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Du R, Knight RA. The Structure of Hypersexuality and Its Relation to Impulsivity. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2277-2290. [PMID: 38589743 DOI: 10.1007/s10508-024-02828-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 04/10/2024]
Abstract
Among the multiple controversies surrounding hypersexuality is the important issue of whether it constitutes a univocal construct. Although an initial study supported its homogeneity, more resent research has identified two separate subcomponents-problematic sexuality and sexual drive. The present survey study addressed this issue in a sample that included both in-person tested college students (n = 69) and online respondents (n = 339). A factor analysis of scales attempting to capture the indicators of each subcomponent of hypersexuality yielded two correlated, but separate factors. Whereas Problematic Sexuality (PS) comprised scales measuring sexual compulsivity, using sex as a coping mechanism, and the negative consequences of sexual behavior, Sexual Drive (SD) was defined by frequent sexual activity, preoccupation with sexual fantasies, a predilection for impersonal sexual behavior, and facile sexual arousal. These two subcomponents of hypersexuality were found to covary with different types of impulsivity, further supporting their discrimination and providing external validation for their differentiation. Contrary to a priori hypotheses, however, PS correlated highly with Callous/Manipulative/Risk-Taking as well as with a predicted Affective Instability/Behavioral Disinhibition factor, suggesting that PS may constitute an equifinality of separate developmental trajectories for those high on both subtypes of hypersexuality.
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Affiliation(s)
- Rui Du
- Department of Psychology, Brandeis University, Waltham, MA, 02453, USA.
| | - Raymond A Knight
- Department of Psychology, Brandeis University, Waltham, MA, 02453, USA
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Janssen E, Bancroft J. The Dual Control Model of Sexual Response: A Scoping Review, 2009-2022. JOURNAL OF SEX RESEARCH 2023; 60:948-968. [PMID: 37267113 DOI: 10.1080/00224499.2023.2219247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Dual Control Model proposes that sexual arousal and related processes are dependent on the balance between sexual excitation and sexual inhibition, and that individuals vary in their propensity for these processes. This scoping review provides an overview and discussion of the questionnaires used to measure the propensities for sexual excitation and inhibition, their translation and validation in other languages, and their application in empirical research on topics ranging from sexual desire and arousal, sexual (dys)function, sexual risk taking, asexuality, hypersexuality, and sexual aggression. A total of 152 papers, published between 2009 and 2022 and identified using online databases, were included in this review. The findings, consistent with those reviewed by Bancroft et al. (2009), suggest that sexual excitation is particularly relevant to sexual desire and responsivity and predictive of asexuality and hypersexuality. Sexual inhibition plays a role in sexual dysfunction. sexual risk taking, and sexual aggression, although often in interaction with sexual excitation. Suggestions for the further development of the model and for future studies are discussed.
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Affiliation(s)
- Erick Janssen
- Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Belgium
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - John Bancroft
- Horspath, Oxfordshire, UK
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
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Kondur HR, Lee TK, McIntosh R, Gouse H, Paul R, Grov C, Fuchs D, Gómez W, Dilworth SE, Neilands TB, Carrico AW. HIV-related drivers of sexual compulsivity and sexuality in sexual minority men who use methamphetamine. J Neurovirol 2022; 28:446-455. [PMID: 35821194 DOI: 10.1007/s13365-022-01085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/22/2022] [Accepted: 06/14/2022] [Indexed: 10/17/2022]
Abstract
Although co-occurring methamphetamine (meth) use and HIV amplify the risk for neuropsychiatric comorbidities, the underlying neuroimmune mechanisms are not well characterized. We examined whether a detectable viral load and dysregulated metabolism of amino acid precursors for neurotransmitters predicted subsequent levels of sexual compulsivity and sexual sensation seeking. This 15-month longitudinal study enrolled 110 sexual minority men (SMM) living with HIV who had biologically confirmed meth use (i.e., reactive urine or hair toxicology results). Peripheral venous blood samples collected at baseline, 6 months, 12 months, and 15 months were used to measure a detectable viral load (> 40 copies/mL), the kynurenine/tryptophan (K/T) ratio, and the phenylalanine/tyrosine (P/T) ratio. The K/T and P/T ratios index dysregulated serotonin and catecholamine (e.g., dopamine) synthesis, respectively. In a cross-lagged panel model, a detectable viral load at 6 months predicted greater sexual compulsivity at 12 months after adjusting for prior levels of sexual compulsivity and recent stimulant use (β = 0.26, p = 0.046). A greater P/T ratio at baseline predicted decreased sexual sensation seeking at 6 months (β = - 0.25, p = 0.004) after adjusting for baseline sexual sensation seeking and recent stimulant use. Taken together, HIV replication and dysregulated catecholamine synthesis could potentiate sexual compulsivity while decreasing sexual pleasure in SMM who use meth.
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Affiliation(s)
- Hema R Kondur
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Tae K Lee
- Department of Child Psychology and Education, Sungkyunkwan University, Seoul, Korea
| | - Roger McIntosh
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Hetta Gouse
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Robert Paul
- Department of Psychological Sciences, University of Missouri St. Louis, St. Louis, MO, USA
| | - Christian Grov
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | | | - Walter Gómez
- Jane Addams College of Social Work, University of Illinois, Chicago, IL, USA
| | - Samantha E Dilworth
- School of Medicine, Department of Medicine, Division of Prevention Science, San Francisco Center for AIDS Prevention Studies, University of California, San Francisco, USA
| | - Torsten B Neilands
- School of Medicine, Department of Medicine, Division of Prevention Science, San Francisco Center for AIDS Prevention Studies, University of California, San Francisco, USA
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
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Rao TSS, Banerjee D, Tandon A, Sawant NS, Jha A, Manohar S, Rao SS. Psychosexual Health and Sexual Medicine in Consultation-Liaison Psychiatry. Indian J Psychiatry 2022; 64:S429-S448. [PMID: 35602370 PMCID: PMC9122165 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_13_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/03/2022] [Accepted: 01/03/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- T S Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | | | - Abhinav Tandon
- Department of Psychiatry, United Institute of Medical Sciences, Allahabad, Uttar Pradesh, India
| | - Neena S Sawant
- Department of Psychiatry, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India
| | | | - Shivanand Manohar
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Suman S Rao
- Department of Psychiatry, BGS Global Institute of Medical Sciences, Bengaluru, Karnataka, India E-mail:
