A feasibility trial of online Acceptance and Commitment Therapy for women with provoked vestibulodynia.
Acceptance and Commitment Therapy
Cognitive Behavioral Therapy
internet-based intervention
sexual dysfunction
vestibulodynia
vulvodynia
Journal
Scandinavian journal of pain
ISSN: 1877-8879
Titre abrégé: Scand J Pain
Pays: Germany
ID NLM: 101520867
Informations de publication
Date de publication:
26 07 2023
26 07 2023
Historique:
received:
11
10
2022
accepted:
26
05
2023
medline:
21
7
2023
pubmed:
4
7
2023
entrez:
4
7
2023
Statut:
epublish
Résumé
Acceptance and Commitment Therapy (ACT) is an established treatment for chronic pain. However, it is a form of treatment that have not yet been applied much in the treatment of persistent vulvar pain disorders. This study examines the feasibility and preliminary effects of online ACT for patients with provoked vestibulodynia. Women diagnosed with provoked vestibulodynia were assigned randomly either to online ACT or to a waitlist control group. Feasibility was assessed in terms of recruitment potential, treatment credibility, completions rates, retention in trial, and data quality. Participants completed measures of pain with sexual activity, sexual functioning, emotional and relational adjustment, and potential treatment processes before and after treatment. Of the 111 women who were invited to participate in the study, 44 were included (39.6 % recruitment rate). Thirty seven participants (84.1 %) completed the pre-treatment assessment. Participants who received online ACT rated treatment credibility positively, and completed on average 4.31 (SD=1.60) of the six treatment modules. Of participants, 34 provided post treatment data, giving a trial retention rate of 77 %. Effects of online ACT, as compared to waitlist, were large for pain acceptance and quality of life, medium for anxiety and pain catastrophizing, and small for sexual satisfaction, pain with sexual activity, and relationship adjustment. With some adjustments to recruitment procedures, a full scale randomized controlled trial of online ACT for provoked vestibulodynia appears feasible.
Identifiants
pubmed: 37401654
pii: sjpain-2022-0146
doi: 10.1515/sjpain-2022-0146
doi:
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
476-482Informations de copyright
© 2023 the author(s), published by De Gruyter, Berlin/Boston.
Références
Hayes, SC, Strosahl, KD, Wilson, KG. Acceptance and Commitment Therapy: an experiential approach to behavior change . New York; London: Guilford Press; 1999:304 p.
Hughes, LS, Clark, J, Colclough, JA, Dale, E, McMillan, D. Acceptance and commitment therapy (ACT) for chronic pain: a systematic review and meta-analyses. Clin J Pain 2017;33. https://doi.org/10.1097/ajp.0000000000000425 .
doi: 10.1097/ajp.0000000000000425
Bergeron, S, Binik, YM, Khalife, S, Pagidas, K, Glazerd, HI, Meana, M, et al.. A randomized comparison of group cognitive-behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Pain 2001;91:297–306. https://doi.org/10.1016/s0304-3959(00)00449-8 .
doi: 10.1016/s0304-3959(00)00449-8
Brotto, LA, Basson, R, Smith, KB, Driscoll, M, Sadownik, L. Mindfulness-based group therapy for women with provoked vestibulodynia. Mindfulness 2015;6:417–32. https://doi.org/10.1007/s12671-013-0273-z .
doi: 10.1007/s12671-013-0273-z
Brotto, LA, Bergeron, S, Zdaniuk, B, Driscoll, M, Grabovac, A, Sadownik, LA, et al.. A comparison of mindfulness-based cognitive therapy vs cognitive behavioral therapy for the treatment of provoked vestibulodynia in a hospital clinic setting. J Sex Med 2019;16:909–23. https://doi.org/10.1016/j.jsxm.2019.04.002 .
