Exploring pain perception and depression in vulvodynia: the role of catastrophizing and pain acceptance

Background: In the context of vulvodynia, a gynecological disorder characterized by chronic vulvar pain affecting an estimated 10% of women, with significant impacts on sexual health, mental well-being, and productivity, the Common-Sense Model of Illness Self-Regulation, a well-established framework for understanding the impact of illness perceptions and coping strategies on mental health, has not yet been empirically tested. Aim: We aimed to explore whether illness perceptions and pain-specific coping strategies-namely, pain catastrophizing and chronic pain acceptance-influence the relationship between vulvar pain severity and depression in women with vulvodynia. Methods: A cross-sectional study was conducted on a total of 119 women with reporting diagnosis of vulvodynia. Outcomes: Through an online questionnaire, we assessed demographic and clinical characteristics, vulvar pain severity, illness beliefs, pain catastrophizing, pain acceptance, and depressive symptoms. Results: The path analysis showed that vulvar pain positively influences directly illness perceptions (beta = .56, P < .001) and depressive symptoms (beta = .24, P < .001). Negative perceptions of the illness were significantly associated with increased pain catastrophizing (beta = .66, P < .001), and decreased pain acceptance (beta = -.59, P < .001), resulting in heightened depressive symptoms (beta = .33, P < .001, beta = -.27, P < .001, respectively). Clinical Implications: Interventions that challenge negative illness perceptions and promote more positive views could reduce maladaptive coping strategies, enhance pain acceptance, and ultimately diminish psychological distress. Strengths and Limitations: This study's strengths lie in its foundation on a theoretical, well-established model and the use of validated measures. However, the cross-sectional design precludes concluding causality between predictor and outcome variables, and the clinical information was self-reported and could not be verified with medical records. Conclusions: The findings underscore the importance of targeting illness perceptions and coping strategies in shaping psychological outcomes for women with vulvodynia.