SEXUAL CONTINGENT SELF-WORTH AND THE WELL-BEING OF COUPLES COPING WITH PROVOKED VESTIBULODYNIA
MetadataShow full item record
Provoked vestibulodynia (PVD)—a recurrent vulvovaginal pain condition—is associated with disruptions to women and partners’ psychological and sexual well-being. A novel factor that may impact couples’ well-being is sexual contingent self-worth (CSW), which is self-esteem that is dependent on maintaining what one perceives to be a successful sexual relationship. According to the theoretical model of CSW, if an individual perceives failure in the contingent domain, then they will experience distress about the domain and in turn poorer well-being. Those with greater sexual CSW may perceive a sexual problem, such as PVD, as a significant failure in their sexual relationship and, in turn, experience poorer psychological and sexual well-being. This dissertation aimed to develop and validate a measure of sexual CSW and to use this measure to evaluate how sexual CSW is related to women’s pain and the well-being of couples coping with PVD. In Study 1, I developed the Sexual CSW Scale in a community sample and found that it was composed of two factors (positive and negative sexual events) that could be summed for a total score. I confirmed this factor structure in a second community sample and found support for the scale’s internal consistency, test-retest reliability over a period of two weeks, and convergent, discriminant, and incremental validity. Individuals who reported sexual problems had greater sexual CSW than those without sexual problems. Studies 2 and 3 examined sexual CSW in women with PVD and their partners. In Study 2, I examined the cross-sectional associations between sexual CSW, relationship CSW (self-esteem based on the overall relationship), and the well-being of couples. Results showed that women’s greater sexual CSW was associated with their own greater sexual distress and pain intensity during intercourse. When the partners of women with PVD had greater sexual CSW, they had lower sexual and relationship satisfaction and greater sexual distress and women reported lower relationship satisfaction and greater depressive symptoms. In contrast, partners’ greater relationship CSW was associated with their greater sexual satisfaction and their own and women’s greater relationship satisfaction and fewer depressive symptoms. Thus, greater sexual CSW was associated with poorer psychological, relational, and sexual well-being in couples coping with PVD and with women’s greater pain. Study 3 aimed to examine whether daily sexual distress was a potential pathway that explained the links between greater sexual CSW and poorer daily well-being and women’s pain in couples coping with PVD. Results indicated that only women’s greater sexual CSW was significantly associated with their own greater sexual distress, therefore only women’s sexual distress was examined as a mediator between women’s sexual CSW and their own outcomes. I found that women with greater sexual CSW were more likely to experience greater sexual distress on days that they engaged in sexual activity than women with lower sexual CSW. On days that women with greater sexual CSW were more sexually distressed (compared to their average level of sexual distress), they in turn were less sexually satisfied and reported greater depressive symptoms, anxiety, and pain during intercourse. Thus, there was a significant indirect effect of women’s greater sexual CSW on women’s poorer daily psychological and sexual well-being through women’s greater daily sexual distress. Overall, the findings in this dissertation support the continued investigation of sexual CSW in couples coping with PVD. Psychological interventions that target reducing sexual CSW may help couples affected by PVD adjust to this pain condition.