Journal of Personality Disorders, 34(3), 348–376, 2020

© 2020 The Guilford Press

THE HIGHER-ORDER STRUCTURE

OF SCHEMA MODES
Ingo Jacobs, PhD, Lisa Lenz, MSc, Anna Wollny, PhD,
and Antje Horsch, PhD

In schema therapy, modes are proposed as a key concept and main target
for treatment of personality disorders. The present study aimed to assess a
comprehensive set of 20 modes, to explore their higher-order structure, and
to link the mode factors to the generic schema factor and basic personality
traits. The sample consisted of N = 533 inpatients. Earlier versions of
the Schema Mode Inventory (SMI, SMI-2) were merged into the German
Extended SMI (GE-SMI). Item-level confirmatory factor analyses indicated
that the structure of 16 out of 20 GE-SMI scales might be unidimensional.
Scale-level exploratory factor analysis revealed three hierarchically
structured mode factors: internalization, externalization, and compulsivity.
Regressing mode factor scores on the Big Five factors and the generic
schema factor supported the validity of the mode factors. The hierarchical
structure of modes will be linked to the Hierarchical Taxonomy of
Psychopathology, and implications for case conceptualization and treatment
will be discussed.

Keywords: Big Five, externalization, internalization, HiTOP, schema

mode, schema therapy, SMI

Schema therapy (ST) has been developed as a treatment for patients with
personality disorders (PDs) and other chronic, complex emotional disorders
(Young, Klosko, & Weishaar, 2003). The theory underlying ST is based on
three key concepts: Early maladaptive schemas (or schemas) refer to traitlike
dysfunctional beliefs regarding oneself, to one’s relationships with others and
the world, and to emotional and behavioral-procedural information (van
Genderen, Rijkeboer, & Arntz, 2012). In the formation of schemas, innate

Department of Natural Sciences, Medical School Berlin, Germany (I. J.); Department of Psychology, Sigmund
Freud University Berlin, Germany (I. J.); Zentrum Ausbildung Psychotherapie, Lehrinstitut Bad Salzuflen,
Germany (L. L.); University of Potsdam, Germany (A. W.); Institute of Higher Education and Research in
Healthcare, Lausanne University and Lausanne University Hospital, Switzerland (A. H.); and Department
Woman-Mother-Child, Lausanne University Hospital, Switzerland (A. H.).
We are grateful to S. Dörner for support during data collection.
This study did not receive any specific grant from funding agencies in the public, commercial, or nonprofit
sectors.
Address correspondence to Ingo Jacobs, Department of Natural Sciences, Medical School Berlin, Calan-
drellistr. 1-9, Berlin, Berlin 12247, Germany. E-mail: ingojacobs@yahoo.de

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 STRUCTURE OF SCHEMA MODE FACTORS 349

factors interact with early adverse relational experiences with significant oth-
ers. The current schema model includes 18 schemas (e.g., mistrust/abuse, fail-
ure) grouped into four domains (Young, 2014; see Bach, Lockwood, & Young,
2018, for preliminary support). When a schema is triggered, painful emotions
ensue (e.g., shame, fear, sadness). In order to cope with schema-related distress,
a person may surrender to a schema, avoid schema activation, or act contrary
to what the schema evokes (van Genderen et al., 2012). Finally, schema modes
(or modes) are cognitive, emotional, and behavioral states that dominate
a person’s current psychological functioning. Maladaptive modes reflect a
constellation of currently activated schemas along with the schema-related
distress and coping responses (Young, Klosko, & Weishaar, 2003). A recent
study accordingly showed that schemas influence maladaptive modes through
the type of coping and that links between schemas and psychopathological
problems in adolescents are mediated by coping responses and modes (van
Wijk-Herbrink, Bernstein, et al., 2018). Maladaptive modes are thus regarded
as dynamic processes and statelike features of personality pathology.
Schema therapy is effective in treating patients with PDs or PD features
(e.g., Bamelis, Evers, Spinhoven, & Arntz, 2014; Jacob & Arntz, 2013; Skewes,
Samson, Simpson, & van Vreeswijk, 2014). Despite the well-documented effi-
cacy of ST, there is a dearth of research into the foundations of the mode
model, such as the higher-order structure of modes. Growing evidence suggests
that the maladaptive trait domain is hierarchically organized (see Krueger &
Markon, 2014), and that symptoms of clinical disorders and maladaptive traits
can be integrated within the same Hierarchical Taxonomy of Psychopathol-
ogy (HiTOP; Kotov et al., 2017). The hierarchical structure of modes might
be consistent with the hierarchical structure of maladaptive traits and with
the HiTOP. Given that specific mode models provide valid representations of
PDs (e.g., Bamelis, Renner, Heidkamp, & Arntz, 2011) and chronic emotional
disorders (e.g., Gross, Stelzer, & Jacob, 2012), and that interventions were
developed to target specific modes (Jacob & Arntz, 2015), the mode model
might provide a basis for the HiTOP to translate into case conceptualization
and treatment.

THE GENERAL MODE MODEL AND

ASSESSMENT OF SCHEMA MODES

The general mode model defines four mode categories that organize more than
20 modes (Jacob & Arntz, 2015; for initial definitions of 10 modes, see also
Young & First, 2003): Maladaptive child modes are characterized by intense
negative emotions that ensue when patients’ needs are not met. They can be
subdivided into inwardly directed vulnerable modes (e.g., lonely child) and
outwardly directed modes (e.g., angry child, impulsive child). In the maladap-
tive parent modes, patients put too much pressure on themselves to meet unre-
lenting standards, take too much responsibility for others (demanding parent),
or act overly critical, impatient, and aggressive toward themselves (punitive
parent). Maladaptive coping modes reflect rigidly used coping responses. They
can be divided into the compliant surrender mode, avoidant modes (e.g.,

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 350 JACOBS ET AL.

detached protector), and overcompensator modes (e.g., bully and attack). In

the adaptive happy child mode, patients feel loved, validated, and secure, and
they behave playfully and spontaneously. The adaptive healthy adult mode
includes functional cognitions and behaviors that promote healthy relation-
ships and adequate self-regulation.
The Schema Mode Inventory (SMI; Lobbestael, van Vreeswijk, Spin-
hoven, Schouten, & Arntz, 2010) provides an established method to assess
14 modes. The SMI-2 (Bamelis et al., 2011) measures 18 modes, of which
five modes were omitted in the SMI and two modes (lonely child, abandoned/
abused child) are merged in SMI’s vulnerable child mode. Altogether, the SMI
and SMI-2 assess 20 different modes. By asking respondents how often each
mode item applies to them in general, the SMI and SMI-2 yield an overview
of the habitual manifestation frequency of modes. Manifestation frequency
alters the state-like into a more trait-like mode concept (Lobbestael, 2012).
Confirmatory factor analyses (CFAs) revealed an acceptable global model
fit of the 14-factor model (Lobbestael et al., 2010; Reiss et al., 2012; Reiss,
Krampen, Christoffersen, & Bach, 2016) and of the 18-factor model (Bamelis
et al., 2011).
The first aim of this study is to introduce the German extended SMI (GE-
SMI) that assesses 20 modes taken from the SMI and SMI-2 (see Appendix
Table A1 for sample items). However, such large multifactorial models with
over 100 observed variables usually fail to satisfy liberal standards of model
fit in item-level CFAs in moderately sized samples (see Gignac, 2007; Marsh,
Morin, Parker, & Kaur, 2014). We therefore focused on the local fit of the 20
GE-SMI scales (cf. Zimmermann et al., 2014). We expected that the 20 scales
are reasonably unidimensional and will satisfy minimal standards of model
fit (hypothesis 1; H1).

