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Bőthe B, Potenza MN, Demetrovics Z. Debates on Compulsive Sexual Behavior Disorder: A Call for Global and Interdisciplinary Perspectives. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1215-1220. [PMID: 38418717 DOI: 10.1007/s10508-024-02836-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Beáta Bőthe
- Département de Psychologie, Université de Montréal, Succursale Centre-Ville, C.P. 6128, Montréal, QC, H3C 3J7, Canada.
- Centre de Recherche Interdisciplinaire sur les Problèmes Conjugaux et les Agressions Sexuelles, Montréal, QC, Canada.
| | - Marc N Potenza
- Yale University School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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Fotinos K, Sansone A, Greifenberger A, Katzman MA, Jannini TB, Reisman Y, Limoncin E, Jannini EA. Pornography and sexual function in the post-pandemic period: a narrative review from psychological, psychiatric, and sexological perspectives. Int J Impot Res 2024:10.1038/s41443-023-00812-3. [PMID: 38184709 DOI: 10.1038/s41443-023-00812-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 01/08/2024]
Abstract
The COVID-19 pandemic and lockdowns had significant impacts on sexual functioning and behavior. Partnered sexual activity decreased overall, while solo sex activities such as masturbation and pornography consumption increased exponentially. Given the ongoing debate about the effects of pornography on sexual function, it was prudent to consider how the increase in porn consumption during the pandemic might have impacted sexual function in the post-pandemic period. Results indicated that despite the increased rates of use during lockdowns, there remains no evidence supporting the relationship between sexual dysfunction and porn use during and following the pandemic period. On the contrary, pornography consumption and solo sex activities offered an alternative to conventional sexual behavior during a highly stressful period and were found to have positive effects of relieving psychosocial stress otherwise induced by the pandemic. Specifically, those who maintained an active sexual life experienced less anxiety and depression, and greater relational health than those who were not sexually active. It is important to consider factors including frequency, context, and type of consumption when analyzing the impact of pornography on sexual function. While excessive use can have negative effects, moderate use can be a natural and healthy part of life.
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Affiliation(s)
- Kathryn Fotinos
- Course of Clinical Psychosexology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
- Stress Trauma Anxiety Rehabilitation Treatment (S.T.A.R.T.) Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada
| | - Andrea Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Alexandria Greifenberger
- Stress Trauma Anxiety Rehabilitation Treatment (S.T.A.R.T.) Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada
| | - Martin A Katzman
- Stress Trauma Anxiety Rehabilitation Treatment (S.T.A.R.T.) Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada
- Adler Graduate Professional School, Toronto, ON, Canada
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada
| | - Tommaso B Jannini
- School of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | | | - Erika Limoncin
- Course of Clinical Psychosexology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
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Rahm-Knigge RL, Gleason N, Mark K, Coleman E. Identifying Relationships Between Difficulties with Emotion Regulation and Compulsive Sexual Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3443-3455. [PMID: 37670204 DOI: 10.1007/s10508-023-02690-8] [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: 05/27/2023] [Revised: 08/04/2023] [Accepted: 08/16/2023] [Indexed: 09/07/2023]
Abstract
Emotion dysregulation is an associated feature of compulsive sexual behavior disorder (CSBD), now recognized by the World Health Organization. Previous studies have identified associations between trait emotion dysregulation and CSBD. Given that difficulties with emotion regulation (DERS) is comprised of several facets (e.g., difficulty with impulse control and lacking awareness of one's feelings when upset), and that these facets differentially relate to other mental health concerns, the present study aimed to examine how DERS facets relate to compulsive sexual behavior (CSB). The present study also considered interpersonal emotion regulation via attachment avoidance and attachment anxiety. Hierarchical regression was conducted, first accounting for demographic covariates, then adding attachment styles, and finally all DERS subscales. Results indicated that, among a large, diverse, online U.S. sample (N = 915; Mage = 39.21, SD = 0.81; 54.3% men), difficulty controlling impulses when upset, difficulty with clarity of emotions, and non-acceptance of emotions were significantly positively associated with CSB (small to moderate effects). Attachment anxiety and avoidance were also significantly positively associated with CSB, although their effects were minimal when adding DERS facets. Overall, this study supports the theorized impact of emotion dysregulation on CSB. Assessment of individual differences in DERS and intervening on these concerns are important for treating CSB.
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Affiliation(s)
- Ryan L Rahm-Knigge
- Department of Family Medicine and Community Health, Eli Coleman Institute for Sexual and Gender Health, University of Minnesota Medical School, 1300 South 2nd Street, Suite 180, Minneapolis, MN, 55415, USA.
| | - Neil Gleason
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Kristen Mark
- Department of Family Medicine and Community Health, Eli Coleman Institute for Sexual and Gender Health, University of Minnesota Medical School, 1300 South 2nd Street, Suite 180, Minneapolis, MN, 55415, USA
| | - Eli Coleman
- Department of Family Medicine and Community Health, Eli Coleman Institute for Sexual and Gender Health, University of Minnesota Medical School, 1300 South 2nd Street, Suite 180, Minneapolis, MN, 55415, USA
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Grant Weinandy JT, Lee B, Hoagland KC, Grubbs JB, Bőthe B. Anxiety and Compulsive Sexual Behavior Disorder: A Systematic Review. JOURNAL OF SEX RESEARCH 2023; 60:545-557. [PMID: 35482896 DOI: 10.1080/00224499.2022.2066616] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The inclusion of the novel diagnosis of Compulsive Sexual Behavior Disorder in the forthcoming 11th edition of the International Classification of Diseases has spurred increasing interest in the clinical profile of the disorder. Such attention has included a focus on potential comorbidities, risk factors, or symptoms resulting from such behaviors, including anxiety. Anxiety disorders have long been noted as comorbid with many other diagnoses, such as posttraumatic stress disorder, obsessive compulsive disorder, and substance use disorders. This review aims to understand the relationship between anxiety and compulsive sexual behavior in adults and adolescents, based on available quantitative studies. A search of PsycInfo and PubMed revealed 40 studies which quantitatively assessed a relationship between an anxiety measure and a Compulsive Sexual Behavior Disorder measure, including dissertations and published articles using clinical and community samples. A qualitative synthesis and risk of bias analysis of the studies was conducted, rather than a meta-analysis, due to the variety of methods. Overall, studies were primarily cross-sectional and the relationship between these two constructs was unclear, likely due to several factors, including inconsistent measurement of Compulsive Sexual Behavior Disorder, lack of gender diversity, and very little longitudinal data. Directions for future research are discussed.
