Apego y psicopatología en adolescentes y jóvenes que han sufrido maltrato: implicaciones clínicas Se estudia la relación entre apego y psicopatología en una muestra de 40 adolescentes y jóvenes que han sufrido maltrato intrafamiliar. El apego se evalúa mediante el cuestionario RQ de Bartholomew, que distingue cuatro estilos de apego en función de la imagen positiva o negativa del self y de los demás: apego seguro, preocupado, temeroso y evitativo. Los resultados del estudio muestran que el apego inseguro, sobre todo el subtipo evitativo, es el más prevalente. Algo más de la mitad de la muestra (52.5%) presenta sintomatología clínicamente significativa (evaluada mediante el SCL-90-R), en especial hostilidad, obsesión-compulsión, ideación paranoide, psicoticismo y sensibilidad interpersonal. Los estilos de apego con una visión negativa del self (preocupado y temeroso) tienden a presentar más sintomatología psicopatológica. Se discuten las implicaciones clínicas de estos resultados.In this research, the relationship between attachment and psychopathology was studied in a sample of 40 adolescents and young adults who have suffered from intrafamily maltreatment. Attachment was assessed with Bartholomew's RQ, which distinguishes four attachment styles depending on the positive or negative image of the self and others: secure, preoccupied, fearful and dismissive attachment. Results show that insecure attachment, particularly the dismissive subtype, is the most prevalent one. Slightly more than half of the sample (52.5%) shows clinically significant symptoms (as assessed with the SCL-90-R), particularly hostility, obsessive-compulsive, paranoid ideation, psychoticism, and interpersonal sensitivity. Attachment styles with a negative vision of the self (preoccupied and fearful) tend to show more psychopathological symptoms. The clinical implications of these results are also discussed.

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 .

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