Background & Objectives: Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders in modern society. It is characterized by chronic, excessive, and uncontrollable worry about aspects of everyday life, including work, health, social relationships, and the future. When these symptoms persist for more than 6 months, they can significantly impair an individual's normal functioning. The lifetime prevalence of GAD in the general population is approximately 3%, while its 12–month prevalence is about 2%. Given the high prevalence of GAD and its extensive impact on mental health, social functioning, and quality of life in women, identifying the underlying cognitive–emotional mechanisms of this disorder is of particular importance. One emerging theoretical framework in this field is the theory of early maladaptive schemas. In the Iranian cultural context, empirical evidence specifically examining schema differences between women with and without generalized anxiety disorder remains limited and fragmented, posing challenges to generalizing existing findings and designing evidence–based interventions. The present study aimed to compare early maladaptive schemas in women with and without generalized anxiety disorder.

Methods: This descriptive study was of a causal–comparative type. The study included women with GAD who attended mental health centers in District 3 of Behshahr City, Iran, in 2025. Using G*Power, 52 women (26 with GAD and 26 without) were purposively selected. Women without GAD were matched to the clinical group on age, gender, and educational level. The inclusion criteria were as follows: providing written informed consent to participate in the study; a diagnosis of GAD based on the Generalized Anxiety Disorder Scale (GAD–7) (Spitzer et al., 2006), established through a clinical interview conducted according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5), by a clinical psychologist trained in psychopathology; at least a high school diploma; and an age between 20 and 50 years. Exclusion criteria included incomplete or invalid questionnaires, the presence of other anxiety or mood disorders as determined by the clinical interview, and unwillingness to continue participation in the study. Data on early maladaptive schemas were collected using the Young Schema Questionnaire–Short Form (YSQ–SF) (Young & Brown, 2005). In the present study, ethical principles were observed, including obtaining informed consent from all participants before enrollment, ensuring the confidentiality of participants' identities, providing all participants with adequate information about the study procedures, and emphasizing their right to withdraw from the study at any time without any consequences. Data were analyzed using multivariate analysis of variance (MANOVA) at the 0.05 significance level in SPSS version 22.

Results: The results showed significant differences between women with GAD and women without GAD across all domains of early maladaptive schemas, including disconnection and rejection, impaired autonomy and performance, impaired limits, other–directedness, and overvigilance and inhibition (p < 0.001). Effect size analysis indicated that the largest between–group differences were observed in the domains of impaired autonomy and performance (η²=0.33), disconnection and rejection (η²=0.25), overvigilance and inhibition (η²=0.19), other–directedness (η²=0.11), and impaired limits (η²=0.07).

Conclusion: Based on the study findings, women with GAD exhibited significantly higher levels of early maladaptive schemas than women without generalized anxiety disorder. These findings highlight the potential role of deep cognitive–emotional structures in the development and maintenance of generalized anxiety disorder.