Natalie O. Rosen

A little uncertainty goes a long way: State and trait differences in uncertainty interact to increase information seeking but also increase worry

This study examines the effect of an interaction between intolerance of uncertainty (IU) and situational uncertainty (SU) on worry due to uncertainty and on information seeking. Health providers may benefit from knowing when communicating uncertain information is beneficial. The study was a 2 (IU condition: high vs. low) × 2 (SU condition: high vs. low) experimental design resulting in four conditions to which university students (N = 153) were randomly assigned. IU was manipulated through a linguistic manipulation of responses to an IU questionnaire coupled with written false feedback. SU was manipulated by modifying the information participants read about a fictitious infection. Individuals in the high IU and high SU condition sought the most information and worried most due to uncertainty compared to people in the low IU and low SU condition, who sought the least information and worried least. Findings suggest that high IU may increase positive health behaviors such as screening intentions when individuals are faced with an uncertain health threat, but that it also increases worries due to that uncertainty. Providing opportunities for discussing ones emotional response to uncertainty and providing instrumental support for managing uncertainty (e.g., booking the follow-up appointment) is essential when communicating uncertain information.

Genital pain in women: Beyond interference with intercourse

This article may not exactly replicate the final version published in the journal. It is not the copy of record. / Cet article ne constitue pas la version officielle, et peut differer de la version publiee dans la revue.

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.

Impact of male partner responses on sexual function in women with vulvodynia and their partners: a dyadic daily experience study.

OBJECTIVE There is a paucity of research investigating the role of interpersonal variables in vulvodynia--a prevalent, chronic, vulvo-vaginal pain condition that negatively affects many aspects of womens sexual health, emotional well-being and intimate relationships. Cross-sectional studies have shown that male partner responses to painful intercourse are associated with pain and sexual satisfaction in women with vulvodynia. Partner responses can be solicitous (attention and sympathy), negative (hostility and frustration), and facilitative (encouragement of adaptive coping). No research has assessed the influence of daily partner responses in this population. Further, there is limited knowledge regarding the impact of partner responses on sexual function, which is a key measure of impairment in vulvodynia. METHODS Using daily diaries, 66 women (M age = 27.91, SD = 5.94) diagnosed with vulvodynia and their cohabiting male partners (M age = 30.00, SD = 8.33) reported on male partner responses and sexual function on days when sexual intercourse occurred (M = 6.54, SD = 4.99). Drawing on the Actor-Partner Interdependence model (APIM), a multivariate multilevel modeling approach was adopted. RESULTS A womans sexual functioning improved on days when she perceived greater facilitative and lower solicitous and negative male partner responses, and when her male partner reported lower solicitous responses. A mans sexual functioning was poorer on days when he reported greater solicitous and negative responses. CONCLUSIONS Findings suggest that facilitative male partner responses may improve sexual functioning whereas solicitous and negative responses may be detrimental. Partner responses should be targeted in psychological interventions aimed to improve the sexual functioning of affected couples.

Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia : a dyadic daily experience study.

Summary Targeting male partner responses and relationship satisfaction may enhance the quality of interventions aimed at reducing depression in women with vulvodynia. ABSTRACT Vulvodynia is a prevalent vulvovaginal pain condition that interferes with womens psychological health. Given the central role of sexuality and relationships in vulvodynia, relationship satisfaction may be an important moderator of daily partner responses to this pain and associated negative sequelae, such as depression. Sixty‐nine women (M age = 28.12 years, SD = 6.68) with vulvodynia and their cohabiting partners (M age = 29.67 years, SD = 8.10) reported their daily relationship satisfaction, and male partner responses on sexual intercourse days (M = 3.74, SD = 2.47) over 8 weeks. Women also reported their depressive symptoms. Relationship satisfaction on the preceding day moderated the associations between partner responses and womens depressive symptoms in several significant ways: (1) On days after women reported higher relationship satisfaction than usual, their perception of greater facilitative male partner responses was associated with their decreased depression; (2) on days after women reported lower relationship satisfaction than usual, their perception of greater negative male partner responses was associated with their increased depression; (3) on days after men reported higher relationship satisfaction than usual, their self‐reported higher negative responses were associated with decreased womens depression, and higher solicitous responses were associated with increased womens depression, whereas (4) on days after men reported lower relationship satisfaction than usual, their self‐reported higher negative responses were related to increased womens depression, and higher solicitous responses were associated with decreased womens depression. Targeting partner responses and relationship satisfaction may enhance the quality of interventions aimed at reducing depression in women with vulvodynia.

