Hospital Practices and Research

The Effectiveness of Compassion-Focused Therapy and Emotion-Focused Schema Therapy on Early Maladaptive Schemas and Anxiety Sensitivity in Women with Bulimia Nervosa

Document Type : Original Article

Authors

Fatemeh Momeni 1
Sasan Bavi 1
Karim Sevari 2
Zahra Eftekhar Saadi 1
Ali Khalafi 3

1 Department of Psychology, Ahv.C., Islamic Azad University, Ahvaz, Iran

2 Department of Psychology, Payame Noor University, Tehran, Iran

3 Department of Psychology, Shad.C., Islamic Azad University, Shadegan, Iran

https://doi.org/10.30491/hpr.2025.529851.1496
Abstract
Background: Bulimia nervosa is a complex eating disorder often associated with maladaptive schemas and anxiety sensitivity.
Objectives: This study investigated the effectiveness of Compassion-Focused Therapy (CFT) and Emotion-Focused Schema Therapy (EFT) individually on early maladaptive schemas and anxiety sensitivity in women with bulimia nervosa.
Methods: This study employed a quasi-experimental, pretest-posttest control group design. The study population consisted of 75 female patients with a confirmed diagnosis of bulimia nervosa, recruited via convenience sampling from those seeking treatment at the Ahvaz Eating Disorders Association. Participants were assigned to one of three groups (n = 25 per group): two experimental groups and a control group. One experimental group received EFT (10 sessions, 90 minutes each), while the other received CFT (8 sessions, 90 minutes each). The control group received no intervention. The Early Maladaptive Schema Questionnaire and the Anxiety Sensitivity Index were used to assess outcomes. Data were analyzed using analysis of covariance (ANCOVA) within SPSS.
Results: Results indicated that both treatments significantly reduced early maladaptive schemas and anxiety sensitivity in women with bulimia nervosa. EFT demonstrated greater efficacy, with larger reductions in early maladaptive schemas (η=0.80, P<0.001) and anxiety sensitivity (η=0.74, P<0.001) compared to CFT. The control group showed no significant changes in either outcome.
Conclusion: This study revealed that EFT and compassion-focused therapy reduce maladaptive schemas and anxiety sensitivity in women with bulimia nervosa, with the former showing greater efficacy. Future research should explore the mechanisms driving these differential effects and their long-term outcomes. These findings suggest that EFT may be prioritized in clinical settings to effectively target maladaptive schemas and anxiety sensitivity in women with bulimia nervosa.

Keywords

Self-Compassion
Schema Therapy
Anxiety
Bulimia Nervosa
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