| 1. |
- Dewitte, Marieke, et al.
(författare)
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A Network Analysis of the Fear Avoidance Model of Genital Pain
- 2024
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Ingår i: Journal of Sex Research. - : Routledge. - 0022-4499 .- 1559-8519.
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Tidskriftsartikel (refereegranskat)abstract
- Using a novel data-driven network approach, this study aimed to examine the interconnection between the key elements of the Fear-Avoidance Model of female genital pain - sexual arousal, fear-avoidant cognitions, and motivational coping - and its associated factors to predict the intensity and frequency of genital pain across women over time. Network modeling allowed for a comprehensive evaluation of the Fear-Avoidance model while capturing the dynamic features of genital pain. We estimated a cross-sectional and a temporal, contemporaneous, and between-persons network model on convenience-based data of 543 female students (mean age = 23.7 years, SD = 3.6) collected at three time points. Results showed that lubrication, pain catastrophizing, pain avoidance, fear-avoidance beliefs, sexual satisfaction, anxiety, and frequency of coital and non-coital sex predicted pain, with lubrication being the most consistent predictor across estimations. The network of women with recurrent genital pain showed a similar pattern as the network of the total sample, except that pain avoidance and fear-avoidance beliefs rather than pain catastrophizing predicted pain directly, and frequency of coital and non-coital sexual activities played a more prominent role. These results suggest that the main problem of genital pain centers around women not being sufficiently aroused during intercourse and inadequate ways of pain coping, which are critical targets of cognitive-behavioral therapy treatment and should be developed further.
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| 2. |
- Ekdahl, Johanna, 1978-, et al.
(författare)
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Vulvovaginal pain from a fear-avoidance perspective : a prospective study among female university students in Sweden
- 2018
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Ingår i: International Journal of Sexual Health. - : Routledge. - 1931-7611 .- 1931-762X. ; 30:1, s. 49-59
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To examine how fear-avoidance influences vulvovaginal pain and sexual function over time.Method: At baseline and at 10-month follow-up, self-report measures for sexual- and fear avoidance factors were obtained from 483 female university students with and without self-reported vulvovaginal pain.Results: Individuals with pain at both times reported lower sexual function, and higher levels of fear-avoidance compared to the pain-free group. Fear-avoidance beliefs predicted the occurrence of vulvovaginal pain at follow up and the level of pain intensity.Conclusion: The results points to the relevance of the components of the fear-avoidance model in vulvovaginal pain over time.
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| 3. |
- Ekholm, Elin, 1981-, et al.
(författare)
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Coping with provoked vestibulodynia in a relational context : A cluster analysis of coping patterns and their associations with relational cognitions and goals
- 2024
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Ingår i: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Provoked vestibulodynia (PVD) is a common pain condition, negatively impacting the relationships and sexual lives of sufferers. Women's coping behaviour has been associated with psychosexual outcomes, yet coping patterns in clinical PVD samples are unexplored, and it is not known how women's coping relates to their relational context.METHOD: Women (N = 128) with PVD answered questionnaires about psychosexual function, pain coping (avoidance and endurance), relational- and pain catastrophizing, sexual goals and perceived partner responses. Cluster analysis was used to explore coping patterns; clusters were validated on measures of pain and psychosexual function and compared on catastrophizing, sexual goals and partner responses using multivariate analyses of variance.RESULTS: The analysis yielded four clusters: endurance; combined high avoidance and endurance; avoidance; and combined low. The group with high levels of both avoidance and endurance coping displayed the worst psychosexual outcomes and high levels of pain- and relational catastrophizing, approach and avoidance goals and perceived negative partner responses.CONCLUSION: There are distinct patterns of coping among women with PVD, and these coping patterns are associated with psychosexual outcomes and relational cognitions and goals, and perceived partner responses. Women who alternate between avoidance and endurance are more distressed and report worse psychosexual functioning. This pattern needs to be identified and addressed in the treatment of PVD.SIGNIFICANCE STATEMENT: This study extends previous findings on vulvar pain coping patterns to a clinical population of women with PVD. It is further the first study to address the relationship between relational variables, such as partner responses and relational catastrophizing and different coping patterns. Thus, the contribution of this study is the contextualizing of coping patterns among women with PVD. The results showed that a combined pattern of avoidance and endurance coping is associated with high distress, poor psychosexual outcomes, and indications of insufficient relational coping, highlighting the need for clinical assessment and intervention to target both women's individual coping patterns and their relational context.
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| 4. |
- Ekholm, Elin, 1981-, et al.
(författare)
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Coping with provoked vestibulodynia in a relational context-A cluster analysis of coping patterns and their associations with relational cognitions and goals
- 2024
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Ingår i: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149.
