Enter your email address
Submit
Write your message
Volume 18, Issue 4 (Iranian Journal of Breast Diseases 2026)
ijbd 2026, 18(4): 57-72 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Jahanmehr S, Majidi A. Predicting Sexual Self-Esteem Based on Sexual Anxiety Mediated by Alexithymia in Women with Breast Cancer. ijbd 2026; 18 (4) :57-72
URL: http://ijbd.ir/article-1-1169-en.html
URL: http://ijbd.ir/article-1-1169-en.html
1- Department of Clinical and Health Psychology, Islamic Azad University, Arak, Iran
2- Faculty of Humanities, Sayyed Jamaluddin Asadabadi University, Asadabad, Hamadan, Iran ,Abed.majidi@sjau.ac.ir
2- Faculty of Humanities, Sayyed Jamaluddin Asadabadi University, Asadabad, Hamadan, Iran ,
Abstract: (321 Views)
Introduction: Breast cancer, one of the most common cancers among women worldwide, has profound effects on the physical and mental health of individuals. This study aimed to investigate the impact of sexual anxiety on sexual self-esteem in women with breast cancer by considering the mediating role of alexithymia.
Methods: This study used a correlational and structural equation modeling, and its statistical population included all women with breast cancer in Arak, Iran, in 2024. A total of 169 women with breast cancer were selected based on the Cochran formula using purposive sampling. Data were collected using questionnaires on women's sexual self-esteem, sexual anxiety, and alexithymia. Data were analyzed using Pearson's correlation test and path analysis in SPSS (version 26) and LISREL (version 8.8).
Results: The results showed a significant inverse correlation between sexual self-esteem and sexual anxiety (r = -0.61) and alexithymia (r = -0.28) (P < 0.01). Also, the regression model showed that sexual anxiety and alexithymia explain 64% of the variance in sexual self-esteem (R2 = 0.64; P < 0.05).
Conclusion: Considering the effect of alexithymia on sexual anxiety and the prediction of sexual self-esteem in women with breast cancer, it is suggested that necessary training be provided to raise awareness among women to recognize their emotions.
Methods: This study used a correlational and structural equation modeling, and its statistical population included all women with breast cancer in Arak, Iran, in 2024. A total of 169 women with breast cancer were selected based on the Cochran formula using purposive sampling. Data were collected using questionnaires on women's sexual self-esteem, sexual anxiety, and alexithymia. Data were analyzed using Pearson's correlation test and path analysis in SPSS (version 26) and LISREL (version 8.8).
Results: The results showed a significant inverse correlation between sexual self-esteem and sexual anxiety (r = -0.61) and alexithymia (r = -0.28) (P < 0.01). Also, the regression model showed that sexual anxiety and alexithymia explain 64% of the variance in sexual self-esteem (R2 = 0.64; P < 0.05).
Conclusion: Considering the effect of alexithymia on sexual anxiety and the prediction of sexual self-esteem in women with breast cancer, it is suggested that necessary training be provided to raise awareness among women to recognize their emotions.
Type of Study: Research |
Subject:
Nutrition, psychology, sport
Received: 2025/02/1 | Accepted: 2025/11/27 | Published: 2026/01/14
Received: 2025/02/1 | Accepted: 2025/11/27 | Published: 2026/01/14
References
1. Zahedi A, Rafiemanesh H, Enayatrad M, Ghoncheh M. S Incidence, Trends and Epidemiology of Cancers in North West of Iran. Asian Pacific Journal of Cancer Prevention, 2015; 16(16):7189-93. [Persian]. doi:10.7314/APJCP.2015.16.16.7189 [DOI:10.7314/APJCP.2015.16.16.7189] [PMID]
2. Inotai A, Ágh T, Maris R, Erdősi D, Kovács S, Kaló Z, et al. Systematic review of real-world studies evaluating the impact of medication non-adherence to endocrine therapies on hard clinical endpoints in patients with nonmetastatic breast cancer, 2021; 100: 102264. doi:10.1016/j.ctrv.2021.102264 [DOI:10.1016/j.ctrv.2021.102264] [PMID]
3. Keshtpour Amlashi Z, Bazrafshan M, Shariat Panahi S, Javadi M, aghababaei Z, Tapak L, et al . Assessment of quality of life and its associated factors in nonmetastatic breast cancer patients. ijbd 2024; 17(1):102-15 [Persian]. doi: 10.61186/ijbd.17.1.102 [DOI:10.61186/ijbd.17.1.102]
