A Psychological View of Sexual Pain among Women: Applying the Fear-Avoidance Model

Thomtén, Johanna; Linton, Steven J.

doi:10.2217/whe.13.19

Cited by 53 publications

(53 citation statements)

References 90 publications

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“…Catastrophizing has been described as the "cognitive element" of the fear network [35], and is a key factor for identifying people who are at risk for developing prolonged pain problems and disability [36]. Our results replicate and extend findings from earlier studies indicating that catastrophic thinking may similarly play an important role in women with vulvar pain [33,37].…”

Section: Discussionsupporting

confidence: 85%

Coping with painful sex: Development and initial validation of the CHAMP Sexual Pain Coping Scale

Flink

Thomtén

Engman

et al. 2015

Scandinavian Journal of Pain

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Background and purpose Recurrent vulvar pain is a common and debilitating condition which has received remarkably little attention in pain research. For instance, little is known about how these women cope with sexual activities, and there are no structured assessment tools. The purpose of this study was to explore coping strategies in this group, with a view to develop a measure to assess how women with vulvar pain cope with sexual activities. Methods The current study is based on a subsample from a longitudinal study about vulvar pain in a student sample consisting of women between 18 and 35 years old (N = 964). Only data from the ones reporting recurrent vulvar pain during the last six months (N = 289) were used in the analyses. First, the CHAMP Sexual Pain Coping Scale (CSPCS) was created, with the aim of assessing how women with vulvar pain cope with sexual activities. The scale was inspired by previous research on women with vulvar pain as well as well-known coping strategies in other pain populations. Second, the psychometric properties of the scale were explored by analyzing the factor structure and internal reliability. Third, validity features were examined in terms of criterion validity and construct validity. Results The analyses supported a three-factor solution, embracing the strategies endurance, avoidance and alternative coping. The internal reliability of the subscales turned out to be good, and the criterion validity was supported for all three subscales. The construct validity was clearly supported for the endurance and the avoidance subscales, but not for the alternative coping subscale. Conclusions The findings support the CSPCS as an instrument for assessing how women with vulvar pain cope with sexual activities. The strategies endurance, avoidance and alternative coping correspond with findings from earlier research. Endurance reflects a tendency to engage in and continue with sexual activities despite pain, while attempting to minimize or suppress thoughts of pain. Avoidance, on the other hand, involves efforts to stay away from sexual activities, in particular vaginal penetration, because of fear of pain. Alternative coping refers to endeavours to find alternative sexual activities that do not necessarily involve vaginal penetration. Even though this first study indicates that the CSPCS may be psychometrically sound, more studies are needed to confirm the psychometric properties and clinical application of this instrument. In particular, the construct validity of the alternative coping subscale needs to be further evaluated. Implications A valid instrument for assessing strategies for coping with sexual activities in this population has important clinical implications, since it provides a method that may enhance assessment procedures, be used in research, and stimulate the development of treatment.

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Section: Discussionsupporting

confidence: 85%

Coping with painful sex: Development and initial validation of the CHAMP Sexual Pain Coping Scale

Flink

Thomtén

Engman

et al. 2015

Scandinavian Journal of Pain

Self Cite

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“…Higher levels of AEE and depressive symptoms have also been found to be correlated in student and chronic pain samples, and this relation was partly mediated by catastrophizing in both populations [27,59]. This may be another pathway that links AEE and psychological distress in couples coping with painful intercourse: catastrophizing is associated with negative overall outcomes for both partners of PVD couples [60–63]. Higher AEE couples, through their emotional regulation difficulties, could come to develop a more catastrophic cognitive appraisal of the genital pain, thereby increasing their distress.…”

Section: Discussionmentioning

confidence: 99%

To Say or not to Say: Dyadic Ambivalence over Emotional Expression and Its Associations with Pain, Sexuality, and Distress in Couples Coping with Provoked Vestibulodynia

Awada

Bergeron

Steben³

et al. 2014

The Journal of Sexual Medicine

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“…endurance) has been related to two fairly distinct emotional and cognitive patterns: one characterized by positive mood and minimizing of pain signals, and one typified by distress and cognitive avoidance (Hasenbring and Verbunt, ). Avoidance has been shown to be common also in women with vulvovaginal pain, manifesting as abstention from sexual intercourse and other pain‐associated activities due to catastrophizing and fear (for a review, see Thomtén and Linton, ). However, recent studies show that 50–68% of women with vulvovaginal pain continue to have intercourse despite the pain (Elmerstig et al., ; Brauer et al., ), suggesting that endurance is another commonly used strategy.…”

Section: Introductionmentioning

confidence: 99%

Avoiding or enduring painful sex? A prospective study of coping and psychosexual function in vulvovaginal pain

Engman

Flink

Ekdahl

et al. 2018

European Journal of Pain

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A Psychological View of Sexual Pain among Women: Applying the Fear-Avoidance Model

Cited by 53 publications

References 90 publications

Coping with painful sex: Development and initial validation of the CHAMP Sexual Pain Coping Scale

Coping with painful sex: Development and initial validation of the CHAMP Sexual Pain Coping Scale

To Say or not to Say: Dyadic Ambivalence over Emotional Expression and Its Associations with Pain, Sexuality, and Distress in Couples Coping with Provoked Vestibulodynia

Avoiding or enduring painful sex? A prospective study of coping and psychosexual function in vulvovaginal pain

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