Gender Differences in Preoperative Anxiety and the Association with Early Maladaptive Schemas: A Cross-Sectional Correlational Study

Background: Preoperative anxiety is a common and clinically significant response among surgical patients, with prevalence estimates ranging from 30% to over 80% depending on measurement method and surgical context. Early maladaptive schemas (EMSs)—deeply rooted, negative cognitive patterns formed in early life—have been theorized to amplify anxiety vulnerability. This study aimed to examine whether EMSs independently predict preoperative anxiety in a surgical population and to explore the role of demographic factors. Methods: A descriptive cross-sectional correlational study was conducted with 310 patients scheduled for elective surgery. Data were collected using a sociodemographic questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and the Young Schema Questionnaire-Short Form, Second Edition (YSQ-S2). Internal consistency of both instruments was computed for this sample. Analyses included Pearson’s correlations and multiple regression. Results: Participants reported preoperative anxiety scores near the clinically meaningful threshold (M = 11.06, SD = 3.80). Small but statistically significant negative bivariate correlations were observed between APAIS scores and several EMS subscales (rs = −0.12 to −0.17). However, in multiple regression analysis, none of the EMS subscales was an independent predictor of preoperative anxiety (all ps > 0.18). Gender was the only significant independent predictor, with females reporting higher anxiety than males (B = 1.27, p = 0.012). The overall model explained 5.6% of variance (R2 = 0.06). Conclusion: This study did not support the hypothesis that EMSs independently predict preoperative anxiety, representing a null result with respect to EMS prediction. The primary finding was a significant gender difference, with females reporting higher preoperative anxiety. Clinicians should prioritize gender-sensitive preoperative screening. Future research should explore potential moderating factors and use prospective, multicenter designs.