Clinical Features Associated with Female Genital Mutilation/Cutting: A Pilot Longitudinal Study.

(1) Background: Female genital mutilation/cutting (FGM/C) is associated with physical and psychological complications. However, there is scarce literature on how women with FGM/C respond to treatment interventions. (2) Methods: In the present pilot longitudinal study, we assessed changes in general psychopathology (Symptom Check List-90-R), sexual functioning and distress (Female Sexual Function Index, Female Sexual Distress Scale-Revised, and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) female sexual dysfunction criteria), body image (Body Shape Questionnaire), and sexual body image (Female Genital Self-Image Scale) in a sample of n = 15 women with FGM/C before and after reconstructive surgery. (3) Results: Sexual distress was significantly improved following surgery. We also observed an improvement in general psychopathology and genital self-image. However, sexual function was not improved. (4) Conclusions: These results provide evidence for the benefits of reconstructive surgery on sexual distress in women with FGM/C. The impact of surgery on sexual function cannot be conclusively evaluated.

A pilot study: Personality, psychopathology and coping strategies of women with sexual interest and arousal disorder / Un estudio piloto: Personalidad, psicopatología y estrategias de afrontamiento en mujeres con trastorno del interés y de la excitación sexual

Sexual interest and arousal disorder (SIAD) is the most common female sexual dysfunction. This mental disorder has a strong negative impact in the women's well-being, relationships and quality of life. A comprehensive approach to the multiple psychological factors that contribute to its appearance and maintenance is needed, in order to optimize the different therapeutic options. In this study, a sample of 10 women with SIAD was compared to a control group of women without a sexual dysfunction. For that purpose, participants were asked to complete standardized questionnaires. Results showed significant differences in psychopathological symptoms, personality dimensions and copying strategies between both groups. This study provides greater empirical understanding of the linkages between SIAD and personality traits, psychopathological symptoms, and stress coping strategies. Further research needs to be conducted to examine the effectiveness of interventions and improve current clinical treatments

El trastorno del interés/excitación sexual (TIES) es la disfunción sexual femenina más frecuente. Ocurre en mujeres de todas las edades y tiene un fuerte impacto negativo en su bienestar, relaciones y calidad de vida. Dado que presenta una elevada resistencia al tratamiento, es preciso revisar las distintas opciones terapéuticas y ello requiere profundizar en la comprensión de algunos de los múltiples factores psicológicos que contribuyen a su aparición y mantenimiento.En este estudio descriptivo comparativo, una muestra de 10 mujeres con TIE se comparó con un grupo control de mujeres sanas mediante entrevistas semiestructuradas y cuestionarios estandarizados. Los datos fueron analizados mediante el programa estadístico SPSS 17.0 Los resultados del estudio indican diferencias significativas en sintomatología psicopatológica, dimensiones de personalidad y uso de estrategias de afrontamiento de estrés

Clinical, Sexual and Psychopathological Changes after Clitoral Reconstruction in a Type II Female Genital Mutilation/Cutting: A Case Report.

Female genital mutilation/cutting (FGM/C) is a health issue associated with serious negative psychological and health consequences. However, there is little literature on the impact of FGM/C on female sexuality, mental health and genital self- image after clitoral reconstructive surgery. Our aim was to assess sexual function, psychopathology and genital self-image in a type II FGM/C patient. The patient was assessed prior to FGM/C reconstructive surgery and at a 6-month follow-up. At follow- up, she reported an improvement in sexual function and a clear improvement of the psychopathological state. However, a worsening in genital self-image was also endorsed after the surgery. Our findings uphold that FGM/C reconstructive surgery can lessen psychopathological and sexual distress, although more research is needed in order to increase awareness of the potential benefits of genital reconstruction and to perfect the surgery procedures. These results have repercussions for health practitioners and psychologists alike in terms of developing prevention strategies and treatment protocols for FGM/C women.

Body dissatisfaction and eating disorder symptomatology: Which factors interfere with sexuality in women with eating disorders?

Body dissatisfaction is a relevant aspect in both eating disorders and sexuality. Using Stice's model, this study aimed to evaluate the relationship between these variables in eating disorder patients compared with healthy controls. Statistically significant correlations between body dissatisfaction and sexuality were found in the whole sample. The clinical group had higher rates of body dissatisfaction and sexual impairment. Within the clinical group, the participants with a greater drive for thinness showed higher sexual dysfunctions. These results suggest that sexuality should be systematically explored in eating disorders. Higher rates of drive for thinness may be associated with greater sexual impairment.