4. Hosseini SM. The Effect of Social Capital on Pain in patients with breast cancer. ijbd, 2014;7(2): 23-35. [Persian].
5. Kim J, Harper A, McCormack V, Sung H, Houssami N, Morgan E. Global Patterns and Trends in breast cancer incidence and mortality 185 countries. Nat Med, 2025; 31:1154-62. doi: 10.1038/s41591-025-03502-3 [DOI:10.1038/s41591-025-03502-3] [PMID]
6. Ahmadian S, Rasouli A. Stress Management Training on Reducing Anxiety and Promoting Happiness and Sexual Integrity in Women with Breast Cancer. IJNR, 2018; 13(1):18-25. [Persian]. doi: 10.21859/ijnr-13013 [DOI:10.21859/ijnr-13013]
7. Bovbjerg DH, Keefe FJ, Soo M, Manculich J, Van Denburg A, Zuley ML, et al. Persistent breast pain in post -surgery breast cancer survivors and women with no history of breast surgery or cancer: associations with pain catastrophizing, perceived breast cancer risk, breast cancer worry, and emotional distress. Acta Oncologica, 2019; 58(5): 763 -8. doi:10.1080/0284186X.2019.1574023 [DOI:10.1080/0284186X.2019.1574023] [PMID] []
8. Dinapoli L, Colloca G, Di Capua B, Valentini V. Psychological Aspects to Consider in Breast Cancer Diagnosis and Treatment. Current Oncology Reports, 2021;23(3):38. doi:10.1007/s11912-021-01049-3 [DOI:10.1007/s11912-021-01049-3] [PMID] []
9. Lee H, Yoon HG. Body change stress, sexual function, and marital intimacy in korean patients with breast cancer receiving adjuvant chemotherapy: A cross -sectional treatment. CoupCouple and Family Psychology: Research and Practice, 2022; 11(1):15-32.
10. Zolfali Pormaleki S, Smkhani Akbarinejhad H. Investigating the effectiveness of emotion- focused couples therapy on marital burnout and sexual intimacy in couples with wives with breast cancer. IJBD, 2024; 16(4):82-97. [Persian]. [DOI:10.61186/ijbd.16.4.82]
11. Hamzehrad M, Niknam M, Amani Kelarijani F. Sexual Function and Marital Intimacy in Mastectomized Women with Breast Cancer: Mediating Role of Body Image Concern. JSSU, 2024; 32(4):7724-38. [Persian]. [DOI:10.18502/ssu.v32i4.15836]
12. Markopoulos C, Traroucha AK, Kouskos E, Mantas D, Antonopoulou Z, Karvelis S. Impact of breast cancer surgery on the self-esteem and sexual life of female patients. Journal of International Medical Research, 2009, 37: 182-8. doi:10.1177/147323000903700122. [DOI:10.1177/147323000903700122] [PMID]
13. Weber E, Hopwool CJ, Denissen JJA, Bleidorn W. Self-Esteem and Sexual Experiences. Personality and Social Psychology Bulletin, 2024;00(0):1-20. doi:10.1177/01461672241257355. [DOI:10.1177/01461672241257355] [PMID] []
14. Marsh S, Borges VF, Coons HL, Afghahi A. Sexual health after a breast cancer diagnosis in young women: clinical implications for patients and providers. Breast Cancer Rese Treat, 2020; 184(3): 655-63. doi:10.1007/s10549-020-05880-3. [DOI:10.1007/s10549-020-05880-3] [PMID]
15. Breitbart WS, Butow PN, Jacobsen PB, Lam WW, Lazenby M, & Loscalzo MJ. Psycho-oncology. Fourth Edition. New York: Oxforod university press. 2021. [DOI:10.1093/med/9780190097653.001.0001]
16. Kazemzadeh J, Rabeipour S, Rajabzadeh H. Investigating the status of sexual self-esteem and its related factors in breast cancer survivors. Nursing and Midwifery Journal, 2022; 20(1): 85-93. [Persian]. doi: 10.52547/unmf.20.1.85 [DOI:10.52547/unmf.20.1.85]
17. Brassard A, Dupuy E, Bergeron S, Shaver PS. Attachment insecurities and women's sexual function and satisfaction: the mediating roles of sexual self-esteem, sexual anxiety, and sexual assertiveness. J Sex Res, 2015; 52(1):110-9. doi:10.1080/00224499.2013.838744. [DOI:10.1080/00224499.2013.838744] [PMID]
18. Barlow DH. Causes of sexual dysfunction: the role of anxiety and cognitive interference. J Consult Clin Psychol, 1986; 54(2):140-8. doi:10.1037/0022-006X.54.2.140 [DOI:10.1037/0022-006X.54.2.140] [PMID]
19. Rowland DL, Kirana PS. A theoretical model for sexual performance anxiety (SPA) and a clinical approach for its remediation (SPA-R). Sexual Medicine Reviews, 2025,13:184-201. doi:10.1093/sxmrev/qeaf012. [DOI:10.1093/sxmrev/qeaf012] [PMID]
20. Sadoc BJ, Sadoc VA, Ruiz P. 2015. Summary of Psychiatry (Behavioral Sciences/Clinical Psychiatry). Translated by Rezaei F & et al. Volume 1. Twelfth Edition. Eleventh Edition. Arjomand Publications. Tehran. 2021. [Persian].