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Affiliation(s)
| | - Brinna Lee
- Department of Psychology, Bowling Green State University
| | | | | | - Beáta Bőthe
- Département de Psychologie, Université de Montréal
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Castro-Calvo J, Flayelle M, Perales JC, Brand M, Potenza MN, Billieux J. Compulsive Sexual Behavior Disorder should not be classified by solely relying on component/symptomatic features •. J Behav Addict 2022; 11:210-215. [PMID: 35895452 PMCID: PMC9295252 DOI: 10.1556/2006.2022.00029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/14/2022] [Accepted: 04/15/2022] [Indexed: 01/02/2023] Open
Abstract
The paper by Sassover and Weinstein (2022) contributes to a timely and complex debate related to the classification of Compulsive Sexual Behavior Disorder (CSBD). The recent inclusion of CSBD as an impulse-control disorder in the ICD-11 has generated debate since a competitive view is that CSBD should rather be classified as an addictive disorder. Sassover and Weinstein (2022) reviewed existing evidence and concluded it does not support the conceptualization of CSBD as an addictive disorder. Although we agree regarding the relevance and timely nature of considering the classification of CSBD, we respectfully disagree with the position that relying on the components model of addiction (Griffiths, 2005) is the optimal approach for determining whether or not CSBD is an addictive disorder. In this commentary, we discuss potential pitfalls of relying on the components model to conceptualize CSBD as an addictive disorder and argue that considering a process-based approach is important for advancing this timely debate.
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Affiliation(s)
- Jesús Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain
- Corresponding authors. E-mail: ,
| | - Maèva Flayelle
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland
| | - José C. Perales
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany
| | - Marc N. Potenza
- Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Department of Neuroscience and the Wu Tsai Institute, Yale University, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- The Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
| | - Joël Billieux
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland
- Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
- Corresponding authors. E-mail: ,
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Coleman E, Rahm-Knigge RL, Danielson S, Nielsen KH, Gleason N, Jennings T, Miner MH. The Relationship between Boredom Proneness, Attachment Styles and Compulsive Sexual Behavior. JOURNAL OF SEX & MARITAL THERAPY 2022; 49:172-188. [PMID: 35695090 DOI: 10.1080/0092623x.2022.2086511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Affect regulation is associated with compulsive sexual behavior (CSB) despite ongoing debate about its inclusion in diagnostic criteria. Previous studies on two specific affect regulation constructs - boredom proneness and attachment styles - suggest that affect regulation is associated with CSB. We tested a moderation model of the effects of attachment anxiety and attachment avoidance on the relationship between boredom proneness and CSB. Results indicate that the relationship between boredom proneness and CSB is stronger at higher levels of attachment anxiety, with no interaction between boredom proneness and attachment avoidance. Overall findings support the importance of affect regulation in conceptualizing and treating CSB.
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Affiliation(s)
- Eli Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ryan L Rahm-Knigge
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Samuel Danielson
- Department of Clinical Psychology, Minnesota State University, Mankato, Minnesota, USA
| | - Katja H Nielsen
- Department of Clinical Psychology, Minnesota State University, Mankato, Minnesota, USA
| | - Neil Gleason
- Department of Clinical Psychology, University of Washington, Seattle, Washington, USA
| | - Todd Jennings
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
| | - Michael H Miner
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Reed GM, First MB, Billieux J, Cloitre M, Briken P, Achab S, Brewin CR, King DL, Kraus SW, Bryant RA. Emerging experience with selected new categories in the ICD-11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. World Psychiatry 2022; 21:189-213. [PMID: 35524599 PMCID: PMC9077619 DOI: 10.1002/wps.20960] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Among the important changes in the ICD-11 is the addition of 21 new mental disorders. New categories are typically proposed to: a) improve the usefulness of morbidity statistics; b) facilitate recognition of a clinically important but poorly classified mental disorder in order to provide appropriate management; and c) stimulate research into more effective treatments. Given the major implications for the field and for World Health Organization (WHO) member states, it is important to examine the impact of these new categories during the early phase of the ICD-11 implementation. This paper focuses on four disorders: complex post-traumatic stress disorder, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. These categories were selected because they have been the focus of considerable activity and/or controversy and because their inclusion in the ICD-11 represents a different decision than was made for the DSM-5. The lead authors invited experts on each of these disorders to provide insight into why it was considered important to add it to the ICD-11, implications for care of not having that diagnostic category, important controversies about adding the disorder, and a review of the evidence generated and other developments related to the category since the WHO signaled its intention to include it in the ICD-11. Each of the four diagnostic categories appears to describe a population with clinically important and distinctive features that had previously gone unrecognized as well as specific treatment needs that would otherwise likely go unmet. The introduction of these categories in the ICD-11 has been followed by a substantial expansion of research in each area, which has generally supported their validity and utility, and by a significant increase in the availability of appropriate services.
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Affiliation(s)
- Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Michael B First
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals, Lausanne, Switzerland
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care, Menlo Park, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sophia Achab
- Outpatient Treatment Unit for Addictive Behaviors ReConnecte, Geneva University Hospitals, Geneva, Switzerland
- Psychological and Sociological Research and Training Unit, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Chris R Brewin
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Daniel L King
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
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Elrafei H, Jamali Q. Assessment and treatment of hypersexuality: a review. BJPSYCH ADVANCES 2021. [DOI: 10.1192/bja.2021.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Hypersexuality is defined under various terms in the DSM and ICD diagnostic classifications. However, it can be challenging to differentiate between hypersexuality as one of the symptoms of a mental disorder and hypersexual disorder as a primary diagnosis. In this article, we explore the physiology, assessment and treatment of hypersexual disorder, and consider its aetiology and epidemiology. In addition, we highlight the paucity of evidence in the literature about licensed or specific pharmacological recommendations for its treatment and the poor awareness of hypersexuality in clinical and research practice. Further research is recommended to identify more precise guidance for the pharmacological management of hypersexuality.
