Sex (Is Not) On Fire: The Mediating Role of Cognitive Schemas Between Symptoms of Endometriosis and Sexual Distress

Authors

DOI:

https://doi.org/10.24193/subbpsyped.2024.1.09

Keywords:

endometriosis symptoms, maladaptive cognitive schemas, sexual distress, structural equation modeling

Abstract

The purpose of this research is to examine the cognitive schemas activated in sexual situations as mediating factors in the relationship between endometriosis symptoms and sexual distress. N=173 women diagnosed with endometriosis, who had a sexually active status during data collection, took part in the research. The survey consisted of a demographic data sheet, the ENDOPAIN-4D, the Questionnaire of Cognitive Schema Activation in Sexual Context and the Female Sexual Distress Scale - Desire/Arousal/Orgasm questionnaires. The results of the Structural Equation Modeling technique indicate that the mediation model does not show a good model fit with our data. We do not see this explanatory power regarding the relationship between pelvic pain and sexual distress sexual, or between bowel pain and sexual distress. Based on the complex indirect effect, maladaptive cognitive schemas mediate the relationship between pain during sexual intercourse and sexual distress, as well as the relationship between other symptoms of endometriosis and sexual distress.

References

American Society for Reproductive Medicine. (2016). Endometriosis. American Society for Reproductive Medicine.

Brown, R. J. (2004). Psychological mechanisms of medically unexplained symptoms: An integrative conceptual model. Psychological Bulletin, 130(5), 793-812. doi: 10.1037/0033-2909.130.5.793

Byrne, B. M. (2010). Structural equation modeling with AMOS: Basic concepts, applications, and programming. Routledge.

Davoodi, E., Wen, A., Dobson, K. S., Noorbala, A. A., Mohammadi, A., Farahmand, Z. (2018). Early maladaptive schemas in depression and somatization disorder. Journal of Affective Disorder, 1(235), 82-89. doi: 10.1016/j.jad.2018.04.017

Derogatis, L. R., Revicki, D. A., Rosen, R. C., Jordan, R., Lucas, J., & Spana, C. (2021). Psychometric validation of the Female Sexual Distress Scale-Desire/Arousal/ Orgasm. Journal of Patient-Reported Outcomes, 5(100), 1-11. doi: 10.1186/s41687-021-00359

Evli, M., Simsek, N., Ozkan, F., & Dagdelen, D. (2021). The effect of sexual self-schemas and sexual embarrassment of nursing students on the attitudes and beliefs of students related to sexual health. Nurse Education in Practice, 57, 1-7. doi: 10.1016/j.nepr.2021.103241

Fritzer, N., Haas, D., Oppelt, P., Renner, S., Hornung, D., Wölfler, M., Ulrich, U., Fischerlehner, G., Sillem, M. & Hudelist, G. (2013). More than just bad sex: sexual dysfunction and distress in patients with endometriosis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 169(2), 392-396. doi: 10.1016/j.ejogrb.2013.04.001

Hair, J., Black, W. C., Babin, B. J. & Anderson, R. E. (2010). Multivariate data analysis. Pearson Educational International.

Kline, R., B. (2015). Principles and Practice of Structural Equation Modeling. The Guilford Press.

Nimbi, F., Rossi, V., Aversa, F., Tripodi, F., Porpora, M. G., & Simonelli, C. (2019). Sexual Beliefs, Modes and Cognitive Schemas in Endometriosis Women: A Barrier in Seeking Help for Sexual Pain?. The Journal of Sexual Medicine, 16(2), 10-17. doi: 10.1016/j.jsxm.2019.03.059

Nobre, P. J., & Pinto-Gouveia, J. (2009). Questionnaire of Cognitive Schema Activation in Sexual Context: A Measure to Assess Cognitive Schemas Activated in Unsuccessful Sexual Situations. The Journal of Sex Research, 46(5), 425-437. doi:10.1080/00224490902792616

Pallant, J. (2011). SPSS Survival Manual. A step by step guide to data analysis using SPSS. Allen & Unwin.

