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Bergner-Koether R, Peschka L, Pastukhov A, Carbon CC, Steins-Loeber S, Hajak G, Rettenberger M. The Relevance of Hypersexuality and Impulsivity in Different Groups of Treatment-Seekers With and Without (Exclusive) Pedophilia. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2024:10790632241271204. [PMID: 39104158 DOI: 10.1177/10790632241271204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
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.
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Affiliation(s)
- Ralf Bergner-Koether
- Department for Sexual Medicine, Sozialstiftung Bamberg, Bamberg, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Lasse Peschka
- Department for Sexual Medicine, Sozialstiftung Bamberg, Bamberg, Germany
- Department of General Psychology and Methodology, University of Bamberg, Bamberg, Germany
| | - Alexander Pastukhov
- Department of General Psychology and Methodology, University of Bamberg, Bamberg, Germany
| | - Claus-Christian Carbon
- Department of General Psychology and Methodology, University of Bamberg, Bamberg, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Göran Hajak
- Department for Sexual Medicine, Sozialstiftung Bamberg, Bamberg, Germany
| | - Martin Rettenberger
- Centre for Criminology (Kriminologische Zentralstelle, - KrimZ), Wiesbaden, Germany
- Department of Psychology at the Johannes Gutenberg University Mainz (JGU), Germany
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2
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Ben Brahim F, Courtois R, Vera Cruz G, Khazaal Y. Predictors of compulsive cyberporn use: A machine learning analysis. Addict Behav Rep 2024; 19:100542. [PMID: 38560011 PMCID: PMC10979147 DOI: 10.1016/j.abrep.2024.100542] [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: 12/09/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Compulsive cyberporn use (CCU) has previously been reported among people who use cyberporn. However, most of the previous studies included convenience samples of students or samples of the general adult population. Research examining the factors that predict or are associated with CCU are still scarce.In this study, we aimed to (a) assess compulsive cyberporn consumption in a broad sample of people who had used cyberporn and (b) determine, among a diverse range of predictor variables, which are most important in CCU scores, as assessed with the eight-item Compulsive Internet Use Scale adapted for cyberporn. Materials and Methods Overall, 1584 adult English speakers (age: 18-75 years, M = 33.18; sex: 63.1 % male, 35.2 % female, 1.7 % nonbinary) who used cyberporn during the last 6 months responded to an online questionnaire that assessed sociodemographic, sexual, psychological, and psychosocial variables. Their responses were subjected to correlation analysis, analysis of variance, and machine learning analysis. Results Among the participants, 21.96% (in the higher quartile) presented CCU symptoms in accordance with their CCU scores. The five most important predictors of CCU scores were related to the users' strength of craving for pornography experiences, suppression of negative emotions porn use motive, frequency of cyberporn use over the past year, acceptance of rape myths, and anxious attachment style. Conclusions From a large and diverse pool of variables, we determined the most important predictors of CCU scores. The findings contribute to a better understanding of problematic pornography use and could enrich compulsive cyberporn treatment and prevention.
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Affiliation(s)
- Farah Ben Brahim
- University of Tours, QualiPsy, Tours, France
- Lausanne University, Lausanne, Switzerland
| | | | - Germano Vera Cruz
- Department of Psychology, UR 7273 CRP-CPO, University of Picardie Jules Verne, Amiens, France
| | - Yasser Khazaal
- Lausanne University, Lausanne, Switzerland
- Addiction Medicine, Lausanne University Hospital
- Department of Psychiatry and Addictology, Montreal University, Canada
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3
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Ågmo A, Laan E. The Sexual Incentive Motivation Model and Its Clinical Applications. JOURNAL OF SEX RESEARCH 2023; 60:969-988. [PMID: 36378887 DOI: 10.1080/00224499.2022.2134978] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sexual motivation (desire) requires the simultaneous presence of an active central motive state and a stimulus with sexual significance. Once activated, sexual motivation leads to visceral responses and approach behaviors directed toward the emitter of the sexual stimulus. In humans, such behaviors follow cognitive evaluation of the context, including predictions of the approached individual's response. After successful approach and establishment of physical contact, manifest sexual activities may be initiated. Sexual interaction is associated with and followed by a state of positive affect in most animals, whereas aversive consequences may be experienced by humans. The affective reactions may become associated with stimuli present during sexual interaction, and these stimuli may thereby alter their incentive properties. Here we show how the incentive motivation model can be used to explain the origins and possible treatments of sexual dysfunctions, notably disorders of desire. We propose that associations formed between negative outcomes of sexual interaction and the salient stimuli, for example, the partner, underlies hypoactive desire disorder. Highly positive outcomes of sexual interaction enhance the incentive value of the stimuli present, and eventually lead to hyperactive sexual desire. Treatments aim to alter the impact of sexual incentives, mainly by modifying cognitive processes.
