Coping with provoked vestibulodynia in a relational context—A cluster analysis of coping patterns and their associations with relational cognitions and goals

IF 3.5 2区 医学 Q1 ANESTHESIOLOGY
Elin Ekholm, Linnéa Engman, Moniek M. ter Kuile, Ida K. Flink
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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.

Abstract Image

在关系背景下应对诱发性前庭大腺炎--应对模式及其与关系认知和目标关联的聚类分析。
背景:诱发性前庭大腺炎(PVD)是一种常见的疼痛症状,对患者的人际关系和性生活造成了负面影响。女性的应对行为与性心理结果有关,但临床前庭神经痛样本中的应对模式尚未得到研究,也不知道女性的应对行为与她们的关系背景有什么关系:方法:患有 PVD 的女性(N = 128)回答了有关性心理功能、疼痛应对(回避和忍耐)、关系和疼痛灾难化、性目标和感知伴侣反应的问卷。聚类分析用于探索应对模式;聚类在疼痛和性心理功能测量上得到验证,并使用多变量方差分析对灾难化、性目标和伴侣反应进行比较:分析得出了四个聚类:忍耐;回避和忍耐相结合的高水平;回避;以及相结合的低水平。回避和忍耐程度都较高的群体表现出最差的性心理结果,以及较高的疼痛和关系灾难化程度、接近和回避目标以及感知到的伴侣负面反应:结论:患有自发性心血管疾病的妇女有不同的应对模式,这些应对模式与性心理结果、关系认知和目标以及感知到的伴侣反应有关。在回避和忍耐之间交替出现的女性会更加痛苦,性心理功能也会更差。这种模式需要在治疗外阴阴道炎时加以识别和解决:本研究将之前关于外阴疼痛应对模式的研究结果扩展到了患有 PVD 的临床女性群体。此外,它还是第一项探讨伴侣反应和关系灾难化等关系变量与不同应对模式之间关系的研究。因此,本研究的贡献在于将患有心血管疾病的妇女的应对模式背景化。研究结果表明,回避和忍耐的综合应对模式与高痛苦、不良的性心理结果以及关系应对不足的迹象相关,这突出表明临床评估和干预需要同时针对女性的个体应对模式和她们的关系背景。
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来源期刊
European Journal of Pain
European Journal of Pain 医学-临床神经学
CiteScore
7.50
自引率
5.60%
发文量
163
审稿时长
4-8 weeks
期刊介绍: European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.
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