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundProvoked vestibulodynia (PVD) is a common pain condition, negatively impacting the relationships and sexual lives of sufferers. Women's coping behaviour has been associated with psychosexual outcomes, yet coping patterns in clinical PVD samples are unexplored, and it is not known how women's coping relates to their relational context.MethodWomen (N = 128) with PVD answered questionnaires about psychosexual function, pain coping (avoidance and endurance), relational- and pain catastrophizing, sexual goals and perceived partner responses. Cluster analysis was used to explore coping patterns; clusters were validated on measures of pain and psychosexual function and compared on catastrophizing, sexual goals and partner responses using multivariate analyses of variance.ResultsThe analysis yielded four clusters: endurance; combined high avoidance and endurance; avoidance; and combined low. The group with high levels of both avoidance and endurance coping displayed the worst psychosexual outcomes and high levels of pain- and relational catastrophizing, approach and avoidance goals and perceived negative partner responses.ConclusionThere are distinct patterns of coping among women with PVD, and these coping patterns are associated with psychosexual outcomes and relational cognitions and goals, and perceived partner responses. Women who alternate between avoidance and endurance are more distressed and report worse psychosexual functioning. This pattern needs to be identified and addressed in the treatment of PVD.Significance StatementThis study extends previous findings on vulvar pain coping patterns to a clinical population of women with PVD. It is further the first study to address the relationship between relational variables, such as partner responses and relational catastrophizing and different coping patterns. Thus, the contribution of this study is the contextualizing of coping patterns among women with PVD. The results showed that a combined pattern of avoidance and endurance coping is associated with high distress, poor psychosexual outcomes, and indications of insufficient relational coping, highlighting the need for clinical assessment and intervention to target both women's individual coping patterns and their relational context.
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| 5. |
- Engman, Linnéa, 1987-, et al.
(författare)
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A longitudinal study of coping strategies in women with vulvovaginal pain
- 2016
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Ingår i: EABCT 2016. - : The European Association for Behaviour and Cognitive Therapies.
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Konferensbidrag (refereegranskat)abstract
- Introduction: Recurring vulvovaginal pain is common, affecting between 8-30 % of women in reproductive age. In addition to evident negative effects regarding sexual function and -satisfaction, vulvovaginal pain also has an impact on sufferers overall quality of life. Despite these extensive consequences little is known about how women with vulvovaginal pain actually cope with pain-triggering sexual activities. Knowledge about coping strategies in this area would give important clinical implications in both creating and targeting effective treatment interventions.Aims: The study aims to explore if the use of coping strategies in relation to pain-triggering sexual activities are stable over time, or if different strategies are used dependent of pain level or situation. A further aim is to explore the relationship between coping and a spectrum of psychosexual aspects over time.Method. The study consists of a student sample of women between 18-35 years old with recurring vulvovaginal pain who responded to a questionnaire at three separate time points (Base line: N=289; 6 months: N=153; 12 months: N= 126). Based on the CHAMP Sexual Pain Coping Scale (CSPCS), which measures avoidance- and endurance coping, cluster analysis was performed to group participants into distinct subgroups of individuals who reported similar coping strategies. The same procedure was performed at each assessment point to explore whether the individuals moved between the subgroups. Lastly the subgroups were compared in regards to several psychosexual factors.Discussion. The results will be discussed at the presentation when analyses are completed.
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| 6. |
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| 7. |
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| 8. |
- Engman, Linnea, 1987-, et al.
(författare)
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An initial proof of concept : A replicated single-case study of a CBT group treatment with partner involvement for vulvodynia.
- 2022
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Ingår i: Cognitive Behaviour Therapy. - : Routledge. - 1650-6073 .- 1651-2316. ; 51:6, s. 503-519
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Tidskriftsartikel (refereegranskat)abstract
- Vulvodynia is common and has an immense impact on affected women and their partners. Psychological factors have been found to contribute to pain maintenance and exacerbation, and treatments addressing psychological factors have yielded positive results. This study employed a replicated single-case experimental design to examine a cognitive behavioral therapy (CBT) group treatment with partner involvement in vulvodynia. Repeated measures of pain intensity related to pain-inflicting behaviors were collected weekly throughout baseline and treatment phases. Associated outcomes were measured pre-, post- and at two follow-up assessments. Participants were 18-45-year-old women, in a stable sexual relationship with a man, experiencing vulvodynia. Five women completed the treatment consisting of 10 group sessions and 3 couple sessions. Data were analyzed through visual inspection and supplementary nonparametric calculations. The study showed promising results of the CBT treatment in alleviating pain intensity in connection to specific pain-inflicting behavior since three out of five participants showed improvements. For the participants who improved, sexual function, pain catastrophizing, avoidance, and endurance behavior changed during treatment and were maintained at follow-ups. These results warrant further study of the CBT treatment, in larger, and controlled formats.
