I hear you – but do you hear me? The Role of Depressive Symptoms and Attachment Styles in Partner Responsiveness

By Stephanie Grantham

This blog is a summary of our published article: Bosisio, M., Pâquet, M., Bois, K., Rosen, N. O., & Bergeron, S. (2019). Are depressive symptoms and attachment styles associated with observed and perceived partner responsiveness in couples coping with genito-pelvic pain? The Journal of Sex Research. doi:10.1080/00224499.2019.1610691

Perceived partner responsiveness describes feeling validated, understood and cared for by your partner and observed responsiveness is the ability to communicate empathy to a partner. Both forms of responsiveness are necessary to develop intimacy and closeness, and to maintain a fulfilling romantic relationship [1].

Provoked vestibulodynia (PVD) is the most common subtype of genito-pelvic pain and occurs mainly during sexual activity. This pain condition is associated with chronic burning when pressure is applied to the entrance to the vagina [2]. Importantly, past research has shown that having a responsive partner is associated with positive outcomes for women with PVD [3].

However, attachment styles and depressive symptoms may alter an individual’s perceptions of their interactions with their partners,  and potentially, impact their responsiveness.  Indeed, individuals with a secure attachment style (i.e., those who are comfortable with intimacy) have been shown to engage in caregiving behaviours towards their romantic partner [4], whereas those with an insecure attachment style (i.e. those who fear either abandonment or intimacy) may be less able to demonstrate empathy and responsiveness to their partner [5].  Moreover, greater depressive symptoms have been associated with lower responsiveness and perspective taking.

Importantly, past research suggests that women with genito-pelvic pain are more likely to also experience depressive symptoms and have insecure attachment styles. Thus, it is important to examine how these factors impact perceived and observed responsiveness in couples coping with PVD in order to improve our understanding of the processes that may enhance or hinder couples’ relationship and sexual well-being.


The goal of this study was to examine whether depressive symptoms and attachment were associated with perceived and observed partner responsiveness in couples coping with genito-pelvic pain.


What did we do?

50 couples with PVD  participated in this study. Couples completed measures assessing depressive symptoms and attachment style. They were then videotaped having two discussions on:

(1) current events

(2) how PVD has affected their lives

They then completed a questionnaire measuring perceived partner responsiveness. A trained researcher reviewed the videotaped discussions and rated the observed responsiveness.


What did we find?

When women and partners reported greater depressive symptoms, they were more likely to perceive each other as less responsive.

When partners reported greater depressive symptoms, women and partners were observed by the raters as being less responsive to each other. 

Women and partners who reported greater anxious attachment (i.e. fear of abandonment) were also more likely to be perceived as being less responsive. 


What does it mean?

The results suggest that depressive symptoms may interfere with how responsive a partner is perceived to be, even when they are engaging in behaviours that may be classified as responsive. As such, clinicians should assess and target depressive symptoms in both members of a couple to improve perceived responsiveness and enhance relationship and sexual well-being in couples coping with PVD.



[1] Reis, H. T., Clark, M. S., & Holmes, J. G. (2004). Perceived partner responsiveness as an organizing construct in the study of intimacy and closeness. Handbook of Closeness and Intimacy, 201–225.

[2] Harlow, B. L., Kunitz, C. G., Nguyen, R. H., Rydell, S. A., Turner, R. M., & MacLehose, R. F. (2014). Prevalence of symptoms consistent with a diagnosis of vulvodynia: Population-based estimates from 2 geographic regions. American Journal of Obstetrics & Gynecology, 210, 40.e1–40.e8

[3] Edlund, S. M., Carlsson, M. L., Linton, S. J., Fruzzetti, A. E., & Tillfors, M.(2015). I see you’re in pain–The effects of partner validation on emotions in people with chronic pain. Scandinavian Journal of Pain, 6, 16–21

[4] Mikulincer, M., Shaver, P. R., Gillath, O., & Nitzberg, R. A.(2005). Attachment, caregiving, and altruism: Boosting attachment security increases compassion and helping. Journal of Personality and Social Psychology, 89, 817–839

[5] Shallcross, S. L., Howland, M., Bemis, J., Simpson, J. A., & Frazier, P.(2011). Not “capitalizing” on social capitalization interactions: The role of attachment insecurity. Journal of Family Psychology, 25, 77–85.