BACKGROUND Women with Vulvodynia experience pain, related impacts on sex and daily functioning, and depression. While psychosocial factors are associated with outcomes in Vulvodynia, longitudinal data are limited, especially in mixed/spontaneous Vulvodynia. Broad psychological models such as Psychological Flexibility (PF) and content-specific factors such as body-exposure anxiety and avoidance during sexual activities (BEA), and perceived injustice, have not been adequately investigated in Vulvodynia. The aim of this study was to explore whether these factors assessed at baseline predict pain severity, pain-interference, sexual functioning and satisfaction, and depression three months later. METHODS A longitudinal study of 349 women with Vulvodynia was conducted. Participants completed online self-report measures of pain-related and sexual outcomes, depression, BEA, perceived injustice, and facets of PF (present-moment-awareness, pain acceptance, committed action) at baseline and after three months, overlapping with the COVID-19 pandemic. RESULTS Seventy per cent of women responded at both assessments (n=244). There were significant decreases in pain severity, pain-interference, present-moment-awareness, committed action, and a significant increase in depression at three-months. All the baseline psychosocial factors significantly correlated with at least one outcome at three-months. When adjusting for baseline outcome and demographics, committed action significantly positively predicted depression at three-months, and pain acceptance significantly positively predicted pain-interference at three-months. CONCLUSIONS Among women with Vulvodynia, pain acceptance and committed action are prospectively associated with pain-interference and depression. The reliability and generalisability of these results needs to be established given the overlap with the COVID-19 pandemic. Future studies should investigate whether targeting these factors enhances outcomes in Vulvodynia.
The role of psychological flexibility, perceived injustice, and body-image in Vulvodynia: a longitudinal study.