Provoked Vestibulodynia: Mediators of the Associations Between Partner Responses, Pain, and Sexual Satisfaction

Provoked vestibulodynia (PVD) is a chronic, recurrent vulvo-vaginal pain condition affecting 12% of the general population,
and is associated with sexual dysfunction, psychological distress, and reduced quality of life. There is growing interest
in the role of interpersonal variables in PVD, which have been widely neglected. In a sample of 175 couples, the present study
examined the mediating roles of partner and participant catastrophizing and self-efficacy in the association between solicitous
partner responses and pain intensity, and that of dyadic adjustment in the association between solicitous and negative partner
responses and sexual satisfaction. Couples completed measures of partner responses, catastrophizing, self-efficacy, dyadic
adjustment, and depression. Women also completed measures of pain, sexual satisfaction, and sexual function. Controlling for
depression and solicitousness perceived by the other member of the couple, catastrophizing and self-efficacy partially mediated
the association between higher solicitous responses and higher pain during intercourse, accounting for 26 and 25% of the variance
in this association for participant and partner-perceived responses, respectively. For both participant and partners, only
pain catastrophizing was a unique mediator. Controlling for depression, sexual function and partner-perceived responses, dyadic
adjustment partially mediated the association between higher participant-perceived solicitous responses and higher sexual
satisfaction, and between higher participant-perceived negative responses and lower sexual satisfaction, accounting for 26%
of the variance in each association. The current findings suggest that catastrophizing and dyadic adjustment may constitute
a route by which partner responses exacerbate pain and increase or decrease sexual satisfaction in PVD couples.