Abstract
In the context of genito-pelvic pain, consideration of interpersonal goals is particularly relevant given that couples’ distress is often predicated upon the relational setting. However, relationship goals have not been examined in this population. We investigated (1) the associations between relationship goals and women’s pain during intercourse as well as the sexual, relational, and psychological well-being of women with provoked vestibulodynia (PVD) and their partners and (2) the moderating role of sexual goals in these associations. Women with PVD (N = 134) and their partners completed measures of relationship goals, sexual goals, sexual satisfaction, relationship satisfaction, and depressive symptoms. Women also reported on their average pain intensity during intercourse. Women with stronger relationship approach goals reported more sexual satisfaction. When the partner pursued more relationship approach goals, both women and partners reported more sexual and relationship satisfaction and partners reported less depression. Stronger relationship avoidance goals in the partner were associated with less sexual satisfaction in women. Several significant interactions showed that the combination of relationship and sexual approach goals was associated with greater relationship and sexual satisfaction, and fewer depressive symptoms, whereas the combination of relationship and sexual avoidance goals was related to lower relationship satisfaction as well as to greater pain during intercourse for women. Targeting relationship approach and avoidance goals as well as those goals specific to sexual activity may improve the quality and efficacy of couples-based psychological interventions for PVD.
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References
Affleck, G., Tennen, H., Urrows, S., Higgins, P., Abeles, M., Hall, C., … Newton, C. (1998). Fibromyalgia and women’s pursuit of personal goals: A daily process analysis. Health Psychology, 17, 40–47. doi:10.1037/0278-6133.17.1.40.
Anderson, A., Rosen, N. O., Price, L., & Bergeron, S. (2016). Associations between penetration cognitions and the experience of genital pain and sexual well-being in women with provoked vestibulodynia. Journal of Sexual Medicine, 13, 444–452. doi:10.1016/j.jsxm.2015.12.024.
Ayling, K., & Ussher, J. M. (2008). “If sex hurts, am I still a woman?” The subjective experience of vulvodynia in hetero-sexual women. Archives of Sexual Behavior, 37, 294–304. doi:10.1007/s10508-007-9204-1.
Basson, R. (2001). Using a different model for female sexual response to address women’s problematic low sexual desire. Journal of Sex and Marital Therapy, 27, 395–403. doi:10.1080/713846827.
Baumeister, R. F., Bratslavsky, E., Finkenauer, C., & Vohs, K. D. (2001a). Bad is stronger than good. Review of General Psychology, 5, 323–370. doi:10.1037/1089-2680.5.4.323.
Baumeister, R. F., Catanese, K. R., & Vohs, K. D. (2001b). Is there a gender difference in strength of sex drive? Theoretical views, conceptual distinctions, and a review of relevant evidence. Personality and Social Psychology Review, 5, 242–273. doi:10.1207/S15327957PSPR0503_5.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio, TX: Psychological Corporation.
Bergeron, S., Binik, Y. M., Khalifé, S., Pagidas, K., & Glazer, H. I. (2001). Vulvar vestibulitis syndrome: Reliability of diagnosis and evaluation of current diagnostic criteria. Obstetrics and Gynecology, 98, 45–51. doi:10.1016/S0029-7844(01)01389-8.
Bergeron, S., Corsini-Munt, S., Aarts, L., Rancourt, K., & Rosen, N. O. (2015). Female sexual pain disorders: A review of the literature on etiology and treatment. Current Sexual Health Reports, 7, 159–169. doi:10.1007/s11930-015-0053-y.
Bergeron, S., Rosen, N. O., & Morin, M. (2011). Genital pain in women: Beyond interference with intercourse. Pain, 152, 1223–1225. doi:10.1016/j.pain.2011.01.035.
Boerner, K., & Rosen, N. O. (2015). Acceptance of vulvovaginal pain in women with provoked vestibulodynia and their partners: Associations with pain, psychological, and sexual adjustment. Journal of Sexual Medicine, 12, 1450–1462. doi:10.1111/jsm.12889.
Bois, K., Bergeron, S., Rosen, N. O., Mayrand, M., Brassard, A., & Sadikaj, G. (2015). Intimacy, sexual satisfaction and sexual distress in vulvodynia couples: An observational study. Health Psychology, 35, 531–540. doi:10.1037/hea0000289.
Brauer, M., Lakeman, M., van Lunsen, R., & Laan, E. (2014). Predictors of task-persistent and fear-avoiding behaviors in women with sexual pain disorders. Journal of Sexual Medicine, 11, 3051–3063. doi:10.1111/jsm.12697.
Busby, D. M., Christensen, C., Crane, D. R., & Larson, J. H. (1995). A revision of the dyadic adjustment scale for use with distressed and nondistressed couples: Construct hierarchy and multidimensional scales. Journal of Marital and Family Therapy, 21, 289–308. doi:10.1111/j.1752-0606.1995.tb00163.x.
