Psychological Distress in Erectile Dysfunction : The Moderating Role of Attachment

Introduction: In clinical consultations, men with erectile dysfunction do not always express personal, sexual, and interpersonal concerns. Aim: We explore whether the attenuated impact of erectile dysfunction may be explained by a regulation of negative affect that causes activation of the attachment system. Methods: The study sample consisted of 69 men diagnosed with erectile dysfunction, mean (SD) age 56 (10.83) years. Participants completed self-reported questionnaires to assess erectile dysfunction severity, attachment style, sexual satisfaction, relationship satisfaction, and psychological symptoms. Main Outcome Measure: The moderating role of attachment between erectile dysfunction and sexual satisfaction, relationship satisfaction, and psychological distress was evaluated using multiple linear regression and moderation analysis. Results: All men in the sample had high attachment avoidance, distributed between the dismissive-avoidant (69.6%) and fearful-avoidant (30.4%) substyles, but low levels of psychological symptoms. Despite their erectile dysfunction, 27 patients (39.1%) rated their sexual life as satisfactory, and 46 (66.7%) rated their relationship with their partner as satisfactory. Men with fearful-avoidant attachment reported feeling more sexual desire and less sexual satisfaction than men with dismissive-avoidant attachment. Multiple linear regression analysis showed that sexual satisfaction variance was explained by erectile dysfunction severity, attachment anxiety, and relationship satisfaction scores. Moderation analysis showed that attachment anxiety, but not relationship satisfaction, moderated the impact of erectile dysfunction on sexual satisfaction. Conclusion: The avoidance dimension of attachment, which tends to be high in patients with erectile dysfunction, involves deactivation of the sexual system in an effort to minimize the emotional distress associated with erectile dysfunction, which damages sexual and relationship intimacy and delays the decision to obtain professional help. The presence of high attachment avoidance and the moderating value of attachment anxiety allow us to propose specific treatments for these men. Maestre-Lorén F, Castillo-Garayoa JA, López-i-Martín X, et al. Psychological Distress in Erectile Dysfunction: The Moderating Role of Attachment. Sex Med 2021;9:100436

Terapia cognitiva de la depresión

The cognitive therapy of depression (Beck, Rush, Shaw & Emery, 1979) is set up by a cognitive model, i.e., the theoretical form as depression is thought, and cognitive-behavioral methods of change, i.e., the form as modifications could be developed in the depressive state. Basically, the present paper revises two aspects of the cognitive therapy of depression: (1) the cognitive-clinical constructs of the cognitive model, which will be integrated into the broader perspective of the information processing model; and (2) the therapeutic change, from the perspectives of therapy's efectivity and change's nature and possibilities.La terapia cognitiva de la depresión, expuesta por Beck, Rush, Shaw & Emery (1979), está constituida por un modelo cognitivo, que da cuenta de la concepción teórica de la depresión, y unos procedimientos de cambio, de carácter cognitivo-conductual, que son la manera cómo se intenta producir modificaciones en el estado depresivo. Este artículo revisa, fundamentalmente, dos aspectos de la terapia cognitiva de la depresión: los constructos clínico-cognitivos que integran el modelo cognitivo, encuadrándolos en el planteamiento más amplio del procesamiento de la información, y el fenómeno del cambio terapéutico, desde la perspectiva de la eficacia de la terapia, la naturaleza del cambio y las posibilidades de cambio de la persona