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Olver ME, Kingston DA, Laverty EK, Seto MC. Psychometric Properties of Common Measures of Hypersexuality in an Online Canadian Sample. J Sex Med 2022; 19:331-346. [PMID: 34987002 DOI: 10.1016/j.jsxm.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/26/2021] [Accepted: 12/06/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hypersexuality has been posited as the central defining feature of Compulsive Sexual Behavior Disorder, and although the acceptance and inclusion of this construct in psychiatric nosologies provides some legitimacy, concerns surrounding terminology, assessment, and diagnosis remain. AIM The present study was an independent psychometric examination of 2 of the most commonly used measures of Compulsive Sexual Behavior Disorder; specifically, the gender invariance of the latent structure, reliability (test retest, internal consistency), and external correlates (concurrent validity) of these measures. METHODS The Sexual Compulsivity Scale and the Hypersexual Behavior Inventory were completed by 2 nonclinical online community samples of cisgender women (ns = 525 and 359), cisgender men (ns = 419 and 364), and transgender or non-binary individuals (ns = 38 and 11). OUTCOMES Criterion based measures of sexual history and total sexual outlet (number of orgasms per week) were gathered to validate Sexual Compulsivity Scale and Hypersexual Behavior Inventory total and factor scores. RESULTS Results supported the factorial validity of both assessment measures: correlated 3 factor solutions were established through exploratory factor analysis of 1 sample, and confirmatory factor analysis in the second sample. Multiple group confirmatory factor analysis, conducted on the 2 combined samples, also supported the gender invariance of the 3-factor solutions. Additional basic psychometric indices of test-retest and internal consistency reliability and criterion-related (concurrent) validity conducted across the 2 online samples were supported. CLINICAL IMPLICATIONS Common measures of hypersexuality have potential for use in its assessment, treatment, and management. STRENGTHS & LIMITATIONS Study strengths include: the inclusion of 2 fairly large and diverse online samples, thorough checks for insufficient effort/validity of responding, validity and reliability methodology (ie, measurement at multiple time points, obtaining behavioral indicators of sexual health), and a comprehensive set of psychometric analyses to inform conclusions regarding the external validity, reliability, and latent structure of hypersexuality measures across gender groups. Study limitations include: potential concerns related to validity and accuracy of responding owing to a reliance on self-report, the potential for selection bias, and limiting the examination of the latent structure of hypersexuality to cisgender men and women such that the results may not generalize to gender diverse populations. CONCLUSION Hypersexuality is a multidimensional construct, with a common latent structure among cisgender men and women, consistency in measurement over time, and meaningful concurrent associations with behavioral criteria that have relevance for sexual health. Olver ME, Kingston DA, Laverty EK, et al. Psychometric Properties of Common Measures of Hypersexuality in an Online Canadian Sample. J Sex Med 2022;19:331-346.
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Affiliation(s)
- Mark E Olver
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Drew A Kingston
- HOPE Program, San Diego, CA, USA; The Royal's Institute of Mental Health Research, Ottawa, ON, Canada.
| | - Erin K Laverty
- The Canadian Public Health Association, Ottawa, ON, Canada
| | - Michael C Seto
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
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Gleason N, Finotelli I, Miner MH, Herbenick D, Coleman E. Estimated Prevalence and Demographic Correlates of Compulsive Sexual Behavior Among Gay Men in the United States. J Sex Med 2021; 18:1545-1554. [PMID: 37057439 DOI: 10.1016/j.jsxm.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/29/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Compulsive sexual behavior (CSB) is a clinical syndrome that causes significant distress and impairment for many individuals in the United States. Gay men are thought to have a higher prevalence of CSB, and it is associated with many relevant health outcomes including HIV risk behavior. AIM To estimate the prevalence and examine demographic correlates of CSB among gay men in the United States. METHODS A U.S. national probability sample of 227 gay-identified men were collected as part of the 2015 National Survey of Sexual Health and Behavior (NSSHB). OUTCOMES Participants completed the Compulsive Sexual Behavior Inventory (CSBI-13) and demographic measures. RESULTS Eighteen participants (7.93%) scored above the CSBI-13 clinical cut point, indicating they would likely meet criteria for clinically significant compulsive sexual behavior. To assess demographic correlates of CSB, demographic variables were entered into a logistic regression. Results of the logistic regression indicated that participant age, education, and religious affiliation were significant predictors of CSB status. Individuals scoring above the cut point were younger on average (M = 39.17; SD = 14.84) than those scoring below the cut point (M = 47.52; SD = 14.62; P = .02). Odds of scoring above the cut point were about six times greater for religiously affiliated participants compared to non-religiously affiliated participants (P = .005), and four times greater for those who had attended college compared to those who had not (P = .03). CLINICAL IMPLICATIONS These results indicate the prevalence of CSB in gay men is more modest than previously estimated, and is similar to the general population prevalence estimated in a previous study. The strongest predictor of CSB in this sample was religious affiliation, which underscores the importance of evaluating the role of religiosity in the etiology and/or identification of this clinical syndrome. STRENGTHS AND LIMITATIONS These findings are strengthened by the national probability sampling methodology and the use of the empirically validated CSBI-13 cut point. However, this sample was also older and had higher income and educational attainment than the larger population of gay men in the U.S. CONCLUSION These results indicate gay men may have a CSB prevalence rate similar to the general population, which contradicts previous research suggesting they are at greater risk for CSB. Gleason N, Finotelli I, Miner MH, et al. Estimated Prevalence and Demographic Correlates of Compulsive Sexual Behavior Among Gay Men in the United States. J Sex Med 2021;18:1545-1554.
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Affiliation(s)
- Neil Gleason
- Department of Psychology, University of Washington, Seattle, WA, USA.
| | - Itor Finotelli
- Program in Human Sexuality, University of Minnesota, Minneapolis, MN, USA
| | - Michael H Miner
- Program in Human Sexuality, University of Minnesota, Minneapolis, MN, USA
| | - Debra Herbenick
- The Kinsey Institute for Research in Sex, Gender and Reproduction, Indiana University, Bloomington, IN, USA
| | - Eli Coleman
- Program in Human Sexuality, University of Minnesota, Minneapolis, MN, USA
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Knight RA, Du R. The Structure, Covariates, and Etiology of Hypersexuality: Implications for Sexual Offending. Curr Psychiatry Rep 2021; 23:50. [PMID: 34196843 DOI: 10.1007/s11920-021-01260-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW A substantial increase in research on the structure, covariates, and etiology of hypersexuality has emerged during the last decade. It is the goal of this review to summarize and integrate this research and to indicate some practical implications for clinical and forensic practice, especially as applied to those who have sexually offended. RECENT FINDINGS Studies from the last half-decade converge on the conclusion that hypersexuality has both problematic and high sexual drive components. Both aspects have consistently been found to be distributed dimensionally and not categorically. Each subdimension covaries differentially with specific types of impulsivity. In addition to sexual abuse, psychological or emotional abuse has emerged to be a potent developmental antecedent of hypersexuality. Current research has focused on the problematic dimension of hypersexuality and has neglected to specify the criteria for high sexual drive. Lacking are large-scale representative and clinical samples that provide determination of optimal cutoffs for treatment and dispositional decisions for both dimensions of hypersexuality. Research on the etiology of both aspects of hypersexuality is in its infancy, and more differentiated assessments of developmental abuse histories are required.
