Limited prognostic value of early maladaptive schemas for acute psychedelic experience and symptom improvement

Limited prognostic value of early maladaptive schemas for acute psychedelic experience and symptom improvement | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Limited prognostic value of early maladaptive schemas for acute psychedelic experience and symptom improvement Albert Buchard, Federico Seragnoli, Michel Sabe, Mickael Eskinazi, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8214817/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Early maladaptive schemas (EMS) are highly prevalent in patients seeking psychedelic-assisted psychotherapy and correlate strongly with baseline depression and anxiety. This study characterized EMS in 192 adults and longitudinally followed 74 patients receiving psilocybin- or LSD-assisted therapy. We found that baseline schema burden, particularly related to failure and defectiveness, was linked to cognitive-depressive symptoms but did not predict the quality of the acute psychedelic experience or moderate overall symptom improvement. While patients experienced significant reductions in both depression and anxiety symptoms with each session, these changes were dependent on initial symptom severity, not their schema profile. Treatment effects were comparable between psilocybin and LSD. These findings suggest the clinical utility of EMS lies not in patient selection or outcome prediction, but in identifying key cognitive-emotional themes, such as core beliefs about failure, to be targeted during psychotherapeutic integration. Health sciences/Diseases Health sciences/Health care Biological sciences/Psychology Social science/Psychology Full Text Additional Declarations No competing interests reported. Supplementary Files npjschemapapersupp.pdf Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 05 Feb, 2026 Editor assigned by journal 10 Dec, 2025 Submission checks completed at journal 02 Dec, 2025 First submitted to journal 26 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8214817","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":552981086,"identity":"91148d57-04ae-4e0a-8cd3-2bfd0d1f912c","order_by":0,"name":"Albert 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