title: 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.
abstract: BACKGROUND
  Provoked vestibulodynia (PVD) is a highly prevalent and taxing female genital pain condition. Despite the intimate nature of this pain and the fact that affective factors such as anxiety have been shown to modulate its manifestations, no study has yet explored the emotional regulation of couples in which the woman suffers from PVD.
  
  
  OBJECTIVE
  Ambivalence over emotional expression (AEE) is an emotional regulation variable that quantifies the extent to which a person is comfortable with the way she or he expresses emotions. We examined whether the dyadic AEE of couples in which the woman suffers from PVD was differentially associated with women's pain and couples' psychological, sexual, and relational functioning.
  
  
  METHODS
  Couples (N = 254), in which the woman suffered from PVD, completed the AEE questionnaire. A couple typology of dyadic AEE was created.
  
  
  METHODS
  Dependent measures for both members of the couple were the global measure of sexual satisfaction scale, the Beck depression inventory II, and the revised dyadic adjustment scale. The female sexual function index and the sexual history form were used to assess the sexual function of women and men, respectively. Women also completed the pain rating index of the McGill pain questionnaire.
  
  
  RESULTS
  Couples, in which both partners were considered low on AEE, had the highest scores on sexual satisfaction (P = 0.02) and function (P < 0.01), the lowest depression scores (P < 0.01), and the best dyadic adjustment (P = 0.02). No difference in pain intensity was found between couples.
  
  
  CONCLUSIONS
  Findings suggest that, for couples in which the woman suffers from PVD, an emotional regulation that is low in ambivalence in both partners is associated with better psychological, sexual, and relational outcomes. Results indicate that emotional regulation may be important to consider in the assessment and treatment of couples coping with PVD.
authors.affiliation: Psychology, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Nayla
authors.initials: N
authors.lastname: Awada
authors.forename: Sophie
authors.initials: S
authors.lastname: Bergeron
authors.forename: Marc
authors.initials: M
authors.lastname: Steben
authors.forename: Victoria-Ann
authors.initials: VA
authors.lastname: Hainault
authors.forename: Pierre
authors.initials: P
authors.lastname: McDuff
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000209:etiology; D004414:Dyspareunia / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000523:psychology; D010549:Personal Satisfaction; D012747:Sexual Partners / Q000523:psychology*; D019529:Sexuality / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D056650:Vulvodynia / Q000523:psychology*
keywords: Ambivalence Over Emotional Expression; Couples; Dyadic; Provoked Vestibulodynia; Sexuality; Vulvodynia