Gender Differences in Preoperative Anxiety and the Association with Early Maladaptive Schemas: A Cross-Sectional...

Background: Preoperative anxiety is a common and clinically significant response among surgical patients, with prevalence estimates ranging from 30% to over 80% depending on measurement method and surgical context. Early maladaptive schemas (EMSs)-deeply rooted, negative cognitive patterns formed in early life-have been theorized to amplify anxiety vulnerability. This study aimed to examine whether EMSs independently predict preoperative anxiety in a surgical population and to explore the role of demographic factors. Methods: A descriptive cross-sectional correlational study was conducted with 310 patients scheduled for elective surgery. Data were collected using a sociodemographic questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and the Young Schema Questionnaire-Short Form, Second Edition (YSQ-S2). Internal consistency of both instruments was computed for this sample. Analyses included Pearson's correlations and multiple regression. Results: Participants reported preoperative anxiety scores near the clinically meaningful threshold (M = 11.06, SD = 3.80). Small but statistically significant negative bivariate correlations were observed between APAIS scores and several EMS subscales (rs = -0.12 to -0.17). However, in multiple regression analysis, none of the EMS subscales was an independent predictor of preoperative anxiety (all ps > 0.18). Gender was the only significant independent predictor, with females reporting higher anxiety than males (B = 1.27, p = 0.012). The overall model explained 5.6% of variance (R² = 0.06). Conclusions: This study did not support the hypothesis that EMSs independently predict preoperative anxiety, representing a null result with respect to EMS prediction. The primary finding was a significant gender difference, with females reporting higher preoperative anxiety. Clinicians should prioritize gender-sensitive preoperative screening. Future research should explore potential moderating factors and use prospective, multicenter designs.