Self-compassion and psychological distress among women and individuals with persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD)

Persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD) is a highly distressing condition characterized by unpleasant or unwanted genital sensations, such as buzzing, tingling, or burning in the absence of sexual desire. PGAD/GPD symptoms may be understood within the framework of the fear-avoidance model of chronic pain, in which cognitive and behavioural factors such as fear, hypervigilance, and avoidance behaviours may perpetuate psychological distress. Evidence suggests that cognitive-affective factors may help disrupt this cycle, thereby reducing distress related to symptoms. Self-compassion is one such protective factor, defined by Kristin Neff as responding to oneself with care and understanding during times of suffering. Greater self-compassion is associated with lower psychological distress among individuals genito-pelvic pain, and furthermore, it may buffer the relationship between chronic pain and distress. However, this has yet to be examined within the context of PGAD/GPD. Additionally, self-compassion can be conceptualized as both a stable trait and a fluctuating state, and this may have implications for the association between self-compassion and psychological distress over time and in daily life. In Chapter 2 of this thesis, I examined trait self-compassion in relation to psychological distress among women and gender diverse individuals with PGAD/GPD. Greater self-compassion was associated with lower psychological distress both cross-sectionally and 6 months later, and self-compassion moderated the relationship between genital sensation intensity and psychological distress, such that the relationship became weaker at greater levels of self-compassion. In Chapter 3, I examined daily associations between self-compassion, genital sensation intensity, and negative affect. Greater self-compassion was associated with lower negative affect at both the within- and between-person levels. However, I observed no moderating effects at either the within- or between-person levels. An exploratory cross-level interaction showed that greater average self-compassion across days moderated the within-person association between genital sensation intensity and negative affect. Time-lagged analyses demonstrated no evidence of lagged effects. In Chapter 4, I discuss the broader literature and implications of these findings. Collectively, these findings provide preliminary evidence that self-compassion may support emotional well-being among women and gender diverse individuals with PGAD/GPD and may represent a promising avenue for future research and intervention.