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Cognitive Schemas Activated in Sexual Context: A Comparative Study with Homosexual and Heterosexual Men and Women, With and Without Sexual Problems

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Abstract

The role of cognitive schemas on sexual functioning has been studied in samples of heterosexual men and women. However, there are no published studies on the impact of cognitive schemas on sexual functioning in gay men or lesbian women. The current study analyzed the differences in cognitive schemas associated with negative sexual events in a sample of heterosexual and homosexual men and women, with and without sexual problems. A total of 168 women and 148 men completed a web-survey. Participants answered questions about self-perceived sexual problems, and completed the Questionnaire of Cognitive Schemas Activated in Sexual Context. Results for men and women were analyzed in separate MANOVAs (sexual problems × sexual orientation). Men with sexual problems scored significantly higher in negative cognitive schemas when facing an adverse sexual episode compared with sexually healthy men, regardless of sexual orientation. Women with sexual problems also scored significantly higher in Undesirability/rejection, Incompetence, and Difference/loneliness schemas when compared women without sexual problems, regardless of sexual orientation. Also, sexual orientation was also found to have a significant effect among women, with lesbian women activating significantly more Undesirability/rejection, Difference/loneliness, and Helpless schemas, than heterosexual women. Overall, findings suggest that, despite some specific patterns particularly in lesbian women, the role of cognitive schemas on sexual functioning is very similar in heterosexual and homosexual men and women. These results highlight the core role of cognitive factors on sexual problems in gay men and lesbian women.

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Notes

  1. For Premature Ejaculation, cutoff was ≥2 in 7 point Likert scale ("Less than 60 seconds").

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Book  Google Scholar 

  • Anderson, B. L., & Cyranowski, J. M. (1994). Women’s sexual self-schema. Journal of Personality and Social Psychology, 67, 1079–1100.

    Article  Google Scholar 

  • Anderson, B. L., Cyranowski, J. M., & Espindle, D. (1999). Men’s sexual self-schema. Journal of Personality and Social Psychology, 76, 645–661.

    Article  Google Scholar 

  • Anderson, B. L., Woods, X., & Cyranowski, J. (1994). Sexual self-schema as a possible predictor of sexual problems following cancer treatment. The Canadian Journal of Human Sexuality, 3, 165–170.

    Google Scholar 

  • Barlow, D. (1986). Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, 54(2), 140–148.

    Article  CAS  PubMed  Google Scholar 

  • Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: The Guilford Press.

    Google Scholar 

  • Beck, A. T. (1996). Beyond belief: A theory of modes, personality, and psychopathology. In P. M. Salkovskis (Ed.), Frontiers of cognitive therapy (pp. 1–25). New York: The Guilford Press.

    Google Scholar 

  • Carey, M. P., Wincze, J. P., & Meisler, A. W. (1993). Sexual dysfunction: Male erectile disorder. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual - (2nd ed., pp. 442–480). New York: The Guilford Press.

    Google Scholar 

  • Carpenter, K. M., Anderson, B. L., Fowler, J. M., & Maxwell, G. L. (2009). Sexual self schema as a moderator of sexual and psychological outcomes for gynecologic cancer survivors. Archives of Sexual Behavior, 38, 828–841. doi:10.1007/s10508-008-9349-6.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cochran, S. D., Sullivan, J. G., & Mays, V. M. (2003). Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gays, and bisexual adults in United States. Journal of Consulting and Clinical Psychology, 71, 53–61. doi:10.1037/0022-006X.71.1.53.

    Article  PubMed Central  PubMed  Google Scholar 

  • Coyne, K., Mandalia, S., McCullough, S., Catalan, J., Noestlinger, C., Colebunders, R., & Asboe, D. (2010). The international index of erectile function: Development of an adapted tool for use in HIV-positive men who have sex with men. Journal of Sexual Medicine, 7, 769–774. doi:10.1111/j.1743-6109.2009.01579.x.

    Article  PubMed  Google Scholar 

  • Cyranowski, J. M., Aarestad, S. L., & Anderson, B. L. (1999). The role of sexual self-schema in a diathesis—stress model of sexual dysfunction. Applied & Preventive Psychology, 8, 217–228.

    Article  Google Scholar 

  • Cyranowski, J. M., & Anderson, B. L. (1998). Schemas, sexuality, and romantic attachment. Journal of Personality and Social Psychology, 74, 1364–1379.

    Article  CAS  PubMed  Google Scholar 

  • Hart, T. A., & Schwartz, D. R. (2010). Cognitive-behavioral erectile dysfunction treatment for gay men. Cognitive and Behavioral Practice, 17, 66–76.

    Article  Google Scholar 

  • Hill, D. B. (2007). Differences and similarities in men’s and women’s sexual self-schemas. Journal of Sex Research, 44, 135–144.

    Article  PubMed  Google Scholar 

  • Koh, A. S., & Ross, L. K. (2006). Mental health issues: A comparison of lesbian, bisexual and heterosexual women. Journal of Homosexuality, 51, 33–57. doi:10.1300/J082v51n01_03.