Clinical, sexual and psychopathological changes after clitoral reconstruction in a Type II Female Genital Mutilation/Cutting: a case report

Female genital mutilation/cutting (FGM/C) is a health issue associated with serious negative psychological and health consequences. However, there is little literature on the impact of FGM/C on female sexuality, mental health and genital self-image after clitoral reconstructive surgery. Our aim was to assess sexual function, psychopathology and genital self-image in a type II FGM/C patient. The patient was assessed prior to FGM/C reconstructive surgery and at a 6-month follow-up. At follow-up, she reported an improvement in sexual function and a clear improvement of the psychopathological state. However, a worsening in genital self-image was also endorsed after the surgery. Our findings uphold that FGM/C reconstructive surgery can lessen psychopathological and sexual distress, although more research is needed in order to increase awareness of the potential benefits of genital reconstruction and to perfect the surgery procedures. These results have repercussions for health practitioners and psychologists alike in terms of developing prevention strategies and treatment protocols for FGM/C women

Cognitive Deficits in Executive Functions and Decision-Making Impairments Cluster Gambling Disorder Sub-types.

To identify Gambling Disorder (GD) subtypes, in a population of men seeking treatment for GD, according to specific executive function domains (i.e., cognitive flexibility, inhibition and working memory as well as decision making) which are usually impaired in addictive behaviors. A total of 145 males ranging from 18 to 65 years diagnosed with GD were included in this study. All participants completed: (a) a set of questionnaires to assess psychopathological symptoms, personality and impulsivity traits, and (b) a battery of neuropsychological measures to test different executive functioning domains. Two clusters were identified based on the individual performance on the neuropsychological assessment. Cluster 1 [n = 106; labeled as Low Impaired Executive Function (LIEF)] was composed by patients with poor results in the neuropsychological assessment; cluster 2 patients [n = 46; labeled as High Impaired Executive Function (HIEF)] presented significantly higher deficits on the assessed domains and performed worse than the ones of LIEF cluster. Regarding the characterization of these two clusters, patients in cluster 2 were significantly older, unemployed and registered higher mean age of GD onset than patients in cluster 1. Additionally, patients in cluster 2 also obtained higher psychopathological symptoms, impulsivity (in both positive and negative urgency as well as sensation seeking) and some specific personality traits (higher harm avoidance as well as lower self-directedness and cooperativeness) than patients in cluster 1. The results of this study describe two different GD subtypes based on different cognitive domains (i.e., executive function performance). These two GD subtypes display different impulsivity and personality traits as well as clinical symptoms. The results provide new insight into the etiology and characterization of GD and have the potential to help improving current treatments.

Non-suicidal Self-Injury in Eating Disordered Patients: Associations with Heart Rate Variability and State-Trait Anxiety.

Background: Non-suicidal self-injury (NSSI) is commonly present in individuals with eating disorders (EDs) and is often employed as a maladaptive emotion regulation strategy to avoid or abate negative emotions. One of the most prevalent negative emotions experienced by self-injurers is anxiety; however, this emotion has not been extensively studied in this population. Thus, the aim of our study was to investigate the influence of anxiety on NSSI in patients with ED from two different dimensions: state anxiety and trait anxiety. Methods: The study comprised a total of 66 females: 12 ED patients with NSSI, 32 ED patients without a history of NSSI, and 22 healthy controls. State and trait anxiety were assessed by means of State-Trait Anxiety Inventory (STAI-S-T) and physiological data [i.e., heart rate variability (HRV)] were collected. Results: STAI-trait scores were significantly higher in ED patients with NSSI than ED patients without NSSI. Furthermore, when conducting logistic regression analyses higher STAI-trait scores were associated with NSSI in ED patients. However, no differences in STAI-state scores and HRV were found between ED patients with and without NSSI. Discussion: The present findings suggest that anxiety as a trait is associated with the use of maladaptive strategies (i.e., NSSI) in ED patients. These results uphold the need to target trait anxiety in ED treatment in order to prevent possible NSSI behaviors.

Is gambling disorder associated with impulsivity traits measured by the UPPS-P and is this association moderated by sex and age?

