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UBC Theses and Dissertations

Sexuality and disordered eating : a dimensional perspective Dunkley, Cara Rae


A growing body of research points to notable parallels between eating disorders and sexual dysfunctions. In addition to being highly comorbid, sexual dysfunctions and eating disorders have similarities in affective and cognitive characteristics, overlapping neurobiological features, and a shared treatment approach. These features provide theoretical evidence for an underlying, shared vulnerability which may serve as risk factors for the development and maintenance of both sexual concerns and disordered eating symptoms. Within the Hierarchical Taxonomy of Psychopathology (HiTOP) – an empirically derived dimensional system of nosology - sexual dysfunctions, eating disorders, and disorders of mood and anxiety are classified under an overarching spectrum of internalizing psychopathology. The current series of studies examines associations between eating disorder symptoms and sexual difficulties across multiple samples from an internalizing disorder perspective. Undergraduate women (n = 656) and clinical samples of women with an eating disorder (n = 120) and women with a chronic vulvar pain condition (n = 166) completed a series of online questionnaires assessing sexual function, sexual distress, sexual insecurities, eating disorder symptoms, body dissatisfaction, negative affect, and psychological features characteristic of eating disorders. In each sample, disordered eating symptoms, body dissatisfaction, and psychological features characteristic of eating disorders were associated with more sexual difficulties, and both psychological features characteristic of eating disorders and negative affect were found to mediate these associations. Women with an eating disorder also reported more sexual concerns than women in the undergraduate sample. These findings suggest that sexual difficulties are common among women with an eating disorder, and that the severity of eating disorder symptoms may be associated with the severity of sexual concerns. Examining sexuality in individuals with an eating disorder has the potential to inform prognosis, case conceptualization, and treatment planning. These findings lend support for the consideration of sexual concerns being included in the internalizing spectrum with specific reference to shared latent liability with eating disorders.

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