title: Fear avoidance and self-efficacy in relation to pain and sexual impairment in women with provoked vestibulodynia.
abstract: BACKGROUND
  Provoked vestibulodynia is believed to be the most frequent cause of vulvodynia in women of childbearing age, with prevalence rates of up to 12% in the general population. Despite this high prevalence and the fact that vestibulodynia impacts negatively on quality of life, in particular sexual functioning, there has been a paucity of sound research to elucidate the condition's etiology. More specifically, few studies have focused on the role of psychologic factors in the experience of vulvo-vaginal pain and associated sexual impairment.
  
  
  OBJECTIVE
  The present study aimed to determine the extent to which fear avoidance variables (catastrophizing, anxiety, fear of pain, hypervigilance) and self-efficacy differentially influenced changes in levels of induced and intercourse pain and also associated sexual dysfunction in these women.
  
  
  METHODS
  Data were obtained from 75 vestibulodynia participants who completed a gynecologic examination, structured interview, and standardized questionnaires.
  
  
  RESULTS
  The results of regression analyses revealed that higher catastrophizing, fear of pain, and hypervigilance in addition to lower self-efficacy together accounted for 15% of the variation in increased intercourse pain intensity. Among these, only catastrophizing contributed unique variance to intercourse pain. Results also showed that higher state anxiety and fear of pain (escape/avoidance) and also lower self-efficacy explained 22% of the variation in women's sexual impairment. However, only self-efficacy was found to be an independent correlate of sexual impairment.
  
  
  CONCLUSIONS
  Findings support a theoretical model of vestibulodynia as a pain disorder influenced among others by cognitive and affective factors.
authors: Département de sexologie, Université du Québec à Montréal, QC, CA. genevieve.desrochers@internet.uqam.ca
authors: Geneviève
authors: G
authors: Desrochers
authors: Sophie
authors: S
authors: Bergeron
authors: Samir
authors: S
authors: Khalifé
authors: Marie-Josée
authors: MJ
authors: Dupuis
authors: Mélanie
authors: M
authors: Jodoin
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D004185:Disability Evaluation; D004414:Dyspareunia / Q000150:complications / Q000523:psychology; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement / Q000379:methods; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D014845:Vulvar Diseases / Q000150:complications* / Q000523:psychology*; D055815:Young Adult