了解阴道痉挛：生物心理社会视角

Understanding vaginismus: a biopsychosocial perspective

——原载《性与关系治疗》2024年第39卷第3期——

<Sexual and Relationship Therapy> Volume 39, issue 3, 2024

【摘要】尽管阴道痉挛普遍存在，但对其的研究仍不足。本文探讨了对阴道痉挛的各种理解，包括医学上对阴道痉挛作为一种痉挛反应的理解，这种理解支撑了迄今为止在性治疗领域占主导地位的行为和认知疗法的症状导向方法。这种症状导向方法被批评为还原论，许多作者支持采用更全面的方法来理解和治疗阴道痉挛。成功治疗阴道痉挛的预测因素之一是将问题归因于心理原因而不是生理原因。为了充分了解阴道痉挛，必须在个人、人际和文化层面进行探索，而其中人际层面的研究仍不足。将生物心理社会和体验方法纳入对阴道痉挛的看法可能会对在实践中与患有阴道痉挛的个人或夫妇合作的治疗师大有裨益。多学科方法治疗阴道痉挛更适合有效应对和解决这种成人亲密关系中男女性交困难的复杂性。本文根据本文献综述为此类从业者提供一些指导。

【关键词】阴道痉挛；性交困难；生殖器盆腔疼痛/插入障碍；性交疼痛；女性性功能障碍

[Abstract] Despite its universal prevalence, vaginismus remains under-researched. This paper explores various understandings of vaginismus, including the medical understanding of vaginismus as a spasmic response, which has underpinned much of the symptom focused approaches of behavior and cognitive therapies that have dominated the field of sex therapy to date. This symptom-focused approach has been criticized as reductionist with many authors supporting a more holistic approach to both understanding vaginismus and treating this condition. One of the predictors of successful treatment for vaginismus is the attribution of the problem to psychological causes rather than physical. In order to fully understand vaginismus, it must be explored at intrapersonal, interpersonal and cultural levels and of all of these the interpersonal level continues to be under researched. Incorporating a biopsychosocial and experiential approach into perspectives on vaginismus could be of benefit to therapists working with individuals or couples who present with vaginismus in their practice. A multidisciplinary approach to the treatment of vaginismus is more appropriate to effectively respond to and resolve the complex nature of this distressing sexual difficulty for women and men in adult intimate relationships. Some guidance, informed by this literature review, is offered here to such practitioners.

[Key words] Vaginismus; dyspareunia; genito-pelvic pain/penetration disorder; painful sex; female sexual dysfunction

论文原文：Maria McEvoy, Rosaleen McElvaney & Rita Glover (2024). Understanding vaginismus: a biopsychosocial perspective. Sexual and Relationship Therapy, Volume 39, Issue 3, Pages 680-701.

https://doi.org/10.1080/14681994.2021.2007233

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