Abstract
The aim of the study was to assess the predictive value of dyspareunia, general chronic pain, and metacognitive beliefs to sexual distress in a sample of women with endometriosis. Ninety-six women (mean age = 34.60 ± 6.44 years) with a diagnosis of endometriosis took part to this cross-sectional study. Sociodemographic and clinical data were collected by means of a structured ad hoc questionnaire. Metacognitive beliefs and sexual distress were assessed by means of the Metacognitions Questionnaire (MCQ30) and the Female Sexual Distress Scale-R (FSDS-r). General chronic pain intensity was collected by means of a Numeric Rating Scale. Data were subjected to Hierarchical logistic regression. We found high percentages of dyspareunia and sexual distress (i.e., 66% and 76%). Findings suggested that dyspareunia and chronic pain did not predict sexual distress, while negative beliefs about worries predicted sexual distress over and above them (p = .040, odd ratio 1.159). In the target population, metacognitive beliefs may have more influence on sexual distress than pain symptomatology.
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References
American Psychological Association (1992) Ethical principles of psychologists and code of conduct. Am Psychol 47:1597–1411
Ballard KD, Seaman HE, De Vries CS, Wright JT (2008) Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study—part 1. BJOG Int J Obstet Gynaecol 115:1382–1391
Bancroft J, Loftus J, Long JS (2003) Distress about sex: a national survey of women in heterosexual relationships. Arch Sex Behav 32:193–208
Barbara G, Facchin F, Buggio L, Somigliana E, Berlanda N, Kustermann A, Vercellini P (2017a) What is known and unknown about the association between endometriosis and sexual functioning: a systematic review of the literature. Reprod Sci 24:1566–1576
Barbara G, Facchin F, Meschia M, Berlanda N, Frattaruolo MP, Vercellin IP (2017b) When love hurts. A systematic review on the effects of surgical and pharmacological treatments for endometriosis on female sexual functioning. Acta Obstet Gynecol Scand 96:668–687. https://doi.org/10.1111/aogs.13031
Basson R et al (2000) Report of the international consensus development conference on female sexual dysfunction: definitions and classifications. J Urol 163:888–893
Burri A, Rahman Q, Spector T (2011) Genetic and environmental risk factors for sexual distress and its association with female sexual dysfunction. Psychol Med 41:2435–2445. https://doi.org/10.1017/S0033291711000493
Butow P, Kelly S, Thewes B, Hruby G, Sharpe L, Beith J (2015) Attentional bias and metacognitions in cancer survivors with high fear of cancer recurrence. Psychooncology 24:416–423. https://doi.org/10.1002/pon.3659
Bylinka J, Oniszczenko W (2016) Temperament, beliefs about pain control, and pain intensity in endometriosis patients. J Clin Psychol Med Settings 23:410–419. https://doi.org/10.1007/s10880-016-9473-8
Cartwright-Hatton S, Wells A (1997) Beliefs about worry and intrusions: the meta-cognitions questionnaire and its correlates. J Anxiety Disord 11:279–296. https://doi.org/10.1016/S0887-6185(97)00011-X
Cavaggioni G, Lia C, Resta S, Antonielli T, Benedetti Panici P, Megiorni F, Porpora MG (2014) Are mood and anxiety disorders and alexithymia associated with endometriosis? A preliminary study. Biomed Res Int 2014:1–5. https://doi.org/10.1155/2014/786830
Cook SA, Salmon P, Dunn G, Holcombe C, Cornford P, Fisher P (2015) The association of metacognitive beliefs with emotional distress after diagnosis of cancer. Health Psychol 34:207–2015
Culley L, Law C, Hudson N, Denny E, Mitchell H, Baumgarten M, Raine-Fenning N (2013) The social and psychological impact of endometriosis on women’s lives: a critical narrative review. Hum Reprod Update 19:625–639. https://doi.org/10.1093/humupd/dmt027
