Dunkley Cara R, Brotto Lori A
Department of Psychology, University of British Columbia.
Department of Obstetrics and Gynecology, University of British Columbia.
J Clin Psychol. 2016 Jul;72(7):637-50. doi: 10.1002/jclp.22286. Epub 2016 Mar 28.
Provoked vestibulodynia (PVD) is a chronic and distressing genital pain condition involving sharp pain to the vulvar vestibule with lifetime prevalence as high as 12%. PVD is the most prevalent cause of pain during sexual intercourse (dyspareunia) in premenopausal women, and gives rise to considerable sexual and relational concerns. As intercourse for women with PVD is either painful or impossible, PVD has pronounced negative effects on women's romantic relationship adjustment and sexual intimacy, as well as their emotional well-being and sense of sexual self-efficacy. Given the low efficacy and high side-effect profile of medications for the treatment of PVD, attention has shifted toward psychological interventions over the past decade. Psychological treatments for PVD have the advantage of targeting both the experience of pain and its many psychosexual consequences, such as reduced desire and arousal. Cognitive behavioral therapy (CBT) currently represents one of the most popular first-line psychological interventions for PVD. Mindfulness has been increasingly used alongside, or instead of CBT for a variety of health-related conditions, particularly with respect to chronic pain disorders and more recently in women with PVD. This review provides a detailed overview of CBT and mindfulness-based approaches in treating PVD.
诱发性前庭痛（PVD）是一种慢性且令人痛苦的生殖器疼痛病症，表现为外阴前庭剧痛，终生患病率高达12%。PVD是绝经前女性性交疼痛（性交困难）的最常见原因，并引发了相当多的性和人际关系问题。由于患有PVD的女性性交时要么疼痛要么无法进行，PVD对女性的浪漫关系调适、性亲密程度以及她们的情绪健康和性自我效能感都有显著的负面影响。鉴于治疗PVD的药物疗效低且副作用大，在过去十年中，注意力已转向心理干预。PVD的心理治疗具有针对疼痛体验及其许多性心理后果（如性欲和性唤起降低）的优势。认知行为疗法（CBT）目前是PVD最常用的一线心理干预措施之一。正念已越来越多地与CBT一起使用，或替代CBT用于各种与健康相关的病症，特别是在慢性疼痛疾病方面，最近也用于患有PVD的女性。本综述详细概述了CBT和基于正念的方法在治疗PVD中的应用。