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Affiliation(s)
- Anders Ågmo
- Department of Psychology, University of Tromsø
| | - Ellen Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam UMC, University of Amsterdam
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Turner D, Briken P, Grubbs J, Malandain L, Mestre-Bach G, Potenza MN, Thibaut F. The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder. DIALOGUES IN CLINICAL NEUROSCIENCE 2022; 24:10-69. [PMID: 37522807 PMCID: PMC10408697 DOI: 10.1080/19585969.2022.2134739] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/18/2022] [Accepted: 10/03/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD. METHODS An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews. RESULTS Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD. CONCLUSIONS An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.
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Affiliation(s)
- Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joshua Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Leo Malandain
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
| | - Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience and Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Florence Thibaut
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
- INSERM U1266, Institute of Psychiatry and Neurosciences, University of Paris Cité, Paris, France
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5
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Toates F. A motivation model of sex addiction - Relevance to the controversy over the concept. Neurosci Biobehav Rev 2022; 142:104872. [PMID: 36113783 DOI: 10.1016/j.neubiorev.2022.104872] [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: 08/12/2022] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 10/31/2022]
Abstract
An integrative model of sexual addiction is presented, involving a combination of models based upon (i) incentive motivation theory and (ii) the dual organisation of the control of behavior. The model is related to ongoing arguments about the validity of the notion of addiction when applied to sexual behavior. It is suggested that the evidence strongly favors the viability of an addiction model of sex. Strong similarities to the classical addiction to hard drugs are observed and features can be better understood with the help of the model. These include tolerance, escalation and withdrawal symptoms. It is argued that other candidates for accounting for the phenomena, such as obsessive-compulsive behavior, faulty impulse control, high drive and hypersexuality do not fit the evidence. The role of dopamine is central to the model. The model's relevance to stress, abuse, development, psychopathy, fantasy, sex differences, evolutionary psychology and the interaction with drug-taking is shown.
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Hertz PG, Turner D, Barra S, Biedermann L, Retz-Junginger P, Schöttle D, Retz W. Sexuality in Adults With ADHD: Results of an Online Survey. Front Psychiatry 2022; 13:868278. [PMID: 35651826 PMCID: PMC9148957 DOI: 10.3389/fpsyt.2022.868278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/25/2022] [Indexed: 12/03/2022] Open
Abstract
Establishing a secure sexual identity is a major developmental goal of an individual's transition from childhood to adolescence and the years that follow. Attention deficit/hyperactivity disorder (ADHD) as a neurodevelopmental disorder defined by the core symptoms of inattention, hyperactivity, and impulsivity, but also with emotional dysregulation, oppositional behaviors, or disorganization appearing early in life, can affect several areas of an individual's personal and social development, including sexual health. Yet, the scientific knowledge about the relationship between ADHD and sexual functioning is still scarce. Using an anonymous online survey, we compared different sexual behaviors including risky sexual behaviors, hypersexual behaviors, and sexual dysfunctions between 206 individuals with (n = 139) and without (n = 76) ADHD. Individuals with ADHD reported significantly more hypersexual behaviors than non-ADHD individuals, whereas no differences were found concerning risky sexual behaviors or sexual dysfunctions. In women with ADHD, hypersexual behaviors, sexual risk-taking as well as sexual dysfunctions were closely related to symptoms of emotional dysregulation, impulsivity, and oppositional symptoms. In men with ADHD, the associations between ADHD symptomatology and the sexuality-related measures were less clear, however, signs of emotional dysregulation seemed to be relevant as well. Since individuals with ADHD seem to be at an increased risk of some peculiarities in sexual behavior, sexuality-related issues should be routinely addressed during clinical consultations to provide more holistic treatment in order to enhance individual well-being and quality of life.
