{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:58:51Z","timestamp":1770289131252,"version":"3.49.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Vaginismus has an unknown etiology, is comorbid with anxiety, and is the most common sexual dysfunction in sexual dysfunction outpatient clinics in Turkey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to determine the frequency of adult separation anxiety disorder (ASAD) and styles of attachment in patients with vaginismus and to investigate its relationship with female sexual dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty women with vaginismus and 60 healthy controls were compared using the Relationship Scales Questionnaire, Female Sexual Function Index (FSFI), and Adult Separation Anxiety Questionnaire (ASA-27).<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes<\/jats:title><jats:p>We report the results of the questionnaires with their implication on the etiology of vaginismus.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Separation anxiety and fearful and dismissive avoidance attachment style in the vaginismus group were significantly higher than in the control group. Both total FSFI scores and arousal, pain, and satisfaction subscale scores were higher in the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Implications<\/jats:title><jats:p>ASAD should be evaluated and addressed separately, when necessary, in the treatment of vaginismus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Strengths &amp; Limitations<\/jats:title><jats:p>The relationship between ASAD and vaginismus has been shown for the first time. Study limitations included the assessment of factors influencing the study results based on self-reporting and possible recall bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Attachment and comorbidity research in vaginismus needs to shift from just reporting disturbances, to identify various clinical variables, such as the severity of the vaginismus, response to therapy, and differences in therapeutic modalities, in terms of outcome.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.jsxm.2021.07.005","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T10:04:15Z","timestamp":1629281055000},"page":"1752-1758","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"title":["Relationship Between Adult Separation Anxiety and Attachment Styles and Vaginismus"],"prefix":"10.1093","volume":"18","author":[{"given":"Eylem","family":"Unlubilgin","sequence":"first","affiliation":[{"name":"Etlik Zubeyde Hanim Gynecology Training and Research Hospital, University of Health Sciences , Ankara , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinan","family":"Tetik","sequence":"additional","affiliation":[{"name":"Etlik Zubeyde Hanim Gynecology Training and Research Hospital, University of Health Sciences , Ankara , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ihsan","family":"Aksoy","sequence":"additional","affiliation":[{"name":"Bolu Abant \u0130zzet Baysal University , Bolu , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilek","family":"Yuksel","sequence":"additional","affiliation":[{"name":"Etlik Zubeyde Hanim Gynecology Training and Research Hospital, University of Health Sciences , Ankara , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ozlem Moraloglu","family":"Tekin","sequence":"additional","affiliation":[{"name":"Ankara City Hospital, University of Health Sciences , Ankara , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"key":"2023041407103841800_","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/j.1743-6109.2008.01048.x","article-title":"Vaginismus and accompanying sexual dysfunctions in a Turkish clinical sample","volume":"6","author":"Dogan","year":"2009","journal-title":"J Sex Med"},{"key":"2023041407103841800_","first-page":"24","article-title":"Relationship between presenting complaint and clinical diagnosis in outpatients applying to the sexual dysfunction clinic\/Cinsel islev bozukluklari klinigine basvuran olgularda basvuru yakinmasi ile klinik tani arasindaki iliski","volume":"48","author":"Yildirim","year":"2011","journal-title":"Arch Neuropsychiatry"},{"key":"2023041407103841800_","article-title":"Diagnostic and statistical manual of mental disorders","author":"DSM-IV-TR.","year":"2000"},{"key":"2023041407103841800_","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/B:ASEB.0000007458.32852.c8","article-title":"Vaginal spasm, pain, and behavior: An empirical investigation of the diagnosis of vaginismus","volume":"33","author":"Reissing","year":"2004","journal-title":"Arch Sex Behav"},{"key":"2023041407103841800_","article-title":"Diagnostic and statistical manual of mental disorders (DSM-5\u00ae)","author":"Association","year":"2013"},{"key":"2023041407103841800_","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/S0140-6736(61)90985-0","article-title":"Non-consummation of marriage: A survey of seventy cases","volume":"278","author":"Dawkins","year":"1961","journal-title":"The Lancet"},{"key":"2023041407103841800_","first-page":"117","article-title":"Vaginismus as a cause of dyspareunia; a report of cases and a method of treatment","volume":"60","author":"Hall","year":"1952","journal-title":"Western J Surg Obstetr Gynecol"},{"key":"2023041407103841800_","doi-asserted-by":"crossref","first-page":"213","DOI":"10.2307\/349732","article-title":"Married virgins. 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