Relationships Among

Emotional-Schemas,
Psychological Flexibility,
Dispositional Mindfulness, &
Emotion Regulation in Adult
Cognitive-Behavioral Therapy
Outpatients

Laura R. Silberstein PsyD,

Dennis D. Tirch PhD & Robert L. Leahy PhD

American Institute for Cognitive Therapy

 Introduction
 Mindfulness, psychological flexibility, and emotional
schemas have each been related to emotional experiencing
and responding, as well as to the alleviation of human
suffering (Corrigan, 2004; Hayes, Wilson, Gifford, Follette, and Strosahl, 1996; Martin,
1997; Fulton and Seigel, 2005).

 Mindfulness, acceptance and emotional schemas have each

been associated with challenging experiential avoidance
and contributing to emotion regulation.

 This study focuses on the relationships between

emotional schemas, psychological flexibility and
dispositional mindfulness.
 Mindfulness
 The meta-experiential concept of mindfulness refers to a mode of
perception or awareness of the present moment in a
nonjudgmental and accepting manner (Kabat-Zinn, 1990).

 Dispositional mindfulness is an innate characteristic reflecting an

individuals’ natural occurring ability to inhabit this intentional
stance of awareness (Brown and Ryan, 2003).

 Mindfulness offers a perceptual, rather than cognitive or affective

presentation of the current moment as it is.

 Dispositional mindfulness has been associated with an increased

capacity to let go of negative thoughts and is viewed as a core
process in psychological flexibility (Frewen, Evans, Maraj, Dozois, and Partridge,
2008; Hayes, Strosahl and Wilson, 1999).
 Psychological Flexibility
 Psychological flexibility has been defined as the ability to
fully encounter an experience without gratuitous defense
and, depending upon the context, continuing or changing
behavior in the pursuit of goals and values (Hayes et al., 2006).

 The term psychological flexibility has been used as a

general factor to provide a more specific description of the
core processes involved in experiential avoidance and
experiential acceptance (Hayes et al., 2006).

 Experiential avoidance and acceptance are subsumed by

psychological flexibility, although they are still useful ways
to describe aspects of this construct (Bond, et al., In press).
 Psychological Flexibility
 Experiential acceptance is the practice of just letting things
be and experiencing them as they are. It involves being
open to an experience and willing to remain in contact with
it, even if the experience is unpleasant (Campbell-Sills, Barlow, Brown,
and Hofman, 2006).

 Acceptance can be described as second-order change or

meta-change and is often viewed as preceding behavior or
thought changes (Germer, 2005; Hayes, 2001).

 The focus is on changing the influence of the thoughts and

emotions by shifting one’s response to them and not trying
to change or struggle with the thoughts or feelings
themselves (Bishop et al., 2004).
 Psychological Flexibility
 Experiential avoidance results when an individual is unwilling to
remain in contact with a particular experience and attempts to
alter the form or frequency of these experiences (Hayes, Wilson, Gifford,
Follette, and Strosahl, 1996).

 Avoidance can be considered a broad category or class of

behaviors that attempt to escape, avoid or modify a particular
internal or external stimulus (Chapman, Gratz, and Brown, 2006).

 Individuals who engage in experiential avoidance often engage in

more control tactics and verbal strategies to regulate their
emotions (Campbell-Sills, Barlow, Brown, and Hofman, 2006; Cochrane, Barnes-Holmes,
Stewart, and Luciano, 2007).

 The negative effects of experiential avoidance result from the

ineffective and often paradoxical process of attempts to avoid or
alter private events (Wenzlaff and Wegner, 2000).
 Emotional Schemas
 Emotional schemas are defined as plans, concepts, and
strategies that an individual utilizes in the event of a certain
emotion (Leahy 2002).

 Similarly, emotion schemas have also been described as

causal or mediating processes that involve the continual
dynamic interaction of emotion, cognition and behavior
(Izard, 2009).

 Emotional schemas can be considered complex emotion-

cognition-action systems that, after a period of social and
emotional development, inform emotional processing and
emotion regulation strategies (Izard, 2009; Leahy, 2002).
 Emotional Schemas
 Individuals vary in their perception of emotions as
temporary, universal, comprehensible, complex experiences that
can be subject to acceptance, validation, and expression (Leahy
2007).

 Emotional schema dimensions range from flexible and

adaptive to more rigid and maladaptive.

 This model of emotional schemas contends that those who

endorse maladaptive emotional schemas are more likely to
resist certain emotions and engage in avoidant strategies
(Leahy 2002).

 Also emphasizes the positive implications in overcoming

avoidance, increasing emotional processing, and the role of
cognition in emotional experiencing (Leahy 2007).
 Present Study Rationale
 The current study aims to explore the relationships between
emotional schemas, psychological flexibility and
dispositional mindfulness.

