Behind common symptoms and psychosocial implications of endometriosis: the role of cognitive and personality factors

Endometriosis is known to be associated with severe painful symptomatology, infertility, low quality of life and high psychological distress. The aim of this doctoral thesis was to explore the role of cognitive and personality factors (e.g. coping strategies, metacognitive beliefs, worry and perfectionistic traits) on pain perception, quality of life and mental health in women with a diagnosis of endometriosis. Three scientific studies about these topics were introduced after an initial general introduction. In general, studies included in this dissertation found that: a) Pain plays an important role in affecting different domains of quality of life and mental health in women with endometriosis; b) Negative metacognitive beliefs have a negative impact on sexual distress, over and above dyspareunia or general chronic pain, both cross-sectionally and longitudinally (i.e. after three months); c) Women with high-pain endometriosis show higher levels of worry personality traits than women with low-pain endometriosis, and higher catastrophization as coping strategy than healthy women without endometriosis; d) High perfectionistic personality traits and importance given to parenthood are associated with low quality of life specifically related to infertility problems. Findings of these studies suggested that cognitive and personality factors play a key role in the understanding of pain-symptomatology, quality of life and mental health of women with endometriosis. These results may provide important clinical suggestions for multidisciplinary management of this population.