doi: 10.1016/j.jsxm.2019.04.002
Guillet, AD, Cirino, NH, Hart, KD, Leclair, CM. Mindfulness-based group cognitive behavior therapy for provoked localized vulvodynia: a randomized controlled trial. J Low Genit Tract Dis 2019;23:170–75. https://doi.org/10.1097/lgt.0000000000000456 .
doi: 10.1097/lgt.0000000000000456
Harlow, BL, Kunitz, CG, Nguyen, RHN, Rydell, SA, Turner, RM, MacLehose, RF. Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from 2 geographic regions. Am J Obstet Gynecol 2014;210:40.e1–8. https://doi.org/10.1016/j.ajog.2013.09.033 .
doi: 10.1016/j.ajog.2013.09.033
Reed, BD, Haefner, HK, Sen, A, Gorenflo, DW. Vulvodynia incidence and remission rates among adult women: a 2-year follow-up study. Obstet Gynecol 2008;112:231–7. https://doi.org/10.1097/aog.0b013e318180965b .
doi: 10.1097/aog.0b013e318180965b
Reed, BD, Harlow, SD, Sen, A, Legocki, LJ, Edwards, RM, Arato, N, et al.. Prevalence and demographic characteristics of vulvodynia in a population-based sample. Am J Obstet Gynecol 2012;206:170.e1–9.
Moyal-Barracco, M, Lynch, PJ. ISSVD terminology and classification of vulvodynia: a historical perspective. J Reprod Med 2003;49:772–7.
Reed, BD. Vulvodynia: diagnosis and management. Am Fam Physician 2006;73:1231–8.
Khandker, M, Brady, SS, Vitonis, AF, MacLehose, RF, Stewart, EG, Harlow, BL. The influence of depression and anxiety on risk of adult onset vulvodynia. J Women’s Heal. 2011;20:1445–51. https://doi.org/10.1089/jwh.2010.2661 .
doi: 10.1089/jwh.2010.2661
Masheb, RM, Lozano-Blanco, C, Kohorn, EI, Minkin, MJ, Kerns, RD. Assessing sexual function and dyspareunia with the female sexual function index (FSFI) in women with vulvodynia. J Sex Marital Ther 2004;30:315–24. https://doi.org/10.1080/00926230490463264 .
doi: 10.1080/00926230490463264
Gates, EA, Galask, RP. Psychological and sexual functioning in women with vulvar vestibulitis. J Psychosom Obstet Gynecol 2001;22:221–8. https://doi.org/10.3109/01674820109049977 .
doi: 10.3109/01674820109049977
Hayes, SC, Luoma, JB, Bond, FW, Masuda, A, Lillis, J. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther 2006;44:1–25. https://doi.org/10.1016/j.brat.2005.06.006 .
doi: 10.1016/j.brat.2005.06.006
Maathz, P, Flink, IK, Engman, L, Ekdahl, J. Psychological inflexibility as a predictor of sexual functioning among women with vulvovaginal pain: a prospective investigation. Pain Med 2020;21:3596–602. https://doi.org/10.1093/pm/pnaa042 .
doi: 10.1093/pm/pnaa042
Chisari, C, Budhraja, M, Monajemi, MB, Lewis, F, Moss-Morris, R, Scott, W, et al.. The role of psychological flexibility, perceived injustice and body image in Vulvodynia: a longitudinal study. Eur J Pain 2021;26:103–13. https://doi.org/10.1002/ejp.1841 .
doi: 10.1002/ejp.1841
Goldstein, AT, Pukall, CF, Brown, C, Bergeron, S, Stein, A, Kellogg-Spadt, S. Vulvodynia: assessment and treatment. J Sex Med 2016;13:572–90. https://doi.org/10.1016/j.jsxm.2016.01.020 .
doi: 10.1016/j.jsxm.2016.01.020
Harlow, BL, Stewart, EG. A population-based assement of cronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia? J Am Med Women’s Assoc 2003;58:82–8.
