Psychological and Sociocultural Correlates of Genito-Pelvic Pain/Penetration Disorder in Iranian Women: A Comparative Study of Sexual Self-Schema and Temperament

Background: Genito-Pelvic Pain/Penetration Disorder (GPPPD) is a distressing sexual dysfunction often shaped by psychological and sociocultural factors. Although sexual self-schema and temperament traits may contribute to GPPPD, little is known about their role in non-Western contexts such as Iran. This study aimed to compare sexual self-schema, affective-emotional temperament, and selected sociocultural factors between Iranian women with GPPPD and healthy controls. Methods: This case–control study recruited married women aged 18– 45 years from a referral fertility and sexual health clinical setting in Tehran, Iran. Cases were clinically diagnosed with GPPPD, and controls were randomly selected from eligible women attending the same settings. Participants completed validated Persian versions of the Sexual Self-Schema Questionnaire and Affective and Emotional Composite Temperament Scale. Demographic and psychosocial data, including self-reported religiosity and employment characteristics, were collected. Multivariable logistic regression identified factors associated with GPPPD. Results: The final sample included 75 women: 38 with GPPPD and 37 controls. Women with GPPPD had higher shy–cautious schema scores than controls (19.5 ± 4.2 vs 17.3 ± 4.2; p = 0.035). Emotional sensitivity was also higher in women with GPPPD (35.7 ± 5.9 vs 33.6 ± 7.9) and independently associated with GPPPD (OR = 1.14, 95% CI: 1.02– 1.27). Obsessive temperament was positively associated with GPPPD (OR = 2.54, 95% CI: 1.09– 5.89), while euthymic temperament was negatively associated (OR = 0.47, 95% CI: 0.25– 0.90). Higher self-reported religiosity increased the odds of GPPPD (OR = 5.89, 95% CI: 1.47– 23.69), whereas spousal freelance employment reduced the odds (OR = 0.20, 95% CI: 0.04– 0.98). Conclusion: These findings suggest that GPPPD in Iranian women may be better understood within an integrated psychological and sociocultural framework incorporating cognitive schemas, emotional sensitivity, temperament traits, and religious beliefs, supporting culturally sensitive psychological assessment and intervention. Plain Language Summary: Pain or difficulty during sexual intercourse is a common but often misunderstood problem for many women. This study looked at how personality traits and beliefs about sexuality might be linked to a condition called Genito-Pelvic Pain/Penetration Disorder (GPPPD) among married women in Iran. We compared 38 women diagnosed with GPPPD to 37 women without sexual problems. Each participant completed questionnaires that measured emotional traits and sexual self-image. Women with GPPPD were more likely to describe themselves as shy or cautious in sexual situations, more emotionally sensitive, and more likely to have obsessive personality traits. They also reported higher levels of religiosity. In contrast, women with more positive and stable moods were less likely to have GPPPD. These findings suggest that psychological and cultural factors—such as beliefs about sexuality, emotional temperament, and religious values—play important roles in this condition. Understanding these links can help healthcare professionals design more effective, culturally sensitive treatments for women experiencing sexual pain or fear of penetration.