THE HIGHER-ORDER STRUCTURE OF

PSYCHOPATHOLOGY AND SCHEMA MODES

The notion that psychopathology is hierarchically organized is rooted in per-

sonality disorder research that preceded and followed the introduction of the
Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5;
American Psychiatric Association, 2013) Section III trait model. Growing evi-
dence supports an integrative hierarchical framework for normal and abnor-
mal personality dimensions (Al-Dajani, Gralnick, & Bagby, 2016; Krueger &
Markon, 2014; Widiger & Simonsen, 2005; Wright & Simms, 2014): At the
apex of the hierarchy, a general personality pathology dimension captures a
fundamental quality that pervades all maladaptive trait dimensions (Hopwood
et al., 2011). The broad dimensions of internalization and externalization
emerge at the second tier. According to Widiger and Simonsen (2005), both
dimensions play a pivotal role in the organization of personality traits and
behaviors. Internalization usually splits into detachment and negative affect
at the third level, and externalization usually splits into antagonism/dissocial-
ity and disinhibition at the fourth tier. At the final tier, psychoticism emerges
as a separate dimension. The metastructure is robust to the source of the

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 STRUCTURE OF SCHEMA MODE FACTORS 351

data (self-reports or clinician ratings) and to sampled populations (normal

or clinical; e.g., Krueger & Markon, 2014; Morey, Krueger, & Skodol, 2013;
Wright & Simms, 2014; Wright et al., 2012). Small structural deviations may
occur for specific instrumentations due to idiosyncrasies of the trait features
sampled by those instruments: Van den Broeck et al. (2014) analyzed the
joint hierarchical structure of the 25 DSM-5 trait facets and 18 traits from
an alternative maladaptive trait model. A compulsivity dimension emerged at
the fourth tier, but a separate psychoticism dimension did not appear. Because
trait features of psychoticism are omitted in the ICD-11 PD trait model, an
anankastic dimension instead of psychoticism emerges at the fifth tier of the
hierarchical structure of the ICD-11 trait domain (Bach et al., 2017), which
is akin to van den Broeck et al.’s (2014) compulsivity dimension.
In clinical disorders, internalization represents the propensity to over-
control one’s behavior and to express distress inwards as found in unipolar
mood, anxiety, and eating disorders (Caspi et al., 2014; Kotov et al., 2011;
Krueger, McGue, & Iacono, 2001; Markon, 2010). Externalization captures
the propensity to undercontrol one’s behavior and to express distress out-
wards as found in attentional difficulties, conduct disorder, substance abuse,
and antisocial tendencies (Caspi et al., 2014; Krueger et al., 2001; Markon,
2010). Thought disorder is linked with schizophrenia spectrum disorders,
mania (Kotov et al., 2011; Markon, 2010), and, albeit inconsistently, obsessive-
compulsive symptoms (Caspi et al., 2014).
The HiTOP integrates personality pathology and clinical disorders into
the same hierarchically structured dimensional taxonomy (Kotov et al., 2017):
Symptoms and signs, located at the lowest level, are organized by components
and maladaptive traits at the second level. Homogeneous components and
maladaptive traits form 11 syndrome/disorder dimensions at the third level
(e.g., bipolar I and II). At the fourth level, seven subfactors (e.g., distress, fear)
organize covarying syndromes. At the fifth level, six broad spectra emerge:
disinhibited and antagonistic externalization, internalization (or negative
affectivity), thought disorder, detachment, and somatoform spectra. A general
psychopathology factor called p resides on top of the hierarchy, and several
superspectra (i.e., extremely broad dimensions consisting of multiple spectra)
exist between p and the six spectra. To date, no attempts have been made to
link modes to the HiTOP. Thus, the current study also aimed to explore the
hierarchical structure of modes, thus promoting their integration within the
HiTOP.
The close ties between modes and DSM-5’s maladaptive traits (Bach,
Lee, Mortensen, & Simonsen, 2016) provide a basis for assigning modes
to internalization, externalization, and thought disorder/compulsivity: Trait
markers for internalization are emotional lability, anhedonia, depressivity,
anxiousness, suspiciousness, separation insecurity, submissiveness, identity
problems, and low affiliation (van den Broeck et al., 2014). The mode model
covers analogous qualities in inwardly directed child modes, the avoidant
protector, detached protector, compliant surrender, suspicious overcontroller,
punitive parent, and weak adaptive modes. Externalizing traits are attention
seeking, grandiosity/narcissism, callousness, deceitfulness, manipulativeness,
and rejection (van den Broeck et al., 2014). Similar qualities are captured by

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 352 JACOBS ET AL.

the attention and approval seeker, self-aggrandizer, bully and attack, and out-
wardly directed child modes. Given that schizophreniform personality features
are usually not targeted in schema therapy, core aspects of thought disorder
(e.g., unusual experiences and beliefs) are poorly represented in the mode
model (Bach et al., 2016). However, van den Broeck et al.’s (2014) compulsivity
component and Bach et al.’s (2017) anankastic factor reflect trait features (e.g.,
compulsivity, rigid perfectionism, perseveration, distractibility) that are akin
to the perfectionistic overcontroller and demanding parent modes. Such trait
features (e.g., overly exacting expectations of others, perfectionism, workahol-
ism) along with pathological obsessive-compulsive beliefs have been linked to
thought disorder (Bach et al., 2017; Hopwood, Schade, Krueger, Wright, &
Markon, 2013; Markon, 2010). In sum, we hypothesized that modes have a
hierarchical structure ranging from a general personality pathology factor to
internalization, externalization, and compulsivity (H2).
In order to find preliminary support for the three supposed mode fac-
tors, we submitted the correlation matrices of the 14 SMI factors reported in
Lobbestael et al. (2010) and Reiss et al. (2012, 2016) to principal component
analyses. The analyses revealed internalization and externalization in three
analyses and compulsivity in two analyses (for pattern matrices, see Appen-
dix Table A2). Two recent studies elaborated the higher-order structure of
16 modes: In a forensic sample, internalization and externalization emerged
along with a healthy modes component (marker: happy child & healthy adult;
Keulen-de Vos et al., 2017). In a sample of adolescents (van Wijk-Herbrink,
Roelofs, et al., 2018), internalization, externalization, and a healthy modes
factor were found along with an overachieving modes factor (marker: self-
aggrandizer, demanding parent, overcontroller) resembling the supposed
compulsivity factor. However, the fourth eigenvalue was only 0.60, and the
structure had problems with replication. Thus, internalization, externaliza-
tion, and compulsivity might emerge more clearly in a more comprehensive
set of 20 modes. It remains also to be clarified whether both adaptive modes
load on a distinct healthy modes factor or negatively on internalization (see
Appendix Table A2).

THE CONCURRENT VALIDITY OF

THE HIGHER-ORDER MODE FACTORS

The present study also aimed to link the mode factors to personality trait fac-
tors and to the schema domain. However, the exact structure of the schema
domain is still controversial (see Kriston, Schäfer, von Wolff, Härter, & Hölzel,
2012). Recently, Bach et al. (2018) investigated the hierarchical structure of
18 schemas. They found, similar to the meta-structure of maladaptive traits,
a general maladaptivity component residing at the top of the hierarchy and
explaining 53.8% of the variance in schemas. Internalization and externaliza-
tion emerged jointly at the second tier, accounting for 61.2% of the variance.
Given that the 18 schemas mainly address internalizing content (van Genderen
et al., 2012), the generic schema component was more strongly linked to the
internalization component (Bach et al., 2018). A large generic schema factor

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 STRUCTURE OF SCHEMA MODE FACTORS 353

is also implied by bifactor models, including a g-factor and 18 group factors,

which showed a reasonable fit (Bach, Simonsen, Christoffersen, & Kriston,
2015) or outperformed a model with 18 correlated factors (Kriston et al.,
2012). Moreover, schemas organized under internalization (Bach et al., 2018)
contribute to both internalizing and externalizing modes and problems by
different types of coping (van Wijk-Herbrink, Bernstein, et al., 2018). One of
the reviewers of this article thus suggested that regarding a schema as either
internalizing or externalizing is problematic because a schema operates at a
deeper level and gives rise to both internalizing and externalizing modes and
symptoms. Nevertheless, current evidence suggests that the generic schema
factor will be positively linked to all mode factors, and that the strongest
association will be found with the internalization modes factor (H3).
Basic personality trait factors such as the Big Five (i.e., conscientiousness,
neuroticism, extraversion, agreeableness, and openness to experience; Gold-
berg, 1993) may affect modes either directly or indirectly via their associations
with schemas. Moreover, four domains in the DSM-5 Section III trait model
are closely linked to four Big Five factors (Al-Dajani et al., 2016): disinhibi-
tion and low conscientiousness, detachment and low extraversion, negative
affectivity and neuroticism, and antagonism and low agreeableness. The hier-
archical structure of the DSM-5 trait model (Krueger & Markon, 2014) can
thus be translated into the Big Five. We hypothesized that internalization will
relate negatively to extraversion and positively to neuroticism (H4.1), whereas
externalization will be negatively linked to agreeableness and conscientiousness
(H4.2). Obsessive-compulsive traits are related to conscientiousness (Samuel
& Widiger, 2008), and in van den Broeck et al.’s (2014) model, compulsiv-
ity emerged from negative affect and detachment. Thus, we expected that
compulsivity will relate positively to neuroticism and conscientiousness, and
negatively to extraversion (H4.3).

MATERIALS AND METHODS

PROCEDURE AND PARTICIPANTS
The sample was recruited at the psychiatric department of a hospital in Berlin,
Germany. German-speaking inpatients between the ages of 18 and 80 years
were invited to take part. After giving written informed consent, all participants
completed computerized inventories in order to assess their modes, schemas,
the Big Five factors, and other measures not reported here. The data collection
was carried out during the first week of hospitalization. Participants completed
the questionnaires in a random order using a handheld computer. Patients did
not receive any compensation for their participation. Ethical approval for the
study was granted by the ethical review board of the University of Potsdam,
Germany.
A total of N = 533 inpatients completed the study (n = 416 females, and
n = 117 males). Mean age of the sample was 40.83 years (SD = 15.00; range: 18
to 78 years). The majority of the participants were German (n = 507, 95.1%),
unmarried (n = 291, 54.6%), and had no children (n = 405, 76.0%). About
one third of the sample either had vocational training (n = 196, 37.0%) or

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 354 JACOBS ET AL.

obtained a university degree or an applied sciences degree (n = 170, 31.9%).

