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Early maladaptive schemas and attention-deficit/hyperactivity disorder: a scoping review
Journal article   Open access   Peer reviewed

Early maladaptive schemas and attention-deficit/hyperactivity disorder: a scoping review

Maddie Cook and Andrew Allen
Clinical Psychologist , Vol.Advanced Access
13-Aug-2026
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Early maladaptive schemas and attention-deficit hyperactivity disorder a scoping review2.10 MBDownloadView
Published Version (Advanced Access) Open Access CC BY-NC-ND V4.0
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https://doi.org/10.1080/13284207.2026.2713449View
Published Version Open CC BY-NC-ND V4.0

Abstract

Attention-deficit /hyperactivity disorder early maladaptive schemas schema therapy scoping review
Objective: Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder associated with executive functioning difficulties. ADHD individuals are at a higher risk of persistent criticism, potentially leading to the development of early maladaptive schemas (EMS). Yet, little is known about the link between ADHD and EMS. The purpose of this scoping review was to examine the existing literature regarding ADHD and EMS, synthesising and evaluating relevant research. Method: A comprehensive search of seven electronic databases was undertaken to identify literature regarding ADHD and EMS. Reference lists of articles were also searched. Results: Six studies were included in the review. Several EMS—most prominently social isolation/alienation, defectiveness/shame, failure, and insufficient self-control/self-discipline—were consistently found to be correlated with ADHD symptoms and elevated in ADHD populations when compared to healthy controls. However, limitations of the evidence include insufficient sample-size justification, inconsistent analysis of EMS individually, reliance on cross-sectional designs, and limited studies investigating specific subpopulations of ADHD. Conclusion: Based on the results, a theoretical schema therapy formulation for ADHD is proposed. Evidence suggests a link between ADHD and EMS, but further research is required to understand the directionality and variance among subpopulations, and to support relationships between ADHD and other aspects of schema therapy. KEY POINTS What is already known about this topic: (1) Individuals with ADHD often face persistent criticism from caregivers, educators, and peers in early life, increasing the risk of developing co-occurring mental disorders. (2) EMS, a core construct of Schema Therapy, develop in early childhood and have been recognised as a transdiagnostic factor across several mental disorders. (3) Limited research has associated ADHD symptoms and diagnoses with various EMS. What this topic adds: (1) The results of six included studies indicated that several EMS were consistently elevated in ADHD populations and positively correlated with ADHD symptoms. (2) The most prominent EMS included social isolation/alienation, defectiveness/shame, failure to achieve, insufficient self-control/self-discipline, and emotional inhibition, which align with common symptoms and difficulties associated with ADHD. (3) Based on these findings, it is suggested that individuals with ADHD form EMS based on negative early experiences and criticism, which may be activated later in life

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