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L. Kriston
Journalof
et al.:
Psychological
Reliability and
Assessment
Validity
2013;
of
2012
theVol.
Hogrefe
German
29(3):205212
Publishing
YSQ-S3
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Original Article
Introduction
Schema therapy is a psychotherapy approach combining
traditional cognitive-behavioral therapy with elements of
psychodynamic approaches, Gestalt therapy, and humanistic therapies (Young, Klosko, & Weishaar, 2003). It recently gained increased attention, since outcome studies demonstrated its efficacy and effectiveness in patients with personality disorders, mainly borderline personality disorder
(Farrell, Shaw, & Webber, 2009; Giessen-Bloo et al., 2006;
Gude & Hoffart, 2008; Nadort et al., 2009; Nordahl &
Nysaeter, 2005).
Central to schema therapy is the concept of early maladaptive schemas (EMS), thought to develop in childhood
when essential needs of the child remain unmet. EMS comprise feelings, cognitions, bodily sensations, and coping behaviors (Young et al., 2003). Young et al. defined 18 schemas, clustered in five schema domains, each of which is
considered to be connected with specific unmet childhood
needs (see Table 1).
2012 Hogrefe Publishing
EMS are usually assessed with self-report questionnaires, mainly the Young Schema Questionnaire (YSQ).
The original version of this instrument was developed by
Young (1990) to assess 16 schemas. It consists of 205
items, and it was shown to be reliable and valid in large
clinical and student samples (Schmidt, Joiner, Young, &
Telch, 1995). Based on the findings of Schmidt et al.
(1995), Young and Brown (1994) developed a short form
of the YSQ comprising five items for each of the 16 EMS.
The psychometric properties of various translations of both
YSQ versions have been investigated in several studies
(overview in Oei & Baranoff, 2007). In their review, Oei
and Baranoff (2007) conclude that internal consistency,
test-retest reliability, convergent validity, and discriminant
validity of the YSQ are sufficient to warrant the use of the
YSQ in research settings. However, since findings on the
factorial structure are conflicting, the relevance of further
research was highlighted (Oei & Baranoff, 2007).
The short form of the YSQ has been revised repeatedly.
In its latest form, the YSQ-S3, it comprises 90 items asEuropean Journal of Psychological Assessment 2013; Vol. 29(3):205212
DOI: 10.1027/1015-5759/a000143
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This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
206
Instruments
The YSQ-S3 (Young, 2006) is a self-report instrument. People are asked to describe themselves by rating descriptive
statements through a 6-step Likert-type response format
ranging from completely untrue of me to describes me perfectly. Higher values indicate a stronger presence of the respective schema. The YSQ-S3 assesses 18 EMS (see Table
1) with five items per scale, resulting in a total of 90 items.
Table 1. Schemas, schema domains, and associated needs
Schema domains Associated needs
Disconnection
Schemas
Emotional deprivation
Safe attachment,
acceptance, nurtur- Abandonment/Instability
Mistrust/Abuse
ing, protection
Social isolation/Alienation
Defectiveness/Shame
Other-directedness
Emotional inhibition
Unrelenting standards
Negativity/Pessimism
Punitiveness
Cross-sectional data were collected in a convenience community sample and a clinical sample. Data in the community sample were collected via internet from July 14 to August 13, 2009. The survey link was distributed via email to
psychology faculties at German universities, several internet forums, and the of authors surroundings. Participants
did not get incentives for study participation, and no personal data (e.g., IP-address) were recorded.
Data from the clinical sample were collected among inpatients of the psychiatric Department of a university medical center between August 14 and September 25, 2009.
Patients gave written informed consent and were then
asked to fill out a paper-and-pencil version of the instruments used in the online survey. Completed questionnaires
were collected in envelopes that were closed by the patients
themselves to ensure anonymity.
The study protocol was approved by the local ethics
committee.
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Statistical Analysis
Due to the limited size of the clinical sample, analysis of
reliability as well as factorial and convergent validity was
calculated only with data from the community sample.
Reliability was estimated by calculating item discrimination statistics and Cronbachs for each scale. Factorial
validity was analyzed with confirmatory factor analysis.