According to the ICD-10 diagnoses documented in the patient files, the fre-
quencies of primary diagnoses in the sample were grouped as follows: 33.2%
(n = 177) affective disorders (F31–F34), 16.1% (n = 86) somatoform disor-
ders (F45), 14.8% (n = 79) psychological and behavioral factors associated
with disorders or diseases classified elsewhere (F54), 10.3% (n = 55) anxiety
disorders (F40–F41), 9.6% (n = 51) reaction to severe stress and adjustment
disorders (F43), 6.4% (n = 34) disorders of adult personality and behavior
(F60–F63), 4.3% (n = 23) eating disorders (F50), 3.2% (n = 17) other disor-
ders (F42, F44, F90), 0.8% (n = 4) diseases from ICD-10 chapters IV, XI, and
XVIII. For 1.3% (n = 7), this information was missing. Given that diagnoses
were not obtained systematically from structured clinical interviews and that
more than one third of psychiatric patients usually meet the criteria for a PD
diagnosis (e.g., Tyrer et al., 2014; Zimmerman, Rothschild, & Chelminski,
2005), the low prevalence rate of PD diagnoses in the current sample likely
underestimates the actual prevalence rate of PDs.

MEASURES
German Extended Schema Mode Inventory (GE-SMI). The GE-SMI is a
self-report inventory assessing the habitual manifestation frequency of 20
modes. Participants indicate on a 6-point scale (1 = never or hardly never to
6 = always) how often they experienced mode-specific feelings, cognitions,
behaviors, and impulsions. A total of 108 items organized in 13 scales were
taken from the German SMI (Reiss et al., 2012). Sixty-eight items organized
in seven scales were taken from the Dutch SMI-2 (Bamelis et al., 2011):
dependent child, lonely child, abandoned/abused child, avoidant protector,
attention and approval seeker, suspicious overcontroller, and perfectionis-
tic overcontroller (SMI-2’s lonely child and abandoned/abused child scales
replaced SMI’s vulnerable child scale). Dr. Gitta Jacob (personal commu-
nication, November 21, 2012) provided us with German versions of both
overcontroller mode scales that were taken from a 143-item SMI version
and that were identical with the respective SMI-2 scales. The translation of
the remaining 49 SMI-2 items accorded with guidelines for the translation of
foreign language assessment instruments (e.g., Geisinger, 1994): Two native
German translators created independent translations of the 49 items. After
reconciliation of both translations and resolution of discrepancies between
the original and translated items, the items were back-translated by a na-
tive Dutch translator. A bilingual speech therapist (MA level) checked the
translated and original items for correspondence. A German psychologist
(PhD level), who graduated in the Netherlands, checked for discrepancies
between the back-translated and the original items. In both checks, the
translated items appeared to be in order.

Young Schema Questionnaire (YSQ-S2-extended). The YSQ-S2-extended

(Young, Brown, Berbalk, & Grutschpalk, 2003) assesses 19 schemas (e.g.,
emotional deprivation, subjugation). Respondents rated the 95 items on a

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 STRUCTURE OF SCHEMA MODE FACTORS 355

6-point scale (1 = completely untrue of me to 6 = describes me perfectly).

Although the social undesirability schema is omitted in the current schema
model (Young, 2014), we retained all 19 scales for pragmatic reasons. In prior
research, the YSQ-S2-extended showed reasonable validity and reliability
(Wichmann, 2012). Due to missing data, Cronbach’s ɑ estimates for YSQ-S2
scales were derived from a single dataset imputed with error directly from
expectation-maximization (EM) parameters. In the current study, mean Cron-
bach’s ɑEM of the 19 scales was .84 (range: .71–.93; for descriptive statistics,
see Appendix Table A3).

Big Five Inventory short version (BFI-K). The BFI-K (Rammstedt & John,
2005) is a self-report inventory designed to assess the Big Five factors with four
or five items per scale. The 21 items were rated on a 5-point scale (1 = strongly
disagree to 5 = strongly agree). The BFI-K has shown acceptable reliability and
validity in prior research (Rammstedt & John, 2005). In the present study,
Cronbach’s ɑEM of the scales was fair: conscientiousness (.81), agreeableness
(.81), neuroticism (.76), extraversion (.70), and openness to experience (.69).

STATISTICAL ANALYSES
All calculations were carried out with IBM SPSS 22, EQS 6.2 (Bentler, 2006),
and FACTOR 10 (Ferrando & Lorenzo-Seva, 2017). First, schema g-factor
scores were created by submitting the 19 YSQ-S2-extended schemas to an
exploratory factor analysis (EFA), using unweighted least squares (ULS) esti-
mation (throughout this article, all EFAs are based on the respective correlation
matrix). One factor was retained and factor scores were saved.
Second, to provide tests of the GE-SMI scales’ unidimensionality, 20 item-
level CFAs were performed based on the respective covariance matrix and
robust maximum likelihood (ML) estimation (Satorra & Bentler, 2001). Mal-
functioning items with loadings a < .40 were removed. For each scale, the fit
of a model with a single latent factor was assessed by three fit indices: the root
mean square error of approximation (RMSEA), the standardized root mean
square residual (SRMR), and the comparative fit index (CFI). Minimal model
fit is indicated by RMSEA < .10, SRMR < .08, and CFI > .90; a good model fit
is indexed by RMSEA < .05, SRMR < .06, and CFI > .95 (e.g., Brown, 2006).
When two fit indices failed to meet minimal standards of model fit, we contin-
ued with examining the scale structure using item-level EFA (cf. Zimmermann
et al., 2014). In order to explore the factor structure underlying the 20 modes,
a scale-level EFA with ULS estimation and promax rotation (κ = 4) was carried
out and factor scores were saved. The similarity of the factor structures obtained
in the subsamples of males and females was tested with separate EFAs using
ULS estimation, target rotation, and Tuckers φ. The number of factors to retain
was determined via Velicer’s (1976) minimum average partial (MAP) test and
Horn’s (1965) parallel analysis using 1,000 resamples, principal components
extraction, and a 95% threshold for random eigenvalues.
Third, the hierarchical structure of modes was explored using Goldberg’s
(2006) “bass-ackwards” method. First, we conducted a single-factor EFA with

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 356 JACOBS ET AL.

ULS estimation, followed by a series of EFAs with an increasing number of

factors and varimax rotation. At each step, the factor scores were saved. The
correlations between the factor scores from adjoining levels estimated the path
coefficients in the hierarchical structure (Goldberg, 2006).
Finally, specific associations of the Big Five factors and the generic schema
factor with each mode factor were tested in a series of three hierarchical
regression analyses. In the first step, the respective mode factor scores were
regressed on age, sex, and the Big Five scale scores. In the second step, the
schema g-factor scores entered the model. At this final step, each partial effect
was controlled for the effects of the remaining seven predictor variables in the
model, thus allowing a more conservative test of specific associations.
A total of n = 3 (0.6%) subjects did not complete the YSQ-S2-extended.
The BFI-K was not given to n = 185 (34.7%) patients, resulting in n = 345
(64.7%) complete datasets. Normal-model multiple imputation (MI; Graham,
2012) was chosen for dealing with the missing data. Two item-level imputation
models were run in order to estimate Cronbach’s α of the YSQ-S2-extended
scales and BFI-K scales. The main imputation model included age, sex, the
mode factor scores, the Big Five scales, the schema g-factor scores, and aux-
iliary variables. Imputing at item or scale level makes virtually no difference,
provided that all cases have either no data or all data for items that make up
a scale (Graham, 2012), which applied to the present data. A total of n = 50
imputed datasets were generated with NORM 2.03 (Schafer, 2000), and all
MI diagnostic plots appeared in order. Datasets were analyzed with complete-
cases procedures, and parameter estimates were pooled. Analyses that did not
require standard errors (i.e., R2, ΔR2, Cronbach’s α) were derived from a single
dataset imputed directly from EM parameters.
The enraged child, attention and approval seeker, bully and attack scales
were highly skewed and therefore log10-transformed prior to the analyses. To
increase the likelihood of replication due to greater strength of evidence, an
a priori alpha level of 1% was chosen.