Cano, A., & Williams, A. C. (2010). Social interaction in pain: Reinforcing pain behaviors or building intimacy? Pain, 149, 9–11. doi:10.1016/j.pain.2009.10.010.
Cooper, M. L., Shapiro, C., & Powers, S. (1998). Motivations for sex and risky sexual behavior among adolescents and young adults: A functional perspective. Journal of Personality and Social Psychology, 75, 1528–1558. doi:10.1037//0022-3514.75.6.1528.
Corsini-Munt, S., Bergeron, S., Rosen, N. O., Mayrand, M., & Delisle, I. (2014). Feasibility and preliminary effectiveness of a novel cognitive-behavioral couple therapy for provoked vestibulodynia: A pilot study. Journal of Sexual Medicine, 11, 2515–2527. doi:10.1111/jsm.12646.
Derogatis, L. R. (1997). The Derogatis Interview for Sexual Functioning (DISF/DISF-SR): An introductory report. Journal of Sex and Marital Therapy, 23, 291–304. doi:10.1080/00926239708403933.
Desrochers, G., Bergeron, S., Khalifé, S., Dupuis, M. J., & Jodoin, M. (2009). Fear avoidance and self-efficacy in relation to pain and sexual impairment in women with provoked vestibulodynia. Clinical Journal of Pain, 25, 520–527. doi:10.1097/AJP.0b013e31819976e3.
Dewitte, M., Van Lankveld, J., & Crombez, G. (2010). Understanding sexual pain: A cognitive-motivational account. Pain, 152, 251–253. doi:10.1016/j.pain.2010.10.051.
Elliot, A. J., Gable, S. L., & Mapes, R. R. (2006). Approach and avoidance motivation in the social domain. Personality and Social Psychology Bulletin, 32, 378–391. doi:10.1177/0146167205282153.
Elmerstig, E., Wijma, B., & Bertero, R. N. T. (2008). Why do young women continue to have sexual intercourse despite pain? Journal of Adolescent Health, 43, 357–363. doi:10.1016/j.jadohealth.2008.02.011.
Funk, J. L., & Rogge, R. D. (2007). Testing the ruler with item response theory: Increasing precision of measurement for relationship satisfaction with the Couples Satisfaction Index. Journal of Family Psychology, 21, 572–583. doi:10.1037/0893-3200.21.4.572.
Gable, S. L. (2006). Approach and avoidance social motives and goals. Journal of Personality, 74, 175–222. doi:10.1111/j.1467-6494.2005.00373.x.
Gates, E. A., & Galask, R. P. (2001). Psychological and sexual functioning in women with vulvar vestibulitis. Journal of Psychosomatic Obstetrics and Gynaecology, 22, 221–228. doi:10.3109/01674820109049977.
Gordon, A. S., Panahian-Jand, M., McComb, F., Melegari, C., & Sharp, S. (2003). Characteristics of women with vulvar pain disorders: Responses to a web-based survey. Journal of Sex and Marital Therapy, 29(Suppl. 1), 45–58. doi:10.1080/00926230390154899.
Gray, J. (1987). The psychology of fear and stress (2nd ed.). New York: Cambridge.
Hadjistavropoulos, T., Craig, K. D., Duck, S., Cano, A., Goubert, L., Jackson, P., … Fitzgerald, T. D. (2011). A biopsychosocial formulation of pain communication. Psychological Bulletin, 137, 910–939. doi:10.1037/a0023876.
Hardy, J. K., Crofford, L. J., & Segerstrom, S. C. (2011). Goal conflict, distress, and pain in women with fibromyalgia: A daily diary study. Journal of Psychosomatic Research, 70, 534–540. doi:10.1016/j.jpsychores.2010.10.013.
Harlow, B. L., Kunitz, C. G., Nguyen, R. H., Rydell, S. A., Turner, R. M., & Maclehose, R. F. (2014). Prevalence of symptoms consistent with a diagnosis of vulvodynia: Population based estimates from 2 geographical regions. American Journal of Obstetrics and Gynecology, 210, 40.e1–40.e8. doi:10.1016/j.ajog.2013.09.033.
Harlow, B. L., Wise, L. A., & Stewart, E. G. (2001). Prevalence and predictors of chronic lower genital tract discomfort. American Journal of Obstetrics and Gynecology, 185, 545–550. doi:10.1067/mob.2001.116748.
Impett, E. A., Gordon, A. M., Kogan, A., Oveis, C., Gable, S. L., & Keltner, D. (2010). Moving toward more perfect unions: Daily and long-term consequences of approach and avoidance goals in romantic relationships. Journal of Personality and Social Psychology, 99, 948–963. doi:10.1037/a0020271.
