2 - (IOP 36) Investigating Sexual Dysfunctions from a Hitop Perspective: Associations with Depression, Anxiety, and Mindfulness in Polish Women

Traditional diagnostic nosologies often struggle to capture the nuanced overlap and comorbidity among internalizing disorders, such as depression and anxiety. The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged as a dimensional alternative to categorical systems, aiming to classify psychopathology based on shared symptom dimensions rather than strict diagnostic boundaries. While HiTOP places sexual dysfunctions within the internalizing spectrum, little research has specifically examined how sexual problems in women might align with or diverge from internalizing constructs—especially in cultural contexts where female sexual health is less openly discussed. A sample of 224 Polish women aged 18–61 completed an anonymous online survey. Validated instruments were employed: the Female Sexual Function Index (FSFI) to assess sexual problems, the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) for depressive and anxiety symptoms, and the Five Facet Mindfulness Questionnaire (FFMQ) to measure dispositional mindfulness. Confirmatory Factor Analysis (CFA) was conducted to compare multiple model structures. One model placed FSFI, PHQ-9, and GAD-7 as separate lower-order factors under a single higher-order internalizing factor. In contrast, alternative models combined PHQ-9 and GAD-7 into a unified “distress” subfactor and then examined FSFI as a distinct factor. Analyses revealed poor fit for any models that included FSFI within the higher-order internalizing-distress factor (e.g., CFI < 0.75, RMSEA > 0.13), whereas the model comprising solely anxiety and depressive symptoms under the higher-order internalizing factor achieved acceptable fit indices (CFI = 0.925, RMSEA = 0.077). Correlational analyses revealed a robust positive relationship between depressive and anxiety symptoms. Higher levels of sexual dysfunction were weakly negatively associated with depression and showed no significant association with anxiety. In contrast, higher trait mindfulness was significantly associated with lower depression (r = –0.487, p < 0.01) and lower anxiety (r = –0.474, p < 0.01), while its correlation with FSFI was non-significant. These results indicate that within the HiTOP model, depressive and anxiety symptoms merge into a unified internalizing-distress factor, whereas female sexual dysfunction appears to be an independent construct in this Polish female sample. The weak associations between FSFI and emotional symptoms—and the absence of a significant relationship between mindfulness and sexual functioning—indicate that cultural factors and the multifaceted nature of female sexuality might limit the applicability of a unified internalizing model to sexual dysfunction. Clinically, these results imply that interventions effective for depressive and anxiety disorders (e.g., mindfulness-based therapies) may not adequately address sexual dysfunction, underscoring the need for targeted treatment approaches and further research into alternative or culturally adapted models for female sexual dysfunction.