Dysregulated sexuality and childhood trauma in eating disorders: Psychopathological, biological, and behavioural correlates

Abstract

Introduction Sexual dysfunction is common in eating disorders (EDs), but its relevance is often overlooked. Objectives To describe different ED clinical subgroups in terms of psychopathology, putative biological correlates, and consequences of dysregulated sexuality, focusing on the role of childhood trauma. Methods Healthy controls (n=60), binge-purging (n=38), and restricting patients (n=24) were compared (age- and BMI-adjusted ANOVA; Bonferroni post-hoc tests), using total scores of Eating Disorder Examination Questionnaire (EDE-Q), Emotional Eating Scale (EES), SCL-90-R Global Severity Index (GSI), Barratt Impulsiveness Scale (BIS-11), Difficulties in Emotion Regulation Scale (DERS), Childhood Trauma Questionnaire (CTQ), Female Sexual Functioning Index (FSFI), Hypersexual Behaviour Inventory (HBI), and patients’ hormonal profiles (gonadal and pituitary hormones, ghrelin). Self-reported voluntary termination of pregnancy (VTP) and promiscuous sexual activity were recorded. For ED patients (N=62), regression analyses between significant variables and HBI were carried, applying moderation models for different CTQ scores. Results Table 1 outlines significant between-group comparisons (°: different from controls; *: different from restricting patients; p<0.05). Binge-purging patients had higher FSH, LH, and ghrelin levels, more VTPs and promiscuity. HBI showed significant correlations with EES, SCL-90-R-GSI, DERS, CTQ, and ghrelin levels. CTQ moderated interactions for DERS and EES (Figure 1). Binge-purging Restricting Controls F EDE-Q 3.86±1.20° 3.41±1.64° 0.85±0.83 67.32 EES 40.85±22.74°* 16.01±15.88 19.87±15.21 7.01 SCL-90-R GSI 1.73±0.65° 1.27±0.69° 0.68±0.44 20.32 BIS-11 62.47±9.91° 60.81±8.56 57.04±10.04 4.99 DERS 106.97±29.15°* 83.97±33.12 78.14±14.12 10.21 CTQ 55.32±21.06° 49.31±10.81° 38.02±8.32 15.24 FSFI 17.32±11.89°* 11.70±10.98° 29.32±7.45 24.02 HBI 28.75±13.89* 20.56±3.12 26.11±4.90 4.92 Conclusions Dysregulated sexuality is linked to emotion dysregulation and childhood trauma. Binge-purging patients experience adverse behavioural consequences. Disclosure No significant relationships.

Keywords

• hypersexuality
• childhood trauma
• eating disorders
• emotion dysregulation