Peixoto, M., & Nobre, P. (2015). Automatic Thoughts During Sexual Activity, Distressing Sexual Symptoms, and Sexual Orientation: Findings from a Web Survey. Journal of Sex and Marital Therapy, 42(7), 1-38. doi:10.1080/0092623x.2015.1113583

Peixoto, M., & Nobre, P. (2015). Cognitive schemas activated in sexual context: A comparative study with homosexual and heterosexual men and women, with and without sexual problems. Cognitive Therapy and Research, 39(3), 390–402. doi:10.1007/s10608-014-9661-5

Privitera, G., O’Brien, K., Misajon, R. A., & Lin, C. H. (2023). Endometriosis Symptomatology, Dyspareunia, and Sexual Distress Are Related to Avoidance of Sex and Negative Impacts on the Sex Lives of Women with Endometriosis. International Journal of Environmental Research and Public Health, 20, 1-9. doi:10.3390/ijerph20043362

Puchar, A., Panel, P., Oppenheimer, A., Cheyron, J. D., Fritel X., & Fauconnier, A. (2021). The ENDOPAIN 4D Questionnaire: A New Validated Tool for Assessing Pain in Endometriosis. Journal of Clinical Medicine, 10, 1-13. doi:10.3390/jcm10153216

Rossi, V., Galizia, R., Tripodi F., Simonelli, C., Grazia Propora, M., & Nimbi, F. M. (2022). Endometriosis and Sexual Functioning: How Much Do Cognitive and Psycho-Emotional Factors Matter? International Journal of Environmental Research and Public Health, 19(9), 1-14. doi: 10.3390/ijerph19095319

Saariaho, T. H. J., Saariaho, A. S. I., Karila, I. A., & Joukamaa, M. I. (2012). Early maladaptive schema factors, chronic pain and depressiveness: a study with 271 chronic pain patients and 331 control participants. Clinical Psychology and Psychotherapy, 19, 214-233. doi: 10.1002/cpp.737

Saariaho, T. H. J., Saariaho, A. S. I., Karila, I. A., & Joukamaa, M. I. (2010). Early maladaptive schemas in Finnish adult chronic male and female pain patients. Scandinavian Journal of Pain, 1(4), 196-202. doi: 10.1016/j.sjpain.2010.09.003

Salari, S., Shaygan, M., & Setoodeh, G. (2022). The mediating role of maladaptive cognitive schemas regarding the relationship between parenting styles and chronic pain in adolescents: a structural equation modelling approach. Child and Adolescent Psychiatry and Mental Health, 16(60), 1-16. doi: 10.1186/s13034-022-00496-5

Shum, L. K., Bedaiwy, M. A., Allaire, C., Williams, C., Noga, H., Albert, A., Lisonkova, S., & Young, P. J. (2018). Deep Dyspareunia and Sexual Quality of Life in Women With Endometriosis. Sexual Medicine, 6(3), 224-233. doi: 10.1016/j.esxm.2018.04.006

Smolarz, B., Szyłło, K., & Romanowicz, H. (2021). Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature). International Journal of Molecular Sciences, 22(19), 1-29. doi: 10.3390/ijms221910554

Steavens, B. A., & Roediger, E. (2017). Schema Therapy: Toward a Science of Relationships. Wiley Blackwell.

Vakili, N., Rezaei, F., & Hosseini, N. (2020). The Mediating Role of Depression Between Early Maladaptive Schema and Pain: A Structural Equation Modelling. Research Square, 1-20. doi: 10.21203/rs.3.rs-120596/v1

Van Den Broeck, U., Meuleman, C., Tomassetti, C., D’Hoore, A., Wolthuis, A., Van Cleynenbreugel, B., Vergote, I., Enzlin, P., & D’Hooghe, T. (2013). Effect of laparoscopic surgery for moderate and severe endometriosis on depression, relationship satisfaction and sexual functioning: comparison of patients with and without bowel resection. Human Reproduction, 28(9), 2389-2397. doi: 10.1093/humrep/det260

Vannuccini, S., Maseroli, E., Vignozzi, L., & Petraglia, F. (2023). The challenge of endometriosis for female sexual health. The Journal of Sexual Medicine, 20, 240-246. doi: 10.1093/jsxmed/qdad004

World Health Organization (1986). Ottawa Charter for Health Promotion. Retrieved from: http://www.who.int/healthpromotion/conferences/previous/ottawa/en/

Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press.

Zarbo, C., Brugnera, A., Compare, A., Secomandi, R., Candeloro, I., Malandrino, C., Betto, E., Trezzi, G., Rabboni, M., Bondi, E., & Frigerio, L. (2019). Negative metacognitive beliefs predict sexual distress over and above pain in women with endometriosis. Archives of Women’s Mental Health, 22, 575-582. doi: 10.1007/s00737-018-0928-9.

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Published

2024-06-30

How to Cite

GÁLFI, B., COBEANU, O., KÁLCZA-JÁNOSI, K., & BALÁZSI, R. (2024). Sex (Is Not) On Fire: The Mediating Role of Cognitive Schemas Between Symptoms of Endometriosis and Sexual Distress. Studia Universitatis Babeș-Bolyai Psychologia-Paedagogia, 69(1), 167–182. https://doi.org/10.24193/subbpsyped.2024.1.09

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