Psychological Inflexibility as a Predictor of Sexual Functioning Among Women with Vulvovaginal Pain: A Prospective Investigation

Abstract

Objective Persistent vulvovaginal pain affects many women and often has adverse effects on sexual functioning. Psychological inflexibility related to pain is associated with distress and functional disability across different types of chronic pain conditions, but little is known about the role of psychological inflexibility in vulvovaginal pain. The present study examines psychological inflexibility related to pain as a predictor of sexual functioning over time among women with vulvovaginal pain. Methods Questionnaires including measures of psychological inflexibility, pain severity, and sexual functioning were administered to female university students at two points in time. One hundred thirty women with vulvovaginal pain responded to the questionnaire at baseline and at follow-up after 10 months. A multiple regression model was used to explore psychological inflexibility and pain severity as predictors of sexual functioning at follow-up. Results Higher levels of psychological inflexibility and more severe pain at baseline were associated with poorer sexual functioning 10 months later. In analysis adjusting for baseline levels of sexual functioning, psychological inflexibility was the only significant predictor of sexual functioning at follow-up. Conclusions The findings provide preliminary evidence that psychological inflexibility is associated with sexual adjustment over time among women with vulvovaginal pain and point to the relevance of further examinations of the psychological inflexibility model in the context of vulvovaginal pain.

Associations Between Six Core Processes of Psychological Flexibility and Functioning for Chronic Pain Patients: A Three-Level Meta-Analysis

“…These six core processes can be fostered in the ACT by different exercises. From the view of the psychological flexibility model, chronic pain patients can relieve the psychological burden or improve their psychological functioning through accepting inner experiences, being mindful, and participating in actions that are aligned with individual goals and values ( 2 , 32 ). Likewise, many researches have classified functioning into physical and psychological functioning ( 7 , 33 ).…”

Which outcome variables are associated with psychological inflexibility/flexibility for chronic pain patients? A three level meta-analysis

“…This may be due to the fact that psychological flexibility could provide less painful experiences and psychological distress in the pursuit of value-oriented behavior and reduce long-term distress and increase the ability to cope with chronic pain (Hayes et al, 2014 ; Goldbart et al, 2020 ). While for those who were trapped in their negative thinking or avoidance (i.e., psychological inflexibility), they may experience more anxiety, depression, dysfunction, and lower levels of quality of life which in turn may exacerbate the pain over time (Maathz et al, 2020 ; Rhodes et al, 2021 ). As such, targeting psychological inflexibility/flexibility may likely be valuable for chronic pain patients.…”

“…It also leads to short-term relief behaviors, such as physical inactivity and avoidance of activities (i.e., remaining still or not going out of doors). However, these behaviors often prevent them from activities that increase their quality of life (e.g., visiting friends, working, or playing sports) (Maathz et al, 2020 ; Rhodes et al, 2021 ). Over time, the patient's strategy of avoiding negative psychological events produces a narrow and inflexible pattern of action, resulting in increased disability (Wicksell et al, 2008 ).…”

“…In comparison, the flexibility model suggests that pain and suffering are inherent aspects of human life. Psychological flexibility, on the other hand, is characterized by accepting inner experiences, being mindful, and participating in actions aligned with individual goals and values, which may relieve the psychological burden and increase wellbeing (Maathz et al, 2020 ; Rhodes et al, 2021 ). Moreover, psychological flexibility is a malleable factor which is amenable to change through ACT (Hayes et al, 2012 ).…”

Mindfulness, Self-Compassion, and Acceptance as Predictors of Sexual Satisfaction in Cisgender Heterosexual Men and Women

“…Being psychologically flexible means accepting the experience as it is, without judgment, and being able to tolerate the emotions, feelings, physical sensations, and thoughts without falling into behavioral, emotional, or experiential avoidance in order to avoid suffering [ 35 ]. Psychological inflexibility has been studied in relation to sexual pain [ 35 ] and vulvodynia [ 36 , 37 ]. The studies found lower levels of acceptance (i.e., greater psychological inflexibility) in women with sexual pain and vulvodynia [ 36 , 37 , 38 ].…”