title: Provoked vestibulodynia: psychological predictors of topical and cognitive-behavioral treatment outcome.
abstract: Psychological factors have been found to impact the pain experience and associated sexual impairment of women suffering from provoked vestibulodynia (PV). Despite a lack of randomized treatment outcome studies, particularly concerning psychological predictors of outcome, recent studies have shown that topical applications and cognitive-behavioral therapy (CBT) are among the most popular first-line interventions for PV. The present study aimed to determine the extent to which baseline fear-avoidance variables and pain self-efficacy were differentially associated with topical application and CBT outcomes at six-month follow-up. Data were obtained from 97 women who completed a randomized trial comparing these two treatments. Regression analyses revealed that for topical treatment, higher levels of baseline avoidance predicted worse pain and sexual functioning outcomes, whereas higher levels of pain self-efficacy predicted better outcomes. For CBT, higher levels of baseline fear of pain and catastrophizing contributed to higher pain intensity at follow-up, whereas higher levels of pain self-efficacy were associated with less pain. Psychological factors did not predict sexual functioning outcomes for CBT. Consistent with biopsychosocial models of pain and sexual dysfunction, results indicate that psychological factors contribute to pain and sexual impairment following treatment for PV. Specifically, findings suggest that fear-avoidance variables and pain self-efficacy are significant predictors of topical and CBT treatment outcomes in women with PV.
authors.affiliation: Université du Québec à Montréal, Montréal, Department of Psychology, C.P. 8888, Suc. Centre-Ville, Montréal, QC H3C 3P8, Canada.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Desrochers
authors.forename: Sophie
authors.initials: S
authors.lastname: Bergeron
authors.forename: Samir
authors.initials: S
authors.lastname: Khalifé
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Dupuis
authors.forename: Mélanie
authors.initials: M
authors.lastname: Jodoin
mesh_terms: D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D015928:Cognitive Behavioral Therapy; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054327:Lubricants / Q000008:administration & dosage / Q000627:therapeutic use; D010146:Pain / Q000175:diagnosis / Q000523:psychology*; D059408:Pain Management; D011379:Prognosis; D011581:Psychological Tests; D012044:Regression Analysis; D020377:Self Efficacy; D016896:Treatment Outcome; D056650:Vulvodynia / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D054327:Lubricants