EXPLORING THE ROLE OF PARENTAL CARE AND OVERPROTECTION IN PREDICTING ERECTILE DYSFUNCTION: A MACHINE LEARNING APPROACH

Abstract Objectives Erectile dysfunction (ED) is a prevalent condition among young men, often attributed to a combination of physiological and psychological factors. Attachment theory suggests that early experiences of parental care and overprotection can influence relational styles in adulthood, potentially impacting sexual health. However, no studies have directly investigated whether parental attachment is associated with sexual dysfunctions, such as ED. This study aimed to examine the predictive role of Parental Cure and Overprotection (both to Mother and Father) on ED using Machine Learning (ML)Approaches. Methods A cross-sectional sample of 290 young male subjects (age < 35) was recruited in the study. Presence of ED was assessed using the International Index of Erectile Function (IIEF-15), while parental attachment was evaluated through the Parent Bonding Instrument (PBI). ED Subjects (IIEF<26) were 92 (31.72%). Two Machine Learning approaches were employed. Logistic Regression (LR) was used to evaluate linear relationships, while Gradient Boosting Machine (GBM) was employed to enhance predictive accuracy. Model performance was assessed through accuracy, precision, recall, F1 score, and Area Under the Curve (AUC), with feature importance analysis in the GBM model. Results The LR model yielded an accuracy of 64.5%, with high specificity (87.8%) but low sensitivity (21.6%), showing poor ability to detect ED cases. Father Care emerged as a significant protective factor (OR = 0.95, p < 0.05), while Mother Overprotection was positively associated with ED (OR = 1.038, p < 0.05). The GBM model outperformed logistic regression, with an accuracy of 73.6% and improved precision (55.0%) and recall (44.0%) for ED cases. In the GBM model, Father Care was the most important predictor (53.0%), followed by Mother Overprotection (39.9%). Conclusions This study highlights the role of parental attachment as a potential factor in the development of ED. Father Care was identified as a protective factor, while Mother Overprotection appeared to increase the risk of ED. These findings suggest that parental attachment could be considered one of the predisposing factors for ED, in addition to physiological, psychological, relational and social factors. Conflicts of Interest None.