A prospective two-year examination of cognitive and behavioral correlates of provoked vestibulodynia outcomes.

Note de l'éditeur : This article may not exactly replicate the final version published in the journal. It is not the copy of record. / Cet article ne constitue pas la version officielle, et peut différer de la version publiée dans la revue.

Partner behavioral responses to pain mediate the relationship between partner pain cognitions and pain outcomes in women with provoked vestibulodynia.

Partner behavioral responses to pain can have a significant impact on patient pain and depression, but little is known about why partners respond in specific ways. Using a cognitive-behavioral model, the present study examined whether partner cognitions were associated with partner behavioral responses, which prior work has found to predict patient pain and depressive symptoms. Participants were 354 women with provoked vestibulodynia and their partners. Partner pain-related cognitions were assessed using the partner versions of the Pain Catastrophizing Scale and Extended Attributional Style Questionnaire, whereas their behavioral responses to pain were assessed with the Multidimensional Pain Inventory. Patient pain was measured using a numeric rating scale, and depressive symptoms were assessed using the Beck Depression Inventory–II. Path analysis was used to examine the proposed model. Partner catastrophizing and negative attributions were associated with negative partner responses, which were associated with higher patient pain. It was also found that partner pain catastrophizing was associated with solicitous partner responses, which in turn were associated with higher patient pain and depressive symptoms. The effect of partner cognitions on patient outcomes was partially mediated by partner behavioral responses. Findings highlight the importance of assessing partner cognitions, both in research and as a target for intervention. Perspective The present study presents a cognitive-behavioral model to partially explain how significant others' thoughts about pain have an effect on patient pain and depressive symptoms. Findings may inform cognitive-behavioral therapy for couples coping with PVD.

Women with provoked vestibulodynia experience clinically significant reductions in pain regardless of treatment : results from a 2-year follow up study.

Introduction Provoked vestibulodynia (PVD) is a prevalent genital pain syndrome that has been assumed to be chronic, with little spontaneous remission. Despite this assumption, there is a dearth of empirical evidence regarding the progression of PVD in a natural setting. Although many treatments are available, there is no single treatment that has demonstrated efficacy above others. Aims The aims of this secondary analysis of a prospective study were to (i) assess changes over a 2-year period in pain, depressive symptoms, and sexual outcomes in women with PVD; and (ii) examine changes based on treatment(s) type. Methods Participants completed questionnaire packages at Time 1 and a follow-up package 2 years later. Main Outcome Measures Visual analog scale of genital pain, Global Measure of Sexual Satisfaction, Female Sexual Function Index, Beck Depression Inventory, Dyadic Adjustment Scale, and sexual intercourse attempts over the past month. Results Two hundred thirty-nine women with PVD completed both time one and two questionnaires. For the sample as a whole, there was significant improvement over 2 years on pain ratings, sexual satisfaction, sexual function, and depressive symptoms. The most commonly received treatments were physical therapy, sex/psychotherapy, and medical treatment, although 41.0% did not undergo any treatment. Women receiving no treatment also improved significantly on pain ratings. No single treatment type predicted better outcome for any variable except depressive symptoms, in which women who underwent surgery were more likely to improve. Discussion These results suggest that PVD may significantly reduce in severity over time. Participants demonstrated clinically significant pain improvement, even when they did not receive treatment. Furthermore, the only single treatment type predicting better outcomes was surgery, and only for depressive symptoms, accounting for only 2.3% of the variance. These data do not demonstrate the superiority of any one treatment and underscore the need to have control groups in PVD treatment trials, otherwise improvements may simply be the result of natural progression.

Genital pain in women : beyond interference with intercourse.

This article may not exactly replicate the final version published in the journal. It is not the copy of record. / Cet article ne constitue pas la version officielle, et peut différer de la version publiée dans la revue.

Beyond a "woman's problem" : the role of relationship processes in female genital pain

Female genital pain is a prevalent condition that can disrupt the psychosexual and relational well-being of affected women and their romantic partners. Despite the intimate context in which the pain can be elicited (i.e., during sexual intercourse), interpersonal correlates of genital pain and sexuality have not been widely studied in comparison to other psychosocial factors. This review describes several prevailing theoretical models explaining the role of the partner in female genital pain: the operant learning model, cognitive-behavioral and communal coping models, and intimacy models. The review includes a discussion of empirical research on the interpersonal and partner correlates of female genital pain and the impact of genital pain on partners’ psychosexual adjustment. Together, this research highlights a potential reciprocal interaction between both partners’ experiences of female genital pain. The direction of future theoretical, methodological, and clinical research is discussed with regard to the potential to enhance understanding of the highly interpersonal context of female genital pain

Do romantic partners' responses to entry dyspareunia affect women's experience of pain? : the roles of catastrophizing and self-efficacy.