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| 9. |
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| 10. |
- Engman, Linnea, 1987-, et al.
(författare)
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Avoiding or enduring painful sex? : A longitudinal study of coping patterns and sexual function in women with vulvovaginal pain
- 2017
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Ingår i: SSTAR (Society for Sex Therapy and Research) 42nd annual meeting.
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Konferensbidrag (refereegranskat)abstract
- Introduction: Recurring pain in the vulvar- or vaginal region induced by touch or pressure is common, affecting between 10-28% of women in reproductive age (e.g., Harlow et al., 2014). In addition to evident negative effects on sexual aspects such as frequency of sexual activity, sexual satisfaction and sexual function (for a review see Bergeron et al., 2015), vulvovaginal pain has an impact on women’s overall quality of life (Arnold et al., 2006). Despite these extensive consequences little is known about how women with vulvovaginal pain actually cope with sexual activities and the subsequent pain, and how their coping may affect the pain experience and sexual function over time. While avoidance (of pain associated activities) seem to be a commonly used strategy (for a review see Thomtén and Linton, 2013) amongst women with vulvovaginal pain, there is also evidence of endurance (of sexual activity despite pain) as a prevalent strategy (Brauer et al., 2014; Elmerstig et al., 2013). Method: The study used questionnaire data from female university students between 18 and 35 years old, with two measurement points of five months apart. Women who reported experiencing recurring vulvovaginal pain during the last six months, and who responded at both measurement points constitute the sample of the study (N=117). First, multiple regression analysis was executed to test whether avoidance and endurance coping had a predictive value of sexual function beyond the pain experience in itself. Then, cluster analyses based on the respondent’s answers to the CHAMP Sexual Pain Coping Scale (CSPCS) were performed at both time points. Finally, common pathways over time was investigated to explore whether the same coping was used at baseline and follow-up. Results: The multiple regression model exploring if pain, avoidance and endurance at baseline predicted sexual function at follow-up was significant, explaining 25% of the variance (F(2, 90) = 10.22, p < .001). Avoidance at baseline was the only significant predictor in the model, explaining unique variance of sexual function over time. The cluster analyses at baseline and follow up resulted in four distinct clusters respectively; Low scores, Avoidance, Endurance and High scores. The common pathways analyses, exploring typical pathways of change, revealed high stability within the clusters over time meaning that it was common for individuals in all clusters to use the same patterns of coping at both measurement points. Discussion: The results of the study further manifests findings from earlier research while also making an important attribution in quantifying coping strategies in relation to vulvovaginal pain. The study reveals a strong association between vulvovaginal pain and how women cope with sexual activities, the stability of the use of coping over time, as well as the connection between coping and sexual function. Utility/Limitations/Risks: Further knowledge about the relationship between coping and vulvovaginal pain will provide important theoretical and clinical implications regarding the development of the pain as well as potential clinical interventions. Behavioral learning objectives:After attending this poster presentation, the participants will be able to:1. Recognize the importance of avoidance coping in relation to sexual function2. Discuss the use of avoidance and endurance coping as a combined pattern3. Identify the stability of the use of coping patterns over time References:Arnold, L. D., Bachmann, G. A., Kelly, S., Rosen, R., & Rhoads, G. G. (2006). Vulvodynia: characteristics and associations with co-morbidities and quality of life. Obstetrics and gynecology, 107(3), 617. Bergeron, S., Corsini-Munt, S., Aerts, L., Rancourt, K., & Rosen, N. O. (2015). Female sexual pain disorders: a review of the literature on etiology and treatment. Current Sexual Health Reports, 7(3), 159-169. Brauer, M., Lakeman, M., Lunsen, R., & Laan, E. (2014). Predictors of task‐persistent and fear‐avoiding behaviors in women with sexual pain disorders. The journal of sexual medicine, 11(12), 3051-3063. Elmerstig, E., Wijma, B., & Swahnberg, K. (2013). Prioritizing the partner’s enjoyment: a population-based study on young Swedish women with experience of pain during vaginal intercourse. Journal of Psychosomatic Obstetrics & Gynecology, 34(2), 82-89. Harlow, B. L., Kunitz, C. G., Nguyen, R. H., Rydell, S. A., Turner, R. M., & MacLehose, R. F. (2014). Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from 2 geographic regions. American journal of obstetrics and gynecology, 210(1), 40-e1. Thomtén, J., & Linton, S. J. (2013). A psychological view of sexual pain among women: applying the fear-avoidance model. Women’s Health, 9(3), 251-263.
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