21. Samadi S, Elbeigi R. Predicting marital satisfaction based on time perspective, inferiority complex, and sexual anxiety in women with uterine diseases. Journal of Women and Family Studies, 2023; 16 (61):89-108. [Persian]. doi: 10.30495/jwsf.2022.1961707.171.
22. Golkar Ghamsari R. Determining the predictive value of insecure attachment styles (anxious and avoidant) on women's sexual performance and satisfaction with regard to the mediating role of sexual self-esteem, sexual anxiety, and sexual assertiveness. Master's thesis in clinical psychology-family therapy. University of Science and Culture. 2015. [Persian].
23. Heidarirad F, Yarahmadi M, Heidarirad H, Shafiei M. Evaluation of Prevalence of Depression and Its Related Factors among Women with Breast Cancer Referred to the Radiotherapy Center of Tawhid Hospital of Sanandaj, Iran in 2017. SJNMP, 2018; 4 (2):39-49. [Persian].
24. Esmaili S. Determining the role of types of domestic violence in eating disorders with the mediating role of alexithymia in women. Master's thesis, General Psychology. University of Zanjan. 2022. [Persian].
25. Preece D, Becerra R, Robinson K, Dandy J, & Allan A. The psychometric assessment of alexithymia: Development and validation of the Perth Alexithymia Questionnaire. Personality and Individual Differences, 2018; 132: 32-44. doi.org/10.1016/j.paid.2018.05.011 [DOI:10.1016/j.paid.2018.05.011]
26. Narimani M, Jani S, Rezaei R. The role of alexithymia and mindfulness in predicting depression and anxiety in women with cancer. Shenakht Journal of Psychology and Psychiatry, 2020; 7(1):78-89. [Persian]. doi: 10.52547/shenakht.7.1.78 [DOI:10.52547/shenakht.7.1.78]
27. Motamedi M, Arefi M. Investigating Alexithymia among Women with and Without Thyroid Cancer in Isfahan. International Journal of Body, Mind and Culture, 2018;5(2): 104-11. [Persian]. doi.org/10.22122/ijbmc.v5i2.121
28. SeyedTabaee SR, Rahmatinejad P, Mohammadi SD, Mohammadi SD, Akbari V. Psychological Defense Mechanisms and Alexithymia in Cancer Patients. AUMJ, 2018; 7 (2): 141-50. [Persian]. doi: 10.29252/aums.7.2.141 [DOI:10.29252/aums.7.2.141]
29. Gutiérrez Hermoso L, Velasco Furlong L, Sánchez-Román S and Salas Costumero L. The Importance of Alexithymia in Post-surgery. Differences on Body Image and Psychological Adjustment in Breast Cancer Patients. Front. Psychol, 2020; 11:604004. doi:10.3389/fpsgy.2020.604004. [DOI:10.3389/fpsyg.2020.604004] [PMID] []
30. Manna G, Foddai E, Di Maggio MG, Pace F, Colucci G, Gebbia N, Russ A. Emotional expression and coping style in female breast cancer. Annals of Oncology, 2007; 18(6):77-80. doi:10.1093/annonc/mdm231. [DOI:10.1093/annonc/mdm231] [PMID]
31. Yaraei N. Comparative study of the effectiveness of group sexual couple therapy (CBPI) and medical treatment of sexual problems on sexual satisfaction and marital satisfaction of women recovered from breast cancer. Doctoral thesis in counseling and guidance. Kharazmi University. 2018. [Persian].