Introduction Entry dyspareunia is a sexual health concern which affects about 21% of women in the general population. Characterized by pain provoked during vaginal penetration, introital dyspareunia has been shown by controlled studies to have a negative impact on the psychological well-being, sexual function, sexual satisfaction, and quality of life of afflicted women. Many cognitive and affective variables may influence the experience of pain and associated psychosexual problems. However, the role of the partner's cognitive responses has been studied very little. Aim The aim of the present study was to examine the associations between partners' catastrophizing and their perceptions of women's self-efficacy at managing pain on one side and women's pain intensity, sexual function, and sexual satisfaction on the other. Methods One hundred seventy-nine heterosexual couples (mean age for women = 31, SD = 10.0; mean age for men = 33, SD = 10.6) in which the woman suffered from entry dyspareunia participated in the study. Both partners completed quantitative measures. Women completed the Pain Catastrophizing Scale and the Painful Intercourse Self-Efficacy Scale. Men completed the significant-other versions of these measures. Main Outcome Measures Dependent measures were women's responses to (i) the Pain Numeric Visual Analog Scale; (ii) the Female Sexual Function Index; and (iii) the Global Measure of Sexual Satisfaction scale. Results Controlled for women's pain catastrophizing and self-efficacy, results indicate that higher levels of partner-perceived self-efficacy and lower levels of partner catastrophizing are associated with decreased pain intensity in women with entry dyspareunia, although only partner catastrophizing contributed unique variance. Partner-perceived self-efficacy and catastrophizing were not significantly associated with sexual function or satisfaction in women. Conclusions The findings suggest that partners' cognitive responses may influence the experience of entry dyspareunia for women, pointing toward the importance of considering the partner when treating this sexual health problem.

Provoked vestibulodynia : mediators of the associations between partner responses, pain, and sexual satisfaction.

Provoked vestibulodynia (PVD) is a chronic, recurrent vulvo-vaginal pain condition affecting 12% of the general population, and is associated with sexual dysfunction, psychological distress, and reduced quality of life. There is growing interest in the role of interpersonal variables in PVD, which have been widely neglected. In a sample of 175 couples, the present study examined the mediating roles of partner and participant catastrophizing and self-efficacy in the association between solicitous partner responses and pain intensity, and that of dyadic adjustment in the association between solicitous and negative partner responses and sexual satisfaction. Couples completed measures of partner responses, catastrophizing, self-efficacy, dyadic adjustment, and depression. Women also completed measures of pain, sexual satisfaction, and sexual function. Controlling for depression and solicitousness perceived by the other member of the couple, catastrophizing and self-efficacy partially mediated the association between higher solicitous responses and higher pain during intercourse, accounting for 26 and 25% of the variance in this association for participant and partner-perceived responses, respectively. For both participant and partners, only pain catastrophizing was a unique mediator. Controlling for depression, sexual function and partner-perceived responses, dyadic adjustment partially mediated the association between higher participant-perceived solicitous responses and higher sexual satisfaction, and between higher participant-perceived negative responses and lower sexual satisfaction, accounting for 26% of the variance in each association. The current findings suggest that catastrophizing and dyadic adjustment may constitute a route by which partner responses exacerbate pain and increase or decrease sexual satisfaction in PVD couples.

Harmful or helpful : perceived solicitous and facilitative partner responses are differentially associated with pain and sexual satisfaction in women with provoked vestibulodynia.