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Neves S. The religious disguise in “sex addiction” therapy. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.2008344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Malki K, Rahm C, Öberg KG, Ueda P. Frequency of Pornography Use and Sexual Health Outcomes in Sweden: Analysis of a National Probability Survey. J Sex Med 2021; 18:1735-1751. [PMID: 37057500 DOI: 10.1016/j.jsxm.2021.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/12/2021] [Accepted: 08/05/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about pornography use and its relationship with sexual health outcomes in the general population. AIM To assess frequency of pornography use and the association of sexual health outcomes with frequent pornography use in Sweden. METHODS Cross-sectional analysis of 14,135 participants (6,169 men and 7,966 women) aged 16-84 years in a Swedish nationally representative survey from 2017. We used logistic regression to assess the association of sexual health outcomes with use of pornography ≥3 times/wk. OUTCOMES Frequency of pornography use (never; less than once/mo to 3 times/mo; 1-2 times/wk; 3-5 times/wk; and daily or almost daily) and sexual health outcomes (eg, sexual satisfaction and sexual health problems). RESULTS In total, 68.7% of men and 27.0% of women used pornography. Among men aged 16-24 years, 17.2% used pornography daily or almost daily, 24.7% used pornography 3-5 d/wk and 23.7% used pornography 1-2 d/wk. Among women aged 16-24 years, the proportions were 1.2% for daily or almost daily, 3.1% for 3-5 times/wk, and 8.6% for 1-2 times/wk. Frequency of pornography use decreased with age among both men and women. While 22.6% of all men and 15.4% of all women reported that their or a sex partner's pornography use predominantly had positive effects on their sex life, 4.7% of men and 4.0% of women reported that the effects were predominantly negative. Variables indicating sexual dissatisfaction and sexual health problems were associated with use of pornography ≥3 times/wk: for example, dissatisfaction with sex life (age-adjusted odds ratio [aOR]: men 2.90 [95% CI 2.40-3.51]; women 1.85 [95% CI 1.09-3.16]), not having sex in the preferred way (aOR: men 2.48 [95% CI 1.92-3.20]; women 3.59 [95% CI 2.00-6.42]) and erection problems (aOR: men 2.18 [95% CI 1.73-2.76]). CLINICAL IMPLICATIONS While frequent pornography use is common, potential effects on sexual health outcomes are likely to differ between individuals. STRENGTH & LIMITATIONS We used a large and recent nationally representative survey with detailed information regarding frequency of pornography use. The temporality of associations of sexual health variables with frequency of pornography use could not be assessed. CONCLUSION In this analysis of a nationally representative survey in Sweden, we found that frequent pornography use was common among young men; that reporting predominantly positive effects of pornography use on the sex life was more common than reporting predominantly negative effects; and that sexual dissatisfaction and sexual health problems were associated with using pornography ≥3 times/wk. Malki K, Rahm C, Öberg KG, et al. Frequency of Pornography Use and Sexual Health Outcomes in Sweden: Analysis of a National Probability Survey. J Sex Med 2021;18:1735-1751.
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Affiliation(s)
- Kinda Malki
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Christoffer Rahm
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Katarina Görts Öberg
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Anova, Karolinska University Hospital, Stockholm, Sweden
| | - Peter Ueda
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
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Lampalzer U, Tozdan S, von Franqué F, Briken P. Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study. Sex Med 2021; 9:100429. [PMID: 34509753 PMCID: PMC8498949 DOI: 10.1016/j.esxm.2021.100429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/24/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Studies on characteristics of self-referred men with sexual interest in minors (SIM) and treatment approaches in this group of patients are still relatively rare. Aim The aim of this exploratory pilot study was to investigate hypersexuality and impulsivity as 2 dynamic risk factors that could possibly change during treatment in self-referred men with SIM. Methods Data were collected at the “Kein Täter Werden (means: not become an offender)” network site in Hamburg. Using self-report questionnaires, the extent of hypersexuality and impulsivity was analyzed with the samples’ pretreatment data via descriptive statistics and compared with nonclinical samples of other studies. The relation between hypersexuality and impulsivity was analyzed via Spearman's correlation coefficient with pretreatment data (N = 77). Intragroup analysis compared hypersexuality and impulsivity from pre- and posttreatment (n = 29). Main Outcome Measures Hypersexual Behavior Inventory and Barratt Impulsiveness Scale Version 11. Results The degree of generalized impulsivity in the SIM group was comparable to that in nonclinical samples while the degree of hypersexuality was considerably higher than in nonclinical samples. Sixty-four percent of the participants were in the range of clinically relevant hypersexuality. Impulsivity and hypersexuality were weakly positively correlated with each other. During treatment hypersexuality significantly decreased while impulsivity did not differ significantly between before beginning treatment and after (partial) completion. Conclusion Hypersexuality, but not impulsivity, was pronounced in the group of self-referred men with SIM and should be targeted in treatment. In order to improve treatment outcome regarding risk reduction in self-referred men with SIM, a focus on treatment approaches that were developed to treat hypersexuality can be expected to be effective while focusing on generalized impulsivity may be less relevant. Lampalzer U, Tozdan S, von Franqué F, et al. Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study. Sex Med 2021;9:100429.
