CBT Group Treatment for Women With Dyspareunia

NCT ID: NCT03427255

Last Updated: 2022-04-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-09-29

Study Completion Date

2023-12-31

Brief Summary

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The current study will employ a group CBT treatment program of 10 group sessions and 3 individual couple sessions targeting the thoughts, emotions, behaviors and couple interactions associated with the experience of dyspareunia. Women with superficial dyspareunia and their partners will be randomized to the CBT group program-plus or a waiting list control period at one treatment location in Sweden and two treatment locations in the Netherlands. The waiting-list control period will be comparable to the treatment duration of six months.

It is hypothesized that the group program-plus is more effective in improving pain during intercourse in women with superficial dyspareunia compared to women on a waiting-list control period.

Detailed Description

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Rationale:

Superficial dyspareunia, a frequent form of chronic genital pain, is associated with decreased sexual function for afflicted women, as well as impoverished sexual satisfaction for women and their partners. While recent research has showed that cognitive-behavioral therapy (CBT) interventions have effects in regards to reducing pain, enhancing sexual function and improving relational aspects, randomized controlled trials are still sparse. Despite recommendations in the literature to include the partner in the CBT treatment targeted at improving pain and sexuality outcomes, there are no published randomized CBT controlled trials incorporating the partner in the treatment.

Primary objective: To evaluate whether the group program-plus improves pain during intercourse in women with superficial dyspareunia compared to women in a waiting-list control condition.

Secondary Objective(s): are to evaluate a) women (and partners) sexuality (sexual function, distress \& satisfaction), b) women's psychological adjustment (negative and positive penetration beliefs, pain/penetration coping behavior); c) relationship factors (partner responses and relationship satisfaction), and whether an improvement in pain during intercourse is moderated by pre-treatment patient characteristics, such as age, sexual functioning, relationship satisfaction, abuse history, and mediated by a) reduction of negative penetration beliefs, avoidance behavior and/or improvement in positive penetration beliefs and sexual function (i.e. sexual arousal).

Study design:

Eligible women and their partners in one of the participating centers (n=3, in two countries) will be randomized to either the CBT group program-plus or waiting-list control group (WLC), using a block randomization design stratified for each center. The waiting-list period of 6 months is comparable to the period from the start of the active treatment until the post-treatment measurement. After the WLC, the patients from the WLC will receive the active treatment. Data of these participants will be included in the repeated measures analyses to test the temporal stability of treatment gains. Within-subjects repeated measures comparisons will be conducted for data of participants and their partners at pre-treatment, post-treatment, follow-up at 3 months and 6 months following treatment termination. In addition, participants complete monthly questionnaires at home during the first 6 months. Participants in the active treatment group will also complete weekly measures. These extra measurement are necessary for the mediation analyses. The total study duration (including follow-up) for the participants and their partners is 12-18 months.

Intervention:

The CBT group program-plus consists of 3 1-hr CBT couple sessions and 10 2-hr CBT group sessions over a period of 6 months. The manualized treatment comprise, pain- and sexual education, relaxation and gradual exposure exercises as well as sensate focus and sexual communication exercises for the couple. 6-8 women participate in each group. Two psychologists will conduct the couple and group sessions.

Conditions

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Dyspareunia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized Controlled Trial with a waiting list condition
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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CBT group treatment

CBT group treatment-plus involving partners: 10 group sessions and 3 couple sessions

Group Type ACTIVE_COMPARATOR

CBT group treatment-plus

Intervention Type BEHAVIORAL

The CBT group program-plus consists of 3 1- hr CBT couple sessions and 10 2-hr CBT group sessions over a period of 6 months. The manualized treatment comprise, pain- and sexual education, relaxation and gradual exposure exercises as well as sensate focus and sexual communication exercises for the couple. 6-8 women participate in each group. Two psychologists conduct the couple and group sessions.

Waiting list

Six months waiting-list control condition.

Group Type OTHER

CBT group treatment-plus

Intervention Type BEHAVIORAL

The CBT group program-plus consists of 3 1- hr CBT couple sessions and 10 2-hr CBT group sessions over a period of 6 months. The manualized treatment comprise, pain- and sexual education, relaxation and gradual exposure exercises as well as sensate focus and sexual communication exercises for the couple. 6-8 women participate in each group. Two psychologists conduct the couple and group sessions.

Waiting-list control condition

Intervention Type OTHER

Waiting-list control condition during length of active treatment (6 months).

Interventions

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CBT group treatment-plus

The CBT group program-plus consists of 3 1- hr CBT couple sessions and 10 2-hr CBT group sessions over a period of 6 months. The manualized treatment comprise, pain- and sexual education, relaxation and gradual exposure exercises as well as sensate focus and sexual communication exercises for the couple. 6-8 women participate in each group. Two psychologists conduct the couple and group sessions.

Intervention Type BEHAVIORAL

Waiting-list control condition

Waiting-list control condition during length of active treatment (6 months).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* woman
* 18-45 years old
* in a heterosexual relationship for at least 3 months
* diagnosis of superficial dyspareunia (in accordance to DSM5) with no apparent ongoing physical cause to the condition (i.e. ongoing infections).
* past experience of a successful intercourse
* attempted intercourse during the last year

Exclusion Criteria

* reporting to never have had full intercourse at any time in life
* partner not willing to participate in the study
* major affective disorder, psychotic disorder, substance-related disorder or post traumatic-stress disorder related to the genitals (e.g., as a sequel to sexual abuse) according to DSM-5 criteria
* being pregnant
* gone through child delivery during the last year
* not speaking Dutch or Swedish well enough to participate in assessment and treatment
* receiving concurrent psychological therapy or physiotherapy for superficial dyspareunia during CBT or WLC period.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Leiden University Medical Center

OTHER

Sponsor Role collaborator

Maastricht University Medical Center

OTHER

Sponsor Role collaborator

Örebro University, Sweden

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ida K Flink, PhD

Role: PRINCIPAL_INVESTIGATOR

Örebro University, Sweden

Moniek M ter Kuile, PhD

Role: PRINCIPAL_INVESTIGATOR

Leiden University Medical Center

Locations

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Leiden University Medical Center, Department of Gynecology

Leiden, , Netherlands

Site Status NOT_YET_RECRUITING

Maastricht Universiy Medical Center (MUMC)

Maastricht, , Netherlands

Site Status NOT_YET_RECRUITING

Center for Health and Medical Psychology (CHAMP) Örebro University

Örebro, , Sweden

Site Status RECRUITING

Countries

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Netherlands Sweden

Central Contacts

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Ida K Flink, PhD

Role: CONTACT

+46(0)19313740

Linnéa Engman, MS

Role: CONTACT

+46(0)19303168

Facility Contacts

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Moniek Ter Kuile, PhD

Role: primary

+31(0)715263121

Reinhilde Melles, MS

Role: primary

Ida K Flink, PhD

Role: primary

Linnea Engman, MS

Role: backup

Other Identifiers

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CBT group program-plus

Identifier Type: -

Identifier Source: org_study_id

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