The Relationship Between Early Maladaptive Schemas and Obsessive–Compulsive Symptoms: The Mediating Role of Emotional Self-Regulation in Women Seeking Cosmetic Surgery

Abstract

The present study aimed to investigate the relationships of abandonment, dependence–incompetence, emotional inhibition, defectiveness–shame, unrelenting standards, and failure with obsessive–compulsive symptoms, with emotional self-regulation as a mediating variable, among women seeking cosmetic surgery. This applied study used a descriptive-correlational design based on structural equation modeling. The statistical population consisted of women seeking cosmetic surgery who attended Imam Khomeini and Mofarah hospitals in Tehran during 2025–2026. A total of 300 eligible participants were selected using convenience sampling. Data were collected using the Young Schema Questionnaire, the Obsessive-Compulsive Inventory–Revised, and the Miller and Brown Self-Regulation Questionnaire. Pearson correlation coefficients, structural equation modeling, and bootstrap analysis were used to analyze the data. All six maladaptive schema domains were positively and significantly associated with obsessive–compulsive symptoms and negatively and significantly associated with emotional self-regulation. Emotional self-regulation was also negatively and significantly related to obsessive–compulsive symptoms. In the structural model, the direct standardized effects of abandonment, dependence–incompetence, emotional inhibition, defectiveness–shame, unrelenting standards, and failure on obsessive–compulsive symptoms were 0.18, 0.14, 0.19, 0.23, 0.12, and 0.16, respectively. Their effects on emotional self-regulation were -0.21, -0.17, -0.24, -0.27, -0.14, and -0.18, respectively. Emotional self-regulation significantly predicted obsessive–compulsive symptoms with β = -0.36. Bootstrap analysis further showed that the indirect effects of all six schema domains through emotional self-regulation were statistically significant, indicating partial mediation. Early maladaptive schemas were associated with greater obsessive–compulsive symptoms both directly and indirectly through reduced emotional self-regulation; therefore, assessment and intervention targeting specific maladaptive schemas and emotional self-regulation may be clinically useful in psychological screening and preoperative care for women seeking cosmetic surgery.