2 - (OP30) Cognitive Strategies and Beliefs About Sex in Relation to Sexual Well-being of Female Medical Students in Russia and Malaysia

Sexual dysfunctions are common among young women, yet cognitive mechanisms underlying sexual functioning remain insufficiently explored in culturally diverse student populations. This study examined how cognitive strategies and beliefs relate to sexual functioning among female medical students in Russia and Malaysia, addressing a cross-cultural gap in the research. Participants were 646 female medical students aged 18–25 (Russia: n=368; Malaysia: n=268). Online surveys included sociodemographics, Cognitive Emotion Regulation Questionnaire, Sexual Dysfunctional Beliefs Questionnaire, Sexual Expectations Questionnaire, and Female Sexual Function Index. FSFI scores were analyzed only for sexually active participants (Russia: n=143; Malaysia: n=25).
Most scales deviated from normality (Shapiro–Wilk, p< 0.05). Spearman correlations showed FSFI scores positively related to adaptive CERQ strategies in the Russian sample: Refocus on Planning (r=0.318, p=0.003), Positive Reappraisal (r=0.248, p< 0.001), and Putting into Perspective (r=0.232, p=0.005), while no significant correlations were found in the Malaysian sample. FSFI scores were negatively associated with SDBQ in both samples (Russia: r=-0.371, p< 0.001; Malaysia: r=-0.285, p< 0.001). In Russia, FSFI correlated negatively with Denying Affection Primacy (r=-0.343, p< 0.001), Sexual Conservatism (r=-0.242, p=0.004), and Sexual Desire/Pleasure as Sin (r=-0.238, p< 0.001). In Malaysia, Denying Affection Primacy correlated negatively with FSFI (r=-0.540, p=0.005) and subscales of Arousal (r=-0.529, p=0.008), Desire (r=-0.452, p=0.023), and Lubrication (r=-0.492, p=0.012); Body Image concerns correlated with lower Satisfaction (r=-0.410, p=0.04) and Lubrication (r=-0.479, p=0.015). Sexual Expectations correlated moderately with FSFI in both samples (r≈0.50, p< 0.005).
In multiple regression analyses, Denying Affection Primacy (β=-0.479, p< 0.001) and Sexual Desire/Pleasure as Sin (β=-0.278, p< 0.001) independently predicted lower FSFI, together explaining 34.8% of variance in the Russian sample. In the Malaysian sample, Denying Affection Primacy (β=-0.562, p=0.003) and Sexual Desire/Pleasure as Sin (β=-0.373, p=0.034) independently predicted lower FSFI, explaining 40.6% of variance. Mann–Whitney U test demonstrated significant differences between the Russian and Malaysian samples across all SDBQ domains (p < 0.001).
These findings indicate that dysfunctional sexual beliefs are associated with sexual functioning and vary across cultural contexts, supporting culturally sensitive sexual education and CBT interventions. Limitations include a not yet validated Russian version of SDBQ, a non-validated Expectations Questionnaire, and a relatively small number of FSFI responses in the Malaysian sample.