Health Psychology Section, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
St John's Institute of Dermatology, Guy's Hospital, NHS Foundation Trust, London, UK.
Eur J Pain. 2022 Jan;26(1):103-113. doi: 10.1002/ejp.1841. Epub 2021 Aug 2.
Women with Vulvodynia experience pain, related impacts on sex and daily functioning, and depression. While psychosocial factors are associated with outcomes in Vulvodynia, longitudinal data are limited, especially in mixed/spontaneous Vulvodynia. Broad psychological models such as psychological flexibility (PF) and content-specific factors, such as body-exposure anxiety (BEA) and avoidance during sexual activities and perceived injustice, have not been adequately investigated in Vulvodynia. The aim of this study was to explore whether these factors assessed at baseline predict pain severity, pain interference, sexual functioning and satisfaction and depression 3 months later.
A longitudinal study of 349 women with Vulvodynia was conducted. Participants completed online self-report measures of pain-related and sexual outcomes, depression, BEA, perceived injustice and facets of PF (present moment awareness, pain acceptance, committed action) at baseline and after 3 months, overlapping with the Coronavirus disease 2019 (COVID-19) pandemic.
Seventy percent of women responded at both assessments (n = 244). There were significant decreases in pain severity, pain interference, present moment awareness, committed action and a significant increase in depression at 3 months. All the baseline psychosocial factors significantly correlated with at least one outcome at 3 months. When adjusting for baseline outcome and demographics, committed action significantly positively predicted depression at 3 months and pain acceptance significantly positively predicted pain interference at 3 months.
Among women with Vulvodynia, pain acceptance and committed action are prospectively associated with pain interference and depression. The reliability and generalizability of these results needs to be established given the overlap with the COVID-19 pandemic. Future studies should investigate whether targeting these factors enhances outcomes in Vulvodynia.
This longitudinal study explored the role of PF, perceived injustice and body image during sexual activities in predicting pain severity, pain interference, sexual functioning, sexual satisfaction and depression in women with Vulvodynia. The study findings reveal that two facets of PF (committed action and pain acceptance) predicted pain interference and depression over time. It may be important to incorporate these processes in treatments developed for Vulvodynia.
患有外阴痛的女性会经历疼痛、与性和日常生活功能相关的疼痛影响以及抑郁。虽然心理社会因素与外阴痛的结果相关，但纵向数据有限，尤其是在混合/自发性外阴痛中。心理灵活性（PF）等广泛的心理模型和身体暴露焦虑（BEA）等特定内容因素以及在性行为期间的回避和感知不公正，在外阴痛中尚未得到充分研究。本研究的目的是探讨这些因素在基线时是否预测 3 个月后疼痛严重程度、疼痛干扰、性功能和满意度以及抑郁。
对 349 名患有外阴痛的女性进行了一项纵向研究。参与者在基线和 3 个月后完成了在线自我报告的疼痛相关和性功能、抑郁、BEA、感知不公正和 PF 方面的测量（当下意识、疼痛接受、承诺行动），这与 2019 年冠状病毒病（COVID-19）大流行重叠。
70%的女性在两次评估中都有回应（n=244）。3 个月时疼痛严重程度、疼痛干扰、当下意识、承诺行动显著下降，抑郁显著增加。所有基线心理社会因素与至少一个 3 个月时的结果显著相关。在调整基线结果和人口统计学因素后，承诺行动显著正向预测 3 个月时的抑郁，疼痛接受显著正向预测 3 个月时的疼痛干扰。
在患有外阴痛的女性中，疼痛接受和承诺行动与疼痛干扰和抑郁呈前瞻性相关。鉴于与 COVID-19 大流行的重叠，需要确定这些结果的可靠性和普遍性。未来的研究应调查针对这些因素是否会增强外阴痛的疗效。
这项纵向研究探讨了 PF、感知不公正和性行为期间的身体形象在预测患有外阴痛的女性疼痛严重程度、疼痛干扰、性功能、性满意度和抑郁中的作用。研究结果表明，PF 的两个方面（承诺行动和疼痛接受）随着时间的推移预测疼痛干扰和抑郁。在为外阴痛开发的治疗中纳入这些过程可能很重要。
