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Sexual Self Schema as a Moderator of Sexual and Psychological Outcomes for Gynecologic Cancer Survivors

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Abstract

Gynecologic cancer patients are at high risk for emotional distress and sexual dysfunction. The present study tested sexual self schema as an individual difference variable that might be useful in identifying those at risk for unfavorable outcomes. First, we tested schema as a predictor of sexual outcomes, including body change stress. Second, we examined schema as a contributor to broader quality of life outcomes, specifically as a moderator of the relationship between sexual satisfaction and psychological statue (depressive symptoms and quality of life). A cross-sectional design was used. Gynecologic cancer survivors (N = 175) 2–10 years post treatment were assessed during routine follow up. In regression analyses controlling for sociodemographic variables, patients’ physical symptoms/signs as evaluated by nurses, health status, and extent of partner sexual difficulties, sexual self schema accounted for significant variance in the prediction of current sexual behavior, responsiveness, and satisfaction. Moreover, schema moderated the relationship between sexual satisfaction and psychological outcomes, suggesting that a positive sexual self schema might “buffer” patients from depressive symptoms when their sexual satisfaction is low. Furthermore, the combination of a negative sexual self schema and low sexual satisfaction might heighten survivors’ risk for psychological distress, including depressive symptomatology. These data support the consideration of sexual self schema as a predictor of sexual morbidity among gynecologic cancer survivors.

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Acknowledgments

Supported by grants from Henry M. Jackson Foundation for the Military Medicine (Department of Defense; Gynecological Cancer Center for Health Disparities GCC-2004-1), the National Cancer Institute (RO1CA92704, KO5 CA098133), and The Ohio State University Alumni Grants for Graduate Research and Scholarship. We thank the patients for their participation. These individuals also made important contributions: Elisabeth Yost, B.A., Lois Dial, R.N., Laura Peterson, M.P.H., and gynecologic oncologists David E. Cohn, M.D., Larry J. Copeland, M.D., Lynne A. Eaton, M.D., and David O’Malley, M.D.

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Authors and Affiliations

  1. Division of Cancer Prevention and Control Research, University of California, Los Angeles, 650 Charles Young Drive South, A2-125, Box 956900, Los Angeles, CA, 90095-6900, USA

    Kristen M. Carpenter

  2. Departments of Psychology and Obstetrics and Gynecology, Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA

    Barbara L. Andersen

  3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, College of Medicine, Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA

    Jeffrey M. Fowler

  4. Gynecologic Disease Center, U.S. Military Cancer Institute, Walter Reed Army Medical Center, Washington, DC, USA

    G. Larry Maxwell

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  1. Kristen M. Carpenter
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  4. G. Larry Maxwell
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Correspondence to Kristen M. Carpenter.

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Carpenter, K.M., Andersen, B.L., Fowler, J.M. et al. Sexual Self Schema as a Moderator of Sexual and Psychological Outcomes for Gynecologic Cancer Survivors. Arch Sex Behav 38, 828–841 (2009). https://doi.org/10.1007/s10508-008-9349-6

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