Objective: The aim of this study was to examine the relationships
between early maladaptive schemas, vaginal penetration-related
cognitions, and sexual functioning in women diagnosed with Genito-
Pelvic Pain/Penetration Disorder (GPPPD), compared with a control
group.
Method: This cross-sectional, multicenter study included 100 women
diagnosed with GPPPD and 120 volunteer women in whom no sexual
dysfunction was detected. Participants completed the Structured Clinical
Interview for DSM-5 (SCID-5), the Young Schema Questionnaire Short
Form-3 (YSQ-SF3), the Vaginal Penetration Cognitions Questionnaire
(VPCQ), and the Golombok-Rust Inventory of Sexual Satisfaction
(GRISS). Group differences were analyzed using the Mann-Whitney U
test, associations were assessed with Spearman correlation analysis, and a
multivariable logistic regression analysis was also performed.
Results: Compared with the control group, women diagnosed with
GPPPD had significantly higher levels of negative vaginal penetration
cognitions and early maladaptive schemas, particularly pessimism,
approval-seeking, defectiveness, punitiveness, vulnerability to harm, and
unrelenting standards (p<0.001). In addition, genital incompatibility
cognitions were associated with pessimism and self-sacrifice schemas,
whereas catastrophic and pain-related cognitions were associated
with the approval-seeking schema. In the logistic regression analysis,
unemployment, higher age at marriage, catastrophic and pain-related
cognitions, and genital incompatibility cognitions were independently
associated with the presence of GPPPD.
Conclusion: Women diagnosed with GPPPD were found to have more
negative sexual cognitions and more pronounced maladaptive schema
patterns. The findings suggest that evaluating negative penetrationrelated
cognitions together with early maladaptive schemas may be
clinically useful in GPPPD.
Keywords: Genito-pelvic pain/penetration disorder, schemas, sexual
functioning, vaginal penetration cognitions, vaginismus