Daily Associations Between Partner Responses and Sexual and Relationship Satisfaction in Couples Coping with Provoked Vestibulodynia

INTRODUCTION Women with provoked vestibulodynia (PVD) experience a recurrent vulvo-vaginal pain triggered primarily during sexual intercourse. Although affected couples report adverse effects on their sexual and global romantic relationships, few studies have examined interpersonal factors that may influence their sexual and relationship satisfaction. Cross-sectional studies have shown that greater partner solicitous and negative responses and lower facilitative responses are associated with poorer sexual and relationship satisfaction in women with PVD. AIM The aim of this study was to investigate the within-person associations between partner responses to painful intercourse and the sexual and relationship satisfaction of affected couples. METHODS In a dyadic daily experience study, 69 women (M(age) = 28.46, SD = 6.66) diagnosed with PVD and their cohabitating male partners (M(age) = 30.29, SD = 8.13) reported on male partner responses, as well as sexual and relationship satisfaction on sexual intercourse days (M = 6.81; SD = 5.40) over 8 weeks. MAIN OUTCOME MEASURES Dependent measures were the (i) Kansas Marital Satisfaction Scale and (ii) Global Measure of Sexual Satisfaction Scale. RESULTS On sexual intercourse days when women perceived more facilitative partner responses than usual and on days when they perceived lower negative partner responses than usual, they reported higher sexual and relationship satisfaction. On sexual intercourse days when men reported more solicitous responses than usual, both they and their female partners reported lower sexual satisfaction. CONCLUSIONS Interventions aimed at improving the day-to-day sexual and relationship satisfaction of couples with PVD should target increasing facilitative and decreasing negative and solicitous partner responses.

Beyond a “Woman’s Problem”: The Role of Relationship Processes in Female Genital Pain

Female genital pain is a prevalent condition that can disrupt the psychosexual and relational well-being of affected women and their romantic partners. Despite the intimate context in which the pain can be elicited (i.e., during sexual intercourse), interpersonal correlates of genital pain and sexuality have not been widely studied in comparison to other psychosocial factors. This review describes several prevailing theoretical models explaining the role of the partner in female genital pain: the operant learning model, cognitive-behavioral and communal coping models, and intimacy models. The review includes a discussion of empirical research on the interpersonal and partner correlates of female genital pain and the impact of genital pain on partners’ psychosexual adjustment. Together, this research highlights a potential reciprocal interaction between both partners’ experiences of female genital pain. The direction of future theoretical, methodological, and clinical research is discussed with regard to the potential to enhance understanding of the highly interpersonal context of female genital pain.

Female Sexual Pain Disorders: a Review of the Literature on Etiology and Treatment

Female sexual pain disorders, although highly prevalent and increasingly studied, remain a distressing complaint for women and their partners. Empirical evidence points to a multifactorial conceptualization of the etiology, course, and associated difficulties of sexual pain; thus, treatment options span the medical, pelvic floor rehabilitation psychological and multimodal. Given the interpersonal context in which sexual pain occurs, recent work has underscored the importance of considering the dyadic framework in research and treatment. This review presents understanding from across disciplines focusing on the impact of sexual pain on the woman and the couple, proposed etiologic pathways and risk factors related to its development and course, and current treatment options. Recommendations for research point to an urgency for multidisciplinary exchanges in the development of conceptual models and refinement of targeted interventions.

The impact of intolerance of uncertainty on anxiety after receiving an informational intervention about HPV: A randomised controlled study

This study examined the impact of intolerance of uncertainty (IU) and an informational intervention about human papillomavirus (HPV) infection on perceived uncertainty about ones HPV testing status (referred to as ‘HPV uncertainty’) and anxiety. IU, HPV uncertainty and other pre-intervention measures were assessed through mailed questionnaires. Participants were then randomly assigned to receive either a long (N = 125) or short (N = 124) HPV-specific information pamphlet or a long (N = 131) or short (N = 115) control pamphlet about cancer prevention. Participants subsequently completed measures of HPV uncertainty and anxiety. Providing a lot of HPV information increased HPV uncertainty more than providing little HPV information and cancer prevention information. Among women who received the long HPV or the short control pamphlet, those with higher IU were more anxious than those with lower IU. Women with higher IU are more likely to seek HPV information, but they may also be at risk for experiencing higher anxiety because factual uncertainties about HPV cannot be resolved through the provision of more information.

Do individual differences in intolerance of uncertainty affect health monitoring

Researchers have postulated that individual differences in intolerance of uncertainty (IU) may affect peoples health behaviours. Study 1 (N = 147 university students) supports this proposition showing that higher IU is associated with higher monitoring (seeking threat-relevant information). Study 2 (N = 117 university students) experimentally manipulated IU to ensure that the association is not due to other related constructs such as anxiety or worry. Results show that inducing high IU led to increased monitoring as reflected by higher scores on an index of monitoring measures. Wanting information about the health threat in order to reduce their uncertainty was an independent predictor of monitoring and did not mediate the relationship between IU and monitoring. Findings suggest that high IU induces people to increase their monitoring; an adaptive strategy when the health threat can be reduced through this behaviour.