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Affiliation(s)
- Raymond A Knight
- Department of Psychology, Brandeis University, MS 062, Waltham, MA, 02454-9110, USA.
| | - Rui Du
- Department of Psychology, Brandeis University, MS 062, Waltham, MA, 02454-9110, USA
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Rendel T, Steinberg H. [Concepts of nymphomania in the German academic psychiatry: Changes over the last two centuries]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 90:49-59. [PMID: 33592669 DOI: 10.1055/a-1365-8868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND This chronology aims to provide an overview of the views on nymphomania in the history of German academic psychiatry over the past 200 years. AIM The aim of this study was to answer the following questions: What are the continuities over that period with regard to the etiology, diagnosis, classification or therapeutic recommendations? What changes can be observed? Was the increase in sexual desire in women seen as a disease or rather as a symptom? What significance did psychiatry attribute to female sexuality at a certain point in time? What reasons can be identified for the perceptions made and conclusions drawn at a certain time? METHODS A cursory review of the most influential German-language psychiatric textbooks of the respective period was conducted in chronological continuity. Relevant passages were identified, analyzed in detail and compared with each other, taking the historical context into account. RESULTS At the turn of the 19th and 20th century, a clear break in the understanding of nymphomania as a disease could be observed. In the 19th century, it was seen as a severe mental illness, which was assumed to have been caused at least in part by a peripheral disease of the female reproductive organs and the nervous system associated with them, which could lead to irreversible terminal mental states. In the 20th and 21st centuries, nymphomania was perceived as either a sexual neurosis or a functional sexual disorder, limited to the symptom complex of hypersexuality. The reasons for this were, on the one hand, the overall change in diagnosis resulting from a comprehensive reclassification of mental disorders, which assigned nymphomaniac symptoms of the 19th century to both manic and schizophrenic disorders, and, on the other hand, changes in the perception of female sexuality in the social discourse in general. The fact that nymphomania as a diagnosis was eliminated with the 11th edition of the International Classification of Diseases is a clear expression of this change. CONCLUSION The concept of nymphomania has undergone considerable changes over time. At the beginning of the 20th century, the understanding of the disease changed significantly, so that it is even possible to distinguish between an early and a late phase. The diagnosis has meanwhile become obsolete.
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Affiliation(s)
- Teresa Rendel
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Leipzig, Forschungsstelle für die Geschichte der Psychiatrie
| | - Holger Steinberg
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Leipzig, Forschungsstelle für die Geschichte der Psychiatrie
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Janssen E, Prause N, Swinburne Romine R, Raymond N, MacDonald A, Coleman E, Miner MH. Sexual Responsivity and the Effects of Negative Mood on Sexual Arousal in Hypersexual Men Who Have Sex With Men (MSM). J Sex Med 2020; 17:1751-1760. [PMID: 32653392 DOI: 10.1016/j.jsxm.2020.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/20/2020] [Accepted: 05/05/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND A number of studies have found that hypersexuality is associated with a high propensity for sexual excitation. In comparison, less is known about the relationship between hypersexuality and sexual arousal at the state level. Also, previous research has revealed a relationship between hypersexuality and negative mood. However, the possibility that sexual response might not be as negatively impacted by negative mood in hypersexual individuals has, as yet, not been tested. AIM The purpose of this study was to investigate sexual responsivity and the effects of negative mood on sexual arousal in hypersexual men who have sex with men (MSM). METHODS A total of 211 MSM were assigned to a hypersexuality (N = 81) or a control (N = 130) group using an interview patterned with a semi-structured Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders format. Participants filled out questionnaires and were shown neutral, sexual, and anxiety- and sadness-inducing films. OUTCOMES Changes in penile circumference and self-reported sexual arousal were the primary outcomes analyzed in this study. RESULTS Controlling for age and HIV status, no differences were found in genital response between hypersexual and non-hypersexual men. Also, the 2 groups did not differ in subjective sexual arousal. Moreover, no effects of negative mood were found. Time series clustering analyses revealed 3 groups-low responders and slow and fast high responders. Sexual excitation, but not sexual compulsivity or pornography use, predicted cluster membership. CLINICAL TRANSLATION Hypersexual MSM may benefit more from an exploration of motivational and behavioral, as compared to psychophysiological, mechanisms underlying possible links between (negative) mood and sexual behavior. STRENGTHS & LIMITATIONS Strengths of the study include its sample size, making it one of the larger psychophysiological sex studies; the use of clinical interviews for group assignment; the inclusion of genital response measures; and the application of time series clustering to examine differences among participants. Limitations include possible sample heterogeneity and the reliance on researcher-selected stimuli. CONCLUSION Given the lack of any effects of negative mood on sexual response in hypersexual MSM, future studies could explore in more depth possible motivational and behavioral effects, including, for example, the impact of negative mood on the tendency to seek out sex as a form of distraction or for validation or emotional support. Janssen E, Prause N, Romine RS, et al. Sexual Responsivity and the Effects of Negative Mood on Sexual Arousal in Hypersexual Men Who Have Sex With Men (MSM). J Sex Med 2020;17:1751-1760.
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Affiliation(s)
- Erick Janssen
- Institute for Family and Sexuality Studies, Department of Neurosciences, University of Leuven, Leuven, Belgium; Kinsey Institute, Indiana University, IN, USA.
| | | | | | - Nancy Raymond
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Angus MacDonald
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Eli Coleman
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Michael H Miner
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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Briken P. An integrated model to assess and treat compulsive sexual behaviour disorder. Nat Rev Urol 2020; 17:391-406. [DOI: 10.1038/s41585-020-0343-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2020] [Indexed: 12/12/2022]
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Dolan SB, Johnson PS, Johnson MW. The Hotel Room Purchase Task: Effects of Gender and Partner Desirability on Demand for Hypothetical Sex in Individuals with Disordered Cocaine Use and Controls. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1251-1262. [PMID: 31989411 PMCID: PMC8977073 DOI: 10.1007/s10508-020-01634-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 05/03/2023]
Abstract
Hypothetical purchase tasks allow for rapid assessment of behavioral economic demand for numerous commodities and are useful in evaluating reinforcer pathologies, such as substance and behavioral addiction. Currently, there is not a task for evaluating demand for sex without requiring implicit engagement in sex work. The current study used a novel purchase task with hotel rooms for sex as the hypothetical commodity to assess demand for sex in individuals with disordered cocaine use, a population that frequently engages in risky sexual behavior. Adults meeting criteria for cocaine abuse or dependence (13 males, ten females) and noncocaine-using controls (eight males, three females) chose hypothetical sexual partners from a series of photographs and endorsed two partners with whom they would most and least like to have sex. Participants then completed the hotel purchase task for both partners, wherein they reported how many nights at a hotel room, at prices from $10 to $1280 per night, they would purchase in a year. Demand intensity was significantly greater and demand elasticity was significantly lower for the most preferred relative to the less preferred partner. Males demonstrated significantly greater intensity and lesser elasticity for sex than females. Demand metrics did not differ between the cocaine and control group. This task may serve as a useful measure of demand for sex without requiring implicit hypothetical engagement in sex work. Future studies exploring the relation between task performance and other characteristics such as sexual dysfunction, in addition to acute substance administration effects, may further determine the task's clinical utility.
