A longitudinal network analysis of pain, psychological processes and psychological and sexual distress in women with endometriosis

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology Pub Date : 2026-04-12 DOI:10.1111/bjhp.70071

Sérgio A. Carvalho, Brittany Patafio, Patrícia M. Pascoal, Teresa Lapa, David Skvarc

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Abstract

Objectives

Previous studies in endometriosis have linked the experience and impact of pain to psychological distress and sexual dysfunction. However, little is known about how these factors interact over time or how underlying cognitive-emotional processes contribute to their complex interconnections.

Design

This study followed a Longitudinal Network Approach and explored the interconnections over time between pain (intensity and impact), psychopathological symptoms, sexual distress, and cognitive-emotional processes (cognitive fusion and difficulties in emotion regulation) in adult women with endometriosis.

Methods

Data was collected in a sample composed of N = 210 Portuguese cisgender women with endometriosis in a three-wave online assessment spanning 12 months.

Results

Using multilevel vector autoregressive network analysis, results showed significant temporal pathways in which pain intensity and pain impact predicted future increases in cognitive fusion, depression, and somatization, indicating a directional cascading effect of physical symptoms on psychological processes. Higher sexual distress over time was associated with decreases in cognitive fusion. Results also found strong positive associations among pain, anxiety, depression, and somatization at each time point, as well as between-subjects asymmetrical relationships, with anxiety and somatization more strongly predicting sexual distress than the reverse.

Conclusions

Overall, these findings highlight the importance of targeting transdiagnostic cognitive-emotional processes in interventions to improve pain, mental health, and sexual outcomes in women with endometriosis.

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查看原文本刊更多论文

子宫内膜异位症患者的疼痛、心理过程以及心理和性困扰的纵向网络分析。

目的：先前对子宫内膜异位症的研究已经将疼痛的经历和影响与心理困扰和性功能障碍联系起来。然而，对于这些因素如何随着时间的推移而相互作用，以及潜在的认知-情绪过程如何促成它们复杂的相互联系，人们知之甚少。设计：本研究采用纵向网络方法，探索子宫内膜异位症成年女性疼痛（强度和影响）、精神病理症状、性困扰和认知-情绪过程（认知融合和情绪调节困难）之间的相互关系。方法：在为期12个月的三波在线评估中收集了N = 210名患有子宫内膜异位症的葡萄牙顺性女性的样本数据。结果：采用多层次向量自回归网络分析，结果显示疼痛强度和疼痛影响预测未来认知融合、抑郁和躯体化增加的显著时间通路，表明身体症状对心理过程的定向级联效应。随着时间的推移，更高的性痛苦与认知融合的减少有关。结果还发现，在每个时间点，疼痛、焦虑、抑郁和躯体化之间存在强烈的正相关关系，以及受试者之间的不对称关系，焦虑和躯体化更能预测性困扰，而不是相反。结论：总的来说，这些发现强调了在干预中针对跨诊断认知-情绪过程的重要性，以改善子宫内膜异位症患者的疼痛、心理健康和性结局。

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来源期刊

British Journal of Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

14.10

自引率

1.30%

发文量

期刊介绍： The focus of the British Journal of Health Psychology is to publish original research on various aspects of psychology that are related to health, health-related behavior, and illness throughout a person's life. The journal specifically seeks articles that are based on health psychology theory or discuss theoretical matters within the field.