CAMBRIDGE, MASS. – Certain cognitive factors are significant predictors of pain intensity and sexual impairment in women with vulvar vestibulitis syndrome, Geneviève Desrochers said in a poster presentation at the annual meeting of the Society for Sex Therapy and Research.
The findings of her study suggest that targeted cognitive-behavioral therapy might help mediate the severe pain associated with the chronic, persistent inflammatory condition.
Hierarchic regression analysis of data obtained from 67 women with vulvar vestibulitis syndrome showed that lower levels of pain self-efficacy (confidence in one's ability to perform a range of tasks despite pain) and higher levels of pain catastrophization (a negative cognitive response to, or anticipation of, pain) were both associated with more intense pain during intercourse, reported Ms. Desrochers, a Ph.D. candidate in psychology at the University of Quebec, Montreal.
All of the women enrolled in the study had a prior diagnosis of vulvar vestibulitis syndrome. As part of the investigation, the women underwent a gynecologic examination and completed a structured interview and standarized questionnaires focusing on pain self-efficacy, pain catastrophization, anxiety, and pain during intercourse.
The regression analysis also showed that catastrophization remained a strong predictor of the severity of pain symptoms after controlling for state-trait anxiety and self-efficacy. “Higher levels of catastrophization were still related to more severe pain,” Ms. Desrochers wrote. Of the variables, only self-efficacy was a good predictor of global sexual functioning after controlling for pain intensity and state-trait anxiety, with lower self-efficacy predicting increased sexual impairment.
“We did find that [lower levels of] state-trait anxiety mediated the role of catastrophizing in pain intensity,” Ms. Desrochers noted.
The findings of the study are consistent with a cognitive-behavioral model of chronic pain, “and they may be important components to consider for sex therapy with this population of women,” she suggested.
In a separate poster discussion at the meeting, which was also sponsored by the American College of Obstetricians and Gynecologists, Mélanie Jodoin, also a Ph.D. candidate in psychology at the university, presented additional data from the same investigation linking dyadic adjustment to psychological distress and sexual impairment in women with vulvar vestibulitis syndrome.
“The results of hierarchic regression analyses revealed that higher levels of dyadic adjustment were associated with better sexual functioning and lower psychological distress,” she reported.
The analyses also linked higher levels of state anxiety to increased dysfunctional dyadic adjustment, even after controlling for psychological distress and intensity of pain, suggesting that dyadic adjustment is a “powerful predictor of sexual impairment in women with vulvar vestibulitis syndrome, despite their pain intensity,” Ms. Jodoin wrote.