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Affiliation(s)
- Ute Lampalzer
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Safiye Tozdan
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fritjof von Franqué
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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12
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Carvalho J, Rosa PJ, Štulhofer A. Exploring Hypersexuality Pathways From Eye Movements: The Role of (Sexual) Impulsivity. J Sex Med 2021; 18:1607-1614. [PMID: 37057434 DOI: 10.1016/j.jsxm.2021.06.018] [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: 02/18/2021] [Revised: 05/18/2021] [Accepted: 06/28/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Impulsivity is regarded as a key factor underpinning hypersexuality like-conditions. However, impulsivity is a multifaceted construct, and existing research has not been capturing such complexity, which includes the effects of domain-general and domain-specific impulsivity in hypersexuality. AIM The aim of this study was to test the predictive role of specific impulsivity domains, ie, domain-general and domain-specific, in hypersexuality and its associated consequences. METHODS Fifty-five men and 58 women went through an emotional Go/-no-Go task (including sexual, high-valence positive, and neutral pictures), aimed at capturing domain-general and domain-specific impulsivity. Ocular metrics were further considered in order to increase the validity of the experimental task, and provide a metric of attention capturing. The study was carried out in a community sample. OUTCOMES Self-reported (general)impulsivity and commission errors toward high-valence positive and sexual pictures (signaling domain-general and domain-specific impulsivity, respectively) were settled as independent variables, along with Time to First Fixation to stimuli, capturing early/uncontrolled attention. Scores on hypersexuality and negative consequences emerging from hypersexual behavior were settled as outcome variables. RESULTS Self-reported (general)impulsivity was the only predictor of hypersexuality scores, while negative consequences were best accounted by higher fixation time to sexual pictures. In all, findings did not support the role of domain-specific impulsivity (ie, sexual impulsivity) in hypersexuality. CLINICAL TRANSLATION Findings tentatively suggest that hypersexuality, as captured at the community level, may be best positioned within the general spectrum of psychopathology, thus influencing educational and clinical intervention protocols aimed at addressing hypersexuality related complaints. Protocols would be expected to primarily target general psychopathology phenomena, rather than specific sexual aspects. STRENGTHS & LIMITATIONS This study implemented an innovative approach to capture different impulsivity domains, thus adding to previous literature in the field. However, the current study precludes the generalization of findings to clinical samples, where psychological comorbidities are expected to impact results. Further, findings must be read with caution given to limited effect sizes. CONCLUSION While hypersexuality was related to self-reported (general) impulsivity, findings on the negative consequences associated with hypersexual behavior mirrored response patterns found in depression. Such evidence aligns with the assumption that hypersexuality related phenomena might be better positioned in the psychopathology domain, rather than simply framed as a specific sexual problem. Carvalho J, Rosa PJ, Štulhofer A. Exploring Hypersexuality Pathways From Eye Movements: The Role of (Sexual) Impulsivity. J Sex Med 2021;18:1607-1614.
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Affiliation(s)
- Joana Carvalho
- CPUP: Center for Psychology of Porto University, Faculty of Psychology and Educational Sciences, Porto University, Porto, Portugal.
| | - Pedro J Rosa
- Lusófona University, Digital Human-Environment Interaction Lab (HEI-lab), Lisbon, Portugal; ISMAT, Transdisciplinary Research Center (ISHIP), Portimão, Portugal
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
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13
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Shuler J, Brosi M, Spencer T, Hubler D. Pornography and Romantic Relationships: A Qualitative Examination of Individual Experiences. JOURNAL OF SEX & MARITAL THERAPY 2021; 47:605-620. [PMID: 34032184 DOI: 10.1080/0092623x.2021.1930308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Using a qualitative design, the current study explored the perceived effects of pornography use on romantic relationships. Thematic analysis was conducted on 588 participants' open ended responses to a question about the effect of pornography use on their relationship and sexual satisfaction within a larger survey assessing aspects of couples media use and relationship dynamics. Participant responses were categorized into three overarching themes; beneficial, detrimental, and neither entirely beneficial or detrimental effects of pornography use. The most common responses indicated that the participants reported no effects of pornography use on their relationship. Among those indicating a positive effect, the emergent themes centered on increased diversity of sexual experiences, increased sexual gratification, increased satisfaction with a partner, and increased erotic climate in a relationship. Among responses indicating a negative experience with pornography, identified themes included increased feelings of inadequacy, decreased sexual satisfaction in a relationship, a feeling of unrealistic expectations, and feelings of betrayal. Implications for more nuanced research and clinical applications are discussed.
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Affiliation(s)
- Jordan Shuler
- Oklahoma State University, Stillwater, Oklahoma, USA
| | - Matthew Brosi
- Oklahoma State University, Stillwater, Oklahoma, USA
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14
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Draps M, Kowalczyk-Grębska N, Marchewka A, Shi F, Gola M. White matter microstructural and Compulsive Sexual Behaviors Disorder - Diffusion Tensor Imaging study. J Behav Addict 2021; 10:55-64. [PMID: 33570504 PMCID: PMC8969848 DOI: 10.1556/2006.2021.00002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/30/2020] [Accepted: 12/27/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND AIMS Even though the Compulsive Sexual Behavior Disorder (CSBD) was added to the ICD-11 under the impulse control category in 2019, its neural mechanisms are still debated. Researchers have noted its similarity both to addiction and to Obssesive-Compulsive Disorder (OCD). The aim of our study was to address this question by investigating the pattern of anatomical brain abnormalities among CSBD patients. METHODS Reviewing 39 publications on Diffusion Tensor Imaging (DTI) we have identified main abnormalities specific for addictions and OCD. Than we have collected DTI data from 36 heterosexual males diagnosed with CSBD and 31 matched healthy controls. These results were then compared to the addiction and OCD patterns. RESULTS Compared to controls, CSBD individuals showed significant fractional anisotropy (FA) reduction in the superior corona radiata tract, the internal capsule tract, cerebellar tracts and occipital gyrus white matter. Interestingly, all these regions were also identified in previous studies as shared DTI correlates in both OCD and addiction. DISCUSSION AND CONCLUSIONS Results of our study suggest that CSBD shares similar pattern of abnormalities with both OCD and addiction. As one of the first DTI study comparing structural brain differences between CSBD, addictions and OCD, although it reveals new aspects of CSBD, it is insufficient to determine whether CSBD resembles more an addiction or OCD. Further research, especially comparing directly individuals with all three disorders may provide more conclusive results.
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Affiliation(s)
- Małgorzata Draps
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland,Corresponding author. E-mail:
| | | | - Artur Marchewka
- Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Feng Shi
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Mateusz Gola
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland,Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, USA
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15
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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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16
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Tolman DL, Chmielewski JF. Toward Women Wanting. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1709-1714. [PMID: 30523473 DOI: 10.1007/s10508-018-1342-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 11/02/2018] [Indexed: 06/09/2023]
Affiliation(s)
- Deborah L Tolman
- Department of Women and Gender Studies, Hunter College, New York, NY, 10065, USA.
