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Re-evaluating vaginismus : an empirical investigation of diagnostic reliability, vaginal spasm, pain, and associated etiological correlates
"Vaginismus is a sexual dysfunction that has received insufficient empirical attention. The first chapter of this thesis consists of a critical review of the literature and demonstrates the overall paucity of research studies and their poor methodological quality. The second and third chapter are based on the results of an experimental study comparing 87 women, matched on age, relationship status, and parity and assigned to 3 groups, vaginismus, dyspareunia/vulvar vestibulitis syndrome (VVS), and no pain. A structured interview evaluating pain with intercourse and history of gynecological problems as well as psychometric measures; evaluating sexual and physical abuse, sexual knowledge and schema, sexual functioning, relationship adjustment and psychological distress were administered. The reliability of vaginal muscle spasm as the main diagnostic criterion, differential diagnosis, and the role of pain were assessed via by 2 separate gynecological and, 2 separate physical therapist examination, 2 EMG evaluations, and a review of the interview data by 2 separate psychologists. Findings suggest that the spasm-based definition and resulting diagnostic reliability of vaginismus are not adequate. Both, women in the vaginismus and VVS groups exhibited higher levels of pelvic floor hypertonicity compared to women with no pain; however, women in the vaginismus group demonstrated the highest levels. Measures of pain did not distinguish between women with vaginismus and VVS. The only dependent measure clearly differentiating women with vaginismus was defensive and avoidant reactions during the physical exams. A re-conceptualization based on a multidimensional diagnostic framework including pelvic floor hypertonicity, avoidance and defensive reactions to vaginal penetration, and genital pain was suggested. The third paper was based on the results of questionnaires investigating etiological correlates of vaginismus, sexual and physical abuse, sexual self-schema, sexual knowled" --
- ""Vaginismus is a sexual dysfunction that has received insufficient empirical attention. The first chapter of this thesis consists of a critical review of the literature and demonstrates the overall paucity of research studies and their poor methodological quality. The second and third chapter are based on the results of an experimental study comparing 87 women, matched on age, relationship status, and parity and assigned to 3 groups, vaginismus, dyspareunia/vulvar vestibulitis syndrome (VVS), and no pain. A structured interview evaluating pain with intercourse and history of gynecological problems as well as psychometric measures; evaluating sexual and physical abuse, sexual knowledge and schema, sexual functioning, relationship adjustment and psychological distress were administered. The reliability of vaginal muscle spasm as the main diagnostic criterion, differential diagnosis, and the role of pain were assessed via by 2 separate gynecological and, 2 separate physical therapist examination, 2 EMG evaluations, and a review of the interview data by 2 separate psychologists. Findings suggest that the spasm-based definition and resulting diagnostic reliability of vaginismus are not adequate. Both, women in the vaginismus and VVS groups exhibited higher levels of pelvic floor hypertonicity compared to women with no pain; however, women in the vaginismus group demonstrated the highest levels. Measures of pain did not distinguish between women with vaginismus and VVS. The only dependent measure clearly differentiating women with vaginismus was defensive and avoidant reactions during the physical exams. A re-conceptualization based on a multidimensional diagnostic framework including pelvic floor hypertonicity, avoidance and defensive reactions to vaginal penetration, and genital pain was suggested. The third paper was based on the results of questionnaires investigating etiological correlates of vaginismus, sexual and physical abuse, sexual self-schema, sexual knowled" --"@en
- "Re-evaluating vaginismus an empirical investigation of diagnostic reliability, vaginal spasm, pain, and associated etiological correlates"
- "Re-evaluating vaginismus : an empirical investigation of diagnostic reliability, vaginal spasm, pain, and associated etiological correlates"@en