title: Sex after amputation: the relationships between sexual functioning, body image, mood and anxiety in persons with a lower limb amputation.
abstract: OBJECTIVE
  The study examined the relationships between psychological variables and sexual functioning in persons with lower limb amputations.
  
  
  METHODS
  Sixty-five participants (n = 49 males, n = 16 females) with lower limb amputations completed a battery of self-report questionnaires regarding their current psychological well-being and their current sexual activity. Measures included the anxiety items on the Hospital Anxiety and Depression Scale, the Beck Depression Inventory - Second Edition, Body Image Quality of Life Inventory, Body Exposure Self-Consciousness during Intimate Situations and the Golombok-Rust Inventory of Sexual Satisfaction.
  
  
  RESULTS
  Half of all participants with lower limb amputations were not currently sexually active. Approximately 60% of those who were sexually active scored within the clinical range for overall sexual dysfunction. Overall levels of sexual dysfunction were associated with significantly higher levels of anxiety (r = 0.40, p < 0.005), depression (r = 0.41, p < 0.015) and body exposure self-consciousness during sexual activities (r = 0.56, p < 0.005). Body image self-consciousness during sexual activities was the strongest predictor of sexual dysfunction.
  
  
  CONCLUSIONS
  Psychological challenges following limb loss are strongly associated with levels of sexual dysfunction. The study highlights the need for psychological and psychosexual assessment and intervention following limb loss to enhance sexual functioning and overall quality of life. Implications for Rehabilitation Only half of the participants with a lower limb amputation were sexually active. Over 60% of those who were sexually active reported clinical levels of sexual dysfunction. One third of the entire sample scored within the clinical range for depression and for anxiety. Depression, anxiety and body image issues were significantly associated with sexual dysfunction in the current sample of individuals with lower limb amputation. There is a need for psychosexual assessment following limb loss to ensure that appropriate and timely interventions are made available. Interventions that target the psychological factors related to sexual dysfunction are likely to improve overall quality of life for these individuals.
authors.affiliation: a Department of Psychology, Aras an Phiarsaigh, Trinity College Dublin , Dublin , Ireland.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Woods
authors.affiliation: a Department of Psychology, Aras an Phiarsaigh, Trinity College Dublin , Dublin , Ireland.
authors.forename: David
authors.initials: D
authors.lastname: Hevey
authors.affiliation: b Prosthetic, Orthotic and Limb Absence Rehabilitation Programme , National Rehabilitation Hospital , Dublin , Ireland.
authors.forename: Nicola
authors.initials: N
authors.lastname: Ryall
authors.affiliation: b Prosthetic, Orthotic and Limb Absence Rehabilitation Programme , National Rehabilitation Hospital , Dublin , Ireland.
authors.forename: Fiadhnait
authors.initials: F
authors.lastname: O'Keeffe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000674:Amputees / Q000523:psychology*; D001007:Anxiety / Q000209:etiology; D001828:Body Image; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D012725:Sexual Behavior / Q000523:psychology*; D012735:Sexual Dysfunction, Physiological; D020018:Sexual Dysfunctions, Psychological; D011795:Surveys and Questionnaires
keywords: Sexual function; depression; self-consciousness; sexual activity; sexuality; stress