Perfectionism, Worry, and Cognitive Distraction’s Role in Sexual Distress and Pleasure: Insights from a Transdiagnostic Framework Using Cross-Sectional Data

2026/07/21 by Patrícia M. Pascoal, Rui Ferreira Carvalho, Rui Ferreira-Carvalho +3
Medicine · Psychology · #Sexual function and dysfunction studies #Perfectionism, Procrastination, Anxiety Studies #Semiotics and Cultural Interpretation

paper · pdf · doi:10.1080/0092623x.2026.2694401

Abstract

We aimed to explore the associations between perfectionism, sexual distress, and sexual pleasure, using worry and cognitive distraction as serial mediators. Grounded in dimensional and transdiagnostic frameworks of emotional problems, as well as cognitive models of perfectionism and sexual function, we tested a theoretically driven mediation model in a large online community sample (N = 902; Mage = 32.89, SD = 11.21). Controlling for gender identity and sexual orientation, results showed that perfectionistic evaluative concerns were indirectly associated with greater sexual distress through sequential pathways involving worry and cognitive distraction related to body appearance and performance. Smaller indirect effects were also observed for sexual pleasure. Overall, findings highlight the role of maladaptive cognitive processes in linking perfectionism to sexual outcomes, supporting transdiagnostic accounts of sexual distress and pleasure, and underscoring the relevance of targeting transdiagnostic cognitive mechanisms in future clinical interventions.

Citations

• The gender similarities hypothesis.
• Commentary: Mediation Analysis, Causal Process, and Cross-Sectional Data
• Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods
• Bias in Cross-Sectional Analyses of Longitudinal Mediation: Partial and Complete Mediation Under an Autoregressive Model
• Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence.
• The Relationship Between Perfectionism and Psychopathology: A Meta‐Analysis
• Transdiagnostic approaches to mental health problems: Current status and future directions.
• Cognitive Distraction and Women's Sexual Functioning

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• The Role of Emotion Regulation Strategies for Sexual Function and Mental Health: A Cluster Analytical Approach
• Self‐objectification and sexual dysfunction among women: Testing and extending objectification theory