- Program in Critical Social Psychology, The Graduate Center of the City University of New York, New York, NY, USA.
| | - Jennifer F Chmielewski
- Program in Critical Social Psychology, The Graduate Center of the City University of New York, New York, NY, USA
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17
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Fernandez DP, Griffiths MD. Psychometric Instruments for Problematic Pornography Use: A Systematic Review. Eval Health Prof 2019; 44:111-141. [PMID: 31284745 DOI: 10.1177/0163278719861688] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Despite a lack of consensus in the field about how best to conceptualize problematic pornography use, psychometric instruments have nonetheless been developed to assess the construct. The present systematic review aimed to (i) identify psychometric tools that have been developed to assess problematic pornography use; (ii) summarize key characteristics, psychometric properties, and strengths and limitations of instruments for problematic pornography use; (iii) compare the instruments' theoretical conceptualizations of problematic pornography use; and (iv) evaluate each instrument on their ability to assess various core components of addiction. In this article, 22 instruments assessing problematic pornography use were reviewed. Results indicated that while the instruments had different conceptualizations of problematic pornography use, addiction still emerged as the most common theoretical framework used by the instruments. Five of the most commonly assessed addiction components across the different instruments were (1) impaired control, (2) salience, (3) mood modification, (4) interpersonal conflict, and (5) general life conflict. Contextual factors that may potentially affect the assessment of problematic pornography use and recommendations for researchers and clinicians are discussed.
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Affiliation(s)
- David P Fernandez
- Psychology Department, 6122Nottingham Trent University, Nottingham, United Kingdom
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, 6122Nottingham Trent University, Nottingham, United Kingdom
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18
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Bőthe B, Koós M, Tóth-Király I, Orosz G, Demetrovics Z. Investigating the Associations Of Adult ADHD Symptoms, Hypersexuality, and Problematic Pornography Use Among Men and Women on a Largescale, Non-Clinical Sample. J Sex Med 2019; 16:489-499. [DOI: 10.1016/j.jsxm.2019.01.312] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
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19
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Miner MH, Dickenson J, Coleman E. Effects of Emotions on Sexual Behavior in Men with and without Hypersexuality. ACTA ACUST UNITED AC 2019; 26:24-41. [PMID: 31772491 DOI: 10.1080/10720162.2018.1564408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The association between positive and negative affect and sexual behavior in 39 MSM with and without hypersexuality (HS) was explored using ecological momentary assessment. Participants reported their current positive and negative affect three times per day and their sexual behavior each morning and evening. The relationship between affect and sexual behavior differed between men with or without HS. In those with HS, the timing of and interactions between experienced affect differentially predicted types of sexual behavior, indicating differing mechanisms driving partnered sexual behavior and masturbation. These findings lend support to conceptualizing HS behavior as a coping strategy for affective arousal.
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Affiliation(s)
- Michael H Miner
- Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Janna Dickenson
- Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Eli Coleman
- Department of Family Medicine and Community Health, University of Minnesota Medical School
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20
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Willoughby BJ. Stuck in the Porn Box. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:449-453. [PMID: 30128982 DOI: 10.1007/s10508-018-1294-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 08/06/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Brian J Willoughby
- School of Family Life, Brigham Young University, 2081 JFSB, Provo, UT, 84602, USA.
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21
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Grubbs JB, Perry SL, Wilt JA, Reid RC. Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:397-415. [PMID: 30076491 DOI: 10.1007/s10508-018-1248-x] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 05/04/2023]
Abstract
The notion of problematic pornography use remains contentious in both academic and popular literature. Although the mental health community at large is divided as to the addictive versus non-addictive nature of Internet pornography, substantial numbers of individuals report "feeling" as if their use of Internet pornography is problematic. The present work seeks to construct a model related to problematic pornography use that is clearly derived from empirical literature and that provides directions to be tested in future research. The focus of the present work is on those perceptions as they relate to the overarching experience of moral incongruence in pornography use, which is generally thought of as the experience of having one's behaviors be inconsistent with one's beliefs. To this end, we put forth a model of pornography problems due to moral incongruence. Within this model, we describe how pornography-related problems-particularly feelings of addiction to pornography-may be, in many cases, better construed as functions of discrepancies-moral incongruence-between pornography-related beliefs and pornography-related behaviors. A systematic review of literature and meta-analysis is conducted in order to evaluate support for this model, and the implications of this model for research and clinical practice are discussed.
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Affiliation(s)
- Joshua B Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, 43403, USA.
| | - Samuel L Perry
- Department of Sociology, University of Oklahoma, Norman, OK, USA
| | - Joshua A Wilt
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Rory C Reid
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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22
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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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23
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de Alarcón R, de la Iglesia JI, Casado NM, Montejo AL. Online Porn Addiction: What We Know and What We Don't-A Systematic Review. J Clin Med 2019; 8:E91. [PMID: 30650522 PMCID: PMC6352245 DOI: 10.3390/jcm8010091] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/27/2018] [Accepted: 01/10/2019] [Indexed: 01/09/2023] Open
Abstract
In the last few years, there has been a wave of articles related to behavioral addictions; some of them have a focus on online pornography addiction. However, despite all efforts, we are still unable to profile when engaging in this behavior becomes pathological. Common problems include: sample bias, the search for diagnostic instrumentals, opposing approximations to the matter, and the fact that this entity may be encompassed inside a greater pathology (i.e., sex addiction) that may present itself with very diverse symptomatology. Behavioral addictions form a largely unexplored field of study, and usually exhibit a problematic consumption model: loss of control, impairment, and risky use. Hypersexual disorder fits this model and may be composed of several sexual behaviors, like problematic use of online pornography (POPU). Online pornography use is on the rise, with a potential for addiction considering the "triple A" influence (accessibility, affordability, anonymity). This problematic use might have adverse effects in sexual development and sexual functioning, especially among the young population. We aim to gather existing knowledge on problematic online pornography use as a pathological entity. Here we try to summarize what we know about this entity and outline some areas worthy of further research.
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Affiliation(s)
- Rubén de Alarcón
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
| | - Javier I de la Iglesia
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
| | - Nerea M Casado
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
| | - Angel L Montejo
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
- University of Salamanca, EUEF, 37007 Salamanca, Spain.
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24
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Coleman E, Dickenson JA, Girard A, Rider GN, Candelario-Pérez LE, Becker-Warner R, Kovic AG, Munns R. An Integrative Biopsychosocial and Sex Positive Model of Understanding and Treatment of Impulsive/Compulsive Sexual Behavior. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/10720162.2018.1515050] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Eli Coleman
- University of Minnesota, Minneapolis, Minnesota
| | | | - Abby Girard
- University of Minnesota, Minneapolis, Minnesota
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25
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Blum AW, Chamberlain SR, Grant JE. Quality of life of young adults with non-paraphilic problematic sexual behaviors: An exploratory study. Addict Behav Rep 2018; 8:164-169. [PMID: 30386816 PMCID: PMC6205335 DOI: 10.1016/j.abrep.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 10/08/2018] [Accepted: 10/14/2018] [Indexed: 12/03/2022] Open
Abstract
Introduction Many young adults are unable to control their sexual behavior despite distress or negative consequences created by these activities—a clinical phenomenon described as non-paraphilic problematic sexual behavior (PSB). Little is known about clinical features associated with quality of life in PSB. Methods 54 participants affected by PSB (ages 18–29 years) were recruited for a study on impulsivity in young adults. PSB was defined as the experience of sexual urges, fantasies, or behaviors that feel overwhelming or out of control. Participants were assessed using the Quality of Life Inventory (QOLI), other validated instruments, and questions examining aspects of health and well-being. Clinical measures associated with variation in quality of life were identified using the statistical technique of partial least squares (PLS). Results Lower quality of life in PSB was associated with greater behavioral and self-report measures of impulsivity (specifically, Barratt attentional impulsiveness, lower age at first alcohol use), emotional dysregulation, problematic use of the internet, current suicidality, higher state anxiety and depression, and lower self-esteem. Conclusions Impulsivity and affective problems are correlated with lower quality of life in PSB. These associations may provide a means to distinguish PSB from healthy sexual behavior. Quality of life is understudied in adults with problematic sexual behaviors. Lower quality of life was associated with affective problems and impulsivity. Higher quality of life was predicted by better self-esteem.
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Affiliation(s)
- Austin W Blum
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, UK.,Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
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26
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Kingston DA, Walters GD, Olver ME, Levaque E, Sawatsky M, Lalumière ML. Understanding the Latent Structure of Hypersexuality: A Taxometric Investigation. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2207-2221. [PMID: 30229520 DOI: 10.1007/s10508-018-1273-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/26/2018] [Accepted: 07/05/2018] [Indexed: 05/25/2023]
Abstract
We examined the latent structure and taxonicity of hypersexuality in large university and community samples of male and female respondents. Participants completed the Hypersexual Behavior Inventory (HBI) and Sexual Compulsivity Scale (SCS), each as part of larger anonymous online surveys of sexual behavior. Exploratory factor analyses (EFA) were performed in part to prepare the data for taxometric analysis and also to identify the putative dimensions underpinning each measure. Three latent dimensions were identified from each of the Sexual Compulsivity Scale (dyscontrol, consequences, and preoccupation) and Hypersexual Behavior Inventory (coping, dyscontrol, and consequences). Taxometric analyses of the generated factors using mean above minus below a cut (MAMBAC), maximum covariance (MAXCOV), and latent mode factor analysis (L-Mode) broadly supported a dimensional latent structure for hypersexuality, particularly in female participants. Implications pertaining to the assessment of hypersexuality are discussed.
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Affiliation(s)
- Drew A Kingston
- HOPE Program, 208-995 Gateway Center Way, San Diego, CA, 92102, USA.
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada.
| | - Glenn D Walters
- Department of Criminal Justice, Kutztown University, Kutztown, PA, USA
| | - Mark E Olver
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Enya Levaque
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Megan Sawatsky
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Martin L Lalumière
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
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27
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Bőthe B, Bartók R, Tóth-Király I, Reid RC, Griffiths MD, Demetrovics Z, Orosz G. Hypersexuality, Gender, and Sexual Orientation: A Large-Scale Psychometric Survey Study. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2265-2276. [PMID: 29926261 DOI: 10.1007/s10508-018-1201-z] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 02/15/2018] [Accepted: 03/19/2018] [Indexed: 05/25/2023]
Abstract
Criteria for hypersexual disorder (HD) were proposed for consideration in the DSM-5 but ultimately excluded for a variety of reasons. Regardless, research continues to investigate hypersexual behavior (HB). The Hypersexual Behavior Inventory (HBI) is one of the most robust scales assessing HB, but further examination is needed to explore its psychometric properties among different groups. Therefore, the aim of the present study was to examine the generalizability of the HBI in a large, diverse, non-clinical sample (N = 18,034 participants; females = 6132; 34.0%; Mage = 33.6 years, SDage = 11.1) across both gender and sexual orientation. Measurement invariance testing was carried out to ensure gender- and sexual orientation-based comparisons were meaningful. Results demonstrated when both gender and sexual orientation were considered (i.e., heterosexual males vs. LGBTQ males vs. heterosexual females vs. LGBTQ females), LGBTQ males had significantly higher latent means on the HBI factors. Results also demonstrated LGBTQ males had the highest scores on other possible indicators of hypersexuality (e.g., frequency of masturbation, number of sexual partners, or frequency of pornography viewing). These findings suggest LGBTQ males may be a group most at risk of engaging in hypersexual behavior, and LGBTQ females are at a higher risk of engaging in hypersexual activities due to coping problems. Given the large-scale nature of the study, the findings contribute to the currently growing body of the literature on hypersexuality.
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Affiliation(s)
- Beáta Bőthe
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46., Budapest, 1064, Hungary.
| | - Réka Bartók
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46., Budapest, 1064, Hungary
| | - István Tóth-Király
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46., Budapest, 1064, Hungary
| | - Rory C Reid
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46., Budapest, 1064, Hungary
| | - Gábor Orosz
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46., Budapest, 1064, Hungary
- Institute of Cognitive Neuroscience and Psychology, Hungarian Research Centre for Natural Sciences, Budapest, Hungary
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28
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Kuiper LB, Coolen LM. Compulsive Sexual Behavior in Humans and Preclinical Models. CURRENT SEXUAL HEALTH REPORTS 2018. [DOI: 10.1007/s11930-018-0157-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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29
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30
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Fernandez DP, Tee EYJ, Fernandez EF. Do Cyber Pornography Use Inventory-9 Scores Reflect Actual Compulsivity in Internet Pornography Use? Exploring the Role of Abstinence Effort. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/10720162.2017.1344166] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Davidson CKD, Cheung G, Jansen K. Hypersexuality in Psychiatric Conditions Observer-Rated Scale (HIPCORS): Evaluation of Reliability and Validity. JOURNAL OF SEX & MARITAL THERAPY 2017; 43:277-287. [PMID: 27007447 DOI: 10.1080/0092623x.2016.1149127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Hypersexual behavior is not uncommon in psychiatric presentations. Most available scales that measure hypersexual behavior are self-rated, often containing sexually explicit questions, unsuitable for use in mentally unwell people. Lack of a clinically suitable instrument may have resulted in underdetection and under-researching of hypersexuality in people with mental disorders, with potential to cause significant consequences for themselves and those around them, including family members, coclients, and clinicians. To address this need, we developed the Hypersexuality in Psychiatric Conditions Observer-Rated Scale (HIPCORS), a rater-rated, nonintrusive tool, designed for use in mentally unwell people. It has been shown to be a reliable and valid instrument.
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Affiliation(s)
- C K Dennisa Davidson
- a Auckland District Health Board, University of Auckland , Auckland , New Zealand
| | - Gary Cheung
- b University of Auckland , Auckland , New Zealand
| | - Karl Jansen
- c Auckland District Health Board , Auckland , New Zealand
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Montgomery-Graham S. Conceptualization and Assessment of Hypersexual Disorder: A Systematic Review of the Literature. Sex Med Rev 2017; 5:146-162. [DOI: 10.1016/j.sxmr.2016.11.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/25/2016] [Accepted: 11/27/2016] [Indexed: 10/20/2022]
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Rissel C, Richters J, de Visser RO, McKee A, Yeung A, Caruana T. A Profile of Pornography Users in Australia: Findings From the Second Australian Study of Health and Relationships. JOURNAL OF SEX RESEARCH 2017; 54:227-240. [PMID: 27419739 DOI: 10.1080/00224499.2016.1191597] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
There are societal concerns that looking at pornography has adverse consequences among those exposed. However, looking at sexually explicit material could have educative and relationship benefits. This article identifies factors associated with looking at pornography ever or within the past 12 months for men and women in Australia, and the extent to which reporting an "addiction" to pornography is associated with reported bad effects. Data from the Second Australian Study of Health and Relationships (ASHR2) were used: computer-assisted telephone interviews (CASIs) completed by a representative sample of 9,963 men and 10,131 women aged 16 to 69 years from all Australian states and territories, with an overall participation rate of 66%. Most men (84%) and half of the women (54%) had ever looked at pornographic material. Three-quarters of these men (76%) and more than one-third of these women (41%) had looked at pornographic material in the past year. Very few respondents reported that they were addicted to pornography (men 4%, women 1%), and of those who said they were addicted about half also reported that using pornography had had a bad effect on them. Looking at pornographic material appears to be reasonably common in Australia, with adverse effects reported by a small minority.
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Affiliation(s)
- Chris Rissel
- a Sydney School of Public Health , University of Sydney
| | - Juliet Richters
- b School of Public Health and Community Medicine , University of New South Wales , Sydney
| | | | - Alan McKee
- d Faculty of Arts and Social Sciences , University of Technology Sydney
| | - Anna Yeung
- b School of Public Health and Community Medicine , University of New South Wales , Sydney
| | - Theresa Caruana
- b School of Public Health and Community Medicine , University of New South Wales , Sydney
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Dhuffar MK, Griffiths MD. Barriers to female sex addiction treatment in the UK. J Behav Addict 2016; 5:562-567. [PMID: 27784181 PMCID: PMC5370362 DOI: 10.1556/2006.5.2016.072] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/08/2016] [Accepted: 09/18/2016] [Indexed: 12/02/2022] Open
Abstract
Background Over the last 20 years, behavioral addictions (e.g., addictions to gambling, playing video games, work, etc.) have become more accepted among both public and scientific communities. Addiction to sex is arguably a more controversial issue, but this does not take away from the fact that some individuals seek professional help for problematic excessive sex, irrespective of how the behavior is conceptualized. Empirical evidence suggests that among treatment seekers, men are more likely than women to seek help for sex addiction (SA). Methods Using the behavioral addiction literature and the authors' own expertise in researching female SA, this paper examines potential barriers to the treatment for female sex addicts. Results Four main types of barriers for female sex addicts not seeking treatment were identified. These comprised (a) individual barriers, (b) social barriers, (c) research barriers, and (d) treatment barriers. Conclusions Further research is needed to either confirm or disconfirm the identified barriers that female sex addicts face when seeking treatment, and if conformation is found, interested stakeholders should provide better awareness and/or see ways in which such barriers can be overcome to aid better uptake of SA services.
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Affiliation(s)
- Manpreet K. Dhuffar
- Psychology Department, University of Exeter, Exeter, United Kingdom
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Mark D. Griffiths
- Psychology Department, University of Exeter, Exeter, United Kingdom
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
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Štulhofer A, Jurin T, Briken P. Is High Sexual Desire a Facet of Male Hypersexuality? Results from an Online Study. JOURNAL OF SEX & MARITAL THERAPY 2016; 42:665-680. [PMID: 26569650 DOI: 10.1080/0092623x.2015.1113585] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Despite a growing number of studies, hypersexuality remains controversial and empirically elusive. Using a group comparison approach, this study revisited the claim that hypersexuality cannot be reliably distinguished from high sexual desire. An online survey, advertised as focusing on pornography use and sexual health, was carried out in 2014 among 1,998 Croatian men aged 18 to 60 years (Mage = 34.7, SD = 9.83). Membership in the hypersexuality group (HYP; n = 57) was determined using the Hypersexual Disorder Screening Inventory and the Hypersexual Behavior Consequences Scale. The highest values on two indicators of sexual desire/interest set membership in the high sexual desire group (HSD; n = 70). The overlap between the groups was negligible (n = 4). Compared to the rest of the sample, men in the HYP group had significantly higher odds of being single, not exclusively heterosexual, religious, depressed, prone to sexual boredom, experiencing substance abuse consequences, holding negative attitudes toward pornography use, and evaluating one's sexual morality more negatively. In contrast, the HSD group differed from controls only in reporting more positive attitudes toward pornography use. The study findings point to a distinct phenomenology of HSD and HYP in men. Clinical implications of the findings are briefly discussed.
