Internalized stigma mediates the relationship between pelvic pain severity and both depression and anxiety in women with chronic pelvic pain.

BACKGROUND

Chronic pelvic pain (CPP, i.e., pain related to the abdomen) disproportionately affects women, with about one in four women experiencing CPP worldwide. CPP has been found to be associated with numerous poor mental health outcomes (e.g., depression and anxiety). Prior research has indicated associations between CPP and stigma, yet much of this research has been qualitative.

OBJECTIVES

The present study builds on that literature by quantitatively exploring associations between CPP severity and both depression and anxiety sensitivity, as well as exploring the moderating role of internalized stigma.

DESIGN

Quantitative, cross-sectional design.

METHODS

A sample of 241 adult women with CPP from the United States completed a series of questionnaires via an online survey. Hierarchical linear regression models and moderation analyses were used to determine associations among the variables of interest (i.e., CPP, depression, anxiety sensitivity, and internalized stigma).

RESULTS

Women who reported more severe CPP also reported more depression ( = 0.61, SE = 0.19,  = 0.002) and more anxiety sensitivity ( = 0.92, SE = 0.14,  < 0.001). These associations were moderated by internalized stigma, such that the effects of depression and anxiety sensitivity on CPP severity were stronger in women who reported more internalized stigma.

CONCLUSION

Clinical implications are that providers treating women with pelvic pain should screen them for emotional distress (e.g., depression and anxiety) and intervene and/or refer them as appropriate. Future work should continue to explore the role of internalized stigma in women with CPP, as well as explore potential interventions aimed at reducing stigma.