ArticleBMC women's health2026
Cue-specific sexual avoidance, metacognitive beliefs, and sexual functioning in women with lifelong vaginismus: a cross-sectional case-control study.
Article in BMC women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAvoidance is a key maintaining factor in lifelong vaginismus and may extend beyond penetration attempts to broader sexual cues. Metacognitive beliefs, particularly beliefs about the usefulness of worry and the uncontrollability and danger of thoughts, may shape threat appraisal and coping responses in sexual contexts. We characterized clinician-elicited sex-related avoidance behaviors in lifelong vaginismus and examined how avoidance and metacognitive beliefs relate to sexual functioning beyond anxiety and depressive symptoms.
methodsThis cross-sectional case-control study was conducted in three outpatient clinics in Türkiye. Participants were 64 women evaluated for lifelong vaginismus and 30 controls. Sex-related avoidance over the past 6 months was assessed using five standardized yes/no clinician-elicited items; endorsing ≥ 1 item defined the avoidant subgroup. Participants completed ASEX (Arizona Sexual Experiences Scale), GRISS (Golombok-Rust Sexual Satisfaction Scale), MCQ-30 (Metacognitions Questionnaire-30), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Between-group comparisons examined sexual outcomes and metacognitive beliefs across groups, and hierarchical regression models examined whether MCQ-30 subscales accounted for additional variance in ASEX and GRISS scores beyond BDI and BAI.
resultsThirty of 64 women with vaginismus (46.9%) were classified as avoidant. The avoidant subgroup showed poorer ASEX and GRISS scores than the non-avoidant subgroup and controls (all adjusted pairwise p < 0.05). Women with vaginismus showed greater endorsement of dysfunctional metacognitive beliefs than controls. However, the avoidant and non-avoidant vaginismus subgroups did not differ on MCQ-30 indices. In logistic regression, adding three theoretically selected MCQ-30 subscales did not significantly improve model fit beyond BDI and BAI (Δχ²(3) = 3.84, p = 0.279). Adding MCQ-30 subscales accounted for an additional 19% of variance in ASEX-total scores (R²=0.13 to 0.32) and an additional 21% of variance in GRISS-total scores (R²=0.05 to 0.26). Negative beliefs about uncontrollability and danger showed the strongest associations with higher ASEX-total (β = 0.52, p = 0.004) and GRISS-total (β = 0.58, p = 0.002) scores.
conclusionsSex-related cue avoidance beyond penetration attempts was endorsed by nearly half of women with lifelong vaginismus and marks poorer sexual functioning. Dysfunctional metacognitive beliefs-particularly beliefs about uncontrollability and danger-relate to sexual impairment beyond anxiety and depressive symptoms, supporting brief screening for avoided cues and metacognitive targets in clinical assessment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.