RESULTS
PRELIMINARY ANALYSES
In the scale-level EFA of the YSQ-S2-extended schemas, three eigenvalues were
≥ 1.00 (8.58, 1.34, and 1.19). The parallel analysis suggested two factors to
retain, whereas the MAP test suggested a unidimensional solution. The large
ratio of the first to the second eigenvalue of 6.40 suggested that the set of sche-
mas can be regarded as sufficiently unidimensional (Morizot, Ainsworth, &
Reise, 2007). Thus, one factor was retained that reached an acceptable model
fit (CFI = .984, RMSEA = .057, and SRMR = .068) and explained 42.4% of
the variance in schemas. Similar to the general maladaptivity dimension in
Bach et al. (2018), all schemas had substantial and positive loadings (range:
.33 to .80; mean: .65). The highest loadings were observed for the schemas
negativity and pessimism, defectiveness/shame, subjugation, and dependence
(for factor loadings, see Appendix Table A3).

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TESTING THE UNIDIMENSIONALITY OF THE GE-SMI SCALES

Table 1 shows descriptive statistics, Cronbach’s α, and factor analytic results
for the final GE-SMI scales. In the item-level CFAs, 10 malfunctioning items
with loadings |a| < .40 were removed, leaving a final set of 165 items (for
affected scales, see Table 1). The 20 scales reached acceptable levels of internal
consistency (Cronbach’s α ranged from .72 to .93). The mean item loadings
in unidimensional CFA models were adequate, ranging from .55 to .75 with a
mean of M = .66 (see Table 1). For 16 scales, two or three fit indices simultane-
ously met minimal standards of model fit (i.e., SRMR < .08, RMSEA < .10, and
CFI > .90), suggesting that they were sufficiently unidimensional (see Table 1).
However, the CFAs for the enraged child, impulsive child, lonely child, and
avoidant protector scales suggested a more complex factor structure because at
least two fit indices indicated poor fit. The factor structure of these four scales
was further investigated using a series of item-level EFAs. For the enraged
child, impulsive child, and lonely child scales, only one eigenvalue >1.00 was
extracted, and parallel analyses and MAP tests consistently indicated that a
unidimensional solution is appropriate for each scale. For the avoidant pro-
tector scale, two eigenvalues > 1.00 were extracted (5.25, 1.28), and parallel
analysis and the MAP test suggested two factors to retain. In EFA, the avoidant
protector items bifurcated into social avoidance and avoidance of decisions,
difficult situations, and problems. Both factors were highly correlated, r = .64,
p < .001. However, the ratio of the first to the second eigenvalue of 4.10 implies
that the item set still can be regarded as unidimensional enough for practical
applications (Morizot et al., 2007). We therefore decided to retain the original
avoidant protector scale in the following analyses.

THE HIGHER-ORDER FACTOR STRUCTURE OF MODES

In the scale-level EFA of the GE-SMI, the eigenvalues > 1.00 were 8.49, 2.56,
and 1.81. MAP test and parallel analysis both suggested three factors to retain.
The three-factor solution was the most parsimonious model that showed a
good fit in terms of RMSEA = .030, SRMR = .044, and CFI = .996. The pattern
matrix of the factor model is shown in Table 1 (for GE-SMI scale correlations,
see Appendix Table A4). The first factor was named externalization. It captures
antagonistic tendencies and problems in controlling one’s impulses and anger
as indicated by high positive loadings of the attention and approval seeker,
bully and attack, self-aggrandizer, impulsive child, enraged child, and angry
child modes. The second factor was termed compulsivity, and it mainly reflects
anankastic qualities (i.e., demanding parent, perfectionistic overcontroller,
detached self-soother modes, and a secondary loading of the self-aggrandizer
mode). The third factor, labeled internalization, captures internalizing features
as reflected in positive loadings of the abandoned/abused child, lonely child,
dependent child, avoidant protector, and detached protector modes, and nega-
tive loadings of both adaptive modes. Only four modes showed moderate
secondary loadings |a| ≥ .30, and Bentler’s simplicity index, S = .95 (percentile
100), suggests a high degree of factor simplicity.

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G4844.indd 358
TABLE 1. Descriptive Statistics, Internal Consistency, and Factor Structure of
the German Extended Schema Mode Inventory (GE-SMI)
Item-level CFA Scale-level EFA (pattern matrix)

M SD α No. Items CFI SRMR RMSEA MLoading I II III h2

Angry childa 2.87 0.83 .81 10 .871 .059 .085 .56 .57 .13 .25 .60
Enraged childa,d 1.52 0.73 .90 9 .782 .058 .101 .73 .66 −.22 .17 .46
Impulsive childa 2.36 0.82 .85 8 .892 .055 .101 .65 .73 −.21 .20 .58
Undisciplined childa 3.05 0.98 .74 4e .985 .025 .075 .65 .34 −.16 .55 .48
Dependent childb 2.75 0.85 .87 10 .927 .049 .076 .64 .10 .01 .75 .63
Abandoned/abused childb 3.24 1.01 .91 11e .910 .066 .109 .73 −.02 .16 .84 .83
Lonely childb 3.10 1.05 .93 11 .898 .057 .122 .75 −.02 .07 .87 .79
Demanding parenta 3.77 1.01 .82 7 .929 .052 .101 .64 −.05 .81 .08 .69
Punitive parenta 2.38 0.93 .89 10 .911 .048 .091 .69 .15 .12 .65 .62
Compliant surrendera 3.31 0.87 .77 6e .921 .056 .102 .60 −.13 .34 .55 .51
Avoidant protectorb 3.21 0.96 .90 10 .831 .093 .155 .69 −.26 .16 .83 .69
Detached protectora 2.71 0.91 .88 9 .902 .057 .104 .67 .07 −.03 .73 .56
Detached self-soothera 3.43 1.01 .72 4 .963 .039 .115 .64 .15 .38 .08 .25
Attention and approval seekerb,d 2.13 0.86 .86 6 .908 .050 .120 .73 .69 .13 −.32 .44
Self-aggrandizera 2.54 0.78 .78 9e .855 .064 .092 .55 .58 .48 −.22 .62
Perfectionistic overcontrollerb 3.65 0.96 .83 7c,f .968 .032 .069 .66 −.06 .79 .06 .63
Suspicious overcontrollerb 2.94 0.94 .76 8e .951 .040 .079 .69 .17 .27 .45 .51
Bully and attacka,d 1.88 0.67 .75 7f .860 .060 .095 .57 .66 .15 −.02 .51
Healthy adulta 3.75 0.79 .81 10 .948 .042 .053 .55 −.02 .26 −.81 .55
Happy childa 3.20 0.88 .87 9e .917 .057 .099 .66 .09 .08 −.88 .66
I Externalization
II Compulsivity .37
III Internalization .42 .42
Note. CFA = confirmatory factor analysis (robust ML); EFA = exploratory factor analysis (ULS, promax rotation, κ = 4); M = mean; SD = standard deviation; α = Cronbach’s alpha;
No. Items = number of items per scale; CFI = comparative fit index; SRMR = standardized root mean square residual; RMSEA = root mean square error of approximation;
MLoading = mean item loading; h2 = communality. aScale taken from SMI; bscale taken from SMI-2; cone item omitted due to technical problems with data collection; dlog10-
transformed prior to the EFA; eone malperforming item removed; ftwo malperforming items removed. The primary loading in each row is underlined; secondary loadings |a| ≥
.30 are shown in italics.

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 STRUCTURE OF SCHEMA MODE FACTORS 359

The scale-level EFA was repeated in both gender-stratified subsamples.

The eigenvalues ≥ 1.00 were 8.38, 2.74, and 1.84 (females) and 9.01, 2.06,
1.74, and 1.13 (males). In both subsamples, MAP test and parallel analysis
consistently suggested three factors to retain. Using oblique target rotation,
the three-factor model for males was rotated against the three-factor solution
obtained for females. Tucker’s phi implied that in both samples externalization
(φ = .97), compulsivity (φ = .96), and internalization (φ = .98) can be regarded
as equal (Lorenzo-Seva & ten Berge, 2006; both pattern matrices are shown
in Appendix Table A5). Thus, the factor structure was well replicated in both
male and female subsamples.
Next, the hierarchical structure of modes consisting of three levels was
elaborated (for a graphical depiction, see Figure 1; for loading matrices, see
Appendix Table A6). In the one-factor solution, all modes showed substantial
factor loadings |a| ≥ 0.30, except the attention and approval seeker mode
(a = .20). All maladaptive modes loaded positively, and both adaptive modes
loaded negatively on this factor. The highest loadings were found for the
abandoned/abused child, lonely child, and punitive parent modes. Hence, the
pattern of loadings indicates that this factor represents general personality
pathology with an emphasis on internalizing features. On the second level,
the general personality pathology factor splits into two factors. These two
factors were defined by internalizing and externalizing mode qualities, based
on the pattern of loadings. Externalization was primarily defined by positive
loadings of the self-aggrandizer, bully and attack, attention and approval,

FIGURE 1. Hierarchical structure of mode factors (N = 533). Exploratory factor

analysis (EFA) with ULS estimation and varimax rotation were employed for each
level. Three GE-SMI scales with the highest primary loadings are shown for each
factor (for full loading matrices, see Appendix Table A6). Only path coefficients |r| ≥
.20 are shown. alog10-transformed prior to the EFA.

