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Mindfulness-based Group Therapy for Women with Provoked Vestibulodynia

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Abstract

Provoked vestibulodynia (PVD) is the most common cause of painful intercourse in women of reproductive age and research supports psychological approaches in the management of chronic pain. We developed a four-session group treatment for women with PVD that relied mostly on mindfulness meditation skills along with education and some discussion of cognitive theory. A total of 85 women were assigned either to immediate treatment (n = 62; mean age, 39 years) or to a 3-month wait-list condition followed by treatment (n = 23; mean age, 40 years). Questionnaires and a genital pain assessment were administered at pre- and post-treatment, and at 6 months follow-up. Women assigned to the two groups did not significantly differ on any measure at baseline. During the pretreatment wait-list period, there were significant improvements in pain self-efficacy, and non-significant improvements in feelings of helplessness, and sex-related distress. Pain self-efficacy, pain catastrophizing, genital pain induced by a cotton swab exam, pain hypervigilance, and sex-related distress all improved with treatment. There was no change in pain with intercourse. Pretreatment genital pain was the best predictor of post-treatment genital pain. Genital pain at 6-month follow-up was predicted by pretreatment genital pain, change in pain self-efficacy, and number of comorbid chronic pain conditions. Taken together, these findings support the use of a brief mindfulness-based program as a promising treatment for distressing genital pain.

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Acknowledgments

The authors wish to thank Robyn Jackowich, Melissa Moses, Miranda Abild, and Pretty Verma for assistance carrying out the study. We also wish to thank group facilitators Marie Carlson, Kate McBride, and Dr. Gail Knudson. We thank Dr. Sydney Thomson and Dr. Mijla Luria for input during the initial design of this study. Funding for this study was provided from a Women’s Health Research Institute Grant to L.A.B. K.B.S. is currently supported by a Post Doctoral Clinical Research Trainee Award from the Michael Smith Foundation for Health Research and a Post Doctoral Fellowship Award from the Canadian Pain Society.

Conflict of Interest

None of the authors have any conflicts of interest.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University of British Columbia, 2775 Laurel Street, 6th Floor, Vancouver, BC, V5Z 1M9, Canada

    Lori A. Brotto, Kelly B. Smith & Leslie Sadownik

  2. Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

    Rosemary Basson & Miriam Driscoll

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  1. Lori A. Brotto
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  2. Rosemary Basson
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  3. Kelly B. Smith
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  5. Leslie Sadownik
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Correspondence to Lori A. Brotto.

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Brotto, L.A., Basson, R., Smith, K.B. et al. Mindfulness-based Group Therapy for Women with Provoked Vestibulodynia. Mindfulness 6, 417–432 (2015). https://doi.org/10.1007/s12671-013-0273-z

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