What psychological processes are involved in the Genito pelvic Pain and/or Penetration Disorder? A scoping review.

Becq, Juliette
(2026) EABCT (European Association for Behavioural and Cognitive Therapies) - Unique as we are — Location: Brussels (16.September.2026)

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In the DSM-5, the former diagnoses of dyspareunia and vaginismus were merged into a single disorder: Genito-Pelvic Pain and/or Penetration Disorder (GPPPD). This change reflects the ongoing challenge in conceptualizing sexual pain and/or penetration difficulties that lead to clinically significant distress. Although therapeutic options appear effective, the underlying psychological mechanisms remain poorly understood. In this context, a process-based approach offers an alternative to the traditional diagnostic framework by targeting the psychological processes involved in the development and the maintenance of this disorder. This scoping review aims to explore and identify the psychological processes involved in GPPPD among adults with vaginas. This scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews guidelines. In July 2025, research was conducted in five databases (PsycInfo, PubMed, Scopus, Embase and CINAHL) and grey literature. Titles and abstracts were screened by two independent reviewers, who then conducted a full-text review of each eligible publication. The inclusion criteria targeted human adults with vaginas, psychological processes (cognitive, attentional, behavioural, affective, emotional, self-related, motivational, relational, interpersonal, sexological, sexual, and psychosexual), and sexual pain or penetration difficulties and their synonyms. A total of 5334 articles were identified, of which 1504 were duplicates. 476 studies were eligible for the full-text review (3354 were excluded) and 111 were included in the final review. The review identified the following processes: cognitive (e.g., pain catastrophizing), attentional (e.g., hypervigilance to pain), behavioural (e.g., avoidance), affective and emotional (e.g., emotion regulation), interpersonal (e.g., dyadic adjustment), self-related processes (e.g., self-efficacy) and motivational processes. These results can pave the way for a process-based approach to GPPPD, which will be discussed further. Several of these processes overlap across categories, and their classification remains theoretical. For instance, self-esteem can be both cognitive and self-related, while avoidance can be both behavioral and emotional.
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Becq, J. (2026). What psychological processes are involved in the Genito pelvic Pain and/or Penetration Disorder? A scoping review. EABCT (European Association for Behavioural and Cognitive Therapies) - Unique as we are, Brussels. https://hdl.handle.net/2078.5/281221