Cognitive processing in women with dyspareunia: What is more salient, the pain or the sex?

A debate exists in the literature over whether dyspareunia should be classified as a sexual dysfunction or as a pain disorder in the Diagnostic and Statistical Manual of Mental Disorders. We do not know, however, the extent to which women with this disorder experience it as more of a pain problem, or more of a sexual problem, or whether both aspects are equally salient. Cognitive methodologies have been informative in the study of sexual information and stimulus processing. By examining visual attention and basic memory for pain- and sex-related words, this study aimed to elucidate whether there was a differential saliency between the pain and sex aspects of dyspareunia. Twenty women with dyspareunia and twenty women experiencing no sexual dysfunction (controls) participated in visual attention and memory protocols designed to detect differences as a function of group membership and type of stimulus. In terms of visual attention, results revealed that all women attended more to pain words than to sex words. In terms of memory, all women had better recall for sex-related words; however, women with dyspareunia evidenced more false memories for pain words than did control women, and pain words elicited more false memories than any other type of word for women with dyspareunia. Results are interpreted to indicate that repeated activation through experience contributed to women with dyspareunia (1) having stronger semantic networks related to pain than no-pain controls, (2) having stronger semantic networks for pain than for sex, (3) and that, in comparison to no-pain controls, activation of pain networks was more easily triggered by pain-related stimuL