Background & aim: Dyspareunia negatively affects women’s intimate relationships. Although early maladaptive schemas (EMS) have been linked to sexual dysfunction, few comparative studies have been conducted in non-Western contexts. This study compared EMS among women with primary and secondary dyspareunia with a control group.
Methods: This comparative cross-sectional study was conducted in Tehran, Iran, between January and May 2023 and included 1912 women (primary dyspareunia: n=402, secondary dyspareunia: n=104, control: n=1406). Women aged 18 to 45, married for at least one year, and willing to participate were included. Exclusion criteria were a history of psychiatric or gynecological disorders, childbirth-related trauma, or sexual violence/abuse. Women with dyspareunia referred to the sexual/reproductive health clinic of a private hospital were recruited through purposive sampling. The control group was selected through convenience sampling and matched for demographic characteristics. Data were collected using the validated Persian version of the Young Schema Questionnaire and analyzed using one-way multivariate analysis of variance and discriminant analysis in SPSS version 26.0.
Results: Mean ages in the control, primary, and secondary dyspareunia groups were 29.49, 28.40, and 30.57 years, respectively. Women with dyspareunia exhibited significantly higher scores on EMS domains including disconnection/rejection, impaired autonomy, and over-vigilance/inhibition compared with controls (P< 0.001). Discriminant analysis yielded two significant functions (eigenvalues: 0.044 and 0.018), with a modest overall classification accuracy of 48.6%. No significant schema-pattern differences were found between primary and secondary dyspareunia groups (P > 0.05).
Conclusion: EMS significantly contribute to dyspareunia, indicating potential benefits of schema-focused interventions. Further research should examine long-term treatment outcomes.