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Affiliation(s)
- Sean B Dolan
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Suite 3026, Baltimore, MD, 21224, USA
| | - Patrick S Johnson
- Department of Psychology, California State University, Chico, Chico, CA, USA
| | - Matthew W Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Suite 3026, Baltimore, MD, 21224, USA.
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Unterhorst K, Gerwinn H, Pohl A, Kärgel C, Massau C, Ristow I, Kneer J, Amelung T, Walter H, Beier K, Walter M, Schiffer B, Kruger THC, Stirn A, Ponseti J. An Exploratory Study on the Central Nervous Correlates of Sexual Excitation and Sexual Inhibition. JOURNAL OF SEX RESEARCH 2020; 57:397-408. [PMID: 30489159 DOI: 10.1080/00224499.2018.1539462] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Sexual Inhibition/Sexual Excitation Scales (SIS/SES) measure sexual excitation and sexual inhibition proneness. We used SIS and SES scores of 62 heterosexual teleiophilic men (Mage 34.3, SD = 9.9) to predict brain activation levels during the presentation of male and female visual sexual stimuli in a magnetic resonance imaging (MRI) scanner. Statistical analyses revealed significant correlations. SES and SIS1 scores were positively associated with brain activation in various brain regions during the presentation of both male and female stimuli. SIS2 turned out to be a weaker predictor of brain activation, still revealing one significant correlation in the right lateral orbitofrontal cortex. Significant regions for SES and SIS1 were, among others, primary and supplementary motor areas, the caudate nucleus, the dorsal anterior cingulate cortex, anterior insula, and prefrontal areas. Our study can be seen as an exploratory investigation of SIS and SES with means of functional brain imaging. The results provide a promising contribution to the assertion of neurophysiological systems of sexual inhibition and excitation proneness.
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Affiliation(s)
- K Unterhorst
- Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Center for Integrative Psychiatry
| | - H Gerwinn
- Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Center for Integrative Psychiatry
| | - A Pohl
- Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Center for Integrative Psychiatry
| | - C Kärgel
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy, and Preventive Medicine, LWL-University Hospital Bochum
- Institute of Forensic Psychiatry, University of Duisburg-Essen
| | - C Massau
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy, and Preventive Medicine, LWL-University Hospital Bochum
- Institute of Forensic Psychiatry, University of Duisburg-Essen
| | - I Ristow
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University Magdeburg
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology
| | - J Kneer
- Division of Clinical Psychology and Sexual Medicine, Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School
| | - T Amelung
- Institute of Sexology and Sexual Medicine, Charité-Universitätsmedizin Berlin
| | - H Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin
| | - K Beier
- Institute of Sexology and Sexual Medicine, Charité-Universitätsmedizin Berlin
| | - M Walter
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University Magdeburg
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology
- Department of Psychiatry, Eberhard Karls University of Tübingen
| | - B Schiffer
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy, and Preventive Medicine, LWL-University Hospital Bochum
- Institute of Forensic Psychiatry, University of Duisburg-Essen
| | - T H C Kruger
- Division of Clinical Psychology and Sexual Medicine, Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School
| | - A Stirn
- Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Center for Integrative Psychiatry
| | - J Ponseti
- Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Center for Integrative Psychiatry
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Rendina HJ, López-Matos J, Wang K, Pachankis JE, Parsons JT. The Role of Self-Conscious Emotions in the Sexual Health of Gay and Bisexual Men: Psychometric Properties and Theoretical Validation of the Sexual Shame and Pride Scale. JOURNAL OF SEX RESEARCH 2019; 56:620-631. [PMID: 29634377 PMCID: PMC6179944 DOI: 10.1080/00224499.2018.1453042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Researchers have theorized about the role of sexual shame as a mechanism through which sexual minority stress manifests into mental health difficulties, such as sexual compulsivity for gay and bisexual men (GBM), and about the resilience-promoting effects of sexual pride. However, no validated measures to date have directly tapped into these constructs rather than using proxies for them, such as internalized homonegativity. We developed the Sexual Shame and Pride Scale (SSPS) and conducted a psychometric evaluation of it using a sample of 260 highly sexually active GBM. The scale had the expected structure in factor analysis and showed evidence of internal consistency and test-retest reliability. Correlational analyses demonstrated the convergent validity of sexual shame and sexual pride with relevant constructs. Regression analyses demonstrated the predictive validity of sexual shame in relation to sexual compulsivity, accounting for unique variability even after adjusting for previously demonstrated etiological factors, and the predictive validity of both shame and pride, which interacted to consistently predict four sexual behavior outcomes. Findings suggest the SSPS is a psychometrically valid and reliable measure that may be useful in future empirical work and highlight preliminary evidence for the role of these constructs in the sexual health of GBM.
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Affiliation(s)
- H Jonathon Rendina
- a Center for HIV/AIDS Educational Studies and Training, New York; Department of Psychology, Hunter College of the City University of New York; and Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York
| | - Jonathan López-Matos
- b Center for HIV/AIDS Educational Studies and Training, New York; and Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York
| | - Katie Wang
- c Department of Social and Behavioral Sciences , Yale School of Public Health , New Haven , CT , USA
| | - John E Pachankis
- c Department of Social and Behavioral Sciences , Yale School of Public Health , New Haven , CT , USA
| | - Jeffrey T Parsons
- a Center for HIV/AIDS Educational Studies and Training, New York; Department of Psychology, Hunter College of the City University of New York; and Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York
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Rendina HJ, Carter JA, Wahl L, Millar BM, Parsons JT. Trajectories of sexual identity development and psychological well-being for highly sexually active gay and bisexual men: A latent growth curve analysis. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2019; 6:64-74. [PMID: 30984797 DOI: 10.1037/sgd0000308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective Examining sexual identity development-the process through which sexual minorities discover and disclose their sexual orientations-within a minority stress framework may help to contextualize sexual and mental health disparities among gay and bisexual men. Research on sexual identity development has typically focused on ages of achieving specific milestones (i.e., awareness, identification, sexual experience, and disclosure), though differences in onset and speed of the process and impact of these trajectories on healthy functioning in adulthood are understudied. Method We analyzed cross-sectional data from 374 highly sexually active gay and bisexual men in NYC. Using latent growth curve modelling, we examined trajectories of sexual identity development through the four primary milestones. We next examined their associations with childhood and background characteristics, adult experiences of sexual minority stress, and adult mental health. Results Gay sexual identity and greater childhood gender nonconformity were associated with earlier reported onset of sexual identity development and younger age was significantly associated with faster progression through the developmental process. The model showed that faster progression through sexual identity development was associated with higher levels of sexual orientation-based discrimination, emotion dysregulation, sexual compulsivity, and anxiety and depression in adulthood. Conclusions These findings support the need for a comprehensive and developmentally-informed model of adulthood functioning among gay and bisexual men that considers trajectories of sexual identity development-including onset and duration-as potential precursors to mental health difficulties in adulthood. Given the early onset of sexual identity development and potential lifelong sequelae, early prevention programs promoting positive sexual identity development are warranted.