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Affiliation(s)
- Aleksandar Štulhofer
- a Department of Sociology , Faculty of Humanities and Social Sciences, University of Zagreb , Zagreb , Croatia
| | - Tanja Jurin
- b Department of Psychology , Faculty of Humanities and Social Sciences, University of Zagreb , Zagreb , Croatia
| | - Peer Briken
- c Institute for Sex Research and Forensic Psychiatry , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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37
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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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Štulhofer A, Bergeron S, Jurin T. Is High Sexual Desire a Risk for Women's Relationship and Sexual Well-Being? JOURNAL OF SEX RESEARCH 2016; 53:882-891. [PMID: 26579557 DOI: 10.1080/00224499.2015.1084984] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Historically, women's sexual desire has been deemed socially problematic. The growing popularity of the concept of hypersexuality-which lists high sexual desire among its core components-poses a risk of re-pathologizing female sexual desire. Data from a 2014 online survey of 2,599 Croatian women aged 18-60 years was used to examine whether high sexual desire is detrimental to women's relationship and sexual well-being. Based on the highest scores on an indicator of sexual desire, 178 women were classified in the high sexual desire (HSD) group; women who scored higher than one standard deviation above the Hypersexual Disorder Screening Inventory mean were categorized in the hypersexuality (HYP) group (n = 239). Fifty-seven women met the classification criteria for both groups (HYP&HSD). Compared to other groups, the HSD was the most sexually active group. Compared to controls, the HYP and HYP&HSD groups-but not the HSD group-reported significantly more negative consequences associated with their sexuality. Compared to the HYP group, women with HSD reported better sexual function, higher sexual satisfaction, and lower odds of negative behavioral consequences. The findings suggest that, at least among women, hypersexuality should not be conflated with high sexual desire and frequent sexual activity.
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Affiliation(s)
- Aleksandar Štulhofer
- a Department of Sociology , Faculty of Humanities and Social Sciences, University of Zagreb
| | | | - Tanja Jurin
- c Department of Psychology , Faculty of Humanities and Social Sciences, University of Zagreb
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Reid RC, Carpenter BN, Hook JN. Investigating Correlates of Hypersexual Behavior in Religious Patients. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/10720162.2015.1130002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kühn S, Gallinat J. Neurobiological Basis of Hypersexuality. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2016; 129:67-83. [PMID: 27503448 DOI: 10.1016/bs.irn.2016.04.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Until now, hypersexuality has not found entry into the common diagnostic classification systems. However it is a frequently discussed phenomenon consisting of excessive sexual appetite that is maladaptive for the individual. Initial studies investigated the neurobiological underpinnings of hypersexuality, but current literature is still insufficient to draw unequivocal conclusions. In the present review, we summarize and discuss findings from various perspectives: neuroimaging and lesion studies, studies on other neurological disorders that are sometimes accompanied by hypersexuality, neuropharmacological evidence, genetic as well as animal studies. Taken together, the evidence seems to imply that alterations in the frontal lobe, amygdala, hippocampus, hypothalamus, septum, and brain regions that process reward play a prominent role in the emergence of hypersexuality. Genetic studies and neuropharmacological treatment approaches point at an involvement of the dopaminergic system.
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Affiliation(s)
- S Kühn
- University Clinic Hamburg-Eppendorf, Clinic and Polyclinic for Psychiatry and Psychotherapy, Hamburg, Germany; Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany.
| | - J Gallinat
- University Clinic Hamburg-Eppendorf, Clinic and Polyclinic for Psychiatry and Psychotherapy, Hamburg, Germany
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Affiliation(s)
- Anthony R. Beech
- School of Psychology, University of Birmingham, Birmingham B15 2TT, United Kingdom;
| | - Michael H. Miner
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota 55455;
| | - David Thornton
- School of Psychology, University of Birmingham, Birmingham B15 2TT, United Kingdom;
- Sand Ridge Secure Treatment Center, Mauston, Wisconsin 53948;
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Abstract
BACKGROUND AND AIMS The concept of severity among providers working with hypersexual behavior is frequently used despite a lack of consensus about how severity should be operationalized. The paucity of dialogue about severity for hypersexual behavior is disconcerting given its relevance in determining level of care, risk, allocation of resources, and measuring treatment outcomes in clinical practice and research trials. The aim of the current article is to highlight several considerations for assessing severity based on the proposed DSM-5 criteria for hypersexual disorder. METHODS A review of current conceptualizations for severity among substance-use disorders and gambling disorder in the DSM-5 were considered and challenged as lacking applicability or clinical utility for hypersexual behavior. RESULTS AND CONCLUSIONS The current research in the field of hypersexual behavior is in its infancy. No concrete approach currently exists to assess severity in hypersexual populations. Several factors in operationalizing severity are discussed and alternative approaches to defining severity are offered for readers to consider.
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Affiliation(s)
- Rory C. Reid
- Corresponding address: Dr. Rory C. Reid; University of California, Los Angeles, 760 Westwood Boulevard, Suite 38-153, Los Angeles, CA 90024, USA; Phone: +1-310-825-8050; E-mail:
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Moser C. Letter to the Editor. CURRENT SEXUAL HEALTH REPORTS 2015. [DOI: 10.1007/s11930-015-0059-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Carvalho J, Štulhofer A, Vieira AL, Jurin T. Hypersexuality and High Sexual Desire: Exploring the Structure of Problematic Sexuality. J Sex Med 2015; 12:1356-67. [DOI: 10.1111/jsm.12865] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ley D, Brovko JM, Reid RC. Forensic Applications of “Sex Addiction” in US Legal Proceedings. CURRENT SEXUAL HEALTH REPORTS 2015. [DOI: 10.1007/s11930-015-0049-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Klein V, Jurin T, Briken P, Štulhofer A. Erectile Dysfunction, Boredom, and Hypersexuality among Coupled Men from Two European Countries. J Sex Med 2015; 12:2160-7. [DOI: 10.1111/jsm.13019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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