Nguyen, RHN, Turner, RM, Rydell, SA, MacLehose, RF, Harlow, BL. Perceived stereotyping and seeking care for chronic vulvar pain. Pain Med 2013;14:1461–7. https://doi.org/10.1111/pme.12151 .
doi: 10.1111/pme.12151
Lamvu, G, Alappattu, M, Witzeman, K, Bishop, M, Robinson, M, Rapkin, A. Patterns in vulvodynia treatments and 6-month outcomes for women enrolled in the national vulvodynia registry—an exploratory prospective study. J Sex Med 2018;15:705–15. https://doi.org/10.1016/j.jsxm.2018.03.003 .
doi: 10.1016/j.jsxm.2018.03.003
Mehta, S, Peynenburg, VA, Hadjistavropoulos, HD. Internet-delivered cognitive behaviour therapy for chronic health conditions: a systematic review and meta-analysis. J Behav Med 2019;42:169–87. https://doi.org/10.1007/s10865-018-9984-x .
doi: 10.1007/s10865-018-9984-x
Wallin, E, Maathz, P, Parling, T, Hursti, T. Self-stigma and the intention to seek psychological help online compared to face-to-face. J Clin Psychol 2018;74:1207–18. https://doi.org/10.1002/jclp.22583 .
doi: 10.1002/jclp.22583
Carlbring, P, Andersson, G, Cuijpers, P, Riper, H, Hedman-Lagerlöf, E. Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cognit Behav Ther 2018;47:1–18. https://doi.org/10.1080/16506073.2017.1401115 .
doi: 10.1080/16506073.2017.1401115
Scott, W, Chilcot, J, Guildford, B, Daly-Eichenhardt, A, McCracken, LM. Feasibility randomized-controlled trial of online Acceptance and Commitment Therapy for patients with complex chronic pain in the United Kingdom. Eur J Pain 2018;22:1473–84. https://doi.org/10.1002/ejp.1236 .
doi: 10.1002/ejp.1236
Kioskli, K, Scott, W, Winkley, K, Godfrey, E, McCracken, LM. Online acceptance and commitment therapy for people with painful diabetic neuropathy in the United Kingdom: a single-arm feasibility trial. Pain Med 2020;21:2777–88. https://doi.org/10.1093/pm/pnaa110 .
doi: 10.1093/pm/pnaa110
Buhrman, M, Skoglund, A, Husell, J, Bergström, K, Gordh, T, Hursti, T, et al.. Guided internet-delivered Acceptance and Commitment Therapy for chronic pain patients: a randomized controlled trial. Behav Res Ther 2013;51:307–15. https://doi.org/10.1016/j.brat.2013.02.010 .
doi: 10.1016/j.brat.2013.02.010
Lin, J, Paganini, S, Sander, L, Lüking, M, Ebert, DD, Buhrman, M, et al.. An internet-based intervention for chronic pain. Dtsch Arztebl Int 2017;114:681–8. https://doi.org/10.3238/arztebl.2017.0681 .
doi: 10.3238/arztebl.2017.0681
Trompetter, HR, Bohlmeijer, ET, Veehof, MM, Schreurs, KMG. Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: a randomized controlled trial. J Behav Med 2015;38:66–80. https://doi.org/10.1007/s10865-014-9579-0 .
doi: 10.1007/s10865-014-9579-0
Rickardsson, J, Gentili, C, Holmström, L, Zetterqvist, V, Andersson, E, Persson, J, et al.. Internet-delivered acceptance and commitment therapy as microlearning for chronic pain: a randomized controlled trial with 1-year follow-up. Eur J Pain 2021;25:1012–30. https://doi.org/10.1002/ejp.1723 .
doi: 10.1002/ejp.1723
Simister, HD, Tkachuk, GA, Shay, BL, Vincent, N, Pear, JJ, Skrabek, RQ. Randomized controlled trial of online acceptance and commitment therapy for fibromyalgia. J Pain 2018;19:741–53. https://doi.org/10.1016/j.jpain.2018.02.004 .
