The Efficacy of Compassion-Focused Therapy on Imposter Phenomenon, Obsessive-Compulsive Disorder, and Alexithymia in Women with Sexual Dysfunction

Document Type : Research Article

Authors

1 Department of Psychology, Faculty of Humanities, Payame Noor University, Nowshahr Branch, Nowshahr, Iran

2 Department of Psychology, Faculty of Humanities, Islamic Azad University, Tabriz Branch, Tabriz, Iran

3 Department of Clinical Psychology, Department of Clinical Psychology, Faculty of Humanities, Islamic Azad University, Ardabil Branch, Ardabil, Iran

4 Department of Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran

Abstract

Background: Sexual functioning refers to an individual’s capacity to experience healthy and satisfying sexual responses across physical, psychological, and social domains. The present study focused on identifying the effectiveness of Compassion-Focused Therapy (CFT) on the reduction of the impersonator actions, Obsessive-Compulsive Disorder (OCD), and alexithymia in female adults with sexual dysfunction.
Methods: This was a quasi-experimental study with a pre-test/ post-test design involving a control group. The study sample included women with sexual dysfunction who were referred to healthcare centers in Ardabil Province, Iran, in 2024. Out of the list of patients, 36 women were chosen based on their medical history and the homogeneity of their medical condition. Then, the study participants were divided into the experimental group (n=18) and the control group (n=18). The balance between groups was provided based on the main clinical features. The experimental group attended eight 90-minute CFT sessions, and the control group did not receive intervention. The study participants were assessed using the Female Sexual Function Index (FSFI), Imposter Syndrome Scale (ISS), Obsessive-Compulsive Disorder Questionnaire (OCDQ), and Toronto Alexithymia Scale (TAS). The T-tests and ANCOVA analyses were performed in SPSS version 27.
Results: The results demonstrated that CFT significantly decreases the imposter phenomenon (CFT group: M=57.89, SD=4.05; control group: M=61.66, SD=2.84, P<0.001), OCD (CFT group: M=105.12, SD=5.45; control group: M=110.56, SD=4.86, P<0.001), difficulty of identifying feelings (CFT group: M=22.72, SD=2.69; control group: M=26.55, SD=1.88, P<0.001), difficulty of describing feelings (CFT group: M=24.06, SD=2.53; control group: M=27.76, SD=1.69, P<0.001), and externally oriented thinking (CFT group: M=19.66, SD=2.37; control group: M=22.43, SD=2.09, P<0.001) in women with sexual dysfunction.
Conclusion: The comparison of the two groups showed that the experimental group experienced greater improvements in these areas than the control group. By enhancing self-compassion and emotional regulation, CFT improves sexual and psychological well-being, with the potential for broader applications in future research.

Highlights

Farzin Bagheri Sheykhangafshe: (Google Scholar)

