Vestibular Anatomic Localization of Pain Sensitivity in Women with Insertional Dyspareunia: A Different Approach to Address the Variability of Painful Intercourse.

The pathophysiology underlying painful intercourse is challenging due to variability in manifestations of vulvar pain hypersensitivity. This study aimed to address whether the anatomic location of vestibular-provoked pain is associated with specific, possible causes for insertional dyspareunia. Women (n = 113) were assessed for "anterior" and "posterior" provoked vestibular pain based on vestibular tenderness location evoked by a Q-tip test. Pain evoked during vaginal intercourse, pain evoked by deep muscle palpation, and the severity of pelvic floor muscles hypertonicity were assessed. The role of potential confounders (vestibular atrophy, umbilical pain hypersensitivity, hyper-tonus of pelvic floor muscles and presence of a constricting hymenal-ring) was analyzed to define whether distinctive subgroups exist. Q-tip stimulation provoked posterior vestibular tenderness in all participants (6.20 ± 1.9). However, 41 patients also demonstrated anterior vestibular pain hypersensitivity (5.24 ± 1.5). This group (circumferential vestibular tenderness), presented with either vestibular atrophy associated with hormonal contraception use (n = 21), or augmented tactile umbilical-hypersensitivity (n = 20). The posterior-only vestibular tenderness group included either women with a constricting hymenal-ring (n = 37) or with pelvic floor hypertonicity (n = 35). Interestingly, pain evoked during intercourse did not differ between groups. Linear regression analyses revealed augmented coital pain experience, umbilical-hypersensitivity and vestibular atrophy predicted enhanced pain hypersensitivity evoked at the anterior, but not at the posterior vestibule (R = 0.497, p < 0.001). Distinguishing tactile hypersensitivity in anterior and posterior vestibule and recognition of additional nociceptive markers can lead to clinical subgrouping.

Psychological distress and communication quality in military couples after deployment to war.

Previous research has found elevated levels of psychological distress (i.e., posttraumatic stress, depressive and anxiety symptoms) among veterans. Existing theory and evidence show how psychological distress is associated with marital disruptions. Only a few studies, however, have tested the link between psychological distress and couple communication quality in military couples, most of which were cross-sectional and employed self-report measures. The current study investigated whether psychological distress predicts changes in observed communication quality across 1 year in 228 couples consisting of male service members, who were deployed to Iraq and/or Afghanistan, and their nondeployed female partners. Psychological distress was indicated by self-reported posttraumatic stress disorder, depressive, and anxiety symptoms. Communication quality was assessed using observed couple interactions. The results of an actor-partner interdependence model showed that men's psychological distress predicted men's lower communication quality at one year after accounting for baseline communication quality. Women's psychological distress did not predict their communication quality, and each partner's psychological distress did not predict changes in their partner's communication quality over time. Consistent with previous findings on civilian populations, our findings highlight the long-term effects of psychological distress among service members on their communication behaviors with their intimate partners, and emphasize the importance of targeting psychological symptoms of service members following deployment to war. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Emotional Regulation and Revictimization in Women's Intimate Relationships.

The aim of the current study was to test whether women's emotional regulation (ER) capacity moderates the relationship between childhood abuse and both adult intimate partner violence (IPV) and relationship quality. Female graduate students (N = 425), either married or in a long-term cohabitation, participated in an Internet-based survey. Structural equation model (SEM) multiple-group analysis was conducted to estimate whether the link between childhood abuse and marital outcomes varied across high and low levels of ER. The data showed that childhood abuse was associated with higher levels of IPV and lower marital quality. A high level of ER was found to buffer the association between child abuse and IPV. Among women with a low level of ER, childhood abuse had a stronger negative effect on relationship quality than for women with a high level of ER. ER is a protective factor against revictimization in intimate relationships.

Psychological mindedness as a protective factor against revictimization in intimate relationships.

OBJECTIVES: We tested the moderating effect of psychological mindedness (PM) on the relationship between past experience of child abuse and both intimate partner violence (IPV) and intimate relationship quality. METHOD: Female Israeli graduate students (N = 425; mean age 35.9 years), either married or in cohabitation, completed an electronic questionnaire. The data were analyzed by SEM multiple group analysis of women with high vs. low PM. RESULTS: Child abuse was associated with IPV among women with a low level of PM but not among women with a high level of PM. Contrary to expectation, childhood abuse was associated with lower marital quality among women with a high level of PM but not for women with a low level of PM. CONCLUSION: Results support the notion that psychologically minded people are "wiser but sadder" (Farber, , p. 216). The findings are discussed in relation to revictimization theories, with clinical implications noted.