    Article  PubMed  Google Scholar 

  • Kuffel, S. W., & Heiman, J. R. (2006). Effects of depressive symptoms and experimentally adopted schemas on sexual arousal and affect in sexually healthy women. Archives of Sexual Behavior, 35, 163–177. doi:10.1007/s10508-005-9015-1.

    PubMed  Google Scholar 

  • Lau, J., Kim, J., & Tsui, H. (2006). Prevalence and factors of sexual problems in Chinese males and females having sex with the same-sex partner in Hong-Kong: A population-based study. International Journal of Impotence Research, 1, 130–140. doi:10.1038/sj.ijir.3901368.

    Article  Google Scholar 

  • Lau, J., Kim, J., & Tsui, H. (2008). Prevalence and sociocultural predictors of sexual dysfunction among Chinese men who have sex with menn Hong Kong. Journal of Sexual Medicine, 5, 2766–2779. doi:10.1111/j.1743-6109.2008.00892.x.

    Article  PubMed  Google Scholar 

  • Masters, W. H., & Johnson, V. E. (1979). Homosexuality in perspectives. New York: Bantam Books.

    Google Scholar 

  • Mays, V. M., & Cochran, S. D. (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91, 1869–1876.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • McCabe, M. (2001). Evaluation of a cognitive behavior therapy program for people with sexual dysfunction. Journal of Sex & Marital Therapy, 27, 259–271. doi:10.1080/009262301750257119.

  • Middleton, L. S., Kuffel, S. W., & Heiman, J. R. (2008). Effects of experimentally adopted schemas on vaginal response and subjective sexual arousal: A comparison between women with sexual arousal disorder and sexually healthy women. Archives of Sexual Behavior, 37, 950–961. doi:10.1007/s10508-007-9310-0.

    Article  PubMed  Google Scholar 

  • Mitchell, K. R., Mercer, C. H., Ploubidis, G. B., Jones, K. G., Datta, J., Field, N., & Wellings, K. (2013). Sexual function in Britain: Findings from the third national survey of sexual attitudes and lifestyles (Natsal-3). The Lancet, 382, 1817–1829.

    Article  Google Scholar 

  • Nobre, P. (2010). Psychological determinants of erectile dysfunction: Testing a cognitive-emotional model. Journal of Sexual Medicine, 7, 1429–1437. doi:10.1111/j.1743-6109.2009.01656.x.

    Article  PubMed  Google Scholar 

  • Nobre, P. (2013). Male sexual dysfunctions. In J. G. Hofmann (Ed.). The Wiley handbook of cognitive behavioral therapy. Part two (pp. 645–672). New York: Wiley-Blackwell.

  • Nobre, P., & Pinto-Gouveia, J. (2006). Dysfunctional sexual beliefs as vulnerability factors for sexual dysfunction. The Journal of Sex Research, 43, 68–75.

    Article  Google Scholar 

  • Nobre, P., & Pinto-Gouveia, J. (2008). Cognitive and emotional predictors of female sexual dysfunctions: Preliminary findings. Journal of Sex and Marital Therapy, 34, 325–342. doi:10.1080/00926230802096358.

    Article  PubMed  Google Scholar 

  • Nobre, P., & Pinto-Gouveia, J. (2009a). Cognitive schemas associated with negative sexual events: A comparison of men and women with and without sexual dysfunction. Archives of Sexual Behavior, 38, 842–851. doi:10.1007/s10508-008-9450-x.

    Article  PubMed  Google Scholar 

  • Nobre, P. J., & Pinto-Gouveia, J. (2009b). Questionnaire of cognitive schema activation in sexual context: A measure to assess cognitive schemas activated in unsuccessful sexual situations. Journal of Sex Research, 46, 1–13. doi:10.1080/00224490902792616.

    Article  Google Scholar 

  • Oliveira, C., & Nobre, P. (2013). Cognitive structures in women with sexual dysfunction: The role of early maladaptative schemas. Journal of Sexual Medicine,. doi:10.1111/j.1743-6109.2012.02737.x.

    Google Scholar 

  • Pazmani, E., Bergeron, S., Van Oudenhove, L., Verhaeghe, J., & Enzlin, P. (2013). Aspects of sexual self-schema in premenopausal women with dyspareunia: Associations with pain, sexual function, and sexual distress. Journal of Sexual Medicine, 10, 2255–2264. doi:10.1111/jsm.12237.

    Article  Google Scholar 

  • Pechorro, P., Diniz, A., Almeida, S., & Vieira, R. (2009). Validação portuguesa do índice de Funcionamento Sexual Feminino (FSFI) [Portuguese validation of the Female Sexual Functioning Index (FSFI)]. Laboratório de Psicologia, 7, 33–44.

    Google Scholar 

  • Peixoto, M. M., & Nobre, P. (2014). Prevalence of sexual problems and associated distress among lesbian and heterosexual women. Journal of Sex and Marital Therapy. doi:10.1080/0092623X.2014.918066.

  • Peixoto, M. M., & Nobre, P. (2015). Prevalence of sexual problems and associated distress among gay and heterosexual men. Sexual and Relationship Therapy. doi:10.1080/14681994.2014.986084.

