(002) THE VAGINAL PENETRATION SKILLS SCALE (VPSS): A NOVEL PSYCHOMETRIC SELF-REPORT INSTRUMENT TO SCREEN AND ASSESS GENITO-PELVIC PAIN PENETRATION DISORDER SYMPTOMS
Authors: Maldonado M , Figueira G , Nardi AE , Sardinha A 
Published: December 2024

Abstract

Introduction
Genito-Pelvic Pain Penetration Disorder (GPPPD) is a common female sexual dysfunction characterized by a wide range of symptoms that impact both sexual and nonsexual aspects of a patient’s life. GPPPD falls under the DSM-5 diagnostic symptom group, encompassing overlapping symptoms of vaginismus, dyspareunia, and vulvodynia. The symptoms criteria refer to four dimensions concerning difficulties with vaginal intercourse, genital-pelvic pain, tightness of the pelvic floor muscles during penetration attempts, and fear–anxiety related to vaginal penetration. These symptom dimensions commonly include difficulties (inability, fear or pain) with receptive vaginal penetration skills (VPS). Understanding these skills is crucial for grasping the etiology, maintenance, and treatment of GPPPD. However, there is currently no standardized psychometric tool for screening and evaluating GPPPD symptoms across physical, emotional, and cognitive domains.

Objective
This study aims to introduce the Vaginal Penetration Skills Scale (VPSS) in its complete and shortened forms (VPSS-29 and VPSS-SF11) as self-report measures for screening and assessing GPPPD symptoms.

Methods
Validity analyses were performed using a convenience sample of Brazilian females (n = 399; 148 clinical; 251 nonclinical). A ROC curve analysis was used to determine the cutoff points for total and dimensional scores of both VPSS versions. Criterion validity was assessed by testing differences between the clinical and non-clinical groups using Welch’s t-test and the Mann–Whitney test for two independent groups. Convergent validity of the VPSS was assessed using Spearman’s rho correlations with the Brazilian versions of the Female Genital Self-Image Scale (FGSIS) and the six-item Female Sexual Function Index (FSFI-6).

Results
Exploratory and confirmatory factor analyses yielded a three-factor model for both versions: “Nonsexual Genital Self-Exploration” (NS-GSE), “Nonsexual Vaginal Penetration Skills” (NS-VPS), and “Sexual Vaginal Penetration Skills” (S-VPS). Total and dimensional VPSS scores accurately predicted the presence of GPPPD in 85.13% of the clinical sample and 92.03% of the nonclinical sample, with S-VPS exhibiting the highest effect size (SE = 184). The clinical group exhibited significantly lower mean total and individual VPSS scores than the non-clinical group on all scales (p &lt; 0.001, d = −1.590 to −2.611). The lifelong GPPPD-scoring group exhibited the lowest VPSS total and dimensional scores for both versions, regardless of engaging in solo or partnered sexual activities. Spearman’s rho measures showed significant medium to strong correlations (rho = 0.715 ~ 0.745) between VPSS, FGSIS, and FSFI-6. Additionally, the effect sizes suggest the measurement of distinct constructs, as none exceeded 0.9.

Conclusions
The three-dimensional VPSS instrument provides a concise screening and a comprehensive evaluation of three of the four DSM-5 GPPPD symptoms criteria (except tension of the pelvic floor muscle) and the levels of associated distress. The VPSS is a self-report questionnaire suitable for administration by a clinician or for self-administration, exhibiting robust psychometric properties. We hope that VPSS could contribute to a paradigm shift in GPPPD symptoms screening and assessment.

Disclosure
No.