 This research also examines the relative contribution of

mindful awareness and emotional schemas to
psychological flexibility.

 The roles of dispositional mindfulness and those emotional

schemas which represent emotion regulation strategies will
be explored in terms of their relationship with psychological
flexibility.
 Current Study
 The current research is a cross sectional, observational
study of current patients at the American Institute for
Cognitive Therapy.

 202 patients volunteered to complete three brief measures

assessing dispositional mindfulness, psychological
flexibility, and emotional schemas. The responses are
largely from intake assessments, typically collected at the
beginning of therapy.

 The cognitive-behavioral therapy offered at this institute

primarily was non-manualized and included elements of
Beckian Cognitive Therapy and integrated with elements of
ACT, DBT, and Buddhist Psychology.
 Measures
 Mindfulness Attention and Awareness Scale (MAAS;
Brown & Ryan, 2003)

 The MAAS is a 15-item self-report scale designed to

assess a core characteristic of dispositional mindfulness,
namely, the general tendency for open or receptive
awareness and attention in the present moment
experience of daily life.
 This measure has demonstrated construct and criterion
validity in clinical and non-clinical samples
 Measures
 Awareness and Attention Questionnaire II (AAQ-II;
Bond et al., In Press)

 The AAQ-II is 10-item self-report scale designed to

assess psychological flexibility in large population based
studies.
 The AAQ-II was developed from the AAQ-I resulting
in enhanced item selection and psychometric
properties.
 Further psychometric information can be found at
http://www.contextualpsychology.org
 Measures
 The Leahy Emotional Schema Scale (LESS; Leahy, 2002)

 The LESS is 50-item self-report measure that asks

participants to report how they have dealt with
emotional experiences in the last month.
 The scale shows strong psychometric properties and has
been validated with psychiatric outpatient samples (Leahy,
2002).

 It was designed to assess individual’s conceptualization

of their emotions and utilizes fourteen dimensions of a
cognitive model of emotional processing.
 Measures
 Factors/Dimensions of the LESS
 Validation: a belief that other people validate or are receptive
to an individual’s emotions.
 Comprehensibility: the perception that an individual’s
emotions make sense.
 Guilt: the belief that one’s emotions are shameful, wrong or
embarrassing.
 Simplistic view of emotions: versus complex views and
reflects difficulty tolerating ambivalent feelings.
 Relationship to higher values: the belief that an emotional
experience can provide insight into values clarification.
 Controllability: the degree to which an individual perceives
he or she will be in control in the face of emotion.
 Measures
 Factors/Dimensions of the LESS
 Numbness: a lack of strong emotions, emotional isolation, and
emotional distancing.
 Rationality: overreliance on logic or ‘anti-emotionality.’
 Duration: the prediction of the length of emotional experiences.
 Consensus: the belief that others share the same feelings.
 Acceptance: the degree to which an individual allows versus
inhibits an emotion.
 Rumination: the tendency to ask unanswerable questions and
dwell on certain emotions.
 Expression: willingness to experience and express emotions.
 Blame: the tendency to externalize the source of the emotion.
 Correlational Analyses:
MASS & LESS Dimensions
MASS
Validation .317**
Comprehension .391**
Guilt -.430**
Simplistic view of emotions -.290**
Values .256**
Control .490**
Numbness -.245**
* p < .05, ** p < .01
 Correlational Analyses:
MASS & LESS Dimensions
MASS
Rationality -.248**
Duration -.187**
Consensus .246**
Acceptance .380**
Rumination -.279 **
Expression .228**
Blame -.190**
* p < .05, ** p < .01
 MASS & LESS Correlations
 MASS positive  MASS negative
correlations: correlations:
 Validation  Guilt
 Comprehension  Simplistic views of
emotions
 Higher values
 Numbness
 Control
 Rationality
 Consensus
 Duration
 Expression
 Rumination
 Acceptance
 Blame
 Correlational Analyses:
MASS & AAQ-II
MASS
AAQ .493**
* p < .05, ** p < .01

