Engman L, Flink I K, Ekdahl J, Boersma K, Linton S J
Center for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden.
Department of Psychology, Mid Sweden University, Östersund, Sweden.
Eur J Pain. 2018 Apr 10. doi: 10.1002/ejp.1227.
Recurring vulvovaginal pain is common, with evident effects on affected women's lives. Little is known about how affected women cope with painful sexual activities and how coping relates to pain intensity and psychosexual functioning over time. This prospective study explored the impact of avoidance and endurance on sexual function over time. Additionally, patterns of coping were studied on an individual level to increase knowledge about coping and its relation to psychosexual functioning.
One hundred and seventeen women, 18-35 years old, with recurring vulvovaginal pain answered questionnaires at two measurement points, five months apart, assessing avoidance and endurance coping, pain intensity and psychosexual functioning. A multiple regression model explored the predictive value of avoidance and endurance on sexual function over time. Cluster analyses investigated patterns of coping and stability within the clusters. These subgroups were compared on psychosexual outcomes.
Avoidance at baseline was the only significant predictor of sexual function five months later. Distinct and stable subgroups with different patterns of coping were identified, where avoidance and endurance coping were used both separately and combined. Women who both avoided and endured had the most unfavourable outcomes in terms of psychosexual functioning.
Avoidance of sexual activities was related to reduced sexual function over time, which calls for attention and clinical interventions targeting avoidance. Additionally, women who both avoid and endure sexual activities despite pain possibly need tailored interventions, as women with this coping pattern reported the lowest levels of psychosexual functioning.
In this prospective study, avoidance of sexual activities predicted sexual function over time, when controlling for pain intensity. Subgroups of women using distinct patterns of coping were identified. Those who both avoided and endured had the lowest levels of psychosexual functioning.
复发性外阴阴道疼痛很常见，对受影响女性的生活有明显影响。对于受影响的女性如何应对疼痛的性行为，以及随着时间推移应对方式与疼痛强度和性心理功能之间的关系，人们了解甚少。这项前瞻性研究探讨了回避和忍耐对随时间变化的性功能的影响。此外，还从个体层面研究了应对模式，以增加对应对方式及其与性心理功能关系的了解。
117名年龄在18 - 35岁之间、患有复发性外阴阴道疼痛的女性在相隔五个月的两个测量点回答了问卷，评估回避和忍耐应对方式、疼痛强度和性心理功能。多元回归模型探讨了回避和忍耐对随时间变化的性功能的预测价值。聚类分析研究了应对模式和聚类内的稳定性。对这些亚组的性心理结果进行了比较。
基线时的回避是五个月后性功能的唯一显著预测因素。识别出了具有不同应对模式的独特且稳定的亚组，其中回避和忍耐应对方式单独使用或联合使用。在性心理功能方面，既回避又忍耐的女性结果最不理想。
随着时间推移，回避性活动与性功能下降有关，这需要引起关注并针对回避行为进行临床干预。此外，尽管疼痛仍既回避又忍耐性活动的女性可能需要量身定制的干预措施，因为具有这种应对模式的女性报告的性心理功能水平最低。
在这项前瞻性研究中，在控制疼痛强度的情况下，回避性活动可预测随时间变化的性功能。识别出了采用不同应对模式的女性亚组。既回避又忍耐的女性性心理功能水平最低。