Introduction.  Provoked vestibulodynia (PVD) is a highly prevalent vulvovaginal pain condition that negatively affects women's emotional, sexual, and relationship well-being. Recent studies have investigated the role of interpersonal variables, including partner responses. Aim.  We examined whether solicitous and facilitative partner responses were differentially associated with vulvovaginal pain and sexual satisfaction in women with PVD by examining each predictor while controlling for the other. Methods.  One hundred twenty-one women (M age = 30.60, SD = 10.53) with PVD or self-reported symptoms of PVD completed the solicitous subscale of the spouse response scale of the Multidimensional Pain Inventory, and the facilitative subscale of the Spouse Response Inventory. Participants also completed measures of pain, sexual function, sexual satisfaction, trait anxiety, and avoidance of pain and sexual behaviors (referred to as “avoidance”). Main Outcome Measures.  Dependent measures were the (i) Pain Rating Index of the McGill Pain Questionnaire with reference to pain during vaginal intercourse and (ii) Global Measure of Sexual Satisfaction Scale. Results.  Controlling for trait anxiety and avoidance, higher solicitous partner responses were associated with higher vulvovaginal pain intensity (β = 0.20, P = 0.03), and higher facilitative partner responses were associated with lower pain intensity (β = −0.20, P = 0.04). Controlling for sexual function, trait anxiety, and avoidance, higher facilitative partner responses were associated with higher sexual satisfaction (β = 0.15, P = 0.05). Conclusions.  Findings suggest that facilitative partner responses may aid in alleviating vulvovaginal pain and improving sexual satisfaction, whereas solicitous partner responses may contribute to greater pain.

Woman and partner-perceived partner responses predict pain and sexual satisfaction in vestibulodynia couples

Introduction.  Provoked vestibulodynia (PVD) is a highly prevalent vulvovaginal pain condition that results in significant sexual dysfunction, psychological distress, and reduced quality of life. Although some intra-individual psychological factors have been associated with PVD, studies to date have neglected the interpersonal context of this condition. Aim.  We examined whether partner responses to women's pain experience—from the perspective of both the woman and her partner—are associated with pain intensity, sexual function, and sexual satisfaction. Methods.  One hundred ninety-one couples (M age for women = 33.28, standard deviation [SD] = 12.07, M age for men = 35.79, SD = 12.44) in which the woman suffered from PVD completed the spouse response scale of the Multidimensional Pain Inventory, assessing perceptions of partners' responses to the pain. Women with PVD also completed measures of pain, sexual function, sexual satisfaction, depression, and dyadic adjustment. Main Outcome Measures.  Dependent measures were women's responses to: (i) a horizontal analog scale assessing the intensity of their pain during intercourse; (ii) the Female Sexual Function Index; and (iii) the Global Measure of Sexual Satisfaction Scale. Results.  Controlling for depression, higher solicitous partner responses were associated with higher levels of women's vulvovaginal pain intensity. This association was significant for partner-perceived responses (β = 0.29, P < 0.001) and for woman-perceived partner responses (β = 0.16, P = 0.04). After controlling for sexual function and dyadic adjustment, woman-perceived greater solicitous partner responses (β = 0.16, P = 0.02) predicted greater sexual satisfaction. Partner-perceived responses did not predict women's sexual satisfaction. Partner responses were not associated with women's sexual function. Conclusions.  Findings support the integration of dyadic processes in the conceptualization and treatment of PVD by suggesting that partner responses to pain affect pain intensity and sexual satisfaction in affected women.

Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia : a dyadic daily experience study.

This article may not exactly replicate the final version published in the journal. It is not the copy of record. / Cet article ne constitue pas la version officielle, et peut différer de la version publiée dans la revue.

Mixed layer characteristics and hydrography off the west and east coasts of India

In this thesis, a detailed attempt has been made to understand the general hydrography of the upper 300m of the water column, in the eastern Arabian Sea and the western Bay of Bengal, the two contrasting basins in the northern Indian Ocean, using recently collected data sets of Marine Research-Living Resources (MR-LR) assessment programme, funded by Department of Ocean Development, from various cruises, pertaining to different seasons. Initially it discuss the general hydrography of the west and east coasts of India are covered, in the context of mixed layer processes. The study describes the materials and methods . To compare the hydrography of the AS and BOB, a unique MLD(Mixed Layer Depth) definition for AS and BOB is essential, for which the 275 CTD profiles were used. A comparison has been made among the various MLD criteria with the actual MLD. The monthly evolution of MLD, barrier layer thickness and the role of atmospheric forcing on the dynamics of the mixed layer in the AS and BOB were studied. The general hydrography along the west coast of India is described. The upwelling/downwelling, winter cooling processes, in the context of chemical and biological parameters, are also addressed. Finally the general hydrography of the Bay of Bengal is covered. The most striking feature in the hydrography are the signature of an anticyclonic subtropical gyre during spring intermonsoon and a cold core eddy during winter monsoon. The TTS(Typical Tropical Structure) of the euphotic layer was also investigated.

