Early maladaptive schemas and sexual dysfunction in men
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Updated: May 28, 2026

Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility
Published on: May 30, 2025
Ana Luísa Quinta Gomes1, Pedro Nobre
1Departamento de Educação e Psicologia, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal. bisagomes@gmail.com
Abstract:
The objective of the present study was to investigate the role played by early maladaptive schemas (EMS) on male sexual functioning and clarify the way these nuclear cognitive structures discriminate men with and without sexual dysfunction. A total of 242 men participated in the study (a community sample of 200 men and a clinical sample of 42 men with a DSM-IV diagnosis of sexual dysfunction). The community sample was divided into a control group (n=147) and a sub-clinical group (n=53), according to the cutoff scores of the International Index of Erectile Dysfunction (Rosen et al., 1997). All participants completed a set of measures assessing EMS (Young & Brown, 1989), sexual functioning (Rosen et al., 1997), psychopathology (Derogatis & Spencer, 1982), and cognitive schemas activated in hypothetical unsuccessful sexual situations (Nobre & Pinto-Gouveia, 2009a). Findings supported the hypothesis of a typical cognitive pattern in men with sexual difficulties. After controlling for psychopathology, men with sexual dysfunction reported more dependence/incompetence EMS and activated more difference, helpless, and particularly incompetence schemas in hypothetical unsuccessful sexual situations, in comparison to sexually healthy men. These results have important therapeutic implications for sex therapy.
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