  • Quinta-Gomes, A., & Nobre, P. (2012a). Early maladaptive schemas and sexual dysfunction in men. Archives of Sexual Behavior, 41, 311–320. doi:10.1007/s10508-011-9853-y.

    Article  PubMed  Google Scholar 

  • Quinta-Gomes, A., & Nobre, P. (2012b). The International Index of Erectile Function: Psychometric properties of the Portuguese version. Journal of Sexual Medicine, 9, 180–187. doi:10.1111/j.1743-6109.2011.02467.x.

    Article  PubMed  Google Scholar 

  • Reissing, E. D., Binik, Y. M., Khalifé, S., Cohen, D., & Amsel, R. (2003). Etiological correlates of vaginismus: Sexual and physical sexual abuse, sexual knowledge, sexual self-schema, and relationship adjustment. Journal of Sex and Marital Therapy, 29, 47–59. doi:10.1080/00926230390154835.

    Article  PubMed  Google Scholar 

  • Reissing, E. D., Laliberté, G. M., & Davis, H. J. (2005). Young women’s sexual adjustment: The role of sexual self-schema, sexual self-efficacy, sexual aversion and body attitudes. The Canadian Journal of Human Sexuality, 14, 77–85.

    Google Scholar 

  • Rellini, A. H., & Meston, C. M. (2011). Sexual self-schemas, sexual dysfunction, and the sexual responses of women with a history of childhood sexual abuse. Archives of Sexual Behavior, 40, 351–362. doi:10.1007/s10508-010-9694-0.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rosen, R. C., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsig, R., & D’Agostino, R, Jr. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy, 26, 191–208.

    Article  CAS  PubMed  Google Scholar 

  • Rosen, R., Riley, A., Wagner, G., Osterloh, I., Kirkpatrick, J., & Mishra, A. (1997). The international index of erectile function (IIEF): A multidimensional scale for assessment erectile dysfunction. Urology, 49, 822–830.

    Article  CAS  PubMed  Google Scholar 

  • Safren, S. A., Hollander, G., & Hart, T. A. (2001). Cognitive-behavioral therapy with lesbian, gay, and bisexual youth. Cognitive and Behavioral Practice, 8, 215–223.

    Article  Google Scholar 

  • Safren, S. A., & Rogers, T. (2001). Cognitive-behavioral therapy with gay, lesbian, and bisexual clients. Journal of Clinical Psychology, 57, 629–643.

    Article  CAS  PubMed  Google Scholar 

  • Sandfort, T. G., Bakker, F., Schellevis, F. G., & Vanwesenbeeck, I. (2006). Sexual orientation and mental and physical health status: Findings from a Dutch population survey. American Journal of Public Health, 96, 1119–1125.

    Article  PubMed Central  PubMed  Google Scholar 

  • Sandfort, T. G., Bakker, F., Schellevis, F., & Vanwesenbeeck, I. (2009). Coping styles as a mediator of sexual orientation-related health differences. Archives of Sexual Behavior, 38, 253–263. doi:10.1007/s10508-007-9233-9.

    Article  PubMed  Google Scholar 

  • Sandfort, T. G., de Graaf, R., Bijl, R. V., & Schnabel, P. (2001). Same-sex behavior and psychiatric disorders. Archives of General Psychiatry, 58, 85–91.

    Article  CAS  PubMed  Google Scholar 

  • Sbrocco, T., & Barlow, D. H. (1996). Conceptualizing the cognitive component of sexual arousal: Implications for sexuality research and treatment. In P. M. Salkovskis (Ed.), Frontiers of cognitive therapy (pp. 419–449). New York: The Guilford Press.

    Google Scholar 

  • Stephenson, K. R., & Meston, C. M. (2012). Consequences of impaired female sexual functioning: Individual differences and associations with sexual distress. Sexual and Relationship Therapy, 27, 344–357. doi:10.1080/14681994.2012.738905.

    Article  Google Scholar 

  • Walsh, K., & Hope, D. A. (2010). LGB-Affirmative cognitive behavioral treatment for social anxiety: A case study applying evidence-based practice principles. Cognitive and Behavioral Practice, 17, 56–65.

    Article  Google Scholar 

  • Wiegel, M., Scepkowski, L. A., & Barlow, D. H. (2007). Cognitive-affective processes in sexual arousal and sexual dysfunction. In E. Janssen (Ed.), The psychophysiology of sex (pp. 143–165). Bloomington: Indiana University Press.

    Google Scholar 

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Acknowledgments

This study was funded by a doctoral scholarship from the Portuguese Foundation for Science and Technology (Reference: SFRH/BD/72919/2010).

Conflict of Interest

Maria Manuela Peixoto and Pedro Nobre declare that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all participants for being included in the study.

Animal Rights

No animal studies were carried out by the authors for this article.

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Correspondence to Maria Manuela Peixoto.

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Peixoto, M.M., Nobre, P. Cognitive Schemas Activated in Sexual Context: A Comparative Study with Homosexual and Heterosexual Men and Women, With and Without Sexual Problems. Cogn Ther Res 39, 390–402 (2015). https://doi.org/10.1007/s10608-014-9661-5

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