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Vulvodynia is not created equally: empirical classification of women with vulvodynia

BACKGROUND: Vulvodynia classification is based on the sensory dimensions of pain and does not include psychological factors associated with the pain experience and treatment outcomes. Previous work has shown that individuals with chronic pain can be classified into subgroups based on pain sensitivit...

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Autores principales: Alappattu, Meryl, Lamvu, Georgine, Feranec, Jessica, Witzeman, Kathryn, Robinson, Michael, Rapkin, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505540/
https://www.ncbi.nlm.nih.gov/pubmed/28740427
http://dx.doi.org/10.2147/JPR.S136751
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author Alappattu, Meryl
Lamvu, Georgine
Feranec, Jessica
Witzeman, Kathryn
Robinson, Michael
Rapkin, Andrea
author_facet Alappattu, Meryl
Lamvu, Georgine
Feranec, Jessica
Witzeman, Kathryn
Robinson, Michael
Rapkin, Andrea
author_sort Alappattu, Meryl
collection PubMed
description BACKGROUND: Vulvodynia classification is based on the sensory dimensions of pain and does not include psychological factors associated with the pain experience and treatment outcomes. Previous work has shown that individuals with chronic pain can be classified into subgroups based on pain sensitivity, psychological distress, mood, and symptom severity. OBJECTIVE: The aim of this study was to identify distinct subgroups of women with vulvodynia enrolled in the National Vulvodynia Registry. We hypothesized that women with vulvodynia can be clustered into subgroups based on distress and pain sensitivity. DESIGN: A cross-sectional study. METHODS: We conducted an exploratory hierarchical agglomerative cluster analysis using Ward’s cluster method and squared Euclidean distances to identify unique subgroups based on baseline psychological distress and pain sensitivity. The variables included the catastrophizing subscale of the Coping Strategies Questionnaire, the Beck Depression Inventory, the State Trait Anxiety Index-Trait scale, McGill Pain Questionnaire-Affective subscale, and vulvar and pelvic muscle pressure pain sensitivity. SUBJECTS: Eight sites enrolled women who presented with vaginal or vulval pain of at least 3-month duration. RESULTS: Two distinct subgroups, high pain sensitivity with high distress (n=27) and low pain sensitivity with low distress (n=100), emerged from the cluster analysis. Validation indicated that subgroups differed in terms of clinical pain intensity, sensory aspects of pain, and intercourse pain. CONCLUSION: Empirical classification indicates that unique subgroups exist in women with vulvodynia. Providers should be aware of the heterogeneity of this condition with respect to pain-related distress and pain sensitivity.
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spelling pubmed-55055402017-07-24 Vulvodynia is not created equally: empirical classification of women with vulvodynia Alappattu, Meryl Lamvu, Georgine Feranec, Jessica Witzeman, Kathryn Robinson, Michael Rapkin, Andrea J Pain Res Original Research BACKGROUND: Vulvodynia classification is based on the sensory dimensions of pain and does not include psychological factors associated with the pain experience and treatment outcomes. Previous work has shown that individuals with chronic pain can be classified into subgroups based on pain sensitivity, psychological distress, mood, and symptom severity. OBJECTIVE: The aim of this study was to identify distinct subgroups of women with vulvodynia enrolled in the National Vulvodynia Registry. We hypothesized that women with vulvodynia can be clustered into subgroups based on distress and pain sensitivity. DESIGN: A cross-sectional study. METHODS: We conducted an exploratory hierarchical agglomerative cluster analysis using Ward’s cluster method and squared Euclidean distances to identify unique subgroups based on baseline psychological distress and pain sensitivity. The variables included the catastrophizing subscale of the Coping Strategies Questionnaire, the Beck Depression Inventory, the State Trait Anxiety Index-Trait scale, McGill Pain Questionnaire-Affective subscale, and vulvar and pelvic muscle pressure pain sensitivity. SUBJECTS: Eight sites enrolled women who presented with vaginal or vulval pain of at least 3-month duration. RESULTS: Two distinct subgroups, high pain sensitivity with high distress (n=27) and low pain sensitivity with low distress (n=100), emerged from the cluster analysis. Validation indicated that subgroups differed in terms of clinical pain intensity, sensory aspects of pain, and intercourse pain. CONCLUSION: Empirical classification indicates that unique subgroups exist in women with vulvodynia. Providers should be aware of the heterogeneity of this condition with respect to pain-related distress and pain sensitivity. Dove Medical Press 2017-07-06 /pmc/articles/PMC5505540/ /pubmed/28740427 http://dx.doi.org/10.2147/JPR.S136751 Text en © 2017 Alappattu et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Alappattu, Meryl
Lamvu, Georgine
Feranec, Jessica
Witzeman, Kathryn
Robinson, Michael
Rapkin, Andrea
Vulvodynia is not created equally: empirical classification of women with vulvodynia
title Vulvodynia is not created equally: empirical classification of women with vulvodynia
title_full Vulvodynia is not created equally: empirical classification of women with vulvodynia
title_fullStr Vulvodynia is not created equally: empirical classification of women with vulvodynia
title_full_unstemmed Vulvodynia is not created equally: empirical classification of women with vulvodynia
title_short Vulvodynia is not created equally: empirical classification of women with vulvodynia
title_sort vulvodynia is not created equally: empirical classification of women with vulvodynia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505540/
https://www.ncbi.nlm.nih.gov/pubmed/28740427
http://dx.doi.org/10.2147/JPR.S136751
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