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Affiliation(s)
- H Jonathon Rendina
- The Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.,Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Joseph A Carter
- The Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Logan Wahl
- The Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Brett M Millar
- The Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Jeffrey T Parsons
- The Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.,Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
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Chumakov EM, Petrova NN, Kraus SW. Compulsive Sexual Behavior in HIV-Infected Men in a Community Based Sample, Russia. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/10720162.2019.1582379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Egor M. Chumakov
- Saint-Petersburg State University, Saint-Petersburg, Russia
- Saint-Petersburg Psychiatric Hospital No. 1 named after P.P. Kaschenko, Saint-Petersburg, Russia
| | | | - Shane W. Kraus
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, USA
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Ballester-Arnal R, Castro-Calvo J, Gil-Julia B, Giménez-García C, Gil-Llario MD. A Validation Study of the Spanish Version of the Hypersexual Behavior Inventory (HBI): Paper-and-Pencil Versus Online Administration. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:283-302. [PMID: 30657020 DOI: 10.1080/0092623x.2018.1518886] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Hypersexuality is a problematic behavior characterized by the combination of an excessive sexual desire and the pathological inability to control it. This study presents the psychometric properties of the Spanish paper-and-pencil and online versions of the Hypersexual Behavior Inventory (HBI), one of the most popular scales to assess this issue. A total of 2,250 participants (1,070 men) completed a translated version of the HBI (1,450 in paper-and-pencil; 800 online). The exploratory factor analysis yielded three factors that explained 67.53% of total variance for the HBI paper-and-pencil version. This factor structure was confirmed in the HBI online version through confirmatory factor analysis (CFA). Factorial, structural, scalar and error variance-invariance according to gender was also confirmed through multigroup CFA. Reliability of the total score and subscales ranged between .89 and .96. Likewise, correlations with other related scales were positive and significant (r between .511 and .743). Temporal stability one year after the first application was .77 (paper-and-pencil format) and .68 (online version). These results support the reliability and validity of the HBI and justify its use in the assessment of hypersexuality in Spanish-speaking countries.
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Affiliation(s)
- Rafael Ballester-Arnal
- a Departmento de Psicología Básica, Clínica y Psicobiología, Universiat , Jaume I , Castellón , Spain
| | - Jesús Castro-Calvo
- a Departmento de Psicología Básica, Clínica y Psicobiología, Universiat , Jaume I , Castellón , Spain
- b Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg , Esch-sur-Alzette , Luxembourg
| | - Beatriz Gil-Julia
- c Departamento de Personalidad, Evaluación y Tratamientos Psicológicos , Universitat de València , Estudi General , Spain
| | - Cristina Giménez-García
- a Departmento de Psicología Básica, Clínica y Psicobiología, Universiat , Jaume I , Castellón , Spain
| | - María Dolores Gil-Llario
- d Departamento de Psicología Evolutiva y de la Educación , Universitat de València , Estudi General, Spain
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Castro-Calvo J, Ballester-Arnal R, Billieux J, Gil-Juliá B, Gil-Llario MD. Spanish validation of the Sexual Addiction Screening Test. J Behav Addict 2018; 7:584-600. [PMID: 30273048 PMCID: PMC6426369 DOI: 10.1556/2006.7.2018.57] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/22/2018] [Accepted: 05/28/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND AIMS Sexual addiction is a pathological behavior characterized by a combination of excessive sexual desire and impaired ability to control it. Its incidence ranges between 1.2% and 32.2%, although this number may vary depending on the screening tool used. This wide variability is largely due to the use of non-validated instruments (e.g., structural validity relying on exploratory analyses, instruments translated without an additional validation process, or instruments validated in another format). To deal with these limitations, this study tested the psychometric properties of the Spanish paper-and-pencil and online versions of the Sexual Addiction Screening Test (SAST). METHODS A total of 2,528 participants (1,163 males) completed the Spanish version of the SAST, along with other instruments assessing sexual compulsivity (1,585 = paper-and-pencil, 943 = online). RESULTS The exploratory factor analysis yielded a four-factor structure explaining 57.39% of the variance for the SAST paper-and-pencil version. This factor structure was then verified for the online version through the use of confirmatory factor analysis [χ2(264) = 441.59; χ2/df = 1.66; RMSEA = 0.02; CFI = 0.94; IFI = 0.94]. This methodology was also used to support measurement invariance (configural, metric, and scalar invariance) according to gender. The reliability of the total score ranged from .82 to .85. Similarly, correlations with related scales were positive and significant (r between .22 and .71). Temporal stability 1 year after the first application was 0.65 (paper-and-pencil format) and 0.60 (online version). CONCLUSION These results, together with the absence of questionnaires translated into Spanish to assess this construct, justify the use of the SAST in the evaluation of sexual addiction in Spanish-speaking countries.
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Affiliation(s)
- Jesús Castro-Calvo
- Salusex-Unisexsida, Departamento de Psicología Básica, Clínica y Psicobiología, Facultad de Ciencias de la Salud, Universitat Jaume I, Castellón, Spain
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Rafael Ballester-Arnal
- Salusex-Unisexsida, Departamento de Psicología Básica, Clínica y Psicobiología, Facultad de Ciencias de la Salud, Universitat Jaume I, Castellón, Spain
| | - Joel Billieux
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Beatriz Gil-Juliá
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Estudi General, Spain
| | - María Dolores Gil-Llario
- Departamento de Psicología Evolutiva y de la Educación, Universitat de València, Estudi General, Spain
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18
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Kingston DA. Hypersexuality: Fact or Fiction? J Sex Med 2018; 15:613-615. [PMID: 29699750 DOI: 10.1016/j.jsxm.2018.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/16/2018] [Accepted: 02/17/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Drew A Kingston
- Integrated Forensic Program, Institute of Mental Health Research, Brockville Mental Health Center, Royal Ottawa Health Care Group, Brockville, ON, Canada.
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Rooney BM, Tulloch TG, Blashill AJ. Psychosocial Syndemic Correlates of Sexual Compulsivity Among Men Who Have Sex with Men: A Meta-Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:75-93. [PMID: 28840435 DOI: 10.1007/s10508-017-1032-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/16/2017] [Accepted: 06/29/2017] [Indexed: 06/07/2023]
Abstract
Efforts have been made to better understand sexual compulsivity by examining salient psychosocial syndemic correlates, though examination of such factors has yielded inconclusive results. Given that research on sexual compulsivity has predominately involved men who have sex with men (MSM), the aims of the current study were to establish the mean effect sizes of seven psychosocial syndemic indicators with sexual compulsivity, to determine if the effect varied as a function of the type of psychosocial syndemic, and investigate the potential moderating effects using MSM samples. A total of 95 studies were included for analyses among the psychosocial syndemic indicators of interest (i.e., depression, anxiety, alcohol use, drug use, intimate partner violence, childhood sexual abuse, and sexual risk behavior). Results revealed a medium mean effect size of sexual compulsivity, the strength of which was significantly moderated by type of psychosocial syndemic indicator. Significant mean effect sizes for all syndemic indicators on sexual compulsivity were found, with depression and anxiety having the strongest relationships; significant moderating effects were found and are discussed. Findings highlight clinical considerations regarding sexual compulsivity and its role within the HIV syndemic framework among MSM.
