title: Sexual self schema as a moderator of sexual and psychological outcomes for gynecologic cancer survivors.
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.
authors.affiliation: 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. kcarpenter@ucla.edu
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Carpenter
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Andersen
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Fowler
authors.forename: G Larry
authors.initials: GL
authors.lastname: Maxwell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology*; D013315:Stress, Psychological; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult