Das Konstrukt „sexuelle Sucht“ im Zusammenhang mit forensisch psychiatrischen Fragestellungen

The Relevance of Hypersexuality and Impulsivity in Different Groups of Treatment-Seekers With and Without (Exclusive) Pedophilia

Hypersexuality and impulsivity are regarded as risk factors for sexual offending against children. Studies exploring these factors in undetected men who offended or are at risk of offending are rare. This study aims to investigate hypersexuality and impulsivity in treatment-seeking men with and without a diagnosis of (exclusive) pedophilia who committed child sexual abuse (CSA), consumed child sexual abuse images (CSAI), or feel at risk of offending sexually. Data were obtained from three child abuse prevention projects in Bamberg, Germany. We employed self-report (BIS-11, HBI), objective measures (TSO), and risk assessment tools (STABLE-2007). We computed Bayesian ordinal logit and binomial generalized linear models to explore differences between groups and to predict lifetime CSA and CSAI. Hypersexuality scores were particularly pronounced in patients with exclusive and non-exclusive pedophilia. Patients without pedophilia scored similarly to nonclinical samples. Impulsivity measures did not consistently differ between groups. We could not predict lifetime CSA and CSAI using impulsivity and hypersexuality measures. Sexual rather than general impulsivity seems to be an issue in men with pedophilia. The motivation to offend in patients without pedophilia is discussed.

Hypersexual behaviour among young adults in Germany: characteristics and personality correlates

BACKGROUND

Hypersexual behaviour (HB) is characterized by recurring unsuccessful efforts to control intense, repetitive sexual impulses that result in sexual activities and manifest in the behaviour of the concerning individual over an extended period. This study aims to describe the characterization of HB among the target group, identify personality correlates, and associations between HB and a lack of sexual education and reflection during school time.

METHODS

A cross-sectional design was used to survey the participants (age 18-27; n = 609) online who were recruited via a web forum for addiction selfcare, a website for casual sex dating, Facebook and the mail distribution of the University of Applied Science Nordhausen (Germany). Standardised questionnaires were used to measure the key variables in the study. The sexual behaviour (masturbation, pornography consumption, promiscuity), several personality tendencies, and retrospective information about sexual education of the participants during school time were investigated. Correlation and binomial logistic regression were used to analyse the data with HB as the outcome variable.

RESULTS

10.5% (n = 64) of the participants were identified as hypersexual. The assignment to male sex, a problematic pornography consumption, and impulsive tendencies were determined as predictors of HB. Strong correlates were identified between HB and promiscuity, and impairments in important areas of life. Weak to moderate correlates comprise between HB and all investigated personality traits, and several aspects of sexual risk behaviour. No association was found between HB and a lacking sexual education during school time. The descriptive analysis revealed further sexual problems within the sample (e.g. feelings of shame and guilt, sexual risk behaviour, sexual dysfunction).

CONCLUSION

Young adults should get more attention as a vulnerable group for the development of hypersexuality in sexual education, prevention and therapy. Regarding to its treatment, HB therefore should be considered together with its associations with sociodemographic information, personality traits, and psychosocial factors.

Konzepte und Implikationen der verminderten Schuldfähigkeit

Die psychiatrische Feststellung einer überdauernd erheblich verminderten Schuldfähigkeit im Sinne von §21 StGB erfordert eine begründete Zuordnung zum Rechtsbegriff der „schweren seelischen Abartigkeit“ und auch einer dadurch beeinflussten motivationalen Steuerungsfähigkeit. Die psychiatrischen Konzepte, die sich im Verlauf der letzten 200 Jahre zur Frage der strafrechtlichen Verantwortlichkeit entwickelt haben, sind aber nicht reine Psychopathologie, sondern haben rechtspolitische Implikationen. So war die Einführung der „erheblich verminderten“ Schuldfähigkeit damit verknüpft, eine Handhabe für eine unbefristete Freiheitsentziehung sozial Devianter, möglicherweise psychisch Gestörter zu bekommen, die gefährlich, manchmal nur lästig sind. Es stellt sich anhand der Argumente für und gegen das Konstrukt einer verminderten Schuldfähigkeit die Frage, ob es einen Bereich jenseits von psychischer Gesundheit und psychischer Krankheit gibt, der geeignet ist, die Fähigkeiten einer Person zu verantwortlichem Handeln erheblich zu beinträchtigen. Dargestellt werden die forensisch-psychiatrischen Lösungsversuche dieses Problems, v. a. seit der Großen Strafrechtsreform 1975. Um zu verhindern, dass sozial abweichendes Verhalten mit dem Ziel einer prophylaktischen unbefristeten Freiheitsentziehung psychiatrisiert wird, sollte das Konzept der verminderten Schuldfähigkeit eng sein und wirklich psychiatrisch relevante Sachverhalte erfassen.