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Attachment, Sexual Assertiveness, and Sexual Outcomes in Women with Provoked Vestibulodynia and Their Partners: A Mediation Model

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Abstract

Provoked vestibulodynia (PVD) is a prevalent women’s sexual pain disorder, which is associated with sexual function difficulties. Attachment theory has been used to understand adult sexual outcomes, providing a useful framework for examining sexual adaptation in couples confronted with PVD. Research to date indicates that anxious and avoidant attachment dimensions correlate with worse sexual outcomes in community and clinical samples. The present study examined the association between attachment, pain, sexual function, and sexual satisfaction in a sample of 101 couples in which the women presented with PVD. The actor–partner interdependence model was used in order to investigate both actor and partner effects. This study also examined the role of sexual assertiveness as a mediator of these associations via structural equation modeling. Women completed measures of pain intensity and both members of the couple completed measures of romantic attachment, sexual assertiveness, sexual function, and satisfaction. Results indicated that attachment dimensions did not predict pain intensity. Both anxious and avoidant attachment were associated with lower sexual satisfaction. Only attachment avoidance predicted lower sexual function in women. Partner effects indicated that higher sexual assertiveness in women predicted higher sexual satisfaction in men. Finally, women’s sexual assertiveness was found to be a significant mediator of the relationship between their attachment dimensions, sexual function, and satisfaction. Findings highlight the importance of examining how anxious and avoidant attachment may lead to difficulties in sexual assertiveness and to less satisfying sexual interactions in couples where women suffer from PVD.

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Acknowledgments

This research was supported by a Fonds de la recherche en santé du Québec doctoral fellowship to Bianca Leclerc and Canadian Institutes of Health Research and Social Sciences and Humanities Research Council grants to Sophie Bergeron.

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Authors and Affiliations

  1. Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, QC, H3C 3J7, Canada

    Bianca Leclerc & Sophie Bergeron

  2. Department of Psychology, Université de Sherbrooke, Sherbrooke, QC, Canada

    Audrey Brassard

  3. Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada

    Claude Bélanger

  4. Department of Social and Preventive Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada

    Marc Steben

  5. Clinique A rue McGill, Montréal, QC, Canada

    Marc Steben

  6. VUVA Clinic, Centre Hospitalier de l’Université de Montréal, Hôpital Saint-Luc, Montréal, QC, Canada

    Bernard Lambert

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  1. Bianca Leclerc
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  2. Sophie Bergeron
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  3. Audrey Brassard
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  4. Claude Bélanger
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  5. Marc Steben
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  6. Bernard Lambert
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Correspondence to Bianca Leclerc.

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Leclerc, B., Bergeron, S., Brassard, A. et al. Attachment, Sexual Assertiveness, and Sexual Outcomes in Women with Provoked Vestibulodynia and Their Partners: A Mediation Model. Arch Sex Behav 44, 1561–1572 (2015). https://doi.org/10.1007/s10508-014-0295-1

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