Denny E, Mann CH (2007) Endometriosis-associated dyspareunia: the impact on women’s lives. J Fam Plann Reprod Health Care 33:189–193. https://doi.org/10.1783/147118907781004831
Derogatis L, Clayton A, Lewis-D'Agostino D, Wunderlich G, Fu Y (2008) Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med 5:357–364. https://doi.org/10.1111/j.1743-6109.2007.00672.x
Di Donato N, Montanari G, Benfenati A, Leonardi D, Bertoldo V, Monti G, Seracchioli R (2013) The impact of socioeconomic and anamnestic characteristics on quality of life and sexual function in women with endometriosis. J Endometr Pelvic Pain Disord 5
Donatti L, Ramos DG, Andres MDP, Passman LJ, Podgaec S (2017) Patients with endometriosis using positive coping strategies have less depression, stress and pelvic pain. Einstein (São Paulo) 15:65–70. https://doi.org/10.1590/S1679-45082017AO3911
Duffy B, Smith K, Terhanian G, Bremer J (2005) Comparing data from online and face-to-face surveys. Int J Mark Res 47:615–639
Evans JR, Mathur A (2005) The value of online surveys. Internet Res 15:195–219
Facchin F, Barbara G, Saita E, Erzegovesi S, Martoni RM, Vercellini P (2016) Personality in women with endometriosis: temperament and character dimensions and pelvic pain. Hum Reprod 31:1515–1521. https://doi.org/10.1093/humrep/dew108
Facchin F, Barbara G, Saita E, Mosconi P, Roberto A, Fedele L, Vercellini P (2015) Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference. J Psychosom Obstet Gynaecol 36:135–141. https://doi.org/10.3109/0167482X.2015.1074173
Fairbanks F, Abdo CH, Baracat EC, Podgaec S (2017) Endometriosis doubles the risk of sexual dysfunction: a cross-sectional study in a large amount of patients. Gynecol Endocrinol 33:544–547. https://doi.org/10.1080/09513590.2017.1302421
Fritzer N, Haas D, Oppelt P, Renner S, Hornung D, Wölfler M, Ulrich U, Fischerlehner G, Sillem M, Hudelist G (2013) More than just bad sex: sexual dysfunction and distress in patients with endometriosis. Eur J Obstet Gynecol Reprod Biol 169:392–396. https://doi.org/10.1016/j.ejogrb.2013.04.001
Gomibuchi H, Taketani Y, Doi M, Yoshida K, Mizukawa H, Kaneko M, Kohda K, Takei T, Kimura Y, Liang SG, Kaibara M (1993) Is personality involved in the expression of dysmenorrhea in patients with endometriosis? Am J Obstet Gynecol 169:723–725
Hendrickx L, Gijs L, Enzlin P (2016) Sexual difficulties and associated sexual distress in Flanders (Belgium): a representative population-based survey study. J Sex Med 13:650–668. https://doi.org/10.1016/j.jsxm.2016.01.014
Lorencatto C, Petta CA, José Navarro M, Bahamondes L, Matos A (2006) Depression in women with endometriosis with and without chronic pelvic pain. Acta Obstet Gynecol Scand 85:88–92
Montanari G, Di Donato N, Benfenati A, Giovanardi G, Zannoni L, Vicenzi C et al (2013) Women with deep infiltrating endometriosis: sexual satisfaction, desire, orgasm, and pelvic problem interference with sex. J Sex Med 10:1559–1566
Moradi M, Parker M, Sneddon A, Lopez V, Ellwood D (2014) Impact of endometriosis on women’s lives: a qualitative study. BMC Womens Health 14:1–12. https://doi.org/10.1186/1472-6874-14-123
Pluchino N, Wenger JM, Petignat P, Tal R, Bolmont M, Taylor HS, Bianchi-Demicheli F (2016) Sexual function in endometriosis patients and their partners: effect of the disease and consequences of treatment. Hum Reprod Update 22:762–774
Quattropani MC, Lenzo V, Mucciardi M, Toffle ME (2014) Psychometric properties of the Italian version of the Short Form of the Metacognitions Questionnaire (MCQ-30). Bollettino di Psicologia Applicata 269:29–41
Quattropani MC, Lenzo V, Mucciardi M, Toffle ME (2016) Metacognition as predictor of emotional distress in cancer patients. Life Span Disabil 19:221–239
