title: Sexual self-schema and depressive symptoms after prostate cancer.
abstract: BACKGROUND
  The years following prostate cancer treatment are characterized by changes in sexual functioning and risk for depressive symptoms. Sexual self-schema (SSS) is a cognitive generalization about sexual aspects of the self that are associated with sexual behavior, affect, and the processing of sexually relevant information. This study tested if men's SSS moderates the impact of sexual morbidity on depressive symptoms.
  
  
  METHODS
  Men (N = 66) treated for localized prostate cancer in the preceding 2 years were assessed at T1 and 4 months later (T2). Questionnaires included the Center for Epidemiologic Studies Depression Scale, Sexual Self-schema Scale for Men, Sexual Experience Scale, and Expanded Prostate Cancer Index Composite.
  
  
  RESULTS
  Regressions controlled for age, sexual activity, and T1 depressive symptoms revealed no significant effect of SSS on depressive symptoms; however, better sexual functioning was related to fewer depressive symptoms (B = -0.25, p < 0.05). Results showed significant interactions between SSS and sexual outcomes. Among men with high SSS, poor sexual functioning was associated with increased depressive symptoms; loss of sexual function was particularly distressing. There was no significant effect of sexual functioning. Among men with high SSS, there was an inverse relationship between sexual engagement and depressive symptoms. Among men with lower SSS, greater frequency of sexual behavior was associated with increased depressive symptoms.
  
  
  CONCLUSIONS
  SSS may be an important individual difference in determining the impact of sexual morbidity on psychological adjustment. Men high on SSS are more vulnerable to psychological consequences of lower sexual functioning and less engagement in sexual activities.
authors.affiliation: Department of Psychology, Hunter College, City University of New York, New York, NY, USA; Department of Psychology, Graduate Center, City University of New York, New York, NY, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Hoyt
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Carpenter
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D015331:Cohort Studies; D003863:Depression / Q000523:psychology*; D000066498:Emotional Adjustment; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000523:psychology; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000628:therapy; D011878:Radiotherapy; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology; D019529:Sexuality / Q000523:psychology*
chemical_list: D018931:Antineoplastic Agents, Hormonal
keywords: depression; oncology; prostate cancer; sexual function; sexual self-schema