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Affiliation(s)
- Benjamin M Rooney
- Department of Psychology, College of Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4611, USA.
| | - Tyler G Tulloch
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Aaron J Blashill
- Department of Psychology, College of Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4611, USA
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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20
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Kraus SW, Martino S, Potenza MN, Park C, Merrel JD, Hoff RA. Examining Compulsive Sexual Behavior and Psychopathology Among a Sample of Postdeployment U.S. Male and Female Military Veterans. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000147] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Shane W. Kraus
- VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts
| | - Steve Martino
- Department of Psychiatry, Yale University School of Medicine, and VISN 1 New England MIRECC, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, and Department of Neurobiology, Child Study Center, CASAColumbia, and Connecticut Mental Health Center, Yale University School of Medicine
| | - Crystal Park
- Department of Psychological Science, University of Connecticut
| | - Jeremy D. Merrel
- VISN 1 New England MIRECC, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Rani A. Hoff
- Department of Psychiatry, Yale University School of Medicine, and VISN 1 New England MIRECC, VA Connecticut Healthcare System, West Haven, Connecticut
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21
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Smith NG, Mohr JJ, Ross LE. The role of bisexual-specific minority stressors in sexual compulsivity among bisexual men. SEXUAL AND RELATIONSHIP THERAPY 2017. [DOI: 10.1080/14681994.2017.1386301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Nathan Grant Smith
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | - Jonathan J. Mohr
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Lori E. Ross
- Social & Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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22
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Nolet K, Larouche Wilson A, Rouleau JL. Using the dual control model to understand problematic sexual behaviors in men. SEXOLOGIES 2017. [DOI: 10.1016/j.sexol.2017.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nolet K, Larouche Wilson A, Rouleau JL. Le modèle du double contrôle dans la compréhension des comportements sexuels problématiques chez les hommes. SEXOLOGIES 2017. [DOI: 10.1016/j.sexol.2017.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Parsons JT, Rendina HJ, Moody RL, Gurung S, Starks TJ, Pachankis JE. Feasibility of an Emotion Regulation Intervention to Improve Mental Health and Reduce HIV Transmission Risk Behaviors for HIV-Positive Gay and Bisexual Men with Sexual Compulsivity. AIDS Behav 2017; 21:1540-1549. [PMID: 27573858 PMCID: PMC5332525 DOI: 10.1007/s10461-016-1533-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Gay and bisexual men (GBM) report high rates of sexual compulsivity (SC), yet no empirically based treatments exist. An intervention based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders was pilot tested in a sample of 13 HIV-positive GBM with SC. Participants completed a baseline interview, and were offered up to ten intervention sessions. Of those, 11 completed a 3-month follow-up assessment. Despite problems with session attendance (only 4 men completed all 10 sessions), improvements were observed in all psychological outcomes, including SC, depression, and anxiety. Decreases were observed in drug use and HIV risk. The Unified Protocol may be useful in improving the health of HIV-positive GBM, however challenges with session attendance must be addressed. Future work should consider if fewer sessions produce similar results, whether barriers to attending all sessions could be alleviated, and how the intervention would perform compared to treatments.
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Affiliation(s)
- Jeffrey T Parsons
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York (CUNY), New York, NY, USA.
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA.
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave., New York, NY, 10065, USA.
| | - H Jonathon Rendina
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave., New York, NY, 10065, USA
| | - Raymond L Moody
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Sitaji Gurung
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York (CUNY), New York, NY, USA
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Tyrel J Starks
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave., New York, NY, 10065, USA
| | - John E Pachankis
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
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Kraus SW, Voon V, Potenza MN. Should compulsive sexual behavior be considered an addiction? Addiction 2016; 111:2097-2106. [PMID: 26893127 PMCID: PMC4990495 DOI: 10.1111/add.13297] [Citation(s) in RCA: 183] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/30/2015] [Accepted: 01/04/2016] [Indexed: 12/16/2022]
Abstract
AIMS To review the evidence base for classifying compulsive sexual behavior (CSB) as a non-substance or 'behavioral' addiction. METHODS Data from multiple domains (e.g. epidemiological, phenomenological, clinical, biological) are reviewed and considered with respect to data from substance and gambling addictions. RESULTS Overlapping features exist between CSB and substance use disorders. Common neurotransmitter systems may contribute to CSB and substance use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases. Similar pharmacological and psychotherapeutic treatments may be applicable to CSB and substance addictions, although considerable gaps in knowledge currently exist. CONCLUSIONS Despite the growing body of research linking compulsive sexual behavior (CSB) to substance addictions, significant gaps in understanding continue to complicate classification of CSB as an addiction.
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Affiliation(s)
- Shane W. Kraus
- VISN 1 Mental Illness Research Education and Clinical Centers, VA Connecticut Healthcare System, West Haven, CT USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Valerie Voon
- University of Cambridge, Cambridge, United Kingdom
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
- Department of Neurobiology, Child Study Center and CASAColumbia, Yale University School of Medicine, New Haven, CT USA
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Miner MH, Romine RS, Raymond N, Janssen E, MacDonald A, Coleman E. Understanding the Personality and Behavioral Mechanisms Defining Hypersexuality in Men Who Have Sex With Men. J Sex Med 2016; 13:1323-1331. [PMID: 27486137 PMCID: PMC4996734 DOI: 10.1016/j.jsxm.2016.06.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/28/2016] [Accepted: 06/30/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Hypersexuality has been conceptualized as sexual addiction, compulsivity, and impulsivity, among others, in the absence of strong empirical data in support of any specific conceptualization. AIM To investigate personality factors and behavioral mechanisms that are relevant to hypersexuality in men who have sex with men. METHODS A sample of 242 men who have sex with men was recruited from various sites in a moderate-size mid-western city. Participants were assigned to a hypersexuality group or a control group using an interview similar to the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition. Self-report inventories were administered that measured the broad personality constructs of positive emotionality, negative emotionality, and constraint and more narrow constructs related to sexual behavioral control, behavioral activation, behavioral inhibition, sexual excitation, sexual inhibition, impulsivity, attention-deficit/hyperactivity disorder, and sexual behavior. MAIN OUTCOME MEASURES Hierarchical logistic regression was used to determine the relation between these personality and behavioral variables and group membership. RESULTS A hierarchical logistic regression controlling for age showed a significant positive relation between hypersexuality and negative emotionality and a negative relation with constraint. None of the behavioral mechanism variables entered this equation. However, a hierarchical multiple regression analysis predicting sexual behavioral control indicated that lack of such control was positively related to sexual excitation and sexual inhibition owing to the threat of performance failure and negatively related to sexual inhibition owing to the threat of performance consequences and general behavioral inhibition CONCLUSION Hypersexuality was found to be related to two broad personality factors that are characterized by emotional reactivity, risk taking, and impulsivity. The associated lack of sexual behavior control is influenced by sexual excitatory and inhibitory mechanisms, but not by general behavioral activation and inhibitory mechanisms.