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Affiliation(s)
- Priscilla Gregório Hertz
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Steffen Barra
- Institute for Forensic Psychology and Psychiatry, University Hospital, Homburg, Germany
| | - Laura Biedermann
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Petra Retz-Junginger
- Institute for Forensic Psychology and Psychiatry, University Hospital, Homburg, Germany
| | - Daniel Schöttle
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Wolfgang Retz
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute for Forensic Psychology and Psychiatry, University Hospital, Homburg, Germany
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7
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Koós M, Orosz G, Demetrovics Z, Bőthe B. Present hedonism and future time perspectives predicting hypersexuality and problematic pornography use. Front Psychiatry 2022; 13:914919. [PMID: 36081467 PMCID: PMC9447492 DOI: 10.3389/fpsyt.2022.914919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022] Open
Abstract
The Time Perspective (TP) theory (i.e., the psychological experience regarding time) was often examined in association with different addictive behaviors, and the different TPs (i.e., Past Positive, Past Negative, Present Hedonistic, Present Fatalistic, and Future TPs) demonstrated different relationship patterns with them. However, most studies were conducted in relation to substance use-related disorders, leaving crucial knowledge gaps concerning the associations between TPs and potential behavioral addictions. The aim of the present study was to examine the associations between the five TP dimensions, hypersexuality, and problematic pornography use (PPU), considering potential gender differences. Participants from two independent samples (N1 = 554; N2 = 453) completed a self-report survey on TPs and sexual behaviors. Structural equation modeling results indicated that the Present Hedonistic TP had a positive, moderate, and the Future TP had a negative, weak association with hypersexuality in both samples. Only the Present Hedonistic TP had a significant, positive, weak-to-moderate association with PPU across the samples. The explained variances of the models were higher in case of hypersexuality (28 and 27%, respectively), than in case of PPU (1 and 14%, respectively). No significant gender differences were observed. In line with previous findings concerning other predictors of hypersexuality and PPU, the results of the present study suggest that hypersexuality and PPU may differ from each other in terms of their TP background. Yet, present hedonism, which is related to impulsivity, may play an important role in both problematic sexual behaviors, suggesting that interventions focusing on this TP might be successful in reducing hypersexuality and PPU.
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Affiliation(s)
- Mónika Koós
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, Faculty of Education and Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Gábor Orosz
- Université d'Artois, Unité de Recherche Pluridisciplinaire Sport Santé Société, France
| | - Zsolt Demetrovics
- Institute of Psychology, Faculty of Education and Psychology, Eötvös Loránd University, Budapest, Hungary.,Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Beáta Bőthe
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,Département de Psychologie, Université de Montréal, Montreal, QC, Canada
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8
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Tjernström N, Roman E. Individual strategies in the rat gambling task are related to voluntary alcohol intake, but not sexual behavior, and can be modulated by naltrexone. Front Psychiatry 2022; 13:931241. [PMID: 36569617 PMCID: PMC9772284 DOI: 10.3389/fpsyt.2022.931241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Gambling disorder (GD) is the first non-substance or behavioral addiction to be included in substance-related and addictive disorders in DSM-5. Since GD is a younger phenomenon relative to alcohol and substance use disorders, little is known about potential unique features in GD and to what extent characteristics are shared with alcohol and substance use disorders. The rat gambling task (rGT) is used to study decision-making in rats. This study aimed to identify individual differences in rGT strategies and explore the stability of these strategies over time. Moreover, motor impulsivity, sexual behavior, and voluntary alcohol intake were examined in rats with different rGT strategies. Finally, the response to naltrexone on performance in rats with different rGT strategies was investigated. METHODS Male Lister hooded rats (n = 40) underwent repeated testing in the rGT, repeated copulatory behavioral tests, and 7 weeks of voluntary alcohol intake through a modified intermittent two-bottle free-choice paradigm. Finally, rats were treated with naltrexone prior to testing in the rGT. RESULTS The results revealed individual choice strategies in the rGT that were stable over time, even after multiple interruptions and other behavioral testing. The rats with a risky choice strategy displayed higher motor impulsivity and voluntary alcohol intake than the other groups. No difference in sexual behavior was found between the different rGT groups. Finally, in all rats irrespectively of rGT strategy, treatment with naltrexone decreased the number of completed trials and premature responses, and increased omissions, which indicates an overall lowered motivation. DISCUSSION In conclusion, rats with risky rGT strategies had higher voluntary alcohol intake but not elevated sexual behavior, indicating shared underlying mechanisms between rGT strategies and alcohol intake but not natural rewards in terms of sexual behavior. Finally, naltrexone treatment resulted in an overall lowered motivation in the rGT.
