2026 ECNP Congress

EP01-1043

Evaluation of early maladaptive schemas and schema modes in genitopelvic pain/penetration disorder

Gülcihan Deniz Madenci — A.G. Gündoğmuş · Barış Mental and Neurological Diseases Hospital, Department of Psychiatry, Nicosia, Cyprus

2026 ECNP Congress

Objectives

This study aimed to identify and compare early maladaptive schemas (EMS) and schema modes in patients with genitopelvic pain/penetration disorder and to examine their role in the cognitive and emotional features associated with the disorder.

Methods

The study included 60 patients with a current diagnosis of genitopelvic pain/penetration disorder who presented to the Psychiatry Outpatient Clinic of Ankara Etlik City Hospital, alongside a healthy control group of 60 participants. All participants completed the Sociodemographic Data Form, the Golombok–Rust Inventory of Sexual Satisfaction (GRISS), the Young Schema Questionnaire-Short Form (YSQ-3), and the Schema Mode Inventory (SMI). These instruments were used to assess sexual functioning, early maladaptive schemas, and schema modes. Statistical analyses were conducted to compare the two groups and to determine the associations between schema domains and schema modes. (1, 2)

Results

The findings demonstrated that anorgasmia and vaginismus subscale scores, and total GRISS scores were significantly higher in the genitopelvic pain/penetration disorder group compared with controls.

In addition, several early maladaptive schemas and schema modes were found to be significantly elevated in the patient group, indicating more pronounced maladaptive cognitive and emotional patterns. Schema domains related to impaired limits and overvigilance were particularly prominent in the patient group.

In terms of schema modes, Angry Child, Undisciplined Child, Enraged Child, Compliant Surrenderer, Detached Self-Soother, Bully/Attack Mode and Self-Aggrandiser modes were significantly more pronounced in the patient group compared with controls.

Conclusions

Although research on early maladaptive schemas and schema domains has expanded (3-5), studies focusing on schema modes -despite their increasing clinical application- remain limited. The present study extends the literature by examining, beyond prior work, whether schema modes also differ in patients diagnosed with genitopelvic pain/penetration disorder. Compared to controls, the patient group demonstrated significantly higher severity in Angry Child, Enraged Child, Impulsive/Undisciplined Child, Compliant Surrender, Detached Self-Soother, Self-Aggrandiser, and Bully/Attack modes, while the Healthy Adult mode was more prominent in controls.

The greater severity of early maladaptive schemas and schema modes observed in the patient group suggests reduced awareness of personal needs and desires in sexual contexts, an excessive focus on others’ needs, difficulties with individuation, increased impatience, and heightened expectations of imminent threat. These findings indicate that schema-focused conceptualizations are clinically relevant for understanding the psychological underpinnings of this disorder.

Furthermore, these findings may be understood within a broader cognitive-behavioural framework, suggesting that maladaptive schema activation contributes to heightened threat perception and avoidance patterns in sexual contexts. This highlights the potential value of integrating schema-focused interventions with existing treatment approaches for genitopelvic pain/penetration disorder.

Clinically, our data suggest that interventions aimed at enhancing awareness of unmet emotional needs, identifying and reducing maladaptive coping modes, decreasing the intensity of dysfunctional child modes while promoting the Happy Child mode, and strengthening the Healthy Adult mode may provide therapeutic benefit in this population.

Future research should investigate longitudinal changes in schema modes following therapeutic interventions and explore whether targeting specific maladaptive modes leads to improved treatment outcomes. Additionally, larger and more diverse samples are needed to enhance the generalizability of these findings.

References

  1. Soygüt G, Karaosmanoğlu A, Çakir Z. Erken Dönem Uyumsuz Şemaların Değerlendirilmesi: Young Şema Ölçeği Kısa Form-3’ün Psikometrik Özelliklerine İlişkin Bir İnceleme. Turk Psikiyatri Dergisi. 2009;20(1).
  2. Tuğrul C, Öztan N, Kabakçı E. Golombok-Rust cinsel doyum ölçeği’nin standardizasyon çalışması. Türk Psikiyatri Dergisi. 1993;4(2):83-8.
  3. DİKMEN SNT, ŞAFAK Y, ÖZDEL K, ÖZDEMİR İ. Vajinismus Hastalarında Erken Dönem Uyumsuz Şema ve Üst Bilişlerin Değerlendirilmesi. 2018.
  4. Tarakci K. Kadınlarda erken dönem uyumsuz şemalar, beden algısı ve cinsel doyum arasındaki ilişkinin incelenmesi: Üzküdar University (Turkey); 2019.
  5. Oliveira C, Nobre PJ. Cognitive structures in women with sexual dysfunction: the role of early maladaptive schemas. The Journal of Sexual Medicine. 2013;10(7):1755-63.