The relationship between patients' causal attributions for pain and biopsychosocial measures was investigated in a sample of 100 women with dyspareunia. Independently of findings from the gynecological examinations, causal attributions were related to adjustment. More specifically, the women who made psychosocial attributions reported higher pain scores, higher levels of psychological distress, lower levels of marital adjustment, more problems with sexual function, and more frequent reports of sexual assault. The relationship between psychosocial causal attributions for pain and psychosocial distress may be clinically useful in the multidisciplinary treatment of this and other pain disorders, regardless of actual physical pathology.