Centre de santé et de services sociaux LaSalle, QC, Canada.
Arch Sex Behav. 2011 Feb;40(1):87-97. doi: 10.1007/s10508-010-9647-7. Epub 2010 Jul 23.
The present study examined whether attributions for vulvo-vaginal pain predicted pain intensity, sexual function, as well as psychological and dyadic adjustment in women with vestibulodynia. Women with vestibulodynia (N = 77) completed measures of attributions, pain, psychological distress, sexual functioning, and dyadic adjustment. They also took part in a structured interview and a gynaecological examination for diagnostic purposes. Attributions are represented by: (1) internality (personal responsibility) or externality (cause lies in an external situation); (2) globality (entire life affected by the problem) or specificity (problem affecting only a specific situation); (3) stability (problem will still remain in the future) or instability (weak probability that the problem will be maintained with time); and (4) partner responsibility (partner responsible or not for the problem). Results indicated that attributions were not significantly correlated with pain outcomes. However, after controlling for pain intensity and relationship duration, internal attributions predicted higher dyadic adjustment, both global and stable attributions predicted lower dyadic adjustment and higher psychological distress, whereas global attributions also predicted increased sexual impairment. Findings suggest that cognitive factors, such as attributions, may be related to psychological distress, sexual functioning, and dyadic adjustment in women with vestibulodynia. Results also highlight the importance of adhering to a biopsychosocial perspective focusing on pain reduction, sexual rehabilitation, and relationship enhancement in the treatment of dyspareunia.
本研究旨在探讨外阴疼痛的归因是否可以预测外阴疼痛患者的疼痛强度、性功能以及心理和伴侣关系的调整情况。77 名患有外阴疼痛的女性完成了归因、疼痛、心理困扰、性功能和伴侣关系调整的评估。他们还参加了结构化访谈和妇科检查以进行诊断。归因的维度包括：（1）内在性（个人责任）或外在性（问题的原因在于外部情况）；（2）整体性（整个生活受到问题的影响）或特殊性（问题仅影响特定情况）；（3）稳定性（问题将在未来仍然存在）或不稳定性（随着时间的推移，问题保持的可能性较小）；以及（4）伴侣责任（伴侣是否对问题负责）。结果表明，归因与疼痛结果之间没有显著相关性。然而，在控制疼痛强度和关系持续时间后，内部归因预测了更高的伴侣关系调整，整体和稳定归因预测了更低的伴侣关系调整和更高的心理困扰，而整体归因也预测了更高的性功能障碍。研究结果表明，认知因素（如归因）可能与外阴疼痛患者的心理困扰、性功能和伴侣关系调整有关。结果还强调了在治疗性交疼痛时，坚持以生物心理社会为视角，注重减轻疼痛、性康复和增强伴侣关系的重要性。
