Attachment styles and propensity for sexual response in adult obsessive-compulsive disorder

Abstract

An impaired sexual functioning has been found to be more frequent in patients with obsessive-compulsive disorder (OCD) than in the general population and other clinical groups. Less is known about the psychological processes associated with this altered sexual response. The present study was carried out to investigate the association between attachment styles and sexual response (i.e. sexual excitation and inhibition) in a group of patients with OCD, controlling for socio-demographics, OCD severity, psychiatric and personality comorbidity, serotonergic medications, and obsessive cognitions. Seventy-two patients with OCD and 72 matched healthy individuals were recruited. OCD patients self-reported significantly higher levels of sexual excitation and inhibition, obsessive-compulsive symptoms, obsessive cognitions, and attachment styles characterized by discomfort with closeness, need for approval, and preoccupation with relationships. The MANCOVA analysis revealed that patients with more severe symptoms had lower propensity to experience sexual excitation. Patients with stronger confidence and need for approval were less inhibited. Attachment styles may be a feature involved in the propensity for sexual response of OCD patients, and they should be assessed during clinical practice with this clinical population. Interventions aimed to improve sexual life of this type of patients should target attachment.

Keywords:

• Obsessive-compulsive disorder
• attachment
• intimate relationships
• sexuality
• sexual excitation
• sexual inhibition

Disclosure statement

The authors have nothing to disclose.

Data availability statement

Data will be made available on request.

Additional information

Notes on contributors

Andrea Pozza

Andrea Pozza, PhD, is clinical psychologist and psychotherapist, researcher at the Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy. He is senior editorial board member of BMC Psychology, editorial board member of Clinical Neuropsychiatry, guest associate editor of Frontiers in Psychiatry. He has published several papers in peer-review journals on obsessive-compulsive disorder.

Silvia Casale

Silvia Casale, PhD, is Associate Professor of Clinical Psychology (University of Florence). She has co-authored various publications concerning technological addictions, narcissism, and perfectionism. She is Associate Editor of Addictive Behaviors and member of the Editorial Board of Addictive Behaviors, Addictive Behaviors Reports, and the Journal of Psychology: Interdisciplinary and Applied.

Donatella Marazziti

Donatella Marazziti, MD, is psychiatrist at the Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy and Professor of Psychology at Saint Camillus University of Medical Sciences, Rome, Italy. Editor-In-Chief of Clinical Neuropsychiatry and field editor of CNS Spectrums. She has published several papers in peer-review journals on obsessive-compulsive spectrum disorders, mood disorders, sexuality, and romantic relationships.

Umberto Albert

Umberto Albert, MD, PhD, MSc, is Associate Professor of Psychiatry at the University of Trieste, Department of Medicine, Surgery and Health Sciences, Italy. He is Director of the Bachelor Degree Programme in Psychiatric Rehabilitation Techniques, University of Trieste. His main research interests are Obsessive-Compulsive Disorder (clinical characterization and personalization of pharmacological and psychotherapeutic interventions; family accommodation) and Bipolar Disorder.

Federico Mucci

Federico Mucci, MD, is psychiatrist and PhD student at the Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy. He has published several papers on obsessive-compulsive disorder.

Erika Berti

Erika Berti has a degree in clinical psychology at the School of Psychology, University of Florence, Florence, Italy. She has participated to research projects and studies on sexual functioning in obsessive-compulsive disorder.

Giacomo Grassi

Giacomo Grassi is a psychiatrist and a Ph.D. in Neuroscience at the University of Florence. He works as clinician and researcher at the Brain Center Firenze in Italy. His research work focuses on impulsive-compulsive spectrum disorders and neuromodulation of neuropsychiatric disorders. He is in the board of directors of the International College of Obsessive-Compulsive and Related Disorders (Icocs).

Davide Prestia

Davide Prestia is a psychiatrist at the Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa. He is the director of the OCD outpatient clinic and is a lecturer in the psychiatry residency at the University of Genoa. He has a MSc in neuroscience. His research interests include OCD, mood disorders and anxiety disorders.

Davide Dèttore

Davide Dèttore, psychologist and psychotherapist, sexologist, is full professor of clinical psychology at the Department of Health Sciences, University of Florence, Florence, Italy. He has published several papers in peer-review journals and books on obsessive-compulsive spectrum disorders, sexual therapy and cognitive behavioural therapy