Comparative Effectiveness of Group-Based Schema Modification on Emotional Dysregulation and Core Maladaptive Schemas in Borderline and Histrionic Traits

Abstract

Group-based Schema Therapy (GST) has emerged as a promising intervention for modifying early maladaptive schemas and improving emotional regulation capacities in individuals with personality disorder features. Borderline and histrionic personality traits, despite sharing certain interpersonal vulnerabilities, exhibit distinct cognitive–emotional patterns that influence treatment responsiveness. Persistent schema configurations, heightened reactivity, unstable relationships, and difficulties in regulating emotional states often contribute to chronic psychological distress in these populations. The present study aims to evaluate the comparative effectiveness of a structured, 12-session group-based schema modification program on transforming core schema patterns and reducing emotional dysregulation across individuals with borderline and histrionic traits. A total of 62 outpatients were recruited through purposive sampling and assigned to two subgroups: borderline-trait (n=32) and histrionic-trait (n=30), based on structured clinical interviews and standardized assessment tools. Baseline evaluations included the Young Schema Questionnaire (YSQ-S3), the Difficulties in Emotion Regulation Scale (DERS), and symptom severity ratings. The intervention incorporated cognitive restructuring, experiential techniques, and behavioral pattern-breaking strategies specifically adapted for group delivery. Post-intervention assessments were conducted at week 12, followed by a monitoring phase at week 20. Results demonstrated distinct therapeutic pathways in the two personality subgroups. Individuals with borderline traits exhibited more substantial reductions in schemas related to abandonment, mistrust, defectiveness, and emotional deprivation. In contrast, individuals with histrionic traits showed pronounced decreases in approval-seeking, attention-seeking, and insufficient self-control schemas. Both groups experienced improvements in emotion regulation; however, the magnitude of change was higher in the borderline subgroup, indicating a stronger responsiveness to group-based schema-oriented techniques in domains associated with affective instability. The study offers clinically meaningful insights into how GST differentially impacts cognitive–emotional mechanisms in borderline and histrionic profiles. These findings support the incorporation of tailored schema-focused group interventions into routine clinical practice and highlight the importance of recognizing personality-specific schema structures when designing treatment protocols. The comparative perspective presented in this research extends existing knowledge by demonstrating how targeted schema modification can lead to measurable changes in emotional regulation and cognitive patterns across personality presentations.