Dysregulated Sexuality in Women with Eating Disorders: The Role of Childhood Traumatic Experiences (2020)

COMMENTS: Female’s scoring high on a sex addiction assessment had higher Ghrelin levels. Ghrelin’s a hormone involved in consumption of natural rewards and drug & behavioral addictions. From abstract:

In the clinical sample, hypersexuality – measured through the Hypersexual Behavior Inventory (HBI) – was associated with severe psychopathology, emotion dysregulation, childhood trauma, adverse consequences, and higher ghrelin levels. Moderation analyses showed that hypersexuality was associated with emotion dysregulation and psychopathology only in those patients reporting childhood traumatic experiences.

FROM THE FULL STUDY:

Regardless of the behavioral level, the present study attempted at elucidating the psychological and biological meaning of a self-perceived uncontrolled sexuality in patients with EDs. First, the lack of association of HBI with sexual hormonal levels seems to partly challenge the construct of hypersexuality in EDs as a mere disturbance of sexual drive, according with the definition of Kafka (2010). Furthermore, none of the dimensions of sexual functioning as measured by FSFI showed a relationship with HBI, except for sexual desire in subjects with experiences of childhood abuse, as shown in the moderation analyses: this could be explained by the fact that the construct of sexual desire as measured by the FSFI embraces a component of motivation for sexual intercourse that transcends the neurobiological sexual drive (Rosen et al., 2000), possibly including a relational component and a thrust to emotional regulation that is typical of patients with a history of childhood abuse (Dvir, Ford, Hill, & Frazier, 2014; Racine & Wildes, 2015). Additionally, the positive correlation between HBI and ghrelin levels suggests that in this population, hypersexuality was not simply related to sexual drive, but rather to a different putative mechanism. Indeed, ghrelin, an orexigenic peptide mainly produced in the stomach, has been linked to reward mechanisms for food and drugs of abuse, as well as with impulsive behaviors (Ralevski et al., 2017). On the other hand, the lack of interaction between impulsivity and hypersexuality observed in this study, did not confirm the typical psychopathological background commonly implicated (Bothe et al., 2019b).

Giovanni Castellini, Giulio D’Anna, Eleonora Rossi, Emanuele Cassioli, Cristina Appignanesi, Alessio Maria Monteleone, Alessandra H. Rellini & Valdo Ricca(2020)

Journal of Sex & Marital Therapy, DOI: 10.1080/0092623X.2020.1822484

Abstract

The present study explored the psychopathological, behavioral, and putative biological underpinnings of dysregulated sexuality in eating disorders (EDs), focusing on the role of childhood trauma – evaluated with the Childhood Trauma Questionnaire (CTQ). The comparison between Binge-Purging and Restricting patients outlined the predominance of markers of dysregulated sexuality in the first subgroup. In the clinical sample, hypersexuality – measured through the Hypersexual Behavior Inventory (HBI) – was associated with severe psychopathology, emotion dysregulation, childhood trauma, adverse consequences, and higher ghrelin levels. Moderation analyses showed that hypersexuality was associated with emotion dysregulation and psychopathology only in those patients reporting childhood traumatic experiences.