OBJECTIVES: Impulsivity is a construct that is strongly associated with Gambling Disorder (GD). The main objectives in the present study are: 1) to explore the role of sex and age on impulsivity levels in GD patients; 2) to identify the relationship of the different impulsivity facets with comorbid psychopathology and other personality traits in GD patients; and (3) to assess whether impulsivity is a predictor for the severity of GD. METHOD: The final sample consisted of 406 consecutive participants. All of them were seeking treatment for GD (88.4% male and 11.6% female) and completed the South Oaks Gambling Screen (SOGS), the UPPS-P Impulsive Behavior Scale, the Symptom Checklist (SCL-90-R), the Temperament and Character Inventory-R (TCI-R) as well as other clinical and psychopathological measures. RESULTS: Results show a negative linear trend between age and lower sensation seeking levels as well as lack of premeditation (the higher the age the lower the UPPS-P scores), and a positive linear trend between age and positive urgency (UR) (the higher the age the higher the UPPS-P score). However, no sex differences were found for the assessed impulsivity dimensions. Lack of perseverance was positively associated with obsessive-compulsive symptoms and harm avoidance trait, and negatively related to persistence and self-directedness traits. Positive UR and negative UR were positively correlated with general psychopathology and the total number of DSM-IV criteria, and negatively associated to the following personality traits: self-directedness and cooperativeness. Finally, only the sensation seeking and negative UR of the UPPS-P showed predictive capacity on the severity of the disorder (the higher the impulsivity scores the higher the illness severity). CONCLUSIONS: These findings highlight the association between impulsivity traits (measured by the UPPS-P) and GD in a large and consecutively recruited clinical sample with GD, taking into account the variables sex and age.

Decision Making Impairment: A Shared Vulnerability in Obesity, Gambling Disorder and Substance Use Disorders?

INTRODUCTION: Addictions are associated with decision making impairments. The present study explores decision making in Substance use disorder (SUD), Gambling disorder (GD) and Obesity (OB) when assessed by Iowa Gambling Task (IGT) and compares them with healthy controls (HC). METHODS: For the aims of this study, 591 participants (194 HC, 178 GD, 113 OB, 106 SUD) were assessed according to DSM criteria, completed a sociodemographic interview and conducted the IGT. RESULTS: SUD, GD and OB present impaired decision making when compared to the HC in the overall task and task learning, however no differences are found for the overall performance in the IGT among the clinical groups. Results also reveal some specific learning across the task patterns within the clinical groups: OB maintains negative scores until the third set where learning starts but with a less extend to HC, SUD presents an early learning followed by a progressive although slow improvement and GD presents more random choices with no learning. CONCLUSIONS: Decision making impairments are present in the studied clinical samples and they display individual differences in the task learning. Results can help understanding the underlying mechanisms of OB and addiction behaviors as well as improve current clinical treatments.

Enduring Changes in Decision Making in Patients with Full Remission from Anorexia Nervosa.

BACKGROUND: Deficits in neuropsychological functioning have consistently been identified in patients with anorexia nervosa (AN). However, little is known on how decision making in AN patients evolves in response to treatment or whether impairments are reversible. METHOD: AN patients (n = 42) completed the Iowa Gambling Task (IGT) upon admission to a 3-month day-hospital treatment programme and at a 1-year follow-up. Patient IGT performance was compared to age-matched controls (n = 46). RESULTS: AN patients displayed poorer performance on the IGT at admission compared to controls (p < .001). Patients with full remission (n = 31; 73.9%) at the 1-year follow-up improved IGT performance (p = 0.007), and scores were similar compared to controls (p = 0.557). AN patients with partial/no remission at follow-up (n = 11; 26.1%) did not improve IGT scores (p = 0.867). CONCLUSIONS: These findings uphold that enduring remission from AN can reverse decision-making impairments, and they might be most likely explained by clinical state rather than a trait vulnerability. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Food Addiction in Bulimia Nervosa: Clinical Correlates and Association with Response to a Brief Psychoeducational Intervention.

Food addiction (FA) has been examined in different populations. Although high FA levels are associated with greater eating disorder severity, few studies have addressed how FA relates to treatment outcome. GOALS: The study aims (1) to determine whether a brief intervention for bulimia nervosa (BN) reduces FA diagnosis or severity compared with baseline and (2) to determine if FA is predictive of treatment outcome. METHOD: Sixty-six female BN patients participated in the study. The Yale Food Addiction Scale was administered at two time points: prior to and following a 6-week intervention. The number of weekly binging/purging episodes, dropout and abstinence from bulimic behaviour were used as primary outcome measures. RESULTS: This brief intervention reduced FA severity and FA diagnosis in the 55 patients who completed treatment. FA severity was a short-term predictor of abstinence from binging/purging episodes after treatment (p = .018). CONCLUSIONS: Food addiction appears to be prevalent in BN although FA severity can improve following a short-term intervention. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.