The predefined structure consisted of 18 oblique (correlated) factors (representing schemas) and uncorrelated errors corresponding to Youngs model. The covariance matrix of the items was analyzed by means of maximum likelihood estimation. We preferred to analyze the covariance
Table 2. Sample characteristics
Community Clinical
sample
sample
n = 1,150
n = 30
female
899 (78.2)
19 (67.9)
male
251 (21.8)
9 (32.1)
Sex; n (%)
Age; years
mean (SD)
896 (77.9)
17 (56.7)
married
188 (16.3)
9 (30.0)
separated
15 (1.3)
2 (6.7)
divorced
48 (4.2)
widowed
3 (0.3)
2 (6.7)
0 (0)
29 (2.5)
5 (16.7)
middle
223 (19.4)
12 (40.0)
high
898 (78.1)
13 (43.3)
451 (39.2)
9 (33.3)
207
rather than the correlation matrix because the latter is likely to lead to statistical and generalizability problems (e.g.,
Cudeck, 1989; Hair, Black, Babin, & Anderson, 2009).
Although the responses to the items of the YSQ-S3 should
be considered ordered categorical rather than continuous,
we applied the maximum likelihood estimator, since it
was shown to be robust in similar situations. Furthermore,
alternative estimation methods would have required a
considerably larger sample size (e.g., Green, Akey, Fleming, Hershberger, & Marquis, 1997; Muthn & Kaplan,
1985; Tabachnick & Fidell, 2007). Local fit was investigated by examining factor loadings, factor reliabilities,
average extracted variance in items, and congruence (correlation) between factor scores and corresponding scale
sum scores. According to expert recommendations (e.g.,
Hair et al., 2009; Kline, 2010; Schweizer, 2010), we assessed global model fit using the discrepancy statistic,
the normed statistic, the Bentler comparative fit index
(CFI), the root mean square error of approximation
(RMSEA), and the standardized root mean square residual
(SRMR). A more detailed evaluation of the latent factorial
structure of the YSQ-S3 was reported by Kriston, Schfer,
Hrter, and Hlzel (2010). Convergent validity was estimated via Pearson correlation coefficients between schema scales and general distress (SCL-K-9) as well as symptoms of personality disorders (SAPAS), respectively.
Discriminant validity was examined by comparing
schema scale scores of the clinical and the community
sample and by comparing subjects with different intensity of health care utilization within the community sample
(former counseling, former outpatient treatment, former
inpatient treatment due to a mental disorder). Mean schema scale scores were compared across groups by univariate analysis of variance (ANOVA). All analyses were
performed using SPSS 15.0 (SPSS Inc., Chicago, IL) and
Mplus 5.1 (Muthn & Muthn, 1998).
23 (2.0)
1 (3.7)
pensioner
23 (2.0)
5 (18.5)
student
557 (48.4)
3 (11.1)
unemployed
35 (3.0)
9 (33.3)
other
61 (5.3)
0 (0)
244 (21.2)
no
906 (78.8)
755 (65.7)
counseling
220 (19.1)
outpatient treatment
229 (19.9)
inpatient treatment
81 (7.0)
Notes. Missing data were not present in the community sample. Valid
sample size varies between 27 and 30 in the clinical sample because
of missing data (valid percentages are reported). Data on lifetime
mental health-disorder diagnosis and health-care utilization were not
collected in the clinical sample. amultiple selections possible.
2012 Hogrefe Publishing
Results
Participant Characteristics
Data were collected from 1,150 online survey participants
(community sample) and 30 psychiatric patients (clinical
sample). Sample characteristics are given in Table 2.
Community sample participants were mostly female,
rather young, and highly educated. One fifth reported a lifetime diagnosis of a mental disorder. The most frequent entries were affective disorder (n = 134), anxiety disorder (n
= 43), eating disorder (n = 32), and borderline personality
disorder (n = 25).
The majority of the clinical sample was female. Their
mean age was 40 years. Most patients had a medium to high
level of education and around one third were employed.
The reasons for inpatient treatment (including comorbid
diseases) were affective disorder (n = 17), psychotic disorEuropean Journal of Psychological Assessment 2013; Vol. 29(3):205212
208
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1st item
2nd item
3rd item
4th item
5th item
Emotional deprivation
0.70
0.74
0.70
0.80
0.60
0.88
Abandonment/Instability
0.67
0.71
0.76
0.63
0.67
0.87
Mistrust/Abuse
0.52
0.62
0.66
0.72
0.58
0.82
Social isolation/Alienation
0.77
0.61
0.82
0.79
0.81
0.90
Defectiveness/Shame
0.75
0.84
0.79
0.79
0.74
0.91
Failure to achieve
0.73
0.50
0.79
0.78
0.74
0.87
Dependence/Incompetence
0.63
0.61
0.58
0.55
0.71
0.82
0.61
0.70
0.44
0.47
0.54
0.77
Enmeshment/Undeveloped self
0.57
0.57
0.43
0.60
0.59
0.78
Subjugation
0.57
0.66
0.53
0.61
0.68
0.82
Self-sacrifice
0.53
0.51
0.67
0.55
0.63
0.80
Emotional inhibition
0.71
0.73
0.58
0.68
0.77
0.87
Unrelenting standards
0.52
0.57
0.51
0.54
0.36
0.74
Entitlement/Grandiosity
0.34
0.55
0.30
0.51
0.43
0.67
Insufficient self-control
0.61
0.57
0.52
0.61
0.56
0.80
Approval-seeking
0.42
0.62
0.62
0.60
0.58
0.79
Negativity/Pessimism
0.71
0.72
0.71
0.58
0.65
0.86
Punitiveness
Note. refers to Cronbachs .