Studies on ocean surface layer responses to atmospheric forcing in the North Indian Ocean

The present study on upper ocean responses to atmospheric forcing (associated with cyclone passage) in North Indian Ocean revealed significant variability between AS and BoB. The analysis of cyclone frequency during 1947 to 2006 exhibited lesser frequency of cyclones in AS than that of BoB. The analysis also revealed significant reduction in cyclone frequency after the year 1976 with substantial reduction during monsoon season. The long term SST data at selected points in AS and BoB could not reveal any relation with reduction in cyclone frequency. However the SLP at same locations exhibited considerable increase during mid 1970’s, which could have contributed to the observed reduction in cyclone frequency after the year 1976.The response in waves during cyclone passage exhibited significant asymmetry on either side of the track in AS and BoB and the response is observed at 100’s of kilometers away from the track. The significant clockwise rotation in wave direction is observed on the right side of the track starting from near the track to far away locations, which existed for a longer duration. However, the anticlockwise rotation in wave direction is observed over a shorter distance on the left side of the track and dissipated immediately.Inertial oscillation is observed in surface current and in the mixed layer temperature associated with cyclone passage, which revealed the role of relative location(s) on either side of the track. The inertial peak closer to the local inertial period indicates maximum transfer of energy during the cyclone passage in both AS and BoB. The absence of strong inertial oscillation even with clockwise rotation in surface current and wind indicates the dominant role of duration of strong wind in generating inertial oscillation.The oceanic response associated with cyclone passage reveal the variable response(s) which depends on cyclone intensity, the proximity to track and cyclone translation speed. It is observed that resonance with wind generates higher response in surface current, wave and SST on the right side of the track and it lasts for a longer duration. The maximum oceanic response is observed at a few kilometers away on right side of the track. However lesser rightward bias in the location of maximum cooling is observed for cyclones with low cyclone translation speed. The response on the left side of the track is less and is limited over a shorter distance and dissipates immediately. It is observed that the ocean response, in general, increases with intensity of cyclones. However the differential cooling produced by the same intensity cyclones in AS and in BoB indicates the dominant role of low cyclone translation speed in oceanic response.The surface cooling exhibited strikingly differential responses between AS and BoB. The TMI-SST and buoy observations exhibited significant cooling for a longer duration in AS compared to that of BoB. The spatial extent of cooling is also much higher in AS than that of BoB. The wide spread cooling associated with cyclone passage in AS indicates the dominant role of thermal structure in oceanic response in AS than that of BoB.

Ecology of Chaetognaths in the Indian EEZ

This thesis entitled ecology of chaetognaths in the indian EEZ.The present study, in general, deals with the distribution pattern of mesozooplankton biomass and abundance with special reference to the detailed ecology of the important carnivorous planktonic group, the chaetognath, in the two major ocean basins of the Indian EEZ, the Arabian Sea (AS) and the Bay of Bengal (BoB). Prior to the International Indian Ocean expedition (IIOE, 1960 – 1965), cmprehensive studies on chaetognath in the Indian waters were very limited and was confined mostly to some coastal and oceanic regions. The study revealed a profound influence of different physical process on the abundance of chaetognath community. The significant influence exerted by different physico-chemical factors on the vertical distribution of chaetognath species was also evident. Prior to this study, only very little information was available on the ecology and distribution pattern chaetognaths in both the Arabian sea and the Bay of Bengal in relation to various mesoscale processes and physicochemical .variables. This study, emphasizing the short term and long term influences of different meso-scale and basin scale physical events on the ecology of this important plankton group provides the baseline data for extensive ecological research on any major mesozooplankton group in this tropical low latitude region.

Bulk Upload 01 Dec 2008 (192/192) - LectureNotesMATH2009.pdf

Lecture notes for MATH2009, Vector Calculus and Applications (discontinued after 2007?). These are based on the notes of Bob Craine, typed up by Ian Hawke.

MATH2009 Lecture notes

MATH2009, Vector Calculus and Applications. The lecture course was discontinued after 2007/8 (?); these notes are from the year before. Based on Bob Craine's notes as typed up by Ian Hawke. Note that they are not complete as they were principally for my own use.