Impett, E. A., Muise, A., & Rosen, N. O. (2015). Is it good to be giving in the bedroom? A prosocial perspective on sexual health and well-being in romantic relationships. Current Sexual Health Reports, 7, 180–190. doi:10.1007/s11930-015-0055-9.
Impett, E. A., Peplau, L. A., & Gable, S. L. (2005). Approach and avoidance sexual motives: Implications for personal and interpersonal well-being. Personal Relationships, 12, 465–482. doi:10.1111/j.1475-6811.2005.00126.x.
Impett, E. A., Strachman, A., Finkel, E. J., & Gable, S. L. (2008). Maintaining sexual desire in intimate relationships: The importance of approach goals. Journal of Personality and Social Psychology, 94, 808–823. doi:10.1037/0022-3514.94.5.808.
Jensen, M. P., & Karoly, P. (2001). Self-report scale and procedures for assessing pain in adults. In D. C. Turk & R. Melzack (Eds.), Handbook of pain assessment (pp. 15–34). New York, NY: Guilford Press.
Karoly, P., Okun, M. A., Ruehlman, L. S., & Pugliese, J. A. (2008). The impact of goal cognition and pain severity on disability and depression in adults with chronic pain: An examination of direct effects and mediated effects via pain-induced fear. Cognitive Therapy and Research, 32, 418–433. doi:10.1007/s10608-007-9136-z.
Karsdorp, P. A., & Vlaeyen, J. W. S. (2011). Goals matter: Both achievement and pain-avoidance goals are associated with pain severity and disability in patients with low back and upper extremity pain. Pain, 152, 1382–1390. doi:10.1016/j.pain.2011.02.018.
Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis. New York: Guilford Press.
Laan, E., & Both, S. (2008). What makes women experience desire? Feminism & Psychology, 18, 505–514. doi:10.1177/0959353508095533.
Lawrance, K., & Byers, E. S. (1995). Sexual satisfaction in long-term heterosexual relationships: The Interpersonal Exchange Model of Sexual Satisfaction. Personal Relationships, 2, 267–285. doi:10.1111/j.1475-6811.1995.tb00092.x.
Leclerc, B., Bergeron, S., Brassard, A., Belanger, C., Steben, M., & Lambert, B. (2015). Attachment, sexual assertiveness, and sexual outcomes in women with provoked vestibulodynia and their partners: A mediation model. Archives of Sexual Behavior, 44, 1561–1572. doi:10.1007/s10508-014-0295-1.
Lemieux, A., Bergeron, S., Steben, M., & Lambert, B. (2013). Do romantic partners’ responses to entry dyspareunia affect women’s experiences of pain? The roles of catastrophizing and self-efficacy. The Journal of Sexual Medicine, 10, 2274–2284. doi:10.1111/jsm.12252.
Massey, E. K., Garnefski, N., & Gebhardt, W. A. (2009a). Goal frustration, coping and well-being in the context of adolescent headache: A self-regulation approach. European Journal of Pain, 13, 977–984. doi:10.1016/j.ejpain.2008.11.012.
Massey, E. K., Garnefski, N., Winifred, A., Gebhardt, W. A., & van der Leeden, R. (2009b). Daily frustration, cognitive coping and coping efficacy in adolescent headache: A daily diary study. Headache, 49, 1198–1205. doi:10.1111/j.1526-4610.2009.01492.x.
Muise, A., Boudreau, G., & Rosen, N. O. (2016). Seeking connection versus avoiding disappointment: An experimental manipulation of approach and avoidance sexual goals and the implications for desire and satisfaction. Journal of Sex Research,. doi:10.1080/00224499.2016.1152455.
Muise, A., Impett, E. A., & Desmarais, S. (2013). Getting it on vs giving it up: Sexual motivation, desire and satisfaction in intimate bonds. Personality and Social Psychology Bulletin, 39, 1320–1332. doi:10.1177/0146167213490963.
Nylanderlundqvist, E., & Bergdahl, J. (2003). Vulvar vestibulitis: Evidence of depression and state anxiety in patients and partners. Acta dermato-venereologica, 83, 369–373. doi:10.1080/00015550310003764.
Oliver, M. B., & Hyde, J. S. (1993). Gender differences in sexuality: A meta-analysis. Psychological Bulletin, 114, 29–51. doi:10.1037/0033-2909.114.1.29.
Ponte, M., Klemperer, E., Sahay, A., & Chren, M. M. (2009). Effects of vulvodynia on quality of life. Journal of the American Academy of Dermatology, 60, 70–76. doi:10.1016/j.jaad.2008.06.032.
Rancourt, K., Rosen, N. O., Bergeron, S., & Neilis, L. (2016). Talking about sex when sex is painful: Dyadic sexual communication is associated with women’s pain and couple’s sexual and psychological outcomes in provoked vestibulodynia. Archives of Sexual Behavior,. doi:10.1007/s10508-015-0670-6.