0.54
0.44
0.45
0.47
0.39
0.70
Reliability
Results of the reliability analysis are shown in Table 3. Item
discriminations (corrected item-total correlations) exceeded the recommended threshold of 0.40 in all but four cases
(one item of the scale Unrelenting Standards, two items of
the scale Entitlement/Grandiosity, and one item of the scale
Punitiveness). Internal consistency of 17 of the 18 scales
was sufficient (Cronbachs > 0.70). Internal consistency
of the scale Entitlement/Grandiosity was 0.67.
extracted variance in items of the scales Entitlement/Grandiosity and Punitiveness was substantially lower than required (0.34 and 0.37, respectively). Factor-scale
congruence (correlation between factor scores and corresponding scale sum scores) was high (at least 0.95) for 17
scales. Congruence of the scale Punitiveness yielded 0.85.
All factors were positively and statistically significantly
(p < .001) interrelated, with correlations ranging from
0.21 to 0.87.
The discrepancy test indicated a statistically significant misfit between defined and observed variance-covariance matrix (2 = 11,516.1; df = 3,762; p < .001). The
normed statistic (3.06) marginally exceeded the
threshold for an acceptable fit (below 3.00). The CFI
(0.847) missed the required threshold for an acceptable
fit (above 0.90). The RMSEA (0.042; 95% CI =
0.0410.043) was less than 0.050, indicating a good fit.
The SRMR (0.060) stayed below 0.100 signifying an acceptable model fit.
Factorial Validity
Factorial validity results are reported in Table 4. Loadings
of all but three items exceeded the required threshold of
0.40 (one item of the scale Entitlement/Grandiosity, two
items of the scale Punitiveness). Factor reliability was satisfactory (> 0.70) in all scales except Entitlement/Grandiosity. Average extracted variance failed to reach the desired threshold of 0.50 but was still above 0.40 for the
scales Vulnerability to Harm or Illness, Enmeshment/Undeveloped Self, Self-Sacrifice, Unrelenting Standards, Insufficient Self-Control, and Approval-Seeking. Average
European Journal of Psychological Assessment 2013; Vol. 29(3):205212
Convergent Validity
Pearson correlation coefficients (r) between YSQ-S3 scales
and general psychopathology as measured by the SCL-K-9
ranged from 0.28 (Scale Entitlement/Grandiosity) to 0.65
(scales Abandonment/Instability and Negativity/Pessimism) as reported in Table 4. Twelve of the 18 scales
showed a medium or strong association (r > 0.5) with the
SCL-K-9.