Rosen RC, Shifren JL, Monz BU, Odom DM, Russo PA, Johannes CB (2009) Correlates of sexually related personal distress in women with low sexual desire. J Sex Med 6:1549–1560. https://doi.org/10.1111/j.1743-6109.2009.01252.x
Ruggiero GM, Spada MM, Caselli G, Sassaroli S (2018) A historical and theoretical review of cognitive behavioral therapies: from structural self-knowledge to functional processes. J Ration Emot Cogn Behav Ther:1–26
Schaefer DR, Dillman DA (1998) Development of a standard e-mail methodology: results of an experiment. Public Opin Q 62:378–397
Spada MM, Gay H, Nikčevic AV, Fernie BA, Caselli G (2016) Meta-cognitive beliefs about worry and pain catastrophising as mediators between neuroticism and pain behaviour. Clin Psychol 20:138–146
Stephenson KR, Meston CM (2010a) Differentiating components of sexual well-being in women: are sexual satisfaction and sexual distress independent constructs? J Sex Med 7:2458–2468. https://doi.org/10.1111/j.1743-6109.2010.01836.x
Stephenson KR, Meston CM (2010b) When are sexual difficulties distressing for women? The selective protective value of intimate relationships. J Sex Med 7:3683–3694. https://doi.org/10.1111/j.1743-6109.2010.01958.x
Sun X, Zhu C, So SHW (2017) Dysfunctional metacognition across psychopathologies: a meta-analytic review. Eur Psychiatry 45:139–153. https://doi.org/10.1016/j.eurpsy.2017.05.029
Tabachnick BG, Fidell LS (2007) Using multivariate statistics, 5th edn. Pearson Education, Inc, Boston, MA
Tripoli TM, Sato H, Sartori MG, de Araujo FF, Girao MJ, Schor E (2011) Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis. J Sex Med 8:497–503. https://doi.org/10.1111/j.1743-6109.2010.01976.x
Vigano P, Parazzini F, Somigliana E, Vercellini P (2004) Endometriosis: epidemiology and aetiological factors. Best Pract Res Clin Obstet Gynaecol 18:177–200. https://doi.org/10.1016/j.bpobgyn.2004.01.007
Wells A (1995) Meta-cognition and worry: a cognitive model of generalized anxiety disorder. Behav Cogn Psychother 23:301–320
Wells A (2000) Emotional disorders and metacognition: innovative cognitive therapy. Wiley, Chichester, UK. https://doi.org/10.1002/9780470713662
Wells A (2009) Metacognitive therapy for anxiety and depression. The Guilford Press, London
Wells A, Cartwright-Hatton S (2004) A short form of the metacognitions questionnaire: properties of the MCQ-30. Behav Res Ther 42:385–396. https://doi.org/10.1016/S0005-7967(03)00147-5
Wells A, Matthews G (1996) Modelling cognition in emotional disorder: the S-REF model. Behav Res Ther 34:881–888
Wells A, Simons M (2009) Metacognitive therapy. John Wiley & Sons, Ltd. https://doi.org/10.1002/9781118528563.wbcbt06
World Medical Association (2013) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 310:2191–2194. https://doi.org/10.1001/jama.2013.281053
Zarbo C, Brugnera A, Frigerio L, Malandrino C, Rabboni M, Bondi E, Compare A (2017) Behavioral, cognitive and emotional coping strategies of women with endometriosis: a critical narrative review. Arch Women’s Mental Health 21:1–13. https://doi.org/10.1007/s00737-017-0779-9
Zarbo C, Brugnera A, Compare A, Candeloro I, Secomandi R, Betto E, Fusi F, Marabini R, Malandrino C, Carnelli M, Trezzi G, Bondi E, Rabboni M, Frigerio L (2018) Perfectionistic traits and importance given to parenthood are associated with infertility-related quality of life in a sample of infertile women with and without endometriosis. Sexual Reprod Healthc 17:86–90. https://doi.org/10.1016/j.srhc.2018.07.008
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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Zarbo, C., Brugnera, A., Compare, A. et al. Negative metacognitive beliefs predict sexual distress over and above pain in women with endometriosis. Arch Womens Ment Health 22, 575–582 (2019). https://doi.org/10.1007/s00737-018-0928-9
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DOI: https://doi.org/10.1007/s00737-018-0928-9