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 360 JACOBS ET AL.

and angry child modes, whereas internalization was marked by the modes
abandoned/abused child, lonely child, avoidant protector and happy child
(reverse). At the third level, internalization and externalization were largely
replicated, and a third factor, compulsivity, emerged. This factor was marked
by the demanding parent and perfectionistic overcontroller modes. Overall,
these three orthogonal factors are almost identical to the oblique three-factor
structure already reported in the Results section (see Table 1 and Appendix
Table A6). Both parallel analysis and MAP test suggested that considering the
four-factor solution was not warranted.

CONCURRENT VALIDITY OF THE MODE FACTORS

The correlations between the study variables are shown in Table 2 (correlations
of the 20 mode scales with the Big Five factors and the schema g-factor are
given in Appendix Table A7). The schema g-factor scores correlated positively
with the factor scores of internalization, r = .89, p < .001, externalization,
r = .51, p < .001, and compulsivity, r = .57, p < .001. To test for specific associa-
tions of the mode factors with the schema g-factor, the schema g-factor scores
were regressed on age and the mode factor scores. Internalization contributed
strongest to the schema g-factor, (β = .77, p < .001), followed by compulsivity
(β = .17, p < .001), externalization (β = .09, p < .001), and age (β = .002, ns).
The results of the three hierarchical regression analyses are shown in
Table 3. The Big Five factors, age, and sex jointly accounted for 57.0% of the
variance in internalization factor scores of the GE-SMI. Higher neuroticism
and lower extraversion, agreeableness, and conscientiousness were specifically
related to greater internalization scores, with the primary association found
for neuroticism. When the schema g-factor scores entered the model, 27.5%
of the criterion variance was additionally accounted for. The strongest partial
effect emerged for the schema g-factor; the partial effects for extraversion,

TABLE 2. Correlations Between Sex, Age, Mode Factor Scores,

Big Five, and Schema g-Factor Scores
Sex 1. 2. 3. 4. 5. 6. 7. 8. 9.
1. Age .12*
2. Internalization −.04 −.26**
3. Externalization −.13* −.26** .46**
4. Compulsivity .03 −.10 .47** .43**
5. Extraversiona .18** .05 −.47** .13* −.13*
6. Agreeablenessa .11 .34** −.47** −.48** −.30** .24**
7. Conscientiousnessa .14* .28** −.42** −.20** .19** .27** .18**
8. Neuroticisma .14* −.08 .64** .24** .42** −.35** −.29** −.26**
9. Openness to experiencea .12 −.01 −.14 .01 .08 .34** .08 .22** −.12
10. Schema g-factora −.004 −.24** .89** .51** .57** −.33** −.43** −.31** .59** −.07
Note, Schema g-factor = general maladaptivity factor (YSQ-S2-extended). aCorrelations including this variable were
derived from combined m = 50 imputed data sets. MI was done with NORM 2.03 (Schafer, 2000) from N = 533 at
scale level (Big Five) and factor level (schema g-factor) with auxiliary variables. Sex (men = 0; women = 1). *p < .01.
**p < .001.

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 STRUCTURE OF SCHEMA MODE FACTORS 361

neuroticism, agreeableness, and conscientiousness remained significant but

were substantially attenuated.
Age, sex, and the Big Five factors jointly explained 39.3% of the variance
in externalization factor scores (see Table 3). Male gender, higher extraversion
and neuroticism, and lower agreeableness and conscientiousness were linked
to greater externalization scores, with the strongest partial effects found for
extraversion and agreeableness. In the second step, the schema g-factor scores
accounted for an additional 12.6% of the criterion variance. The strongest
partial effects emerged for the schema g-factor and extraversion. The partial
effect of agreeableness was attenuated, but remained significant and substan-
tial in size, whereas the effects of neuroticism and conscientiousness became
insignificant.
Finally, the Big Five, sex, and age accounted for 32.9% of the variance
in compulsivity factor scores. Higher conscientiousness and neuroticism and
lower agreeableness were specifically related to higher compulsivity scores (see
Table 3). The schema g-factor scores explained 18.5% additional variance in
compulsivity. Higher scores on the schema-g-factor, neuroticism, and consci-
entiousness contributed independently to higher compulsivity. The strongest
partial effects were found for the schema g-factor and conscientiousness;
the partial effect of agreeableness became insignificant in the presence of the
schema g-factor.

DISCUSSION

The present study investigated the psychometric properties of the GE-SMI

scales, elaborated the higher-order structure of modes, and linked the mode
factors to the schema g-factor and to the Big Five factors. The results provide

TABLE 3. Standardized Coefficients From Hierarchically Regressing Mode Factor Scores on

Sex, Age and the Big Five (Step 1) and the Schema g-Factor Scores (Step 2)
Internalization Externalization Compulsivity
Step 1 Step 2 Step 1 Step 2 Step 1 Step 2
β FMI β FMI β FMI β FMI β FMI β FMI
Sex −.01 .22 −.001 .15 −.16** .14 −.15** .12 −.05 .12 −.05 .09
Age −.08 .20 −.02 .15 −.05 .21 −.01 .20 −.09 .15 −.05 .15
Extraversion −.22** .32 −.15** .29 .39** .27 .44** .26 −.05 .22 .01 .18
Agreeableness −.23** .29 −.07* .35 −.45** .24 −.34** .25 −.19** .27 −.07 .29
Conscientiousness −.19** .29 −.12** .29 −.13* .35 −.08 .36 .37** .22 .43** .23
Neuroticism .44** .26 .12** .30 .23** .26 .01 .27 .45** .20 .19** .21
Openness .05 .39 .002 .42 −.01 .37 −.04 .33 .09 .35 .05 .32
Schema g-factor .69** .28 .47** .20 .56** .23
R2 .57 .85 .39 .52 .33 .51
∆R2 .27 .13 .18
Note. Schema g-factor = general maladaptivity factor (YSQ-S2-extended). Standardized coefficients β and fraction of missing
information (FMI) were derived from m = 50 imputed datasets. Estimates for R2 and ∆R2 were derived from a single dataset
imputed from EM parameters. Sex (men = 0; women = 1). *p < .01. **p < .001.

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 362 JACOBS ET AL.

an important basis to link the mode model (Young, Klosko, & Weishaar,
2003) to hierarchical models of personality pathology (Krueger & Markon,
2014) and psychopathology (Kotov et al., 2017). In the subsequent discus-
sion, several limitations need to be kept in mind. First, the cross-sectional
nature of the data prevents any causal claims. Second, the assessment of
modes, schemas, and traits utilized self-reports, which might have biased the
results. For example, individuals with strong overcompensator modes might
deny their negative characteristics and thus underreport maladaptive char-
acteristics (Lobbestael, 2012). Third, the Big Five factors were assessed with
a short form with limited content coverage, which may have attenuated the
observed effects for traits. Fourth, in the present study, the psychiatric sample
was not very precisely described diagnostically, and externalizing pathology
was underrepresented. This leads to a restriction of variance in externalizing
mode features, which might attenuate associations including externalizing
modes. Thus, future research on the metastructure of modes might sample
from populations with more diverse personality pathology.

THE GERMAN EXTENDED SMI AND HIGHER-ORDER

STRUCTURE OF MODES
The present study revealed acceptable psychometric properties of the GE-
SMI scales in terms of internal consistencies and item loadings. A total of 16
out of 20 scales met minimal standards of model fit when unidimensional
models were tested (H1 partially confirmed). Four GE-SMI scales performed
poorly in CFA, but for three scales (lonely child, impulsive child, and enraged
child), parallel analyses and MAP tests suggested that one factor acceptably
accounts for the common item variance, which mitigated the CFA results.
However, EFA extracted two correlated factors from the avoidant protec-
tor items, one reflecting a tendency to avoid social situations, and the other
reflecting a tendency to avoid decisions, difficult situations, and problems. The
first factor likely reflects features of the avoidant PD (i.e., social inhibition),
the second factor seems to address attributes of the dependent PD (e.g., dif-
ficulties in initiating projects or in assuming responsibilities without advice).
Thus, both factors might relate differently to both PDs. However, despite the
preliminary indication that two separable avoidant protector subfactors exist,
we did not elaborate this distinction further. Future studies might continue to
explore the factor structure within mode scales because the aspect of local fit
is underreported in the SMI literature (e.g., Bamelis et al., 2011; Lobbestael
et al., 2010; Reiss et al., 2012). Doing so provides important information for
future revisions of the mode model.
Scale-level EFA revealed three correlated factors underlying the 20 mode
scales readily interpretable as internalization, externalization, and compulsiv-
ity (H2 supported). Despite four secondary loadings |a| ≥ .30, which can be
expected in applied research on maladaptive constructs (e.g., Bach et al., 2017;
Zimmermann et al., 2014), the factor model showed a well-defined structure.
Externalization was defined by positive loadings of the impulsive child, enraged
child, attention and approval seeker, self-aggrandizer, and bully and attack
modes. Compulsivity included the perfectionistic overcontroller, demanding

