Early Maladaptive Schemas and Penetration Cognitions in Genito-Pelvic Pain/Penetration Disorder: A Multicenter Study

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.

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.

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.

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.