The Significance of Primary Incompatible Schema Differentiation in Women with Primary and Secondary Dyspareunia Compared with a Control Group: A Comparative Analysis in Tehran, Iran (2023)

Articles in Press

Document Type : Original Research Article

Authors

1 Associate Professor, Department of Clinical Psychology, Kharazmi University, Tehran, Iran

2 Graduate of Clinical Psychology, Department of Psychology, Kharazmi University, Tehran, Iran

10.22038/jmrh.2026.83240.2499

Abstract

Background & aims: Dyspareunia, a sexual dysfunction involving painful intercourse, negatively affects women’s emotional well-being and intimate relationships. Although early maladaptive schemas (EMS) have been linked to sexual dysfunction, few studies have compared EMS in primary and secondary dyspareunia, particularly in non-Western contexts where cultural factors may shape schema development and sexual experiences. This study examined EMS among women with primary and secondary dyspareunia compared with a control group, aiming to provide insights for prevention and treatment approaches.
Methods: This cross-sectional study was conducted in Tehran, Iran, between January and May 2023, including 1912 married women: 506 with dyspareunia (402 primary, 104 secondary) and 1406 controls. Participants were recruited through purposive and convenience sampling. Data were collected using the validated Persian version of the Young Schema Questionnaire (Cronbach’s α = 0.87) and analyzed using one-way multivariate analysis of variance (MANOVA) and discriminant analysis in SPSS version 26.0.
Results: Mean ages were 29.49 years for the control group, 28.40 years for primary dyspareunia, and 30.57 years for secondary dyspareunia. Women with dyspareunia exhibited significantly higher on EMS domains such as disconnection/rejection, impaired autonomy, and over-vigilance/inhibition domains compared with controls (MANOVA, p < 0.001). Discriminant analysis identified two significant functions (Function 1: eigenvalue 0.044; Function 2: eigenvalue 0.018), although the overall classification accuracy was modest (48.6%). No significant schema-pattern differences were found between primary and secondary dyspareunia groups (p > 0.05).
Conclusion: Early maladaptive schemas significantly contribute to dyspareunia, indicating potential benefits of schema-focused interventions. Further research should examine long-term treatment outcomes.

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Journal of Midwifery and Reproductive Health

Articles in Press, Accepted Manuscript
Available Online from 26 April 2026

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