Development and Initial Validation of the Vaginal Penetration Cognition Questionnaire (VPCQ) in a Sample of Women with Vaginismus and Dyspareunia Maaike Klaassen, MSc, and Moniek M. Ter Kuile, PhD Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, the Netherlands DOI: 10.1111/j.1743-6109.2009.01217.x ABSTRACT Introduction. Although the relevance of cognitions has been implicated in the etiology, explanatory models, and treatment of female sexual pain disorders, an instrument that assesses vaginal penetration cognitions is nonexistent. Aim. The aim of this study was to develop and to investigate the psychometric properties of the Vaginal Penetration Cognition Questionnaire (VPCQ). The VPCQ was explicitly designed to assess cognitions regarding vaginal penetration in women with vaginismus and dyspareunia. Methods. A sample of 247 Dutch women with a female sexual dysfunction (FSD; 122 women with lifelong vaginismus and 125 women with dyspareunia) and 117 women without sexual complaints completed the question- naire. Factor analyses were only conducted in the sample of women with FSD. Validation measures were conducted in both women with and without FSD. Main Outcome Measure. All women completed the VPCQ and several additional questions regarding biographic and complaint characteristics. Results. Conduction of factor analyses yielded five subscales regarding cognitions about vaginal penetration: “control cognitions,” “catastrophic and pain cognitions,” “self-image cognitions,” “positive cognitions,” and “genital incompatibility cognitions.” Reliability of these five VPCQ subscales ranged from 0.70 to 0.83, and the test–retest correlations were satisfactory. The five VPCQ subscales were reasonably stable across demographic variables and demonstrated good discriminant validity. All five subscales were able to detect significant differences between women with and without FSD. Additionally, the four subscales of the VPCQ concerning negative cognitions demonstrated the ability to differentiate between the two samples of women with FSD. Women with lifelong vaginismus reported lower levels of perceived penetration control and higher levels of catastrophic and pain cognitions, negative self-image cognitions, and genital incompatibility cognitions, when compared with women with dyspareunia. Conclusions. The present study indicates that the VPCQ is a valid and reliable brief self-report measure for assessing cognitions regarding vaginal penetration in women with vaginismus or dyspareunia. Klaassen M, and Ter Kuile MM. Development and initial validation of the Vaginal Penetration Cognition Questionnaire (VPCQ) in a sample of women with vaginismus and dyspareunia. J Sex Med 2009;6:1617–1627. Key Words. Self-report Measure; Vaginismus; Dyspareunia; Cognitions; Validations; Reliability Introduction C ognitions have been implicated in the etiol- ogy, explanatory models, and treatment of vaginismus and dyspareunia. Vaginismus and dys- pareunia are sexual pain disorders that can inter- fere with all aspects of sexual functioning [1]. Vaginismus is commonly described as a persistent and distressing difficulty in vaginal insertion of a penis, finger, tampon, or other object. Dyspareu- nia is commonly described as a recurrent and persistent genital pain associated with sexual in- tercourse, which causes personal distress [2,3]. Despite the wide-ranging list of factors (e.g., somatic/biological factors, psychological as inter- personal issues) that has been proposed to explain 1617 © 2009 International Society for Sexual Medicine J Sex Med 2009;6:1617–1627