| 1. |
- Baylis, Rebecca, et al.
(författare)
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Women's experiences of internet-delivered Cognitive Behaviour Therapy (iCBT) for Fear of Birth
- 2020
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Ingår i: Women and Birth. - : ELSEVIER. - 1871-5192 .- 1878-1799. ; 33:3, s. E227-E233
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fear of Birth is common in pregnant women and associated with negative physical and mental health. There is a clear comorbidity with anxiety and depression. Internet-delivered Cognitive Behaviour Therapy has been suggested as a treatment option for Fear of Birth and a randomized controlled trial comparing internet-delivered Cognitive Behaviour Therapy with midwifery led counselling as standard care has been conducted.Objective: The aim of this study was to describe women's experiences of guided internet-delivered Cognitive Behaviour Therapy for Fear of Birth and to describe the content of their fear.Methods: The present study is a qualitative, follow-up interview study following the randomized controlled trial, the U-CARE Pregnancy Trial. In total 19 women allocated to internet-delivered Cognitive Behaviour Therapy for Fear of Birth were interviewed by telephone. A semi-structured interview guide was used and the transcripts were analyzed with thematic analysis.Results: The women's descriptions of Fear of Birth differed, however their fear was most often associated with fear of losing control, fear for the baby's life or health or own life threatening events. The experiences of internet-delivered Cognitive Behaviour Therapy for Fear of Birth varied, some women were positive to its flexibility although most women preferred a face-to face meeting. The treatment did not pin-point their fears, it was challenging to maintain motivation and to work with the treatment in solitude.Conclusions: Women's descriptions of Fear of Birth varied. Most women undergoing internet-delivered Cognitive Behaviour Therapy would have preferred a face-to-face meeting which they imagined would have soothed their fear. Internet-delivered Cognitive Behaviour Therapy for Fear of Birth may be an alternative for some women.
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| 2. |
- Flink, Ida K., 1980-, et al.
(författare)
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Coping with pain in intimate situations : applying the avoidance-endurance model to women with vulvovaginal pain
- 2017
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 17:October 2017, s. 302-308
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Tidskriftsartikel (refereegranskat)abstract
- Background and aimsChronic vulvovaginal pain is strikingly common and has a serious impact on women's lives. Nevertheless, there are few longitudinal studies focusing on mechanisms involved in the pain development. One area of interest is how women cope with sexual activities and how this affects their pain. In this study, avoidance and endurance coping behaviors were explored as possible mediators of the relation between catastrophizing and pain, cross-sectionally and longitudinally.Methods251 women (18–35 years old) with vulvovaginal pain were recruited in university settings and filled out questionnaires about their pain, catastrophizing and coping behaviors at two occasions, with five months in between. Multiple mediation models were tested, exploring avoidance and endurance as mediators of the relation between catastrophizing and pain.ResultsThe results showed that avoidance was an influential mediator of the link between catastrophizing and pain. Using multiple mediation models we found that although the indirect effects of both avoidance and endurance were significant cross-sectionally, only avoidance was a significant mediator in the combined model exploring associations over time.ConclusionsThis study indicates that the strategies women with vulvovaginal pain use for coping with sexual activities are important for the course of pain. Avoidance and, to a lesser degree, endurance strategies were identified as important mediators of the effects of catastrophizing on pain. When exploring the links over time, only avoidance emerged as a significant mediator.ImplicationsIn this longitudinal study, catastrophizing was linked to vulvovaginal pain, via avoidance and endurance of sexual activities. Hence, targeting catastrophizing early on in treatment, as well as addressing coping, may be important in clinical interventions.
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| 3. |
- Boersma, Katja, professor, 1973-, et al.
