Center for Health and Medical Psychology, School of Behavioural, Social and Legal Sciences, Örebro University, Örebro 701 82, Sweden.
Department of Clinical Psychological Science, Maastricht University, Maastricht 6211, the Netherlands.
J Sex Med. 2023 Jul 31;20(8):1103-1114. doi: 10.1093/jsxmed/qdad085.
Sexual communication is a common target in psychological treatments for vulvodynia, and associations with sexual function and distress, as well as pain intensity, have been demonstrated. However, structured observations of the communication patterns of couples with vulvodynia are lacking, as these are needed to guide treatment efforts.
To explore (1) the sexual communication patterns in couples with vulvodynia in terms of observed communication quality (operationalized as validating and invalidating responses), self-reported sexual assertiveness, and self-disclosure and (2) associations between sexual communication quality and pain intensity.
In a case-control design with within- and between-group comparisons, 62 couples engaged in videotaped discussions about their sexual relationship. Trained coders assessed the discussions by rating sexual communication (validation and invalidation) according to a structured behavioral coding scheme. Group differences in sexual communication quality were examined with parametric and nonparametric tests. Dyadic associations among observed communication quality, self-rated sexual assertiveness, and self-disclosure were examined within the actor-partner interdependence model. Multiple regression was used to test the predictive value of partners' validation/invalidation on the pain intensity of the women with vulvodynia.
Observed communication quality (ie, validation and invalidation), self-reported sexual assertiveness, self-disclosure, and pain intensity.
Partners of women with vulvodynia were more invalidating toward their partners than those of women without pain. There were no significant differences in validating/invalidating communication between women in the 2 groups or in validation between partners. Partners' validating communication were significantly associated with women's lower pain intensity. The sexual communication patterns differed between couples with and without vulvodynia, and the associations between validating/invalidating responses and sexual assertiveness were stronger in the vulvodynia group than in the group without pain. Results on validation/invalidation and self-disclosure were inconclusive.
The results indicate a need to direct treatment interventions toward couples' sexual communication quality (ie, levels of validation and invalidation).
Strengths include systematic behavioral coding and dyadic analyses. Limitations include the cross-sectional design and self-selection of participants.
This study demonstrated sexual communication patterns specific to couples with vulvodynia, and we conclude that validation and invalidation are important components of the sexual communication of couples with vulvodynia as they relate to sexual assertiveness, women's self-disclosure, and pain intensity.
性沟通是外阴痛心理治疗的常见目标，已经证明它与性功能和痛苦以及疼痛强度有关。然而，缺乏对外阴痛夫妇沟通模式的结构性观察，因为这些观察对于指导治疗工作是必要的。
探讨（1）外阴痛夫妇的性沟通模式，包括观察到的沟通质量（表现为肯定和否定反应）、自我报告的性自信和自我表露；（2）性沟通质量与疼痛强度之间的关系。
采用病例对照设计，对 62 对夫妇进行了关于他们性关系的录像讨论。受过训练的评分员根据结构化行为编码方案评估讨论中的性沟通（肯定和否定）。使用参数和非参数检验检查性沟通质量的组间差异。在演员-伙伴相互依赖模型中，检查观察到的沟通质量、自我评估的性自信和自我表露之间的伙伴间关联。使用多元回归测试女性外阴痛患者的伴侣肯定/否定对其疼痛强度的预测价值。
观察到的沟通质量（即肯定和否定）、自我报告的性自信、自我表露和疼痛强度。
与没有疼痛的女性相比，外阴痛女性的伴侣对其伴侣的否定反应更多。两组女性之间或两组女性之间的肯定/否定沟通均无显著差异。伴侣的肯定沟通与女性较低的疼痛强度显著相关。患有外阴痛的夫妇的性沟通模式与没有疼痛的夫妇不同，并且在外阴痛组中，肯定/否定反应与性自信的关联比没有疼痛的组更强。关于肯定/否定和自我表露的结果尚无定论。
研究结果表明，需要将治疗干预措施指向夫妻的性沟通质量（即肯定和否定的程度）。
优点包括系统的行为编码和对偶分析。局限性包括横断面设计和参与者的自我选择。
本研究显示了特定于外阴痛夫妇的性沟通模式，我们得出结论，肯定和否定是与性自信、女性自我表露和疼痛强度相关的外阴痛夫妇性沟通的重要组成部分。
