Dyspareunia, defined as genital pain associated with penile-vaginal intercourse, is a common problem in women. According to the prevailing cognitive-behavioural model of dyspareunia (Spano &... Show moreDyspareunia, defined as genital pain associated with penile-vaginal intercourse, is a common problem in women. According to the prevailing cognitive-behavioural model of dyspareunia (Spano & Lamont, 1975), fear of pain and diminished sexual arousal are key components in the onset and maintenance of this poorly understood condition. In this thesis, a number of experimental studies are reported that sought to gain more insight into the role of these factors in dyspareunia. Results indicated that fear and anticipation of pain indeed inhibit genital and subjective sexual arousal responses in women, whether they have dyspareunia or not. Women with and without dyspareunia did not differ in genital responsiveness but in subjective sexual arousal responses, such that symptomatic women appraised sexual stimuli in a more negative way than women without sexual complaints. This negative appraisal of sexual stimuli was found to be restricted to a conscious level. Of cognitive-affective variables related to sexuality, chronic pain, and well-being, sexuality-related measures were the most important variables that discriminated between women with and without dyspareunia. Taken together, these results are in favour of recent reconceptualizations of sexual problems in women, which emphasize the relevance of subjective sexual arousal problems. Show less