(författare)
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Symposium : Pain and emotion – biological processes, emotion regulation and implications for treatment
- 2016
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Ingår i: EABCT 2016 Abstract Book. ; , s. 162-162
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Co-occurring pain and emotional difficulties are strikingly common and a true challenge in the clinic. Nearly all pain patients suffer from some kind of emotional distress. In the last decade, research in the field has started to focus on the role of underlying processes in concurrent problems with pain and emotional distress. This symposium is therefore focused on the link between pain and emotion and will highlight new perspectives on processes, theoretical as well as clinical. Talks will address the role of biological mechanisms, interpersonal contexts and the development of the new treatment approaches.Poor emotion regulation has been pointed out as one core process, which may explain the high co-occurrence of pain and emotional distress. Current treatments have not succeeded in helping paon patients with high levels of emotional distress, and therefore a new treatment approach has been developed, based on emotion regulation theory and exposure techniques. Dr. Katja Boersma will describe the theory beind this new intervention and present preliminary data from an RCT in patients with chronic pain and emotional distress.Another treatment approach with well documented effects in this area is ACT. However, large variability in treatment effects can be seen consistently across studies and predictors of outcome remain unclear. Few studies have yet investigated the role of biological processes in ACT. Dr. Rikard Wicksell will briefly describe ACT for patients with chronic pain, bring up recent findings on ACT and neuroscience, and discuss implications for future research and clinical development.Pain-related fear is a salient emotion in many pain patients, which tend to lead to avoidance of movements or activities. Avoidance behaviors are negatively reinfrced as they lead to less pain for the moment; in the long run, however, it often results in inactivity and disuse. Furthermore, a change in neural response profile, so called cortical reorganization, occurs in cortical sensory and motor areas. Targeting immobilisation and cortical reorganisation, using cognitive behavioral, sensory, and motor strategies, may improve function in individuals with chronic pain. Dr. Kristoffer Bothelius will present findings in this area and discuss possible treatment implications.One way of regulating pain and negative emotions is to share personal experiences with others. However, it is important to know where, when and with whom to share; in other terms, to be context sensitive. The opposite, context insensitivity, has been related to prolonged and exaggerated emotional distress. The theory, importance and potential clinical implications of context sensitivity in the area pf pain and emotional distress will serve the basis for the presentation by Dr. Ida Flink, and data from an ongoing project will be presented.The link between pain and emotional distress may become extra salient when the pain occurs in an intimate interpersonal context. Vulvovaginal pain in women has been neglected in pain research, but is closely linked to emotional reactions such as fear and anxiety. Dr. Johanna Thomtén will describe the link between pain and emotional distress among women suffering from vulvovaginal pain, presenting data from an ongoing longitudinal project.
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| 4. |
- Elmerstig, Eva, et al.
(författare)
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Vulvar Pain : Associations Between First-Time Vaginal Intercourse, Tampon Insertion and Later Experiences of Pain
- 2016
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Ingår i: Journal of sex & marital therapy. - : Routledge. - 0092-623X .- 1521-0715. ; 42:8, s. 707-720
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Tidskriftsartikel (refereegranskat)abstract
- This study examines associations between the first experience of vaginal intercourse/tampon insertion and later experiences of vulvar pain. The study is based on questionnaire-data from 1259 Swedish female senior high-schools students 18-22 years old. Of these, 592 women reported present vulvar pain. Present vulvar pain was associated with first-time experiences at vaginal intercourse (pain, negative experience, against will) and with pain at tampon insertion. First-time experiences were also related to temporal aspects of present vulvar pain during vaginal intercourse (at the beginning, after a while during and after). Implications of first-time experiences of vaginal intercourse for future symptoms of vulvar pain are discussed.
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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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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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| 9. |
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| 10. |
- Engman, Linnéa, 1987-, et al.
(författare)
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When sex hurts : Avoid, endure or try something different?
- 2016
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Ingår i: IASR 42nd annual meeting.
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Konferensbidrag (refereegranskat)abstract
- Rationale/Background: Recurring vulvovaginal pain is a common problem among women, affecting between 8-30 % of women in reproductive age. In addition to evident negative effects regarding sexual activities, -function and -satisfaction, vulvovaginal pain also has an impact on the individual’s daily life as well as overall quality of life. Despite these extensive consequences little is known about how women with vulvovaginal pain actually cope with sexual activities and the subsequent pain.Research Questions: The study aims to explore how women with vulvovaginal pain cope with sexual activities that has an impact on their pain, and whether certain ways to cope are more or less adaptive in regards to a spectrum of psychosexual aspects.Methods: The study is based on a student sample of women between 18 and 35 years old with recurring vulvovaginal pain (N=289). The CHAMP Sexual Pain Coping Scale (CSPCS) was created to measure coping behaviors among women with vulvovaginal pain. The scale was based on previous qualitative research where three apparent patterns of coping strategies has emerged; avoidance-, endurance- and alternative coping. Based on how the women responded to the avoidance- and endurance subscales of the CSPCS, cluster analysis resulted in four distinct groups of women with different profiles of coping. The coping subgroups were then compared in regards to several psychosexual factors.Results: The results showed that women suffering from vulvovaginal pain cope with sexual activities and the subsequent pain in different ways. Women who showed a pattern of high avoidance and endurance coping strategies reported significantly higher levels of pain, lower sexual function, less sexual satisfaction and lower quality of life. In contrast, women who reported low levels of avoidance and endurance coping strategies showed significantly lower levels of pain, higher sexual function, as well as a higher satisfaction with their sex life and life in general.Conclusions: 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. Causal conclusions can not be drawn since the study is based on cross-sectional data. Hence, there is no knowledge to whether the coping strategy is a result of the individual’s current pain level or if the coping has an effect on the pain and associated psychosexual aspects. However, the study clearly reveals a strong association between vulvovaginal pain and how women cope with sexual activities. Future knowledge about this relationship will provide important theoretical and clinical implications regarding the development of the pain as well as potential clinical interventions.
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