32. Zeanah PD, & Schwarz JC. Reliability and validity of the sexual self-esteem inventory for women. Assessment, 1996;3(1):1-15. doi:10.1177/107319119600300101 [DOI:10.1177/107319119600300101]
33. Farokhi S, Shareh H. Psychometric Properties of the Persian Version of the Sexual Self-Esteem Index for Woman-Short Form. IJPCP, 2014;20(3):252-63. [Persian].
34. Davis D, Shaver PR, Widaman KF, Vernon KL, Folette WC, Beitz K. I can't get no satisfaction: Insecure attachment, inhibited sexual communication, and sexual dissatisfaction. Pers Relat, 2006; 13:465-83. doi:10.1111/j.1475-6811.2006.00130.x [DOI:10.1111/j.1475-6811.2006.00130.x]
35. Khodaparast H. Predicting marital quality based on sexual dysfunction beliefs, sexual guilt, and sexual anxiety in married women in Chalus city. Allameh Muhaddes Nouri University, Faculty of Economics and Administrative Sciences. 2021. [Persian].
36. Gheisari S, Karimian N. A causal model based on relationship satisfaction, sexual satisfaction, marital quality, anxiety of sexual relationship, sexual assertiveness, and the frequency of intercourse in female maried students of Bandarabbas. Counseling Culture and Psycotherapy, 2013;4(16):85-106. [Persian].
37. Bagby RM, Parker JDA, Taylor GJ. The twenty-item Toronto alexithymia scale: I item selection and cross-validation of the factor structure. J Psychosom Res, 1994; 38: 23-32. doi: 10.1016/0022-3999(94)90005-1. [DOI:10.1016/0022-3999(94)90005-1] [PMID]
38. Bagby M, Parker J, Taylor J, Onno K, Mortezaei A. Development and psychometric evaluation of informant form of the 20_item Toronto alexithymia scale. J Psychosom Res, 2021; 141,110329. doi: 10.1016/j.jpsychores.2020.110329. [DOI:10.1016/j.jpsychores.2020.110329] [PMID]
39. Besharat MA. Toronto Emotional Aphasia Scale: Questionnaire, Method of Administration and Scoring (Persian Version). Developmental Psychology: Iranian Psychologists, 2013; 10(37): 90-2. [Persian].
40. Meyers Lawrence S, Gamsett G & Garino AJ. Applied Multivariate Research (Design and Interpretation). Translated by Pasha Sharifi H et al., 6th edition. Tehran: Roshd. 2020. [Persian].
41. Roshan Chesli S, Bostani Khalesi Z, Shirzad Chenari S. The role of sexual self-esteem, sexual desire, and sexual assertiveness in the female sexual function. Psicologia: Reflexão e Crítica, 2024; 37(21): 2-8. [Persian]. doi:10.1186/s41155-024-00303-4. [DOI:10.1186/s41155-024-00303-4] [PMID] []
42. Snani H, Snani H, Tannoubi A, Chortane OG, Azaiez F. Balance and deep connections: the impact of physical activity on body and sexual self-esteem, psychological distress, and marital satisfaction among adults. Front Sports Act Living, 2024; 6:1343951. doi: 10.3389/fspor.2024.1343951 [DOI:10.3389/fspor.2024.1343951] [PMID] []
43. Alacacioglu A, Ulger E, Varol U, Yildiz I, Salman T, Bayoglu V, et al. Depression, Anxiety and Sexual Satisfaction in Breast Cancer patients and their partners-Izmir Oncology Group study. Asian Pac J Cancer Prev, 2014; 15(24):10631-6. doi:10.7314/APJCP.2014.15.24.10631 [DOI:10.7314/APJCP.2014.15.24.10631] [PMID]
44. Mowlaie M, Jani S, Hajloo, N. Role of alexithymia in predicting psychological symptoms in patients with breast and prostate cancer. JQUMS, 2015;19(5):52-60. [Persian].
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
