Cascading model of causal relationships in EMS ontogeny: integration of Piaget, Erikson, Bowlby, and Young paradigms.

The article presents a proposal for a model explaining the ontogeny of early maladaptive schemas (EMS) by linking classical developmental theories (Piaget, Erikson, Bowlby) with contemporary findings in the field of epigenetics. The proposed model indicates that EMS development is sequential in nature, involving interrelated cognitive, relational and biological levels. Early relational experiences, especially during periods of increased neurobiological plasticity, lead to permanent changes in the functioning of the hypothalamic-pituitary-adrenal axis and changes in gene expression associated with the regulation of stress responses (e.g., NR3C1, FKBP5). The dominance of assimilation processes over accommodation processes is conducive to the consolidation of rigid cognitive-emotional structures, which, along with the development of identity, take the form of integrated belief systems. The article introduces the concept of "biological lock", describing the state of stabilization of epigenetic and neurostructural changes responsible for the resistance of schemas to change. The cascade model developed in the present paper implies the need to modify therapeutic interventions toward a sequential approach, taking into account first the regulation of physiological processes (bottom-up), and then relational and cognitive interventions (top-down). This approach may increase the effectiveness of therapy in personality disorders, especially in cases of high resistance to treatment.