Sexual self-schemas are cognitive generalizations regarding sexual aspects of the self that represent a core component of one's sexuality. We contend that individual differences in the sexual self-view represent an important cognitive diathesis for predicting sexual difficulty or dysfunction. We illustrate the role of sexual self-schemas on sexual behavior and responsiveness in healthy female and male samples. Next, we describe how diathesis-stress models of psychopathology have been applied to the sexual arena, and discuss the critical features of clinically useful diathesis variables. Drawing from these criteria, we examine the diathetic properties of sexual self-schemas. Finally, we discuss an empirical test of the proposed diathesis-stress interaction, reviewing the role of women's sexual self-views on sexual morbidity following diagnosis and treatment for gynecologic cancer.
KeywordsDiathesis-stress model; Sexual dysfunction; Sexual functioning; Sexual self-schema Sexual difficulties are both widespread and clinically significant. Recent epidemiological research by Laumann, Gagnon, Michael, and Michaels (1994) obtained telling 1-year prevalence rates across a variety of specific sexual difficulties. Among women, 33% reported lack of sexual desire, 19% had difficulty with lubrication, and 24% were unable to reach orgasm. The male statistics were also significant. Commonly reported difficulties among men included climaxing too early (29%), sexual performance anxiety (17%), and low sexual desire (16%). Whereas 10% of all men surveyed reported significant erectile difficulties, prevalence rates increased with age-with more than 20% of men over age 50 reporting erectile problems. Hence, the sexual dysfunctions are perhaps one of the most common yet underreported of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) diagnoses.Many have commented on the relative dearth of comprehensive and testable models regarding the etiology and course of the sexual dysfunctions (e.g., see R R. Abramson, 1992). The exceptions, such as Barlow's (1986) NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript theoretical models, though conceptually heuristic, have had limited impact on the prevention or treatment of sexual dysfunction in the community or clinic (e.g., see Bancroft, 1997;Weiderman, 1998).The current conceptual framework takes a cognitive approach to sexuality. Previously, we proposed the notion of individual differences in women's (Andersen & Cyranowski, 1994) and men's (Andersen, Cyranowski, & Espindle, 1999) view of themselves as sexual persons-or their sexual self-schemas. This approach to sexual assessment has been shown to predict sexual behavior and responsiveness. More-over, recent research indicates that this cognitive assessment tool may be used to predict sexual difficulty or dysfunction in certain at-risk populations (Andersen, Woods, & Copeland, 1997).Sexual self-schemas represent basic or core beliefs about sexual aspect...