Vulvodynia—It Is Time to Accept a New Understanding from a Neurobiological Perspective

Vulvodynia is one the most common causes of pain during sexual intercourse in premenopausal women. The burden of vulvodynia in a woman’s life can be devastating due to its consequences in the couple’s sexuality and intimacy, in activities of daily living, and psychological well-being. In recent decades, there has been considerable progress in the understanding of vulvar pain. The most significant change has been the differentiation of vulvar pain secondary to pathology or disease from vulvodynia. However, although it is currently proposed that vulvodynia should be considered as a primary chronic pain condition and, therefore, without an obvious identifiable cause, it is still believed that different inflammatory, genetic, hormonal, muscular factors, etc. may be involved in its development. Advances in pain neuroscience and the central sensitization paradigm have led to a new approach to vulvodynia from a neurobiological perspective. It is proposed that vulvodynia should be understood as complex pain without relevant nociception. Different clinical identifiers of vulvodynia are presented from a neurobiological and psychosocial perspective. In this case, strategies to modulate altered central pain processing is necessary, changing the patient’s erroneous cognitions about their pain, and also reducing fear avoidance-behaviors and the disability of the patient.

Training gamblers to re-think their gambling choices: How contextual analytical thinking may be useful in promoting safer gambling

Background and aimsHarmful gambling has been associated with the endorsement of fallacious cognitions that promote excessive consumption. These types of beliefs stem from intuitively derived assumptions about gambling that are fostered by fast-thinking and a lack of objective, critical thought. The current paper details an experiment designed to test whether a four-week online intervention to strengthen contextual analytical thinking in gamblers is effective in changing gamblers cognitions and encouraging safer gambling consumption.MethodsNinety-four regular gamblers who reported experiencing gambling-related harm were randomly allocated to either an experimental (n = 46) or control condition (n = 48), including 45 males, ranging from 19 to 65 years of age (M = 36.61; SD = 9.76). Following baseline measurement of gambling beliefs and prior week gambling consumption, participants in the experimental condition were required to complete an adaption of the Gamblers Fallacy Questionnaire designed to promote analytical thinking by educating participants on common judgement errors specific to gambling once a week for four weeks. Post-intervention measures of beliefs and gambling consumption were captured in week five.ResultsThe experimental condition reported significantly fewer erroneous cognitions, greater endorsement of protective cognitions, and reduced time spent gambling post-intervention compared to baseline. The control group also reported a reduction in cognitions relating to predicting and controlling gambling outcomes.ConclusionCognitive interventions that encourage gamblers to challenge gambling beliefs by reflecting on gambling involvement and promoting critical thinking may be an effective tool for reducing the time people invest in gambling activities.

Student gambling, erroneous cognitions, and awareness of treatment in Scotland

Rates of probable pathological gambling in colleges and universities across Scotland were investigated with a nationally distributed sample consisting of students (n = 1,483) and members of staff (n = 492). Gambling-related erroneous cognitions (Gambling Beliefs Questionnaire [GBQ]) and gambling severity (South Oaks Gambling Screen [SOGS]) were measured, with additional questions enquiring about awareness of treatments available for gambling problems. Rates of past-year problem and probable pathological gambling for students were 4.0% and 3.9%, respectively. An exploratory factor analysis of the GBQ resulted in a 24-item five-factor model, with gambling severity (as indicated by SOGS scores), indices of increasing gambling involvement (gambling frequency and number of gambling activities), and male gender being positively correlated with higher levels of erroneous cognitions, suggesting erroneous cognitions may not be prominent for females with gambling problems. Less than a fifth of students were aware of where to go to receive help for gambling-related problems.

An exploratory investigation into the erroneous cognitions of pathological and social fruit machine gamblers

Although the literature concerning the association between irrational thinking and gambling continues to grow, a number of methodological problems raise questions about the validity of such findings. The present research examined the cognitions and beliefs of a small convenience sample of pathological (n = 5) and social (n = 5) fruit machine gamblers using a within- and between-subjects design, employing the think-aloud method, the Gambling Beliefs Questionnaire, and a semistructured interview. Pathological gamblers were found to display greater levels of irrationality than social gamblers on all three measures. However, by undertaking a methodology more rigorous than that of previous research, this study found that irrational thinking may not be as prominent a reason behind gambling as has been suggested.

Sessions 8–10

Chapter 7 discusses sessions eight to ten of the treatment program. These sessions explore erroneous cognitions that lead to gambling, the development of skills to challenging and casting doubt on these thoughts, and empowering the client to make decisions about their own gambling behaviours.