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Affiliation(s)
- Michael H Miner
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | | | - Nancy Raymond
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA; Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Erick Janssen
- Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Flanders, Belgium
| | - Angus MacDonald
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Eli Coleman
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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How Different are Men Who Do Not Know Their HIV Status from Those Who Do? Results from an U.S. Online Study of Gay and Bisexual Men. AIDS Behav 2016; 20:1989-99. [PMID: 26767536 DOI: 10.1007/s10461-015-1284-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We compared self-described HIV-positive (31.6 %, n = 445), HIV-negative (56.8 %, n = 801), and HIV-unknown (11.6 %, n = 164) gay and bisexual men on sociodemographic and behavioral characteristics. Participants from across the U.S. were enrolled via a popular sexual networking website to complete an online survey. In total, 44.8 % of HIV-negative and HIV-unknown men said they had not been tested for HIV in the CDC-recommended last 6 months. HIV-unknown men significantly differed from HIV-negative and HIV-positive men in sexual behavior and HIV status disclosure patterns. HIV-unknown men were more willing than HIV-negative men to take PrEP; however, HIV-unknown men were significantly less likely than others to have health insurance or a primary care provider. Given the observed differences, researchers should consider analyzing men who are HIV-unknown distinctly from HIV-negative and HIV-positive men.
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Grov C, Rendina HJ, Ventuneac A, Parsons JT. Sexual Behavior Varies Between Same-Race and Different-Race Partnerships: A Daily Diary Study of Highly Sexually Active Black, Latino, and White Gay and Bisexual Men. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:1453-62. [PMID: 26696407 PMCID: PMC4917476 DOI: 10.1007/s10508-015-0677-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 11/23/2015] [Accepted: 12/01/2015] [Indexed: 05/11/2023]
Abstract
Racial homophily (partnering with those of the same race) has been suggested as contributing to racial disparities in HIV among gay and bisexual men (GBM). Using a daily diary study, we examined racial homophily and its role in anal sexual behaviors in a sample of highly sexually active Black, White, and Latino GBM (N = 294, n = 3107 sexual events). In general, (1) men tended to partner with others of the same race, (2) HIV was more prevalent among men of color, and (3) race acted independent of whether one would engage in behaviors that would put them at highest risk for transmitting HIV (i.e., no main or interaction effects for insertive condomless anal sex (CAS) among HIV-positive men, and no main or interaction effects for receptive CAS among HIV-negative men). There were some main and interactive effects observed for lower risk behaviors (receptive CAS among HIV-positive men and insertive CAS among HIV-negative). Our findings suggest that racial disparities in HIV may be due to a higher exposure frequency (i.e., the frequency with which one comes into contact with a partner where a transmission could occur). However, men were also less likely to have anal sex when having sex with someone of the same race-a finding that works against the premise of higher exposure frequency. Future researchers should examine both racial homophily as well as variation in sexual behavior based on same-race or different-race partnerships.
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Affiliation(s)
- Christian Grov
- The Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York (CUNY), Brooklyn, NY, USA
- CUNY School of Public Health, New York, NY, USA
| | - H Jonathon Rendina
- The Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA
| | - Ana Ventuneac
- The Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA
| | - Jeffrey T Parsons
- The Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA.
- CUNY School of Public Health, New York, NY, USA.
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA.
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of CUNY, New York, NY, USA.
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Grov C, Rendina HJ, Whitfield THF, Ventuneac A, Parsons JT. Changes in Familiarity with and Willingness to Take Preexposure Prophylaxis in a Longitudinal Study of Highly Sexually Active Gay and Bisexual Men. LGBT Health 2016; 3:252-7. [PMID: 27183232 DOI: 10.1089/lgbt.2015.0123] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE For gay and bisexual men (GBM), research suggests that familiarity with preexposure prophylaxis (PrEP) has been increasing since being approved by the United States Food and Drug Administration in 2012. However, it is less clear how willingness to start using PrEP has changed over time. Likewise, some have expressed concerns regarding the potential for risk compensation (i.e., reduced condom use) were one to start PrEP; however, again, it is unclear how risk compensation may have changed over time. METHODS We conducted baseline and 12-month assessments with 158 highly sexually active HIV-negative GBM in New York City who were assessed between 2011 and 2014. We examined change over time both between participants (based on when they entered the study), as well as within each participant (over the 12 months of his involvement). RESULTS Familiarity with PrEP increased over time (both between and within participants); however, willingness to take PrEP did not change (neither between nor within participants). Few men believed taking PrEP would cause their condomless anal sex (CAS) to increase and this did not change over time. However, a majority believed PrEP would increase temptation for CAS, and this did not change over time within participants. Sexual compulsivity symptomology was associated with higher willingness to take PrEP and perceiving that PrEP would increase one's temptations for CAS. Furthermore, recent CAS was associated with greater willingness to take PrEP, a perception that PrEP would increase one's likelihood to engage in CAS, and a perception that being on PrEP would increase one's temptation for CAS. CONCLUSIONS Participants became more familiar with PrEP over time; however, willingness to start PrEP did not change, and this may serve as an opportunity for providers to discuss PrEP with their patients. Men who engaged in CAS were interested in PrEP and preexisting patterns of sexual behavior may be the primary determinant of CAS while on PrEP.
