The Relationship Between Early Maladaptive Schemas, Perfectionism, and Obsessive–Compulsive Symptoms: The Mediating Role of Emotion Regulation in Women Seeking Cosmetic Surgery

Abstract

Objective: The present study aimed to develop a structural model of obsessive–compulsive symptoms based on early maladaptive schemas and perfectionism, with the mediating role of emotion self-regulation among women seeking cosmetic surgery.

Methods: This descriptive-correlational study employed structural equation modeling. The statistical population comprised all women seeking cosmetic surgery at Imam Khomeini and Mafrah Hospitals in Tehran during the 2025–2026 period. A sample of 385 women was selected using cluster random sampling. Data were collected using the Young Schema Questionnaire–Long Form (YSQ-LF), Obsessive–Compulsive Inventory–Revised (OCI-R), Miller and Brown Self-Regulation Questionnaire, and Hill Perfectionism Questionnaire. Data were analyzed using SPSS version 26 and AMOS version 24.

Results: The model fit indices indicated a satisfactory fit between the proposed model and the observed data. The results showed that early maladaptive schemas and perfectionism had significant direct effects on obsessive–compulsive symptoms (P < 0.05). Emotion self-regulation also partially mediated the relationships between early maladaptive schemas and perfectionism and obsessive–compulsive symptoms. Among the early maladaptive schemas, dependence/incompetence and abandonment demonstrated the strongest predictive effects.

Conclusion: The findings suggest that obsessive–compulsive symptoms among women seeking cosmetic surgery are associated with underlying maladaptive schema structures and difficulties in emotion regulation. Therefore, psychological interventions aimed at modifying maladaptive schemas, perfectionistic tendencies, and emotion-regulation difficulties may be warranted before cosmetic surgery.