doi: 10.1016/j.jpain.2018.02.004
Whitehead, AL, Julious, SA, Cooper, CL, Campbell, MJ. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable. Stat Methods Med Res 2015;25:1057–73. https://doi.org/10.1177/0962280215588241 .
doi: 10.1177/0962280215588241
Wiegel, M, Meston, C, Rosen, R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther 2005;31:1–20. https://doi.org/10.1080/00926230590475206 .
doi: 10.1080/00926230590475206
Borkovec, TD, Nau, SD. Credibility of analogue therapy rationales. J Behav Ther Exp Psychiatr 1972;3:257–60. https://doi.org/10.1016/0005-7916(72)90045-6 .
doi: 10.1016/0005-7916(72)90045-6
Rosen, J, Heiman, S, Leiblum, C, Meston, R, Shabsigh, D, Ferguson, R, et al.. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191–208. https://doi.org/10.1080/009262300278597 .
doi: 10.1080/009262300278597
DeRogatis, L, Clayton, A, Lewis-D’Agostino, D, Wunderlich, G, Fu, Y. Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med 2008;5:357–64. https://doi.org/10.1111/j.1743-6109.2007.00672.x .
doi: 10.1111/j.1743-6109.2007.00672.x
McCracken, LM, Vowles, KE, Eccleston, C. Acceptance of chronic pain: component analysis and a revised assessment method. Pain 2004;107:159–66. https://doi.org/10.1016/j.pain.2003.10.012 .
doi: 10.1016/j.pain.2003.10.012
Sullivan, MJL, Bishop, SR, Pivik, J. The pain catastrophizing scale: development and validation. Psychol Assess 1995;7:524–32. https://doi.org/10.1037/1040-3590.7.4.524 .
doi: 10.1037/1040-3590.7.4.524
Zigmond, AS, Snaith, RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–70. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x .
doi: 10.1111/j.1600-0447.1983.tb09716.x
Diener, E, Emmons, R, Larsen, R, Griffin, S. The satisfaction with life scale. J Pers 1985;49:71–5. https://doi.org/10.1207/s15327752jpa4901_13 .
doi: 10.1207/s15327752jpa4901_13
Busby, DM, Christensen, C, Crane, DR, Larson, JH. A revision of the dyadic adjustment scale for use with distressed and nondistressed couples: construct hierarchy and multidimensional scales. J Marital Fam Ther 1995;21:289–308. https://doi.org/10.1111/j.1752-0606.1995.tb00163.x .
doi: 10.1111/j.1752-0606.1995.tb00163.x
Cohen, J. Statistical power analysis for the behavioral sciences . Hillsdale, NJ: Taylor & Francis; 1988.
Engström, AH, Kullinger, M, Jawad, I, Hesselman, S, Buhrman, M, Högberg, U, et al.. Internet-based treatment for vulvodynia (EMBLA) – study protocol for a randomised controlled study. Internet Interv 2021;25:100396. https://doi.org/10.1016/j.invent.2021.100396 .
doi: 10.1016/j.invent.2021.100396
Corsini‐Munt, S, Bergeron, S, Rosen, NO, Mayrand, M, Delisle, I. Feasibility and preliminary effectiveness of a novel cognitive–behavioral couple therapy for provoked vestibulodynia: a pilot study. J Sex Med 2014;11:2515–27. https://doi.org/10.1111/jsm.12646 .
doi: 10.1111/jsm.12646
Bergeron, S, Khalifé, S, Glazer, HI, Binik, YM. Surgical and behavioral treatments for vestibulodynia: two-and-one-half–year follow-up and predictors of outcome. Obstet Gynecol 2008;111:159–66. https://doi.org/10.1097/01.aog.0000295864.76032.a7 .
doi: 10.1097/01.aog.0000295864.76032.a7