensional assessment of emotion regulation difficulties in adolescents using the difficulties in emotion regulation scale. Assessment. 2010; (17):138-49.
51. Aziziaram S, Basharpoor S. The Role of Rumination, Emotion Regulation and Responsiveness to Stress in Predicting of Corona Anxiety (COVID-19) among Nurses. Quarterly Journal of Nursing Management. 2020; (9):8-18.
52. Shorey RC, Elmquist J, Anderson S, Stuart GL. The relationship between early maladaptive schemas, depression, and generalized anxiety among adults seeking residential treatment for substance use disorders. Journal of psychoactive drugs. 2015; (47):230-8.
53. Cámara M, Calvete E. Early maladaptive schemas as moderators of the impact of stressful events on anxiety and depression in university students. Journal of Psychopathology and Behavioral Assessment. 2012; (34):58-68.
54. Ghasemi KO, Elahi TA. The relationship between early maladaptive schemas and illness anxiety: The mediating role of experiential avoidance. Journal of Research in Psychological Health. 2019; (13):47-55.