Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, 34197-59811, Iran.
Stress and Immunity Cancer Projects Lab, Department of Psychology, Ohio State University, Columbus, OH, USA.
BMC Psychol. 2022 May 23;10(1):131. doi: 10.1186/s40359-022-00829-1.
Healthy sex can be affected by cognitive schemas activated in the sexual context (CSASCs) and early maladaptive schemas (EMSs). Cognitive schemas are the nuclear structure of the cognitive system which facilitate the interaction between individuals and their environments. CSASCs are emotional and behavioral responses in the sexual context. EMSs are extremely stable, enduring and are developed throughout the life of the individual, beginning in childhood. The present study investigated the relationship between CSASCs and EMSs among married women of childbearing age.
In a cross-sectional study, 260 married women of childbearing age participated. Using two-stage sampling, ten comprehensive urban health centers were first randomly selected and then 26 individuals from each center were invited to participate. Data collection included demographic variables, the Young Schema Questionnaire-Short Form (YSQ-SF) with 15 EMSs (emotional deprivation, abandonment, mistrust/abuse, social alienation, defectiveness, incompetence, dependency, vulnerability to harm, enmeshment, subjugation of needs, self-sacrifice, emotional inhibition, unrelenting standards, entitlement, and insufficient self-control), and the Cognitive Schema Activation in Sexual Context Questionnaires (CSASCQ) with five subscales (undesirability/rejection, incompetence, self-depreciation, difference/loneliness, and helplessness). Data analysis was performed using a uni-variable and multi-variable linear regression model with a stepwise method at a significance level of 0.05.
The mean age of the participants was 32.48 years and the average duration of their marriage was 10.34 years. The average score of early maladaptive schemas on the YSQ-SF was 151.5 (out of 450). Higher scores indicate more severe maladaptive schemas, although the total score has no defined cutoff point. Scores greater than 15 on each subscale constitute the internalization of that particular maladaptive schema. The highest average subscale scores were the schemas of self-sacrifice and unrelenting standards (M = 16.12, 15.90, respectively), indicating that these two schemas play important roles in the cognition of the participants. The mean score on the CSASCQ was 34.60 (SD ± 12.59; range: 25-125), with the highest mean reported on the loneliness subscale. Hypoactive sexual desire was the most common unpleasant sexual problem (6.9%) and disillusion was the most dominant feeling experienced by participants (33.3%). The results of the multivariable model showed that the following were significant predictors of the CSASC: three subscales of EMS (emotional deprivation [β = 0.28], social isolation [β = 0.31], and emotional inhibition [β = 0.14]) and two demographic variables (job [β = 0.11] and consanguineous marriage [β = 0.20]). In total, the multi-variable model explained 92% of variance of CSASCs.
The present study found a significant and meaningful association between EMSs and CSASCs adjusting for the effect of socio-demographic characteristics. The findings indicate that the study of schemas and schema therapy should be considered in both premarital and marital counseling.
健康的性生活可能会受到性情境认知模式（CSASCs）和早期适应不良模式（EMSs）的影响。认知模式是认知系统的核心结构，促进了个体与环境之间的相互作用。CSASCs 是性情境中的情绪和行为反应。EMSs 是极其稳定、持久的，并且是在个体的整个生命周期中发展起来的，从童年开始。本研究调查了育龄已婚妇女 CSASCs 和 EMSs 之间的关系。
在一项横断面研究中，共有 260 名育龄已婚妇女参加。采用两阶段抽样方法，首先随机抽取 10 个综合城市健康中心，然后从每个中心邀请 26 人参加。数据收集包括人口统计学变量、15 个 EMSs（情感剥夺、遗弃、不信任/虐待、社会疏远、缺陷、无能、依赖、易受伤害、纠缠、需要的臣服、自我牺牲、情感抑制、无情标准、权利和自我控制不足）的青年模式问卷-短表（YSQ-SF）和五个子量表（不可取/拒绝、无能、自我贬低、差异/孤独和无助）的认知模式在性情境中的激活问卷（CSASCQ）。数据分析采用单变量和多变量线性回归模型，采用逐步法，显著性水平为 0.05。
参与者的平均年龄为 32.48 岁，平均婚姻持续时间为 10.34 年。YSQ-SF 中早期适应不良模式的平均得分为 151.5（满分 450 分）。分数越高表示适应不良模式越严重，尽管总分没有明确的截止点。各子量表得分大于 15 分表示该特定适应不良模式的内化。平均子量表得分最高的是自我牺牲和无情标准（M=16.12、15.90），这表明这两个模式在参与者的认知中起着重要作用。CSASCQ 的平均得分为 34.60（SD±12.59；范围：25-125），孤独子量表的平均得分最高。性欲减退是最常见的不愉快性问题（6.9%），幻灭是参与者最常见的感觉（33.3%）。多变量模型的结果显示，以下因素是 CSASC 的显著预测因素：三个 EMS 子量表（情感剥夺[β=0.28]、社会孤立[β=0.31]和情感抑制[β=0.14]）和两个人口统计学变量（职业[β=0.11]和近亲婚姻[β=0.20]）。总的来说，多变量模型解释了 CSASCs 变异的 92%。
本研究发现，在调整社会人口特征影响后，EMSs 和 CSASCs 之间存在显著而有意义的关联。研究结果表明，在婚前和婚姻咨询中应考虑模式研究和模式治疗。