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 STRUCTURE OF SCHEMA MODE FACTORS 363

parent, self-aggrandizer (secondary loading), and self-soother modes. The

latter is consistent with the finding that anankastic individuals tend to self-
aggrandize and to use workaholism as a means of self-soothing (Lobbestael,
van Vreeswijk, & Arntz, 2008). Finally, internalization was marked by positive
loadings of inwardly directed child modes, avoidant and detached protector
modes, and negative loadings of both adaptive modes. The factor structure
was replicated in both gender-stratified subsamples, which supports the robust-
ness of the model.
The internalization and externalization factors mirror the internalizing
and externalizing components found in a sample of forensic patients (Keulen
de-Vos et al., 2017). Counterparts for all three mode factors (i.e., internaliz-
ing, externalizing, and overachieving) were found in a sample of adolescents
(van Wijk-Herbrink, Roelofs, et al., 2018). In both studies, the happy child
and healthy adult modes defined an additional healthy modes factor. This
structural deviation might reflect substance. Alternatively, it may have resulted
from idiosyncrasies of the abbreviated SMI that was used (both studies).
In the forensic sample, the underrepresentation of internalizing personality
pathology and a less stable solution due to the small sample size also might
have contributed to this deviation. Moreover, adolescents may not have a fully
developed healthy adult mode, and this mode therefore behaves differently in
populations of adolescents (Roelofs, Muris, & Lobbestael, 2016). This might
contribute to different factor structures in adult and adolescent populations.
The current three-factor model was further confirmed by the reanalyses of
three SMI factor correlation matrices obtained for Dutch, Danish, and Ger-
man samples (see Appendix Table A2). This provides evidence for a replicable
and cross-culturally stable higher-order mode structure in adults that is best
represented by the factors of internalization, externalization, and compulsivity.
Goldberg’s (2006) “‘bass-ackwards” method revealed a hierarchical
structure of modes with a general personality pathology factor at the top of
the hierarchy that splits into internalization and externalization at the second
level and finally arrives at externalization, compulsivity, and internalization at
the third level. This structure parallels the hierarchical structure of maladap-
tive traits consisting of a general personality pathology factor residing at the
apex of the hierarchy and internalization and externalization emerging at the
second level (Morey et al., 2013; Wright & Simms, 2014; Wright et al., 2012).
A more narrowly defined compulsivity/anankastic factor located at lower lev-
els of the trait hierarchy that resembles the compulsivity mode factor is also
documented (Bach et al., 2017; van den Broeck et al., 2014).
But different from the hierarchical mode model, hierarchical maladaptive
trait models usually include additional splits of internalization into detach-
ment and negative affect and of externalization into antagonism/dissociality
and disinhibition (e.g., Bach et al., 2017; Krueger & Markon, 2014). Four
explanations might account for this difference.
First, modes and maladaptive traits covary (Bach et al., 2016), but
both constructs differ conceptually: In a hierarchical model of personality
(­McAdams & Pals, 2006), the latter are more akin to basic personality traits,
whereas modes can be regarded as dynamic processes or characteristic adap-
tations to basic traits. Hence, the differences in the hierarchical structure of

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 364 JACOBS ET AL.

modes and maladaptive traits might reflect actual differences in the processes
and genetic and environmental influences operating at different levels of the
personality.
Second, the GE-SMI does not provide a comprehensive assessment of
antagonistic modes. More specifically, the GE-SMI omits the predator mode
and the conning and manipulative mode (van Genderen et al., 2012). Includ-
ing both modes in the analyses might help the antagonism factor to gain more
weight and to appear as a separable mode factor.
Third, the detached protector mode is rather broadly defined: When in
this mode, a person cuts off his or her feelings, disconnects from others, and
rejects social support, which is related to boredom, emptiness, a cynical or
pessimistic attitude to keep others at distance, and depersonalization (Jacob
& Arntz, 2015). Features of dissociation (e.g., cutting off feelings) belong to
the internalization spectrum (Kotov et al., 2017), which is in line with the clas-
sification of the detached protector mode as internalizing. Moreover, several
core features of detachment are also clustered in this mode. Accordingly, the
detached protector mode shows strong positive relationships with the DSM-5
detachment domain score and all detachment trait facets (Bach et al., 2016).
However, features of the schizoid and schizotypal PDs are traditionally not
targeted in schema therapy (e.g., Jacob & Arntz, 2015), and features of detach-
ment that are closely linked to both PDs are accordingly underrepresented in
the mode model. As a result, detachment did not appear as a major factor in
the factor analysis.
Fourth, with more severe and a broader range of personality pathology
in the sample, eventual minor factors that do not appear in the current results
might gain more weight, leading to a factor structure that is more consistent
with the lower levels of the maladaptive trait hierarchy.
Because all of these explanations might have some merit, future research
on the structure of modes might thus draw on a more comprehensive set of
modes, explore ways to uncluster the detached protector mode, draw on
samples with a broader range of personality pathology, and examine data
sources other than self-reports. A joint factor analysis of maladaptive traits
and modes might help minor mode factors to become more prominent, and it
might help to figure out whether traits and modes are organized by the same
hierarchical structure.
Schemas and modes are thought to underlie PDs and other chronic emo-
tional disorders, and they have been developed as specific targets of treatment
(Young, Klosko, & Weishaar, 2003). But schema therapy does not target all
forms of psychopathology (e.g., schizotypal and schizoid PDs, bipolar and
psychotic disorders). As a result, the mode model is less comprehensive than the
more general HiTOP (Kotov et al., 2017). Thus, not all aspects of the HiTOP
are relevant to the mode model (and vice versa). However, the hierarchical
structure of modes is fairly consistent with the HiTOP, and mode variables can
thus be integrated into the HiTOP at multiple levels: A specific mode as a state
can be located at the lowest level of symptoms. The habitual manifestation fre-
quency of a mode is located at the second level of components. Commonalities
of mode models for PDs or chronic clinical disorders are located at the level

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 STRUCTURE OF SCHEMA MODE FACTORS 365

of syndromes/disorders. Internalization and externalization can be placed at

the superspectra level. The factor residing at the apex of the mode hierarchy
is akin to HiTOP’s p factor. However, the localization of compulsivity in the
HiTOP is less clear. Prior evidence suggests that obsessive-compulsive traits
and beliefs are positively linked to thought disorder or psychoticism (e.g., Bach
et al., 2017; Hopwood et al., 2013; Markon, 2010). Obsessive-compulsive
symptoms, which can be partially conceptualized by modes subsumed under
compulsivity (Gross et al., 2012), overlap with thought disorder as well (Caspi
et al., 2014). Compulsivity might thus be a weak member of the thought dis-
order spectrum. However, features of thought disorder (e.g., unusual beliefs
and experiences) are poorly covered in the mode model (Bach et al., 2016).
And contrary to Bach et al. (2017), Oltmanns and Widiger (2018) showed
that the proposed ICD-11 trait dimension anankastic is negatively related
to psychoticism. To the extent that the anankastic dimension is akin to the
current compulsivity factor, compulsivity might not belong to thought disor-
der at all. More research is needed to clarify the location of compulsivity at
intermediate levels of the HiTOP.

CONCURRENT VALIDITY OF THE HIGHER-ORDER

MODE FACTORS
Finally, further support for the validity of the mode factors was gathered. As
expected, strong and positive correlations between the generic schema factor
and all three mode factors were found, and the strongest correlation included
the internalization factor (H3 supported). When the generic schema factor
scores were regressed on the mode factor scores, a strong positive partial
effect emerged for internalization, whereas only small positive partial effects
were found for externalization and compulsivity. The results imply that the
generic schema factor and internalization mainly assess internalizing content.
This adds to the literature that the schema model overemphasizes internal-
izing problems (Lobbestael, 2012; van Genderen et al., 2012), and that the
generic schema factor mainly captures internalizing schema variance (Bach
et al., 2018). However, given that a schema may contribute to both internal-
izing and externalizing psychopathology (van Wijk-Herbrink, Bernstein, et al.,
2018), classifying schemas as either internalizing or externalizing might be
unwarranted. From this point of view, the current results suggest that a quality
common to all schemas reflecting general maladaptivity (Bach et al., 2018)
or clinical severity (Hopwood et al., 2011) has a stronger impact on internal-
izing modes than on modes organized under externalization and compulsivity.
When the mode factor scores were regressed on the Big Five, higher
neuroticism and lower extraversion along with lower agreeableness and con-
scientiousness contributed to higher internalization scores (H4.1 supported).
Lower agreeableness and conscientiousness contributed to higher externaliza-
tion scores (H4.2 supported), along with positive partial effects for extraver-
sion and neuroticism. Finally, higher neuroticism and conscientiousness and
lower agreeableness were specifically linked to higher compulsivity scores;
extraversion was not related to compulsivity (H4.3 partially supported). The

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 366 JACOBS ET AL.

hypotheses were based on close relationships between four Big Five factors
and four DSM-5 trait domains (Al-Dajani et al., 2016) and on evidence that
conscientiousness is a feature of obsessive-compulsive PD (Samuel & Widiger,
2008). Hence, the observed associations mainly support the validity of the
mode factors. The weak to moderate relations are comparable with correla-
tions typically found between PD scores and the Big Five factors (Samuel &
Widiger, 2008). However, they were smaller when compared to the associations
between modes and maladaptive traits (Bach et al., 2016). This may indicate
that, compared to the Big Five factors, DSM-5’s maladaptive traits are more
intertwined with ST constructs.
When the schema g-factor entered the regression models, the strongest
partial effects were found for the schema g-factor. The Big Five factors con-
tinued to account for unique variance in all mode factors. Substantial effects
emerged for extraversion, agreeableness (externalization), and conscientious-
ness (compulsivity). Thus, the manifestation frequency of broad mode tenden-
cies is under the multiple influences of schemas and broad trait factors.

