Sánchez BC, Carreño MJ, Corres ANP, Henales AC

Language: Spanish
References: 22
Page: 347-353
PDF size: 114.97 Kb.

ABSTRACT

Background
At the Department of Psychology of the National Institute of Perinatology Isidro Espinosa de los Reyes (INPerIER) −a medical unit specialized in reproductive problems−, a line of investigation on human sexuality was opened due to the high numbers of patients with some kind of problem in their sexual lives. We have been performing exploratory studies where we have found a high prevalence of sexual disorders, i.e. 52% in women and 38.8% in men, in addition to other comparative studies. These studies revealed that people with disturbances in their sexual life were in a disadvantageous position when considering factors such as self-concept, assertivity, levels of anxiety, marital satisfaction, style of communication and marital communication, when compared to population not showing sexual problems. This brought us to the conclusion that the presentation of one or more sexual disorders is a risk factor that deserves exhaustive studies from the psychological point of view.
Our studies, made in groups of men and women showing sexual disorders, lead to the need of studying risk factors related with every sexual disorder. We have a hypothesis that not all disorders show in a similar manner and that it is in the different combination of factors where the specificity to provide elements that can help improve intervention plans lies.
Objective
The general objective of this work was to identify the frequency, differences, relationships and combinations between the feminine sexual dysfunctions known as sexual pain disorders: dyspareunia and vaginismus, and some intervening variables. These were gender role and self-esteem (psychological factors) and background (child sexual traumatic experience, sexual information, sexual fears, masturbation and conjugal problems), in order to create a profile of each one of these sexual disorders so that it provides elements for intervention plans.
Material and methods
This was a non-experimental, transversal, retrospective field study with a correlational-multivariate design and an independent sample divided into three groups with individuals selected by intentional sampling according to pre-established quotas.
This work belongs to a wider research study of some risk factors found in male and female sexual dysfunctions, whose original sample consisted of 400 participants; out of this group we selected only participants with dyspareunia and vaginismus and they were compared with the same number of participants who showed no sexual disorder. So, the sample classification remained as follows: Group 1, no sexual dysfunctions; group 2, with dyspareunia, and group 3 with vaginismus. Women participating are frequent attendees of the National Institute of Perinatology (INPerIER) and had to meet all the inclusion criteria.
For the allocation into groups and the collection of sexual background data we used the codified clinical history for female sexuality (CCHFS).
Measurement of personality factors was performed with the Masculinity and Femininity Inventory (MFI) and with Coppersmith’s self-esteem inventory.
A questionnaire on sexuality and the other instruments was provided and filled in one single session at the outpatient room.
For the analysis of results, we used central tendency measurements to describe controlled socio-demographic factors such as age, civil status and schooling. The statistical analysis consisted on determining the frequency of the presence of sexual dysfunctions within the group of women with sexual dysfunctions, out of which we got the patients presenting dyspareunia and vaginismus for group allocation.
Then we made an analysis to compare the groups. The first group was set to be the one with no dysfunctions, the second one with dyspareunia and the third one with vaginismus, in order to get the significative differences and the relationship between groups and personality factors under study (gender role and self-esteem); for these we used the t-Student test and ETA coefficient. For the analysis of sexual background (child sexual traumatic experience, sexual information, sexual fears, masturbation and conjugal problems) and their relationship with dysfunctions, we used X² and Cramer’s V.
Factors resulting related were used to perform a discriminant analysis so as to propose explanational profiles; all variables found to be related, psychological factors and sexual background were included in the analysis. Statistical data analysis was made with the software SPSS version 11.
Results
The description of the samples shows a normal distribution with an average for groups of age and schooling as follows: for group 1, age 31.9± 5.32, years in school 10.9± 3.17; for group 2, age 32.7± 5.54, years in school 10.2± 2.8; and for group 3, age 33.7± 3.1, years in school, 9.9± 2.5.
From every statistical analysis variables were isolated and personality factors studied, indicating women with dyspareunia showed a decrease in masculinity features and in their levels of selfesteem, and an increase in submissive features, when compared to women with no sexual dysfunctions.
As to the analysis of the results of sexual background, in the dyspaurenia group we found a relationship with conjugal problems, suggesting these variables have a significant intervention in the presence of dyspaurenia during women’s adult life. The discriminant analysis launched a factor out of four variables, with 75.9% of the cases correctly classified, demonstrating that women with dyspaurenia within this percentage have related indicators, discriminating variables constituting an explanational approximation.
Results of the group of women with vaginismus indicate a decrease in the self-esteem feature and an increase in the submissive features. Analysis of sexual background showed a relation between women with vaginismus and sexual fears, a decrease in sexual information and presence of conjugal problems. Described background data have a significant intervention in these women’s adult life. The discriminant analysis launched a factor out of five variables, with 84.1% of the cases correctly classified, demonstrating that women with vaginismus within this percentage have these related indicators, discriminating variables constituting an explanational approximation.
Conclusion
The isolation of variables with the purpose of detecting the factors related to the presence of the two sexual disorders, dyspareunia and vaginismus, has as its main target to provide indicators of risk that facilitate the creation of intervention plans, in order to avoid making generalizations for the handling of sexual disorders.

