Department of Psychology, Université de Montréal, Montréal, Québec, Canada.
Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Obstetrics and Gynecology, IWK Health Centre, Halifax, Nova Scotia, Canada.
J Pain. 2018 May;19(5):552-561. doi: 10.1016/j.jpain.2017.12.264. Epub 2018 Jan 5.
Vulvodynia is a idiopathic vulvovaginal pain condition that interferes with the sexual and mental health of affected couples. Research has underscored that psychological factors, such as anxiety and depression, are associated with its development and maintenance and related sexual impairment. However, the daily role of anxiety and depressive symptoms in the pain and sexuality outcomes of couples coping with vulvodynia is not well understood. Using a dyadic daily experience method, 127 women (mean age = 26.21, SD = 6.24 years) diagnosed with vulvodynia and their partners (mean age = 27.44, SD = 7.29 years) reported on anxiety and depressive symptoms, pain, sexual function, and sexual distress over a period of 8 weeks. Multilevel modeling was used to examine how daily deviations in anxiety and depressive symptoms from a participant's own mean were associated with pain, sexual function, and sexual distress. On days of sexual activity, when women reported higher anxiety and depressive symptoms (compared with their average), they reported greater pain and lower sexual function. On days of sexual activity, when women reported higher depressive symptoms, they reported greater levels of sexual distress, and when partners reported higher anxiety and depressive symptoms, women as well as partners reported greater levels of sexual distress. Results suggest that daily anxiety and depressive symptoms play a role in women's experience of vulvodynia-related pain, women's sexual function, and the couple's sexual distress. Targeting daily anxiety and depressive symptoms could enhance the efficacy of psychological interventions for vulvodynia.
This article examines the daily associations between anxiety and depressive symptoms, women's pain, sexual function, and sexual distress among couples coping with vulvodynia. Findings contribute to refine the biopsychosocial model of pain, showing that daily affective factors are associated with pain and sexual well-being.
外阴痛是一种特发性的外阴阴道疼痛疾病，会影响受影响夫妇的性健康和心理健康。研究强调，焦虑和抑郁等心理因素与该病的发展和维持以及相关的性功能障碍有关。然而，夫妻双方在应对外阴痛时，焦虑和抑郁症状在疼痛和性生活结果中的日常作用尚不清楚。采用对偶日常体验方法，对 127 名（平均年龄=26.21，SD=6.24 岁）被诊断患有外阴痛的女性及其伴侣（平均年龄=27.44，SD=7.29 岁）进行了为期 8 周的焦虑和抑郁症状、疼痛、性功能和性困扰的报告。多层次模型用于检验参与者自身平均焦虑和抑郁症状的日常偏差与疼痛、性功能和性困扰的关系。在性行为日，当女性报告的焦虑和抑郁症状高于平均水平时（与她们的平均水平相比），她们报告的疼痛更严重，性功能更低。在性行为日，当女性报告的抑郁症状更严重时，她们报告的性困扰程度更高，当伴侣报告的焦虑和抑郁症状更严重时，女性和伴侣报告的性困扰程度更高。研究结果表明，日常焦虑和抑郁症状在女性外阴痛相关疼痛、女性性功能和夫妻性困扰方面发挥作用。针对日常焦虑和抑郁症状可以提高外阴痛心理干预的效果。
本文探讨了夫妻双方在应对外阴痛时，焦虑和抑郁症状与女性疼痛、性功能和性困扰之间的日常关联。研究结果为完善疼痛的生物心理社会模型做出了贡献，表明日常情感因素与疼痛和性健康有关。