THEORETICAL AND CLINICAL IMPLICATIONS OF

THE HIGHER-ORDER MODE FACTORS
In order to assess change in modes in response to treatment, researchers fre-
quently form mode aggregates based on the distinction between maladaptive
and adaptive modes (e.g., Skewes et al., 2014) or on the categories of the
general mode model (e.g., Videler, Rossi, Schoevaars, van der Feltz-Cornelis,
& van Alphen, 2014). However, the three mode factors cut across the four
categories of Young, Klosko, and Weishaar’s (2003) general mode model. To
the extent that treatment has different impacts on internalizing, externalizing,
and compulsive modes, these aggregates will confound such differential effects.
Thus, researchers might wish to form more valid mode aggregates in align-
ment with the factor structure of modes revealed in the present study. Given
that van Wijk-Herbrink, Roelofs, et al. (2018) found a slightly different mode
structure in adolescents, it is currently unclear whether this recommendation
also holds for adolescents.
Given that the same broad factors may underlie chronic emotional dis-
orders and modes, these factors might help to orient the clinician toward
relevant modes in patients with chronic emotional disorders. For example,
obsessive-compulsive disorder may be seen as an internalizing disorder (Kotov
et al., 2011) or a thought disorder (Caspi et al., 2014). As a consequence,
internalizing modes (lonely child, detached protector) and compulsive modes
(demanding parent, perfectionistic overcontroller) might be typically expected
in patients with chronic obsessive-compulsive disorder (Gross et al., 2012).
More research is needed to test specific mode models underlying chronic
emotional disorders and to figure out the extent to which modes and chronic
emotional disorders are organized by the same spectra. The mode model might
provide an effective way to translate the HiTOP into case conceptualization
and treatment of patients with personality disorders and/or chronic emotional
disorders.

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 STRUCTURE OF SCHEMA MODE FACTORS
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APPENDIX

TABLE A1. Brief Description of Schema Modes Using Sample Items

Schema mode Sample item
Angry child I feel like telling people off for the way they have treated me.a
Enraged child My anger gets out of control.b
I say what I feel, or do things impulsively, without thinking of the
Impulsive child
consequences.a
Undisciplined child I get bored easily and lose interest in things.a
Dependent child I don’t have confidence in my ability to solve daily problems.d
Abandoned/abused child I feel desperate.c
Lonely child I often feel alone in the world.b
Demanding parent I’m trying not to make mistakes; otherwise, I’ll get down on myself.a
Punitive parent I deserve to be punished.a
I try very hard to please other people in order to avoid conflict,
Compliant surrender
confrontation, or rejection.c
Avoidant protector I avoid difficult situations as much as possible.d
Detached protector I feel distant from other people.c
In order to be bothered less by my annoying thoughts or feelings, I make
Detached self-soother
sure that I’m always busy.a
Attention and approval seeker I use my sex appeal in contact with other people.d
It’s important for me to be Number One (e.g., the most popular, most
Self-aggrandizer
successful, most wealthy, most powerful).c
Perfectionistic overcontroller By controlling everything, I can avoid errors.d
Suspicious overcontroller Other people often have hidden intentions.d
Bully and attack If you don’t dominate other people, they will dominate you.a
Healthy adult I can learn, grow, and change.a
Happy child I feel safe.b
Note. aItem derived from Lobbestael et al. (2010, p. 447); bitem derived from Lobbestael et al. (2010, p. 448);
citem derived from Lobbestael et al. (2010, p. 446); dSMI-2 item translated by the authors; for a more complete

description of modes, see Jacob and Arntz (2015) and van Genderen et al. (2012).

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TABLE A2. Results of Principal Component Analyses With Direct Oblimin Rotation
Conducted for SMI Factor Correlations Corrected for Attenuation Reported
in the Respective Original Publications
Lobbestael et al. Reiss et al.
(2010, Table 4)a Reiss et al. (2016, Table 3)b (2012, Table 3)c
SMI scale F1 F2 F3 F1 F2 F3 F1 F2
Vulnerable child .93 .04 .06 .94 .07 −.01 .96 −.01
Angry child .51 .53 .04 .40 .65 .01 .66 .40
Enraged child .16 .80 −.23 .12 .79 −.20 .34 .61
Impulsive child .24 .74 −.23 .19 .76 −.26 .49 .50
Undisciplined child .45 .45 −.18 .57 .29 −.35 .82 .07
Happy child −.91 −.05 .14 −.91 −.01 .06 −.92 −.04
Compliant surrender .85 −.18 .36 .83 −.18 .12 .91 −.27
Detached protector .80 .21 .05 .79 .17 .01 .86 .11
Detached self-soother .69 .21 .32 .57 .26 .26 .71 .01
Self-aggrandizer −.13 .79 .48 −.15 .82 .40 −.08 .92
Bully and attack −.07 .91 .15 −.10 .93 .06 .04 .90
Punitive parent .85 .12 .02 .87 .01 .15 .82 .21
Demanding parent .54 .15 .68 .63 .09 .66 .59 .29
Healthy adult −.89 .05 .34 −.86 .03 .33 −.94 .09
Eigenvalues > 1.00 8.63, 1.69, & 1.13 7.68, 2.06, & 1.03 9.10 & 1.59
Variance explained 81.8% 77.0% 76.3%
Correlation with F2 .48 .41 .47
Correlation with F3 .07 .12 −.001 .06
Note. Components with eigenvalues > 1.00 were retained; F1 = internalization; F2 = externalization;
F3 = compulsivity; primary loadings are underlined. aN = 863 participants (n = 372 psychiatric patients, n = 319
nonpatients, n = 172 not specified); bN = 657 participants (n = 266 psychiatric patients, n = 391 nonpatients);
cN = 433 participants (n = 148 psychiatric patients, n = 32 forensic patients, n = 253 nonpatients).

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TABLE A3. Descriptive Statistics, Internal Consistencies, and Loadings of

YSQ-S2-extended Subscale Scores on the General Maladaptivity Factor Derived
From an Exploratory Factor Analysis
MEM SDEM αEM a
1. Emotional deprivation 3.58 1.33 .91 .50
2. Abandonment/instability 3.53 1.29 .89 .68
3. Mistrust and/or abuse 3.05 1.21 .83 .71
4. Social isolation/alienation 3.44 1.29 .92 .68
5. Defectiveness/shame 3.08 1.40 .93 .79
6. Social undesirability 3.47 1.07 .75 .73
7. Failure to achieve 3.20 1.16 .87 .69
8. Dependence/incompetence 2.73 1.10 .86 .73
9. Vulnerability to harm and illness 2.84 1.21 .83 .62
10. Enmeshment/undeveloped self 2.77 1.29 .85 .58
11. Subjugation 3.31 1.17 .86 .79
12. Self-sacrifice 3.82 1.11 .85 .33
13. Emotional inhibition 3.05 1.24 .90 .58
14. Unrelenting standards 3.96 1.10 .80 .61
15. Entitlement/grandiosity 2.80 0.95 .74 .36
16. Insufficient self-control/self-discipline 3.47 1.10 .85 .63
17. Approval-seeking 3.51 1.16 .83 .66
18. Negativity and pessimism 3.87 1.13 .85 .80
19. Punitiveness 2.99 0.94 .71 .68
Note. MEM and SDEM = expectation-maximization (EM) parameter estimates for M and SD derived with Norm 2.03
(Schafer, 2000); αEM = Cronbach’s alpha was derived from a single dataset imputed directly from EM parameters with
errors (N = 533); a = factor loadings (based on N = 530 and ULS estimation).