Associations of the YSQ-S3 scales with symptoms of
2012 Hogrefe Publishing
209
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Scale (schema)
1st item
Factor
5th item
Variance Factor
Correlation with
SCL-K-9 SAPAS
Emotional deprivation
0.74
0.81
0.78
0.87
0.64
0.88
0.62
0.98
0.50
0.48
Abandonment/Instability
0.70
0.74
0.85
0.69
0.77
0.87
0.61
0.98
0.65
0.56
Mistrust/Abuse
0.58
0.73
0.76
0.78
0.63
0.83
0.51
0.95
0.60
0.59
Social isolation/Alienation
0.81
0.65
0.86
0.86
0.86
0.91
0.70
0.99
0.57
0.51
Defectiveness/Shame
0.80
0.87
0.84
0.84
0.80
0.92
0.72
0.99
0.59
0.54
Failure to achieve
0.78
0.58
0.85
0.85
0.80
0.89
0.65
0.99
0.55
0.41
Dependence/Incompetence
0.69
0.69
0.66
0.62
0.81
0.83
0.54
0.95
0.61
0.51
0.79
0.82
0.48
0.56
0.60
0.78
0.47
0.95
0.60
0.47
Enmeshment/Undeveloped self
0.65
0.62
0.51
0.65
0.76
0.78
0.47
0.95
0.50
0.45
Subjugation
0.70
0.73
0.55
0.68
0.76
0.82
0.53
0.95
0.57
0.50
Self-sacrifice
0.60
0.57
0.79
0.62
0.73
0.80
0.48
0.98
0.34
0.22
Emotional inhibition
0.77
0.80
0.67
0.75
0.81
0.87
0.62
0.99
0.44
0.42
Unrelenting standards
0.64
0.66
0.61
0.67
0.45
0.74
0.42
0.96
0.37
0.41
Entitlement/Grandiosity
0.44
0.72
0.38
0.67
0.56
0.69
0.34
0.96
0.28
0.28
Insufficient self-control
0.67
0.68
0.61
0.67
0.67
0.80
0.49
0.97
0.51
0.40
Approval-seeking
0.48
0.72
0.79
0.65
0.63
0.79
0.46
0.96
0.38
0.34
Negativity/Pessimism
0.79
0.80
0.78
0.64
0.70
0.86
0.61
0.97
0.65
0.57
Punitiveness
0.72
0.57
0.34
0.39
0.68
0.67
0.37
0.85
0.42
0.39
Notes. All reported parameters are statistically significantly different from zero at p < .001. SCL-K-9 = Nine-item short-form of the Symptom
Checklist 90-R (SCL-90-R). SAPAS = Standardized Assessment of Personality Abbreviated Scale.
Figure 1. Mean schema profiles of subgroups according to health-care utilization. The overall difference between group
means in one-factorial analysis of variance is statistically significant for each scale at p < .001.
2012 Hogrefe Publishing
210
test is oversensitive (i.e., almost always statistically significant) in sample sizes over 300, and that the CFI tends
to indicate poorer fit with increasing model complexity.
Schweizer (2010) also points out that the recommended
cutoff limits for the normed statistic may need to be
enlarged in large samples. Since our study was conducted
with a large sample size (more than 1,000 participants)
and a rather complex model (18 correlated factors), we
relied on RMSEA and SRMR more strongly than on the
test and the CFI. But, it should be noted that our confirmatory factor-analytic model support is still slightly
weaker than in the study by Rijo and Gouveia (2008) and
considerably inferior to the findings reported by Saariaho
et al. (2009).
Surprisingly, YSQ-S3 scores are seemingly more
strongly related to general psychopathology than to personality disorder symptoms. Based on this finding one
might argue that the association between personality disorder features and reported schema scores are moderated
by schema modes that may weaken the intercorrelation
when avoidant/detached coping styles are present. However, Lobbestael, van Vreeswijk, and Arntz (2008) argue
that schema modes, particularly the so-called detached
protector mode, which covers avoidant/detached coping,
can reflect general psychopathology. Further investigation of the multiple associations between personality psychopathology, global psychopathology, schemas, and
schema modes are clearly necessary. However, a detailed
clinical discussion of this issue would go beyond the
scope of the present psychometric study. It should also
be noted that the instrument used for assessing personality disorder symptoms (SAPAS) uses binary items that
have higher response thresholds than items of the SCL.
This is likely to lead to a decreased variance of the SAPAS score, which in turn may deteriorate the Pearson correlation coefficients. In summary, no definite conclusion
on the comparison of these interrelations should be
drawn.
A major limitation of our study is our investigating a
convenience community sample. The online survey format allowed us to collect complete data from a large sample, but it did not allow for controlling the selection of
participants. However, a substantial proportion of the
community sample reported current or earlier health-care
treatment, and variance in YSQ-S3 scores was satisfyingly high. Demographic and clinical characteristics ranged
broadly, leading to a heterogeneous sample without a
clear population to which the findings could be generalized. Although we examined an additional clinical sample, its size was rather small because of limited resources.
Thus, further investigations in large clinical samples on
the psychometric properties of the YSQ-S3 are necessary.
To our knowledge this study is the first to test the German version of the YSQ-S3. Largely in agreement with
previous findings in other countries and with former versions of the instrument, we conclude that the YSQ-S3
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Discriminant Validity
Statistically significant (p < .001) group differences in all
YSQ-S3 scales were found for groups defined by healthcare utilization (see Figure 1). Most schemas were most
pronounced in the clinical sample, followed by former
inpatients from the community sample. Similarly, outpatients scored lower than inpatients but higher than subjects reporting counseling sessions. Participants reporting
no mental-health related health-care utilization scored
lowest on all scales. Overall differences were most pronounced for schemas in the domains Disconnection and
Impaired Autonomy and Achievement (see Table 1).
Discussion
Acknowledgments
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Levente Kriston