Too close and too rigid: applying the Circumplex Model of Family Systems to first-generation family firms.

Despite growing research interest in family businesses, little is known about the characteristics of the families engaging in them. The present paper uses Olson's (Journal of Psychotherapy & the Family, 1988, 4(12), 7-49; Journal of Family Therapy, 2000, 22, 144-167) Circumplex Model of Marital and Family Systems to look at first-generation family firms. We describe existing typologies of family businesses and discuss similarities between the characteristics of first-generation family firms and the rigidly enmeshed family type described in the Circumplex Model. The Steinberg family business (Gibbon & Hadekel (1990) Steinberg: The breakup of a family empire. ON, Canada: MacMillan) serves to illustrate the difficulties of rigidly enmeshed first-generation family firms. Implications for understanding troubled family businesses are discussed together with guidelines for the assessment of a family business in crisis and for intervention: enhancing open communication; allowing for more flexible leadership style, roles, and rules; and maintaining a balance between togetherness and separateness.

Ambivalence over emotional expressiveness in intimate relationships: a shift from an individual characteristic to dyadic attribute.

This study investigates how ambivalence over emotional expressiveness (AEE) relates to various aspects of intimate relationships, including perception of the relationship, marital satisfaction, and dyadic closeness. Whereas most commonly AEE has been treated as an individual attribute, we suggest looking at a combined measure of the AEE of both spouses as a dyadic attribute. We examine the contribution of each spouse's level of AEE as well as joint couple AEE to explain variations in the marital relationship. Data were collected from both spouses of 226 Israeli couples. Findings indicated that the AEE of individuals was more predictive of lower relationship quality than neuroticism and that dyadic AEE explains relationship quality more than the AEE of individual partners. Implications for future research and practice are discussed.

The structure of dyadic support among couples with and without long-term disability.

This study examines support relationships among 65 couples in which the husband had a long-term spinal cord injury, and a comparison group of 65 couples without disability. Based on facet theory, we constructed a mapping sentence that forms a definitional framework for couple support, and developed a detailed inventory to assess attitudes regarding mutual support in couple relations, the sense of support availability, support behaviors of giving and receiving, the degree to which the support meets one's needs, response to received support, and preference for support from within the couple and from external sources. These are all measured with respect to instrumental, emotional and informational support. Smallest space analysis showed various structures of the relations between elements of support among men and women living with and without disability, as well as a core element of reciprocal support common to both men and women in couples with and without disability.

The association of daily hassles and uplifts with family and life satisfaction: does cultural orientation make a difference?

The study examined similarities and differences between people having individualist and collectivist cultural orientations in terms of what they perceive as stressful and uplifting experiences in their daily lives, and the relation between daily experiences and family and life satisfaction. Data were collected from two representative community samples (697 Jews and 303 Arabs). Each sample was grouped into individualist and collectivist cultural orientations. The two cultural orientation groups differed with respect to the appraisal of positive and negative daily experiences. A structural equation modeling (SEM) multi-group analysis indicated a similar factor structure for hassles and uplifts in both groups. However, the two groups differed in the effects of positive and negative daily occurrences on family and life satisfaction.

The effect of security-related stress on dyadic closeness among Jews and Arabs in Israel: a daily diary study.

An important aspect of Israeli life is its continuous state of conflict with the neighboring Palestinian people and Arab countries. Given that security-related stress is so intensely experienced by all Israeli residents, we examined the effects of daily fluctuations in security-related stress on dyadic closeness among Jewish and Arab couples. Time sampling approach was used to study repeated sequences of associations between stress and dyadic closeness. Data were collected from 188 Jewish and 93 Arab couples by means of daily diaries. Hierarchical multivariate linear modeling was used to analyze the data. The findings indicate that stress results in increasing distance between intimate partners, but the effect varies with the level of marital quality and socioethnic affiliation.

Use of standardized assessment instruments in couple therapy: the role of attitudes and professional factors.

The study examined therapeutic approach, professional affiliation, training, seniority, and work setting as predictors of attitudes toward standardized instruments and their use in couple therapy. Data were gathered from 163 certified marriage and family therapists in Israel. Results showed that 27.6% of marital therapists used standardized instruments for assessment. More positive attitudes toward standardized instruments were associated with the extent of training in their use and with a structural-strategic approach. Logistic regression analysis indicated that positive attitudes, training, and work setting best predict the application of standardized assessment instruments. Reasons for the relative lack of use of standardized assessment instruments are discussed. It is recommended that more training in assessment instruments be included in marriage and family therapy training.