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G4844.indd 373
TABLE A4. Pearson Correlations Between the GE-SMI Scales
AC ECa IC UC DC AAC LC DP PP CS APt DPt DSS AASa SA PO SO BAa HA
Enraged childa .54
Impulsive child .50 .65
Undisciplined child .42 .32 .48
Dependent child .43 .28 .41 .61
Abandoned/abused child .55 .28 .35 .54 .76
Lonely child .53 .28 .30 .51 .65 .87
Demanding parent .37 .12 .17 .14 .33 .48 .40
Punitive parent .49 .40 .43 .49 .61 .73 .71 .49
Compliant surrender .32 .14 .17 .38 .55 .60 .57 .47 .55
Avoidant protector .31 .13 .18 .47 .66 .69 .66 .34 .51 .66
Detached protector .41 .28 .31 .53 .56 .63 .74 .27 .55 .48 .60
Detached self-soother .28 .17 .22 .21 .26 .31 .26 .44 .32 .30 .24 .26
Attention and approval
seekera .34 .27 .37 .22 .14 .10 .04 .12 .14 .06 −.16 .01 .26

Self-aggrandizer .51 .28 .33 .27 .22 .24 .25 .48 .27 .24 .11 .24 .32 .52
Perfectionistic overcontroller .35 .10 .13 .15 .33 .44 .33 .69 .37 .42 .39 .22 .37 .13 .41
Suspicious overcontroller .56 .27 .33 .42 .49 .61 .58 .40 .51 .42 .56 .49 .29 .14 .36 .48
Bully and attacka .55 .40 .43 .36 .28 .26 .29 .24 .29 .22 .20 .33 .23 .43 .62 .26 .47
Healthy adult −.29 −.28 −.35 −.45 −.61 −.61 −.56 −.15 −.57 −.38 −.51 −.44 −.17 .02 −.05 −.10 −.33 −.14
Happy child −.43 −.25 −.22 −.40 −.54 −.70 −.77 −.25 −.57 −.40 −.62 −.64 −.21 .12 −.12 −.24 −.54 −.21 .68
Note. AC = angry child. alog10-transformed.

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TABLE A5. Pattern Matrices Derived From the EFA of the GE-SMI Subscales Obtained in the Female and
Male Subsamples and Factorial Similarity (Tucker’s phi) of Both Factor Structures
Pattern matrix–females Pattern matrix–males
GE-SMI subscales I II III h2 φ I II III h2 φ
Angry child .57 .11 .26 .58 1.00 .58 .19 .22 .67 .99
Enraged childa .65 −.25 .19 .45 1.00 .76 −.12 .06 .56 .96
Impulsive child .73 −.23 .21 .57 1.00 .80 −.21 .17 .70 1.00
Undisciplined child .34 −.15 .58 .51 1.00 .25 −.18 .53 .40 .99
Dependent child .13 .001 .73 .63 1.00 −.05 −.01 .85 .68 .97
Abandoned/Abused child .03 .12 .85 .84 1.00 −.08 .23 .84 .86 .99
Lonely child −.001 .05 .86 .78 1.00 −.03 .17 .85 .84 .99
Demanding parent −.02 .78 .12 .68 1.00 .01 .90 −.04 .79 .98
Punitive parent .15 .09 .69 .64 1.00 .28 .21 .48 .62 .93
Compliant surrender −.15 .36 .55 .51 1.00 −.15 .30 .60 .51 .99
Avoidant protector −.29 .20 .81 .70 1.00 −.25 .09 .92 .72 .99
Detached protector .04 .02 .72 .55 1.00 .12 −.12 .73 .57 .98
Detached self-soother .13 .40 .07 .25 1.00 .22 .27 .19 .29 .88
Attention and approval seekera .70 .13 −.33 .48 1.00 .54 .14 −.22 .27 1.00
Self-aggrandizer .58 .49 −.25 .65 1.00 .46 .46 −.08 .53 .98
Perfectionistic overcontroller −.06 .78 .08 .63 1.00 −.001 .76 .05 .62 1.00
Suspicious overcontroller .15 .31 .45 .52 1.00 .21 .20 .45 .49 .98
Bully and attacka .65 .21 −.05 .54 1.00 .56 .04 .10 .40 .95
Healthy adult −.03 .28 −.81 .57 1.00 −.04 .17 −.74 .50 1.00
Happy child .11 .08 −.87 .66 1.00 .05 .04 −.84 .64 1.00
I Externalization
II Compulsivity .37 .37
III Internalization .37 .40 .53 .44
Tucker’s φ 1.00 1.00 1.00 1.00 .97 .96 .98 .98
Note. EFA = exploratory factor analysis (ULS extraction, oblique Procrustes rotation; the pattern matrix obtained for the total
sample shown in Table 1 served as target matrix for females; the Procrustes-rotated solution obtained for females was taken
as target matrix for males); h2 = communality; φ = Tucker’s φ indicates the similarity (variables, factors, overall) of the factorial
solutions obtained for the full sample (Table 1 in the main text) and the female subsample and for both female and male
subsamples (φ values in the range 0.85 to 0.94 correspond to a fair similarity, φ ≥ .95 implies that the two factors compared
can be considered equal; Lorenzo-Seva & ten Berge, 2006). alog10-transformed prior to the EFA. The primary loading in each
row is underlined. Nmales = 117; Nfemales = 416.

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TABLE A6. One-Factor, Two-Factor, and Three-Factor EFA Structure of the 20 Mode Scales
After Varimax Rotation and Correlations of Factor Scores
One Two Three
General Ext Int Ext Com Int
Angry child .67 .64 .43 .61 .26 .40
Enraged childa .43 .49 .24 .63 −.07 .25
Impulsive child .50 .55 .29 .70 −.06 .30
Undisciplined child .64 .31 .55 .40 −.02 .57
Dependent child .78 .22 .76 .23 .13 .75
Abandoned/abused child .89 .21 .89 .17 .27 .86
Lonely child .85 .17 .88 .16 .20 .85
Demanding parent .52 .38 .39 .10 .78 .27
Punitive parent .79 .31 .73 .28 .24 .70
Compliant surrender .65 .16 .65 .03 .39 .59
Avoidant protector .71 −.01 .82 −.07 .24 .79
Detached protector .72 .17 .72 .20 .10 .71
Detached self-soother .41 .36 .28 .22 .40 .21
Attention and approval seekera .20 .66 −.10 .62 .19 −.13
Self-aggrandizer .43 .76 .12 .60 .51 .03
Perfectionistic overcontroller .49 .35 .36 .09 .75 .25
Suspicious overcontroller .71 .39 .60 .30 .35 .55
Bully and attacka .48 .69 .20 .65 .25 .16
Healthy adult −.61 −.02 −.68 −.13 .12 −.72
Happy child −.71 −.01 −.80 −.06 −.04 −.81
Externalization (two) .46**
Internalization (two) .91** .05
Externalization (three) .42** .91** .04
Compulsivity (three) .36** .44** .20** .05
Internalization (three) .87** −.02** .99** .04 .05
Note. EFA = exploratory factor analysis (ULS estimation); General = general personality pathology. alog10-transformed;
primary loadings are underlined. N = 533. **p < .001.

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 376 JACOBS ET AL.

TABLE A7. Pearson Correlations Between the Schema Mode Scales and the Big Five Scale Scores,
and the Schema g-Factor Scores
E A C N O g-Factor
Angry child −.04 −.50** −.10 .38** .04 .58**
Enraged childa .001 −.32** −.16** .16** −.08 .35**
Impulsive child .10 −.31** −.26** .23** −.04 .40**
Undisciplined child −.19** −.37** −.59** .37** −.09 .55**
Dependent child −.29** −.30** −.48** .49** −.09 .76**
Abandoned/abused child −.35** −.40** −.31** .66** −.04 .84**
Lonely child −.42** −.45** −.32** .56** −.03 .80**
Demanding parent −.07 −.18** .24** .40** .07 .49**
Punitive parent −.20** −.35** −.25** .46** −.04 .74**
Compliant surrender −.35** −.15* −.23** .41** −.01 .64**
Avoidant protector −.65** −.33** −.34** .52** −.17 .70**
Detached protector −.49** −.49** −.38** .40* −.19** .63**
Detached self-soother −.01 −.23** .06 .22** .01 .36**
Attention and approval seekera .38** −.15* −.07 −.01 .16** .14**
Self-aggrandizer .09 −.38** .04 .16** .07 .33**
Perfectionistic overcontroller −.11 −.24** .24** .41** .03 .46**
Suspicious overcontroller −.30** −.51** −.10 .40** −.06 .69**
Bully and attacka −.04 −.45** −.10 .13* −.12 .39**
Healthy adult .29** .25** .40** −.46** .21** −.64**
Happy child .48** .48** .29** −.58** .19** −.70**
Note. E = extraversion; A = agreeableness; C = conscientiousness; N = neuroticism; O = openness to experience;
g-factor = schema g-factor scores (general maladaptivity). alog10-transformed. Correlations were derived from m = 50
imputed datasets (N = 533). In MI diagnostics, all diagnostic plots appeared in order. *p < .01. **p <.001.

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