Sexuality in breast cancer survivors: sexual experiences, emotions, and cognitions in a group of women under hormonal therapy.

BACKGROUND: Earlier diagnosis and improved treatments have led to better outcomes in breast cancer, making quality of life a key issue. Sexuality represents a pillar of quality of life, although it is often neglected by both healthcare providers and patients when it comes to cancer. This study aims to explore the differences in sexual functioning, distress, psychopathology, emotions, and cognitions between breast cancer patients under hormonal treatment and controls. METHODS: Seventy-nine women (age range between 24 and 69 years) in hormonal therapy for breast cancer completed a self-reported protocol. A matched control group of 103 women was randomly extracted from an Italian general population database. Eight self-report questionnaires exploring biopsychosocial factors were administered. RESULTS: The current study showed an impaired sexuality in breast cancer patients compared to controls. Breast cancer women under hormonal treatment were characterized by diminished or absent sexual activity (chi2 = 36.16; p < 0.001), lower level of sexual functioning in all areas except for pain (F(1,180) = 8.1; p < 0.01), higher sexual (F(1,180) = 10.08; p < 0.001) and psychological distress (F(1,180) = 6.23; p < 0.05), higher scores in Difficulties in Identifying Feelings (F(1,180) = 7.31; p < 0.01) and Externally Oriented Thinking (F(1,180) = 6.64; p < 0.05), higher level of negative emotions related to sexuality (F(1,180) = 11.13; p < 0.001), and more rigid cognition towards peculiar aspects of sexuality, such as Failure Disengagement Thoughts (F(1,180) = 22.01; p < 0.001) and Age related Beliefs (F(1,180) = 5.7; p < 0.05). CONCLUSIONS: Health care providers do not usually assess those issues in their routine practice, so that sexuality remains an unmet need with remarkable effects on general health and quality of life.

Questionnaire of Cognitive Schema Activation in Sexual Context: translation and psychometric properties of the Italian version.

The Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC) is a validated and widespread used measure to assess the self-schemas elicited during sexual negative events in both men and women. The current study aimed to test the psychometric characteristics of the Italian version of the QCSASC in both heterosexual men and women. After linguistic translation, the psychometric properties (internal consistency, construct and discriminant validity) were evaluated in 1038 participants (435 men and 603 women, 767 healthy and 271 clinicals complaining of sexual problems). Confirmatory factor analyses showed a not satisfactory fit of the original factor structure of the QCSASC versions. Principal component analyses were performed highlighting two new factorial structures, further validated with CFAs ("Helpless" and "Unlovable"). Cronbach's alpha, composite reliability and average variance extracted were used as internal consistency measures. Moreover, the QCSASC showed a strong association with emotional response and sexual functioning, being able to differentiate between sexually clinical and control group. Current findings support the validity and the internal consistency of the QCSASC Italian version and allows to assess dysfunctional cognitive schemas activated when facing sexual problematic situations for both clinical and research purposes.