Keywords

References

  1. Rossi V, Galizia R, Tripodi F, Simonelli C, Porpora MG, Nimbi FM. Endometriosis and sexual functioning: how much do cognitive and psycho-emotional factors matter? Int J Environ Res Public Health. 2022;19(9):5319. doi: 10.3390/ijerph19095319. PubMed PMID: 35564711; PubMed Central PMCID: PMC9100036. ##
  2. Padoa A, McLean L, Morin M, Vandyken C. The Overactive Pelvic Floor (OPF) and Sexual Dysfunction. Part 2: Evaluation and Treatment of Sexual Dysfunction in OPF Patients. Sex Med Rev. 2021;9(1):76-92. doi: 10.1016/j.sxmr.2020.04.002. PubMed PMID: 32631813. ##
  3. Razali NA, Sidi H, Choy CL, Roos NA, Baharudin A, Das S. The Role of Bupropion in the Treatment of Women with Sexual Desire Disorder: A Systematic Review and Meta-Analysis. Curr Neuropharmacol. 2022;20(10):1941-1955. doi: 10.2174/1570159X20666220222145735. PubMed PMID: 35193485; PubMed Central PMCID: PMC9886814. ##
  4. Iftekhar N, Mumby P, Lynn M. Partnering With Patients to Improve a Multidisciplinary Sexual Dysfunction Program: A Survey of Patient Experience at a Single Institution. Cureus. 2025;17(1):e77087. doi: 10.7759/cureus.77087. PubMed PMID: 39801703; PubMed Central PMCID: PMC11724680. ##
  5. Gonçalves WS, Gherman BR, Abdo CH, Coutinho ES, Nardi AE, Appolinario JC. Prevalence of sexual dysfunction in depressive and persistent depressive disorders: a systematic review and meta-analysis. Int J Impot Res. 2023;35(4):340-349. doi: 10.1038/s41443-022-00539-7. PubMed PMID: 35194149. ##
  6. Ashrafi M, Jahangiri N, Jahanian Sadatmahalleh Sh, Mirzaei N, Gharagozloo Hesari N, Rostami F, et al. Does prevalence of sexual dysfunction differ among the most common causes of infertility? A cross-sectional study. BMC Women's Health. 2022;22(1):140. doi: 10.1186/s12905-022-01708-y. PubMed PMID: 35477457; PubMed Central PMCID: PMC9044873. ##
  7. Barach P, Ahmed R, Agarwal G, Olson K, Welch J, Chernoby K, et al. Navigating personal health crises, imposter syndrome, sexual harassment, clinical mistakes, and leadership challenges: lessons for work-life wellness in academic medicine: part 3 of 3. Kans J Med. 2023;16(2):165-171. doi: 10.17161/kjm.vol16.19954. PubMed PMID: 37377621; PubMed Central PMCID: PMC10291980. ##
  8. Sarosi Jr GA, Klingensmith M. Entrustable professional activities, a tool for addressing sex bias and the imposter syndrome? Ann Surg. 2022;275(2):230-231. doi: 10.1097/SLA.0000000000005189. PubMed PMID: 34433185. ##
  9. Forson MA, Hao F, Cheung C. Women’s career and imposter syndrome: moderating effects of female role model and diversity management in the hospitality and tourism sector. International Journal of Contemporary Hospitality Management. 2025;37(3):939-955. doi: 10.1108/IJCHM-04-2024-0512. ##
  10. LaPalme M, Luo P, Cipriano C, Brackett M. Imposter Syndrome Among Pre-service Educators and the Importance of Emotion Regulation. Front Psychol. 2022;13:838575. doi: 10.3389/fpsyg.2022.838575. PubMed PMID: 35846602; PubMed Central PMCID: PMC9280479. ##
  11. Pozza A, Veale D, Marazziti D, Delgadillo J, Albert U, Grassi G, et al. Sexual dysfunction and satisfaction in obsessive compulsive disorder: protocol for a systematic review and meta-analysis. Syst Rev. 2020;9(1):8. doi: 10.1186/s13643-019-1262-7. PubMed PMID: 31918750; PubMed Central PMCID: PMC6953228.
  12. Derby D, Tibi L, Doron G. Sexual dysfunction in relationship obsessive compulsive disorder. Sexual and Relationship Therapy. 2024;39(3):711-724. doi: 10.1080/14681994.2021.2009793. ##
  13. Koolwal A, Agarwal S, Manohar S, Koolwal GD, Gupta A. Obsessive–Compulsive Disorder and Sexuality: A Narrative Review. Journal of Psychosexual Health. 2020;2(1):37-43. doi: 10.1177/2631831819896171. ##
  14. Snaychuk LA, Ferrão YA, Fontenelle LF, Miguel EC, de Mathis MA, Scanavino MD, et al. Co-Occurring Obsessive-Compulsive Disorder and Compulsive Sexual Behavior: Clinical Features and Psychiatric Comorbidities. Arch Sex Behav. 2022;51(8):4111-4123. doi: 10.1007/s10508-022-02412-6. PubMed PMID: 36066680. ##
  15. Berenguer C, Rebôlo C, Costa RM. Interoceptive Awareness, Alexithymia, and Sexual Function. J Sex Marital Ther. 2019;45(8):729-738. doi: 10.1080/0092623X.2019.1610128. PubMed PMID: 31018783. ##
  16. Ledermann K, Zuccarella-Hackl C, Altwegg R, Dörner M, Attanasio V, Guth L, et al. Relationship between erectile dysfunction and alexithymia in male patients with implantable cardioverter defibrillators: a cross-sectional study. Front Psychiatry. 2024;15:1327796. doi: 10.3389/fpsyt.2024.1327796. PubMed PMID: 39524131; PubMed Central PMCID: PMC11543441. ##
  17. Ribeiro C, Pereira H. The Impacts of Alexithymia and Sexual Distress on Sexual Functioning Among Portuguese Women. European Journal of Mental Health. 2023;18(23):1-13. doi: 10.5708/EJMH.18.2023.0002. ##
  18. Sünbül EA, Gökçeimam PŞ, Üstündağ M, Taştekin N, Domaç FM, Güleç H. Evaluation of Alexithymia, Anger and Temperament Features in Insomnia Patients with Sexual Dysfunction. Duzce Medical Journal. 2021;23(2):211-217. doi: 10.18678/dtfd.940955. ##
