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

Abstract 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 (β = .56, P < .001) and depressive symptoms (β = .24, P < .001). Negative perceptions of the illness were significantly associated with increased pain catastrophizing (β = .66, P < .001), and decreased pain acceptance (β = -.59, P < .001), resulting in heightened depressive symptoms (β = .33, P < .001, β = -.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.