REFERENCES

1. Sánchez BC, Carreño J, Martínez S, Gómez ME. Disfunciones sexuales femeninas y masculinas: comparación de género en una muestra de la Ciudad de México. Salud Mental 2005;28:74-80.

2. Sánchez BC. Estudio comparativo e identificación de algunos factores de riesgo individuales y de pareja en mujeres con disfunción sexual. Tesis de maestría. México: Facultad de Psicología. Universidad Nacional Autónoma de México; 2001.

3. Sánchez BC, Carreño J, González G, González I. Autoconcepto y satisfacción marital en mujeres con disfunción sexual. Revista Perinatología Reproducción Humana 1997;11:190-197.

4. Masters W, Johnson V, Kolodny R. La sexualidad humana. Barcelona: Grijalbo; 1995.

5. Organización Mundial de la Salud (OMS). Defining sexual health report of a technical consultation on sexual health. Ginebra: 28-31 enero 2002 en http://www.who.int/reproductive-health/gender/sexual_health.html

6. Bancroft JH. Human sexuality and its problems. New York: Churchil Livingstone; 1983.

7. Labrador FJ, Crespo M. Tratamientos psicológicos eficaces para las disfunciones sexuales. Psicothema 2001;13:428-441.

8. American Psyquiatric Association. Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-IV-TR). Madrid: Masson; 2002.

9. International Society for Sexual Medicine (ISSM). Sexual pain disorders in women. Segunda Consulta Internacional sobre Medicina Sexual; Febrero 2009.

10. Kaplan H. La nueva terapia sexual. México: Alianza Editorial; 1990.

11. Sánchez BC. Perfiles y factores explicativos de las disfunciones sexuales. Tesis de doctorado. México: Facultad de Psicología. Universidad Nacional Autónoma de México; 2007.

12. Souza M, Cárdenas J, Montero MC, Mendoza L. Historia clínica de la sexualidad femenina. Ginecología Obstetricia 1987;55:277-287.

13. Lara A: Inventario de masculinidad y femineidad. México: El Manual Moderno; 1993.

14. Coopersmith S. A meted for determining types of self-steem. J Abnormal Social Pychology 1967;59:87-94.

15. Lara C, Verduzco M, Acevedo M, Cortés J. Validez y confiabilidad del Inventario de Autoestima de Coopersmith para Adultos, en Población Mexicana. Revista Latinoamericana Psicología 1987;25(2):247-255.

16. Basson R. Women’s sexual dysfunction: revised and expanded definitions. Canadian Medical Association 2005;172:1327-1333.

17. Tharinger D. Impact of child sexual abuse on developing sexuality. Professional Psychology: Research Practice 1990;21:331-337.

18. Gruszecki L, Forchuk CH, Fisher W. Factors associated with common sexual concerns in women. New findings from the Canadian contraceptions study in women. Canadian J Human Sexuality 2005;14(1-2):1-11.

19. Laumann E, Paik A, Rosen, R. Sexual dysfunction in the United States: Prevalence and predictors. JAMA 1999;281(6):537-544.

20. LoPiccolo J, Stock W. Treatment of sexual dysfunction. J Consulting Clinical Psychology 1986;54(2):158-167.

21. Sánchez BC, Carreño J. Guía clínica de intervención psicológica de la sexualidad humana en parejas. Revista Perinatología Reproducción Humana 2007;21(1):33-43.

22. Drex E. Female dysfunction called complex, individual problem. Urology Times 2003;31:37-38.