  19. McLean L, Steindl SR, Bambling M. Compassion-Focused Therapy as an Intervention for Adult Survivors of Sexual Abuse. J Child Sex Abus. 2018;27(2):161-175. doi: 10.1080/10538712.2017.1390718. PubMed PMID: 29131716. ##
  20. Saunders F, Vosper J, Gibson S, Jamieson R, Zelin J, Barter J. Compassion Focused Psychosexual Therapy for Women Who Experience Pain during Sex. OBM Integrative and Complementary Medicine. 2022;7(2):017. doi: 10.21926/obm.icm.2202017. ##
  21. Bagheri-Sheykhangafshe F, Tajbakhsh K, Savabi Niri V, Bourbour Z, Otadi S. The Effectiveness of Compassion-Focused Therapy on Pain Catastrophizing, Sexual Function, and Resilience in Women with Multiple Sclerosis (MS). Int J Behav Sci. 2023;17(3):133-140. doi: 10.30491/IJBS.2023.390694.1932. ##
  22. Vosper J, Irons C, Mackenzie-White K, Saunders F, Lewis R, Gibson S. Introducing compassion-focused psychosexual therapy. Sexual and Relationship Therapy. 2023;38(3):320-352. doi: 10.1080/14681994.2021.1902495. ##
  23. Petrocchi N, Ottaviani C, Cheli S, Matos M, Baldi B, Basran JK, et al. The Impact of Compassion-Focused Therapy on Positive and Negative Mental Health Outcomes: Results of a Series of Meta-Analyses. Clinical Psychology: Science and Practice. 2024;31(2):230-247. doi: 10.1037/cps0000193. ##
  24. Craig C, Hiskey S, Spector A. Compassion-focused therapy: A systematic review of its effectiveness and acceptability in clinical populations. Expert Rev Neurother. 2020;20(4):385-400. doi: 10.1080/14737175.2020.1746184. PubMed PMID: 32196399. ##
  25. Hocken K, Taylor J. Compassion-focused therapy as an intervention for sexual offending. In: Winder B, Blagden N, Hamilton L, Scott S. Forensic Interventions for Therapy and Rehabilitation. London: Routledge; 2021. p. 189-219. ##
  26. Sessions L, Pipkin A, Smith A, Shearn C. Compassion and Gender Diversity: Evaluation of an Online Compassion-Focused Therapy Group in a Gender Service. Psychology and Sexuality. 2023;14(3):528-541. doi: 10.1080/19419899.2023.2181097. ##
  27. Millard LA, Wan MW, Smith DM, Wittkowski A. The effectiveness of compassion focused therapy with clinical populations: A systematic review and meta-analysis. J Affect Disord. 2023;326:168-192. doi: 10.1016/j.jad.2023.01.010. PubMed PMID: 36649790. ##
  28. Isidori AM, Pozza C, Esposito K, Giugliano D, Morano S, Vignozzi L, et al. Outcomes assessment: Development and validation of a 6-item version of the Female Sexual Function Index (FSFI) as a diagnostic tool for female sexual dysfunction. J Sex Med. 2010;7(3):1139-46. doi: 10.1111/j.1743-6109.2009.01635.x. PubMed PMID: 19968774. ##
  29. Dehghani Neyestani H, Atashpour SH, Torkan H. The Impact of Transactional Analysis Group Therapy, Schema Therapy, and Emotion-Focused Therapy on Emotional Regulation in Female College Students Following Romantic Breakups. Women Health Bull. 2025;12(2):119-128. doi: 10.30476/whb.2025.104565.1323. ##
  30. Shehnifayz K, Haghighat Bayan N, Savabi Niri V, Madani Javnqala M, Bagheri Sheykhangafshe F. The Efficacy of Emotion-Focused Couple Therapy on Self-efficacy, Body Image Concerns, and Couple Burnout in Women with Sexual Dysfunction. Journal of Family Relations Studies. 2025;5(4):54-63. doi: 10.22098/jfrs.2024.15277.1194. ##
  31. Clance PR, Imes SA. The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy. 1978;15(3):241-247. doi: 10.1037/h0086006. ##
  32. Bagheri Sheykhangafshe F, Tajbakhsh K, Savabi Niri V, Mikelani N, Eghbali F, Fathi-Ashtiani A. The Effectiveness of Schema Therapy on Self-efficacy, Burnout, and Perfectionism of Employees with Imposter Syndrome. Health Dev J. 2022;11(3):140-148. doi: 10.34172/jhad.92349. ##
  33. Sanavio E. Obsessions and compulsions: the Padua Inventory. Behav Res Ther. 1988;26(2):169–77. doi: 10.1016/0005-7967(88)90116-7. PubMed PMID: 3365207. ##
  34. Nozari Kohneh Shahri G, Mahdavi Mehr A, Savabi Niri V, Bagheri Sheykhangafshe F, Farahani H. Effectiveness of Group Dialectical Behavior Therapy on Self-doubt, Thought Fusion and Depression in Women with Obsessive-compulsive Disorder. Caspian Journal of Health Research. 2025;10(2):101-110. doi: 10.32598/CJHR.10.2.362.3. ##
  35. Bagby RM, Taylor GJ, Parker JD. The twenty-item Toronto Alexithymia Scale—II. Convergent, discriminant, and concurrent validity. J Psychosom Res. 1994;38(1):33-40. doi: 10.1016/0022-3999(94)90006-x. PubMed PMID: 8126688. ##
  36. Khaledinia A, Makvandi B, Asgari P, Pasha R. Comparison of Group Psychotherapy Effectiveness based on Acceptance and Commitment Therapy Matrix with Group Behavioral Activation Therapy on Quality of Life and Alexithymia in Depress Mood Females. Women Health Bull. 2021;8(1):26-36. doi: 10.30476/whb.2021.87951.1082. ##
  37. Gilbert P. An Introduction to Compassion Focused Therapy in Cognitive Behavior Therapy. International Journal of Cognitive Therapy. 2010;3(2):97-112. doi: 10.1521/ijct.2010.3.2.97. ##

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