The Role of Psychological Flexibility and Psychological Factors in Chronic Pelvic Pain Among Women: A Correlational Study

Chiara Manna, Michelle Semonella, Giada Pietrabissa, Gianluca Castelnuovo
In: Healthcare · 2025 · vol. 13(14) , pp. 1697 · doi:10.3390/healthcare13141697 · PMID:40724721 · W4412422463
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that psychological distress and psychological flexibility are associated with pain interference, physical quality of life, and mental quality of life in women with chronic pelvic pain.

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⚙ AI-generated deep summary by claude@2026-05, 2026-05-18 ⓘ

This correlational study examined the associations between psychological distress, Psychological Flexibility (PF), Psychological Inflexibility (PI), pain, and quality of life in adult Italian women with a documented diagnosis of chronic pelvic pain (CPP). Participants were recruited via two private gynecological clinics in Milan and CPP advocacy associations between September 2023 and June 2024, and completed online self-report questionnaires (DASS-21, MPFI, BPI, SF-12). The paper frames PF — the core construct of Acceptance and Commitment Therapy — as a potentially protective factor whose role in CPP remains under-studied, and positions itself as exploratory rather than confirmatory; the excerpt provided describes the rationale and methods but does not report the correlational results or detail limitations. Relevance to endometriosis: endometriosis is listed as one of several gynecological/urological conditions falling under the CPP umbrella that the study population may include, though the paper's main focus is psychological factors across CPP broadly rather than endometriosis specifically.

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Abstract

Background/Objectives: Chronic Pelvic Pain (CPP) is a multifactorial condition that affects in many ways the daily life of patients suffering from it. Different psychological factors demonstrated to be associated with the genesis and maintenance of CPP. Less is known about the role of the Psychological Flexibility (PF) model. Thus, the aim of this study is to explore the relationship between the PF domains, psychological distress, pain, and quality of life in patients with chronic pelvic pain. Methods: A total of 114 women with a diagnosis of chronic pelvic pain were included in this study. Participants completed online self-report measures to assess psychological distress (anxiety, depression, stress), Psychological Flexibility, Pain interference, and Quality of life. Results: Psychological distress and Psychological Flexibility showed significant association with pain interference. Other PF dimensions related to pain interference were as follows: self as context, defusion, and values. Physical Quality of life showed significant association with Experiential avoidance and Lack of values clarity, while Mental Quality of life was associated with Psychological Inflexibility and Self as content. Conclusions: Psychological distress and Psychological Flexibility have a role in pain perception and its interference with a patient’s daily life, affecting also physical and mental quality of life of CPP patients.

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Outcome instruments

NRS-pain

Condition tags

chronic_pelvic_pain

Citation neighborhood

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References (49)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
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License: CC0 · commercial use OK