Predicting Sexual Distress Based on Self-compassion in Women with a History of Mastectomy: Investigation of the Mediating Role of Body Image and Difficulties in Emotion Regulation

Background: The prevalence of sexual distress in women with a history of breast surgery is a critical issue that warrants investigation. Objectives: This study aimed to predict sexual distress in women with a history of breast surgery based on their self-compassion, considering the mediating roles of body image and emotion regulation abilities. Methods: This correlational descriptive study was conducted in 2022 - 2023. The participants comprised 160 patients with a history of breast surgery from Hazrat Rasool Akram, Bazarganan, and Tarbiat Modares hospitals, and Sepid Psychotherapy Clinic in Tehran. A purposive sampling method was employed. Questionnaires were distributed and completed both in-person and online. The instruments used included the Female Sexual Distress Scale-Revised (FSDS-R), Self-Compassion Scale (SCS), Difficulties in Emotion Regulation Scale (DERS), and Body Image Scale (BIS). Data were analyzed using Pearson correlation coefficients and structural equation modeling in SPSS 25 and R software. Results: The research results demonstrated satisfactory model fit. A positive and significant relationship was found between self-compassion and sexual distress, mediated by body image, in participants with a negative history of breast surgery (P < 0.01). Additionally, difficulties in emotion regulation significantly and negatively mediated the relationship between self-compassion and sexual distress (P < 0.01). Conclusions: The findings suggest that self-compassion and difficulties in emotion regulation, with the mediating role of body image, can predict sexual distress in women post-mastectomy. Self-compassion may shield against the impacts of mastectomy by fostering an empathetic and accepting view of oneself. This perspective helps patients adapt more easily to appearance changes, experience fewer emotional difficulties, and endure less sexual distress. Thus, to mitigate sexual problems, psychotherapists are encouraged to employ approaches that emphasize self-compassion, such as acceptance and commitment therapy.