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Affiliation(s)
- Christian Grov
- 1 The Center for HIV/AIDS Educational Studies & Training (CHEST) , New York, New York.,2 CUNY Graduate School of Public Health and Health Policy , New York, New York
| | - H Jonathon Rendina
- 1 The Center for HIV/AIDS Educational Studies & Training (CHEST) , New York, New York
| | - Thomas H F Whitfield
- 1 The Center for HIV/AIDS Educational Studies & Training (CHEST) , New York, New York.,3 Health Psychology and Clinical Science Doctoral Program, The Graduate Center of CUNY , New York, New York
| | - Ana Ventuneac
- 1 The Center for HIV/AIDS Educational Studies & Training (CHEST) , New York, New York
| | - Jeffrey T Parsons
- 1 The Center for HIV/AIDS Educational Studies & Training (CHEST) , New York, New York.,3 Health Psychology and Clinical Science Doctoral Program, The Graduate Center of CUNY , New York, New York.,4 Department of Psychology, Hunter College of the City University of New York (CUNY) , New York, New York
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Hart TA, Stratton N, Coleman TA, Wilson HA, Simpson SH, Julien RE, Hoe D, Leahy B, Maxwell J, Adam BD. A Pilot Trial of a Sexual Health Counseling Intervention for HIV-Positive Gay and Bisexual Men Who Report Anal Sex without Condoms. PLoS One 2016; 11:e0152762. [PMID: 27054341 PMCID: PMC4824469 DOI: 10.1371/journal.pone.0152762] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 03/18/2016] [Indexed: 01/01/2023] Open
Abstract
Background Even in the presence of promising biomedical treatment as prevention, HIV incidence among men who have sex with men has not always decreased. Counseling interventions, therefore, continue to play an important role in reducing HIV sexual transmission behaviors among gay and bisexual men and other men who have sex with men. The present study evaluated effects of a small-group counseling intervention on psychosocial outcomes and HIV sexual risk behavior. Method HIV-positive (HIV+) peer counselors administered seven 2-hour counseling sessions to groups of 5 to 8 HIV+ gay and bisexual men. The intervention employed information provision, motivational interviewing, and behavioral skills building to reduce sexual transmission risk behaviors. Results There was a significant reduction in condomless anal sex (CAS) with HIV-negative and unknown HIV-status partners, from 50.0% at baseline to 28.9% of the sample at 3-month follow-up. Findings were robust even when controlling for whether the participant had an undetectable viral load at baseline. Significant reductions were also found in the two secondary psychosocial outcomes, loneliness and sexual compulsivity. Conclusions The findings provide preliminary evidence that this intervention may offer an efficient way of concurrently reducing CAS and mental health problems, such as sexual compulsivity and loneliness, for HIV+ gay and bisexual men. Trial Registration ClinicalTrials.gov NCT02546271
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Affiliation(s)
- Trevor A. Hart
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
| | - Natalie Stratton
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Todd A. Coleman
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Holly A. Wilson
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | | | | | - David Hoe
- Poz Prevention Working Group, Gay Men’s Sexual Health Alliance, Toronto, Ontario, Canada
| | - Bob Leahy
- Poz Prevention Working Group, Gay Men’s Sexual Health Alliance, Toronto, Ontario, Canada
| | - John Maxwell
- AIDS Committee of Toronto, Toronto, Ontario, Canada
| | - Barry D. Adam
- Department of Sociology, Anthropology and Criminology, University of Windsor, Windsor, Ontario, Canada
- Ontario HIV Treatment Network, Toronto, Ontario, Canada
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Eldahan AI, Pachankis JE, Rendina HJ, Ventuneac A, Grov C, Parsons JT. Daily minority stress and affect among gay and bisexual men: A 30-day diary study. J Affect Disord 2016; 190:828-835. [PMID: 26625095 PMCID: PMC4684999 DOI: 10.1016/j.jad.2015.10.066] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/18/2015] [Accepted: 10/20/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND This study examined the time-variant association between daily minority stress and daily affect among gay and bisexual men. Tests of time-lagged associations allow for a stronger causal examination of minority stress-affect associations compared with static assessments. Multilevel modeling allows for comparison of associations between minority stress and daily affect when minority stress is modeled as a between-person factor and a within-person time-fluctuating state. METHODS 371 gay and bisexual men in New York City completed a 30-day daily diary, recording daily experiences of minority stress and positive affect (PA), negative affect (NA), and anxious affect (AA). Multilevel analyses examined associations between minority stress and affect in both same-day and time-lagged analyses, with minority stress assessed as both a between-person factor and a within-person state. RESULTS Daily minority stress, modeled as both a between-person and within-person construct, significantly predicted lower PA and higher NA and AA. Daily minority stress also predicted lower subsequent-day PA and higher subsequent-day NA and AA. LIMITATIONS Self-report assessments and the unique sample may limit generalizability of this study. CONCLUSIONS The time-variant association between sexual minority stress and affect found here substantiates the basic tenet of minority stress theory with a fine-grained analysis of gay and bisexual men's daily experience. Time-lagged effects suggest a potentially causal pathway between minority stress as a social determinant of mood and anxiety disorder symptoms among gay and bisexual men. When modeled as both a between-person factor and within-person state, minority stress demonstrated expected patterns with affect.
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Affiliation(s)
- Adam I. Eldahan
- Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, Yale School of Public Health, Yale University, New Haven, CT
| | - John E. Pachankis
- Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, Yale School of Public Health, Yale University, New Haven, CT
| | - H. Jonathon Rendina
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY
| | - Ana Ventuneac
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY
| | - Christian Grov
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY,Department of Health and Nutrition Sciences, Brooklyn College, City University of New York
| | - Jeffrey T. Parsons
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY,City University of New York (CUNY) School of Public Health at Hunter College, New York, NY,Department of Psychology, Hunter College of the City University of New York (CUNY),Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY,Correspondence concerning this article should be addressed to Jeffrey T. Parsons, Hunter College of the City University of New York, Department of Psychology, 695 Park Avenue, New York, NY 10065.
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Parsons JT, Rendina HJ, Moody RL, Ventuneac A, Grov C. Syndemic production and sexual compulsivity/hypersexuality in highly sexually active gay and bisexual men: further evidence for a three group conceptualization. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1903-13. [PMID: 26081246 PMCID: PMC4561029 DOI: 10.1007/s10508-015-0574-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 01/14/2015] [Accepted: 01/14/2015] [Indexed: 05/10/2023]
Abstract
Among gay and bisexual men (GBM), a syndemic describes a situation in which negative conditions (e.g., childhood sexual abuse, intimate partner violence, depression, polysubstance use) co-occur such to amplify HIV risk. Research has suggested that sexual compulsivity (SC) may also be a syndemic condition. Between 2011 and 2013, 368 highly sexually active (9+ male partners in 90 days) GBM completed a survey of syndemic factors as well as measures of sexual compulsivity (Sexual Compulsivity Scale [SCS]) and hypersexuality (hypersexual disorder screening inventory [HDSI]). Based on scores on the SCS and HDSI, participants were organized into three groups-negative on both ("Neither SC nor HD"); positive on the SCS only ("SC Only"), and positive on both the SCS and the HDSI ("Both SC and HD"). We found support for the utility of a three-group classification of sexual compulsivity/hypersexuality as one of the syndemic factors that contribute to HIV risk. The average number of syndemic factors experienced was lowest among those who experienced Neither SC nor HD and highest among the group that experienced Both SC and HD, with those experiencing SC Only falling between the two other groups. This study provided further evidence that sexual compulsivity/hypersexuality is a contributing factor to the syndemics model of HIV risk for GBM and that considering three levels of severity (i.e., SC along with HD) led to stronger model predictions than considering SC alone. SC/HD severity provides another modifiable target for HIV prevention intervention development.
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Affiliation(s)
- Jeffrey T Parsons
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA,
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