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Using a novel data-driven network approach, this study aimed to examine the interconnection between the key elements of the Fear-Avoidance Model of female genital pain - sexual arousal, fear-avoidant cognitions, and motivational coping - and its associated factors to predict the intensity and frequency of genital pain across women over time. Network modeling allowed for a comprehensive evaluation of the Fear-Avoidance model while capturing the dynamic features of genital pain. We estimated a cross-sectional and a temporal, contemporaneous, and between-persons network model on convenience-based data of 543 female students (mean age = 23.7 years, SD = 3.6) collected at three time points. Results showed that lubrication, pain catastrophizing, pain avoidance, fear-avoidance beliefs, sexual satisfaction, anxiety, and frequency of coital and non-coital sex predicted pain, with lubrication being the most consistent predictor across estimations. The network of women with recurrent genital pain showed a similar pattern as the network of the total sample, except that pain avoidance and fear-avoidance beliefs rather than pain catastrophizing predicted pain directly, and frequency of coital and non-coital sexual activities played a more prominent role. These results suggest that the main problem of genital pain centers around women not being sufficiently aroused during intercourse and inadequate ways of pain coping, which are critical targets of cognitive-behavioral therapy treatment and should be developed further.

Petra Prinssen,1,2 Peter Joseph Jongen,3,4 Marco Heerings,5 Elia Wyverkens,6 Guy T’Sjoen,6 Ellen Deschepper,7 Marieke Dewitte8 1Praktijk Seksualiteit en welzijn, Roermond, 6045 GL, the Netherlands; 2Department of Public Health and Primary Care, Ghent University, Ghent, 9000, Belgium; 3MS4 Research Institute, Nijmegen, 6522 KJ, the Netherlands; 4Department of Community and Occupational Medicine, University Medical Centre Groningen, Groningen, 9713 AV, the Netherlands; 5Dutch National MS Foundation, Rotterdam, 3044 AT, the Netherlands; 6Department of Endocrinology, Center for Sexology and Gender, Ghent University Hospital, Ghent, 9000, Belgium; 7Biostatistics Unit, Department of Public Health and Primary Care, Ghent University, Ghent, 9000, Belgium; 8Department of Clinical Psychological Science, Faculty of Psychology and Neurosciences, Maastricht University, Maastricht, 6229 ER, the NetherlandsCorrespondence: Peter Joseph Jongen, MS4 Research Institute, Ubbergseweg 34, Nijmegen, 6522 KJ, the Netherlands, Tel +31243239146 ; +31614037368, Email ms4ri@kpnmail.nlPurpose: Sexual motives are major determinants of sexual behaviour. It has been known that sexual motives may vary according to circumstances. Multiple sclerosis (MS) is a chronic disease causing a broad range of symptoms and disabilities, that often interfere with sexual activities. We aimed to investigate the sexual motives in persons with MS.Patients and Methods: Cross-sectional study in 157 persons with MS and 157 controls matched for age, gender, relationship, duration of relationship and educational status via propensity score matching. The Reasons for Having Sex (YSEX) questionnaire assessed the proportion with which a person had engaged in sexual intercourse for each of 140 distinct motives to have sex. Estimated mean differences in scores for four primary factors (Physical, Goal attainment, Emotional, Insecurity) and 13 sub-factors, and sexual satisfaction and importance of sex were calculated as Averag

BACKGROUND: Sexual communication is a common target in psychological treatments for vulvodynia, and associations with sexual function and distress, as well as pain intensity, have been demonstrated. However, structured observations of the communication patterns of couples with vulvodynia are lacking, as these are needed to guide treatment efforts. AIM: To explore (1) the sexual communication patterns in couples with vulvodynia in terms of observed communication quality (operationalized as validating and invalidating responses), self-reported sexual assertiveness, and self-disclosure and (2) associations between sexual communication quality and pain intensity. METHODS: In a case-control design with within- and between-group comparisons, 62 couples engaged in videotaped discussions about their sexual relationship. Trained coders assessed the discussions by rating sexual communication (validation and invalidation) according to a structured behavioral coding scheme. Group differences in sexual communication quality were examined with parametric and nonparametric tests. Dyadic associations among observed communication quality, self-rated sexual assertiveness, and self-disclosure were examined within the actor-partner interdependence model. Multiple regression was used to test the predictive value of partners' validation/invalidation on the pain intensity of the women with vulvodynia. OUTCOMES: Observed communication quality (ie, validation and invalidation), self-reported sexual assertiveness, self-disclosure, and pain intensity. RESULTS: Partners of women with vulvodynia were more invalidating toward their partners than those of women without pain. There were no significant differences in validating/invalidating communication between women in the 2 groups or in validation between partners. Partners' validating communication were significantly associated with women's lower pain intensity. The sexual communication patterns differed between couples with and without vulvody