Department of Psychology, University of South Florida, 4202 E. Fowler Avenue, PCD 4118G Tampa, FL 33620, United States.
Psychology Department, Western Carolina University, 91 Killian Building Lane, Room 302B, Cullowhee, NC 28723, United States.
J Sex Med. 2023 May 26;20(6):859-870. doi: 10.1093/jsxmed/qdad038.
Among women, disordered eating and sexual difficulties commonly co-occur.
We investigated whether interoceptive dysfunction (ie, altered processing of body cues) may be a common cause (ie, third variable) contributing to these concomitant outcomes above and beyond body mass index (BMI) and body image concerns.
Women (n = 1201; mean age = 25.92 years; mean BMI = 25.46 kg/m2; 61.6% heterosexual, 27.5% bisexual) were recruited from sexual education courses at a midsize southeastern university and Reddit communities related to women's health, sex, and disordered eating. Participants completed online measures of self-reported interoception (Multidimensional Assessment of Interoceptive Awareness Version 2), disordered eating attitudes and behaviors (Eating Disorder Examination Questionnaire), sexual function (Female Sexual Function Index), and demographic information, including height and weight. Regression, commonality, and dominance analyses were completed in R.
Sexual function was assessed via the Female Sexual Function Index.
Both general interoception and body trust (a facet of interoception concerned with trust of internal sensations) predicted dietary restraint and sexual function (Ps < .001). After accounting for both general interoception (β = 0.27, P < .001) and body trust (β = 0.32, P < .001) in hierarchal regression models predicting sexual function, dietary restraint either evidenced a reduction in its standardized beta or was no longer associated with sexual function. Body image concerns also emerged as a robust predictor of women's sexual function. Body trust accounted for the most unique variance (4.45%) in women's sexual function and commonly accounted for another 3.70% of variance with body image concerns.
Interoceptive exposure interventions may contribute to better outcomes for women with disordered eating, sexual difficulties, or co-occurring concerns, a notion worthy of future investigation.
Strengths include a large diverse sample in terms of sexual orientation (>35% sexual minority) and body size (BMIs from underweight to class 3 obesity). The cross-sectional nature of this study precludes any conclusions regarding temporal precedence or causality. Future studies should use different measures of dietary restraint for nonclinical populations (eg, objective measures of caloric intake).
Findings suggest that both interoception and body image concerns contribute to the co-occurrence of disordered eating behaviors and sexual difficulties, and that both may be important risk/maintaining factors to consider in future work. Interoception should be integrated into models of women's sexual function, as it may be just as important to women's sexual well-being as body image concerns.
在女性中，饮食失调和性困难通常同时发生。
我们研究了内脏感知功能障碍（即身体线索处理的改变）是否可能是导致这些同时发生的结果的共同原因（即第三个变量），而不仅仅是身体质量指数（BMI）和身体意象问题。
从一所中东南部大学的性教育课程和与女性健康、性和饮食失调相关的 Reddit 社区招募了 1201 名女性参与者（平均年龄 25.92 岁；平均 BMI 为 25.46kg/m2；61.6%为异性恋，27.5%为双性恋）。参与者在线完成了自我报告的内脏感知（多维内脏感知意识量表 2 版）、饮食失调态度和行为（饮食失调检查问卷）、性功能（女性性功能指数）以及包括身高和体重在内的人口统计学信息的测量。在 R 中完成了回归、共性和优势分析。
性功能通过女性性功能指数进行评估。
一般内脏感知和身体信任（与信任内部感觉有关的内脏感知方面）都预测了饮食限制和性功能（P<.001）。在分层回归模型中，分别考虑了一般内脏感知（β=0.27，P<.001）和身体信任（β=0.32，P<.001）对性功能的预测作用后，饮食限制的标准化β要么降低，要么与性功能不再相关。身体意象问题也成为女性性功能的一个强有力的预测因素。身体信任解释了女性性功能中最独特的差异（4.45%），并与身体意象问题共同解释了另外 3.70%的差异。
内脏感知暴露干预可能有助于改善饮食失调、性困难或同时存在的问题的女性的治疗效果，这一观点值得进一步研究。
本研究的局限性在于，研究对象的性取向（超过 35%的性少数群体）和体型（从体重不足到 3 级肥胖的 BMI）多样化。由于研究是横断面的，因此不能得出关于时间先后顺序或因果关系的任何结论。未来的研究应该使用非临床人群的不同饮食限制测量方法（例如，卡路里摄入量的客观测量）。
