Déterminants dyadiques et évolution dans le temps de la douleur génito-pelvienne
Provoked vestibulodynia (PVD) is the most common form of genito-pelvic pain and is associated with negative psychosexual consequences for women and their partners. The objective of the thesis was to examine the role of perceived injustice, anxiety, and depression in the adjustment of couples coping with PVD. The first study examined the associations between perceived injustice and pain intensity, sexual satisfaction, sexual distress, and depression among 50 women with PVD and their partners via self-report questionnaires. Women’s higher level of perceived injustice was associated with their own greater sexual distress and depression. Partners’ higher level of perceived injustice was associated with their own greater sexual distress and depression and with their own lower sexual satisfaction. Perceived injustice was not associated with women’s pain intensity. Using a daily dyadic methodology over a period of two months, the second study focused on the associations between anxiety and depressive symptoms, and sexual function, sexual distress and pain among 127 couples coping with PVD. On days of sexual activity, when women reported feeling more anxious or depressed, they reported greater pain and lower sexual function. On days of sexual activity, when women reported feeling more depressed, they reported greater levels of sexual distress, and when partners reported feeling more anxious or depressed, women as well as partners reported greater levels of sexual distress. Using three separate measurement time points over a seven-year period, the third study aimed to identify pain trajectories and their predictors in women with PVD. Two pain trajectories were identified, one where pain persisted and one where pain decreased over time, both associated with different predictors. The clinical, theoretical and methodological implications of the thesis are discussed.
Genito-pelvic pain/penetration disorder Provoked vestibulodynia Perceived injustice Anxiety Sexual distress Sexual function Sexual satisfaction Pain trajectories Daily experience methodology