Cognitive Elements Predict Vulvar Disorder Impact


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, who is a Ph.D. candidate in psychology at the University of Quebec, Montreal.

All study participants 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,” Ms. Desrochers suggested during the meeting, which was also sponsored by the American College of Obstetricians and Gynecologists.

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