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Recovery of healthy sexuality in patients with Anorexia Nervosa treated with Enhanced Cognitive Behaviour Therapy (CBT-E): results from a two-year follow-up study highlighting the role of avoidant attachment style

Published online by Cambridge University Press:  01 September 2022

E. Cassioli ,
E. Rossi ,
C. Vizzotto ,
V. Malinconi ,
L. Vignozzi ,
V. Ricca  and
G. Castellini
E. Cassioli
Affiliation:
University of Florence, Psychiatry Unit, Department Of Health Sciences, Florence, Italy
E. Rossi
Affiliation:
University of Florence, Psychiatry Unit, Department Of Health Sciences, Florence, Italy
C. Vizzotto*
Affiliation:
University of Florence, Psychiatry Unit, Department Of Health Sciences, Florence, Italy
V. Malinconi
Affiliation:
University of Florence, Psychiatry Unit, Department Of Health Sciences, Florence, Italy
L. Vignozzi
Affiliation:
University of Florence, Sexual Medicine And Andrology Unit, Department Of Experimental, Clinical, And Biomedical Sciences “mario Serio”, Florence, Italy
V. Ricca
Affiliation:
University of Florence, Psychiatry Unit, Department Of Health Sciences, Florence, Italy
G. Castellini
Affiliation:
University of Florence, Psychiatry Unit, Department Of Health Sciences, Florence, Italy
*
*Corresponding author.

Abstract

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Introduction

There is a known association between the core psychopathological features of anorexia nervosa (AN) and sexual dysfunctions, to the point that the recovery of healthy sexuality could be considered a marker of recovery. However, no studies have evaluated the role of insecure attachment in moderating this recovery during treatment.

Objectives

To evaluate the role of insecure attachment as a possible moderator of the recovery of healthy sexuality in patients with AN treated with Enhanced Cognitive Behaviour Therapy (CBT-E).

Methods

A total of 65 patients with anorexia nervosa were treated with CBT-E in a multidisciplinary environment, after filling out self-administered questionnaires for the evaluation of general (SCL-90-R) and ED-specific psychopathology (EDE-Q), female sexuality (FSFI) and adult attachment style (ECR). The assessment was repeated after one (T1) and two years (T2).

Results

At baseline, all domains of sexual dysfunction were significantly predicted by avoidant attachment. A significant amelioration of both general and eating disorder-specific psychopathology and sexual dysfunctions was observed at all follow-up evaluations with respect to baseline levels. However, only 45% of remitted patients also showed a complete recovery of healthy sexuality: this subgroup reported significantly lower avoidance scores when compared to patients who only recovered from AN. Moderation analysis indicated that sexual desire did not increase in participants with higher levels of avoidant attachment.

Conclusions

This study highlighted the crucial role of avoidant attachment in the relationship between AN and sexual dysfunctions, underlining the importance of assessing adult attachment for a better characterization and treatment. Attachment-focused interventions may be beneficial for a full recovery.

Disclosure

No significant relationships.

Keywords

Cognitive Behaviour TherapyAnorexia nervosafemale sexualityadult attachment style
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S71 - S72
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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