Reed, B. D., Harlow, S. D., Sen, A., Legocki, L. J., Edwards, R. M., Arato, N., & Haefner, H. K. (2012). Prevalence and demographic characteristics of vulvodynia in a population-based sample. American Journal of Obstetrics and Gynecology, 206, 170.e171–170.e179. doi:10.1016/j.ajog.2011.08.012.
Rehman, U. S., Rellini, A. H., & Fallis, E. (2011). The importance of sexual self-disclosure to sexual satisfaction and functioning in commited relationships. Journal of Sexual Medicine, 8, 3108–3115. doi:10.1111/j.1743-6109.2011.02439.x.
Rosen, N. O., Bergeron, S., Leclerc, B., Lambert, B., & Steben, M. (2010). Woman and partner-perceived partner responses predict pain and sexual satisfaction in provoked vestibulodynia (PVD) couples. Journal of Sexual Medicine, 7, 3715–3724. doi:10.1111/j.1743-6109.2010.01957.x.
Rosen, N. O., Bergeron, S., Sadikaj, G., Glowacka, M., Baxter, M., & Delisle, I. (2014). Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia: A dyadic daily experience study. Pain, 155, 1374–1383. doi:10.1016/j.pain.2014.04.017.
Rosen, N. O., Muise, A., Bergeron, S., Impett, E. A., & Boudreau, G. (2015). Approach and avoidance sexual goals in couples with provoked vestibulodynia: Associations with sexual, relational, and psychological well-being. Journal of Sexual Medicine, 12, 1781–1790. doi:10.1111/jsm.12948.
Rubin, H., & Campbell, L. (2012). Day-to-day changes in intimacy predict heightened relationship passion, sexual occurrence, and sexual satisfaction: A dyadic diary analysis. Social Psychological and Personality Science, 3, 224–231. doi:10.1177/1948550611416520.
Sheppard, C., Hallam-Jones, R., & Wylie, K. (2008). Why have you both come? Emotional, relationship, sexual and social issues raised by heterosexual couples seeking sexual therapy in women referred to a sexual difficulties clinic with a history of vulval pain. Sexual and Relationship Therapy, 23, 217–226. doi:10.1080/14681990802227974.
Simpson, J. A. (1990). Influence of attachment styles on romantic relationships. Journal of Personality and Social Psychology, 59, 971–980. doi:10.1037/0022-3514.59.5.971.
Smith, K. B., & Pukall, C. F. (2011). A systematic review of relationship adjustment and sexual satisfaction among women with provoked vestibulodynia. Journal of Sex Research, 48, 166–191. doi:10.1080/00224499.2011.555016.
Smith, K. B., & Pukall, C. F. (2014). Sexual function, relationship adjustment, and the relational impact of pain in male partners of women with provoked vulvar pain. Journal of Sexual Medicine, 11, 1283–1293. doi:10.1111/jsm.12484.
Strachman, A., & Gable, S. L. (2006). What you want (and do not want) affects what you see (and do not see): Avoidance social goals and social events. Personality and Social Psychology Bulletin, 32, 1446–1458. doi:10.1177/0146167206291007.
Sutherland, O. (2012). Qualitative analysis of heterosexual women’s experience of sexual pain and discomfort. Journal of Sex and Marital Therapy, 38, 223–244. doi:10.1080/0092623X.2011.606880.
Turner, J. A., & Romano, J. M. (1984). Self-report screening measures for depression in chronic pain patients. Journal of Clinical Psychology, 40, 909–913. doi:10.1002/1097-4679(198407)40:4<909::AID-JCLP2270400407>3.0.CO;2-J.
Verhoeven, K., Crombez, G., Eccleston, C., Van Ryckeghem, D. M., Morley, S., & Van Damme, S. (2010). The role of motivation in distracting attention away from pain: An experimental study. Pain, 149, 229–234. doi:10.10.6/j.pain.2010.01.019.
Vlaeyen, J. W. S., & Linton, S. J. (2012). Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain, 153, 1144–1147. doi:10.1016/j.pain.2011.12.009.
Acknowledgments
This study was funded by a grant from the Canadian Institutes of Health Research (FRN: 130338) awarded to N. O. Rosen. The authors would like to thank Kathy Petite, Myléne Desrosiers, and Gillian Boudreau for their assistance as well as the couples who participated in this study.
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Rosen, N.O., Dewitte, M., Merwin, K. et al. Interpersonal Goals and Well-Being in Couples Coping with Genito-Pelvic Pain. Arch Sex Behav 46, 2007–2019 (2017). https://doi.org/10.1007/s10508-016-0877-1
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DOI: https://doi.org/10.1007/s10508-016-0877-1