Dyadic characteristics of individual attributes: attachment, neuroticism, and their relation to marital quality and closeness.

The present article focuses on couple types based on 2 personality traits, attachment security and neuroticism, as they relate to 2 facets of the marital relationship--a global evaluation of relationship quality and dyadic closeness-distance. The sample consisted of 248 married couples who completed measures of attachment anxiety and avoidance, neuroticism, and marital quality, as well as levels of closeness reported over 7 consecutive days. Cluster analyses yielded 3 types of dyadic attachment configurations (secure, fearful avoidant, and insecure-mixed) and 4 types of dyadic neuroticism (low couple neuroticism, high couple neuroticism, wife neuroticism, and husband neuroticism). Significant differences were found among attachment and neuroticism dyadic types in marital quality. The findings are discussed in terms of the viability of dyadic types based on individual traits, implying that attachment security yields itself to dyadic conceptualization more than neuroticism.

Psychological factors associated with perception of experimental pain in vulvar vestibulitis syndrome.

This study assessed the association between pain perception and psychological variables in women with vulvar vestibulitis syndrome (VVS) by comparing 28 VVS women with 50 healthy women. We assessed non genital systemic pain perception with quantitative sensory testing by administering experimental pain stimuli to the forearm. The VVS women demonstrated a lower pain threshold and a higher magnitude estimation of pain, combined with a higher trait anxiety, increased somatization, and a lower body image. Among the VVS women, nonvaginal pain catastrophizing was significantly related to reported pain during coitus. A cluster analysis revealed four subtypes of VVS women, as characterized by levels of pain and personality variables. I suggest implications for the assessment and treatment of women suffering from painful coitus.

Emotional expressiveness and neuroticism: do they predict marital quality?

This study examines how neuroticism and emotional expressiveness relate to perceptions of marital quality. Data were gathered from a sample of 197 Israeli couples. Wives scored higher than husbands on neuroticism and emotional expressiveness, but no significant gender differences were found in perceived marital quality. Structural equation models were estimated to examine the effect of both spouses' neuroticism and expressiveness on their own and on their spouse's evaluation of marital quality. Neuroticism was a strong predictor of both spouses' perceived marital quality. Wives' perceived marital quality was positively associated with both their own and their husbands' emotional expressiveness. In contrast, husbands' perceived marital quality was associated neither with their own nor with their wives' expressiveness.

Cultural orientation, ethnic affiliation, and negative daily occurrences: a multidimensional cross-cultural analysis.

The present research focuses on cultural variations in the experience of daily stresses and strains. It simultaneously examines the experiences of daily hassles among people holding different cultural orientations (individualistic vs. collectivist) and different socioethnic groups (Jews and Arabs). Data were gathered from 662 Jewish and 300 Arab Israeli respondents by means of a random telephone number dialing. Differences were found in self-related hassles between individuals holding different cultural orientations and in family-related hassles between members of different ethnic affiliations. Multidimensional scaling analysis revealed a different configuration of relations among hassle domains in four groups of Ethnic Affiliation X Cultural Orientation, yielding a continuum from most typical individualists to most typical collectivists, with groups in cultural transition found in between.

Patterns of change in marital relationships among parents of children with cancer.

This study examined changes in marital relationships among parents of children with cancer. Data for both parents of 35 children treated for cancer for less than a year to more than five years showed changes in marital relationships across 10 dimensions of the relationship. The findings showed that some aspects of the relationship (for example, communication and trust) tended to be strengthened, whereas others (especially sexuality) were prone to deterioration. Second, changes in the marital relationship were examined in relation to the duration of illness. The data showed a slight decrease in relationship satisfaction within one year of diagnosis, an increase in marital strength in cases of children who had been ill for two or three years, and a deterioration in the marital relationship after more than four years of children's illness.

Daily stresses and uplifts during times of political tension: Jews and Arabs in Israel.

This study examined similarities and differences between Jews and Arabs in Israel in terms of their daily stressful and uplifting experiences and assessed the relation between these experiences and family and life satisfaction. Data were collected from representative samples of 697 Jews and 303 Arabs by using a computerized-assisted telephone interviewing system. Contrary to expectation, Jews reported more sources of hassles than did Arabs, whereas Arabs reported more uplifts. A structural equation modeling multigroup analysis indicated a similar factor suucture for hassles and uplifts in both groups. Family satisfaction was positively related to uplifts but not to hassles. For Arabs, uplifts had a positive effect only on family satisfaction, whereas for Jews they had a positive effect on both family and general life satisfaction.