Reviewer ’s report  
 
Title:  Trauma, attachment style, and somatization: A study of women with dyspareunia and 
women survivors of sexual abuse  
 
Version: 0 Date: 18 Apr 2017 
 
Reviewer:  Giacomo  Ciocca  
 
Reviewer’s report:  
 
This study is potentially interesting, although it suffers from several limitations. Firstly,  the 
English language. I encourage to submit the paper to an English native.  
 
Abstract  
 
In the abstract results are unclear. Please clarify the results indicating the groups comparison into 
the bracket. Also the conclusion might be better clarified.  
 
Introduction  
 
Introduction seems exhaustive. You largely introduced the negative role of sexua l abuse for 
general and sexual health, as also the role of attachment style. However, you omitted the role of 
alexithymia and emotional regulation both in the cases of sexual abuse, as in female sexual 
dysfunction. I suggest to treat also this psychologica l aspect.  
 
Moreover, it is important to speak of dyspareunia, but also of vaginismus. These two conditions 
are often associated according to DSM IV criteria. Actually DSM 5 regrouped these two sexual 
dysfunctions. You did not mention about vaginismus, and y ou did not mention about the new 
classification of female sexual dysfunctions.  
 
Methods  
 
In the selection criteria you omitted important exclusion criteria as the presence of severe mental 
disorders. Moreover, as above mentioned, vaginismus and possible dif ferential diagnosis was not 
considered. I am in accord with you to assess somatization, but why not also phobia or anxiety?  I 
suppose there are some correlations also among phobia, SA and dyspareunia. In addition, it is 
suitable to add a tool for the sexua l assessment (desire, pain, orgasm etc..). In this regard, I 
suggest FSFI. Statistical analysis is poor and it do not enough support your aims.  
 
Results  
 
In the figure, results are unclear. I suggest to highlight with graph, for example, and also with p -
value into the figure, the significant differences. Also tables with socio -demographic information 
and t -test comparisons are necessary for the reader.  
 
Discussion  
 
As you have written it is unclear the main finding (line 36 -40, page 7). On the whole several 
changes might be made, based on the above mentioned considerations.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the s tatistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees,  funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
none  
 
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