 Dispositional mindfulness as measured by the MASS

appears to be highly correlated to psychological flexibility
as measured by the AAQ-II.
 Correlational Analyses:
AAQ-II & LESS Dimensions
AAQ-II
Validation .507**
Comprehension .578**
Guilt -.642**
Simplistic view of emotions -.392**
Values .274**
Control .602**
Numbness -.230**
* p < .05, ** p < .01
 Correlational Analyses:
AAQ-II & LESS Dimensions
AAQ-II
Rationality -.237**
Duration -.237**
Consensus .495**
Acceptance .373**
Rumination -.497 **
Expression .163*
Blame -.364**
* p < .05, ** p < .01
 AAQ-II & LESS Dimensions
 AAQ-II positive  AAQ-II negative
correlations: correlations:
 Validation  Guilt
 Comprehension  Simplistic views of
emotions
 Higher values
 Numbness
 Control
 Rationality
 Consensus
 Duration
 Expression
 Rumination
 Acceptance
 Blame
 Results
 Our findings suggests that individuals who endorsed a
higher capacity for mindfulness and those who reported a
higher degree of psychological flexibility reported:
 Other people will validate or be receptive to their emotions
 Their emotions make sense
 Emotional experiences provide insight into their values
 They can control over their emotions
 Their emotions are normal or shared by others
 Acceptance of their emotional experiences
 Willingness to experience and express their emotions
 Results
 Our findings suggest that individuals who reported lower
degrees of dispositional mindfulness and those endorsing
lower degrees of psychological flexibility reported:
 Guilt or shame in regards to their emotions
 Difficulty tolerating ambivalent feelings
 Lacking strong emotional experiences
 Engaging in emotional distancing
 Rationalization or dwelling on their emotions
 Their emotions last for a long time
 Externalizing the source of their emotional experiences
 Results
 The results of this study also revealed a positive
correlation between psychological flexibility as
measured by the AAQ-II and dispositional
mindfulness as measured by the MASS.

 This indicates that individuals who endorsed a high

degree of dispositional mindfulness also reported:
 More psychological flexibility
 Less experiential avoidance
 More acceptance of their experiences
 Stepwise Multiple Regression
 Factors of the LESS that represent emotion regulation
strategies: Rational, Expression, Rumination, and
Acceptance

 Dependent Variable - Psychological Flexibility (AAQ-

II)

 Independent Variables - Dispositional Mindfulness

(MAAS) and Emotional Schema (LESS) dimensions
related directly to emotion regulation strategies
(Rumination, Expression, Rational, Acceptance of
Feelings)
Results: Stepwise Multiple
Regression
Results: Stepwise Multiple
Regression
 Results: Stepwise Multiple
Regression
 The LESS factors Expression, and Rational were not significant
predictors in this analysis and not included in the model.

 A model including the LESS factors Rumination and Acceptance

of Feelings, as well as dispositional mindfulness, as measured by the
MAAS accounted for a significant proportion of the variance in
psychological flexibility as compared to the other LESS factors
hypothesized to be involved in emotion regulation strategies.

 “Rumination” was included in the first step of this model,

followed by “Acceptance of Feelings” and then by dispositional
mindfulness. The addition of each variable resulted in
statistically significant change.
 Results: Stepwise Multiple
Regression
 These results suggest that emotion regulation
strategies involving letting go of a ruminative thinking
style, accepting and allowing emotions as they arrive,
and an active attending to the present moment,
interact significantly with psychological flexibility.

 The degree to which a person is or is not overly-

rational, or verbally expressive appears to be less
important in regards to psychological flexibility.
 Discussion
 The correlational results of this study imply a strong
relationship between dispositional mindfulness,
psychological flexibility and emotional schemas in adults
seeking outpatient therapy.

 We also found some evidence for the relationships between

mindfulness, emotional schema dimensions related to
emotion regulation strategies and psychological flexibility.

 Thus, it may be possible that dispositional mindfulness and

certain emotional schemas are interacting processes
involved in the establishment and maintenance of
psychological flexibility and adaptive functioning.
 Discussion
 A possible function of more adaptive emotional
schemas is a greater degree of psychological flexibility
and a greater receptive attention to and awareness of
present experiences.

 However, as correlations do not establish causality or

direction, it is also possible that, by providing an
accepting and unbiased emotional experience,
dispositional mindfulness and psychological flexibility
allow individuals to perceive the uniqueness of a
current emotion and respond in a flexible and adaptive
manner
 Discussion
 One possible interpretation of the results of the
stepwise multiple regression would suggest that the
foundation of psychological flexibility is informed by
emotion regulation strategies that involve:
 Letting go of a ruminative thinking style
 Acceptance and openness towards emotions
 Active, non-evaluative attending to the present moment
 Discussion
This interpretation
would support the
hypothesis inherent in
the ACT hexaflex
model, that acceptance,
defusion, and contact
with the present moment
are fundamental
components of
psychological flexibility.
 Study Limitations
 Small sample size and clinical population limits
generalizablilty

 Self-report assessment measures

 No causality can be assumed

 Additional variables maybe responsible for the

relationships observed in this study

 Therefore, there is a need for continued research

For copies of this presentation
Please contact me at:

l_silberstein@yahoo.com
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