Boyer Stéphanie C, Goldfinger Corrie, Thibault-Gagnon Stéphanie, Pukall Caroline F
Department of Psychology, Queen's University, Kingston, Ont., Canada.
Adv Psychosom Med. 2011;31:83-104. doi: 10.1159/000328810. Epub 2011 Oct 10.
Our understanding of the sexual pain disorders vaginismus and dyspareunia has been fundamentally altered over the past two decades due to increased attention and empirically sound research in this domain. This increased knowledge base has included a shift from a dualistic view of the etiology of painful and/or difficult vaginal penetration being due to either psychological or physiological causes, to a multifactorial perspective. The present chapter reviews current classification and prevalence rates, including ongoing definitional debates. Research regarding the etiology, assessment and management of sexual pain disorders is discussed from a biopsychosocial perspective. Cyclical theories of the development and maintenance of sexual pain disorders, which highlight the complex interplay among physiological, psychological and social factors, are described. Medical/surgical treatment options, pelvic floor rehabilitation and psychological approaches are reviewed, as well as future directions in treatment research.
在过去二十年里，由于对这一领域的关注度提高以及实证研究的开展，我们对性交疼痛障碍（阴道痉挛和性交困难）的理解发生了根本性的改变。这一不断增长的知识库包括了从将疼痛性和/或困难的阴道插入病因的二元观点（即要么是心理原因要么是生理原因）转变为多因素观点。本章回顾了当前的分类和患病率，包括正在进行的定义性辩论。从生物心理社会角度讨论了关于性交疼痛障碍的病因、评估和管理的研究。描述了性交疼痛障碍发展和维持的周期性理论，该理论强调了生理、心理和社会因素之间的复杂相互作用。还回顾了医学/手术治疗选择、盆底康复和心理方法，以及治疗研究的未来方向。
