Cognitive and emotional predictors of female sexual dysfunctions: preliminary findings.

The influence of cognitive and emotional variables on specific female sexual dysfunctions was investigated. A total of 207 women (160 without sexual problems and 47 with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of sexual dysfunction) answered a set of questionnaires assessing cognitive and emotional variables (cognitive schemas activated in sexual context - Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC); sexual beliefs - Sexual Dysfunctional Beliefs Questionnaire (SDBQ); automatic thoughts and emotions presented during sexual activity - Sexual Modes Questionnaire (SMQ)); and sexual functioning (Female Sexual Function Index (FSFI)). Results indicated that most women with sexual dysfunction activate incompetence schemas when facing unsuccessful sexual situations. Additionally, lack of erotic thoughts and increased attentional focus on failure and disengagement thoughts during sexual activity were also common in the clinical sample. Besides these common factors, results showed that some specific cognitive and emotional factors are associated with different clinical presentations. Sexual conservative beliefs seem to be closely related to hypoactive sexual desire and to a certain extent to arousal difficulties in women. Body image beliefs and automatic thoughts focusing on self-body appearance seem to be strongly associated with orgasmic disorder. Regarding emotions, fear was one of the best predictors of vaginismus, whereas sadness, disillusion, guilt, and lack of pleasure and satisfaction were closely associated to hypoactive sexual desire. Overall, these findings may contribute to the discussion regarding the treatment strategies used for the different female sexual dysfunctions.