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Affiliation(s)
- Nikita Tjernström
- Neuropharmacology and Addiction, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Erika Roman
- Neuropharmacology and Addiction, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.,Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
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9
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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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10
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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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Hegbe KG, Réveillère C, Barrault S. Sexual Addiction and Associated Factors: The Role of Emotion Dysregulation, Impulsivity, Anxiety and Depression. JOURNAL OF SEX & MARITAL THERAPY 2021; 47:785-803. [PMID: 34338617 DOI: 10.1080/0092623x.2021.1952361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The present research aimed to study the relationship between emotion dysregulation, impulsivity, anxiety, depression and sexual addiction. A survey was conducted among 398 voluntary subjects recruited online through specialized forums. The participants completed validated questionnaires. Our results showed that individuals with sexual addiction reported more difficulty regulating emotions and higher levels of impulsivity than those individuals who were not defined as having a sexual addiction. In addition, anxiety and depression were significantly associated with sexual addiction. Furthermore, anxiety and depression seemed to partially mediate the links between impulsivity, emotion dysregulation and this addiction. Finally, emotion dysregulation and impulsivity had mediating effects on the relationship between anxious-depressive affects and sexual addiction. Despite the limitations of this study, our results seem to be consistent with the literature on sexual addiction and have clinical and research implications.
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Affiliation(s)
- Komlan Gnimavo Hegbe
- PRES Centre-Val de Loire University, Qualipsy EE 1901, University of Tours, Tours, France
| | - Christian Réveillère
- PRES Centre-Val de Loire University, Qualipsy EE 1901, University of Tours, Tours, France
| | - Servane Barrault
- PRES Centre-Val de Loire University, Qualipsy EE 1901, University of Tours, Tours, France
- CHRU of Tours, CSAPA 37 (Centre de Soins d'Accompagnement et de Prévention en Addictologie), Tours, Cedex, France
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12
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Rousseau A, Bőthe B, Štulhofer A. Theoretical Antecedents of Male Adolescents' Problematic Pornography Use: A Longitudinal Assessment. JOURNAL OF SEX RESEARCH 2021; 58:331-341. [PMID: 32902343 DOI: 10.1080/00224499.2020.1815637] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Although considerable research has examined the antecedents of adolescents' pornography use (PU), little data exist on the underlying mechanisms of problematic pornography use (PPU) in adolescence. To bridge this gap, the current longitudinal study examined the long-term associations between adolescent boys' PU frequency, PPU, and theory-based predictors of PPU. Testing three conceptual models (the moral incongruence, out of control, and mood management models), we examined the relative contributions of impulsivity, depression/anxiety symptoms, and religiosity to PPU, controlling for PU over time. The analysis was conducted using a panel sample of 337 Croatian men (Mage = 15.9 years, SD = 0.52). Latent growth curve modeling showed that baseline levels of, and subsequent growth in PU predicted later higher levels of PPU, irrespective of participants' religiosity, negative emotions, and impulsivity. Baseline higher levels of negative emotions and impulsivity predicted higher levels of PPU three years later, even after controlling for the growth in PU over time. Religiosity moderated the association between changes in PU and PPU. Growth in PU resulted in higher PPU among more religious adolescents, compared to their less religious peers. This study's findings support all three conceptual models explaining PPU in adults and may guide clinical work with adolescents seeking help for PPU.
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Affiliation(s)
- Ann Rousseau
- School for Mass Communication Research, KU Leuven
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb
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Sexual addiction 25 years on: A systematic and methodological review of empirical literature and an agenda for future research. Clin Psychol Rev 2020; 82:101925. [PMID: 33038740 DOI: 10.1016/j.cpr.2020.101925] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 12/16/2022]
Abstract
In 1998, Gold and Heffner authored a landmark review in Clinical Psychology Review on the topic of sexual addiction that concluded that sexual addiction, though increasingly popular in mental health settings, was largely based on speculation, with virtually no empirical basis. In the more than two decades since that review, empirical research around compulsive sexual behaviors (which subsumes prior research about sexual addiction) has flourished, ultimately culminating in the inclusion of a novel diagnosis of Compulsive Sexual Behavior Disorder in the eleventh edition of the World Health Organization's International Classification of Diseases. The present work details a systematic review of empirical research published between January 1st, 1995 and August 1st, 2020 related to compulsive sexual behaviors, with a specific focus on evaluating the methodologies of that literature. This review yielded 371 papers detailing 415 individual studies. In general, the present review finds that, although research related to compulsive sexual behaviors has proliferated, much of this work is characterized by simplistic methodological designs, a lack of theoretical integration, and an absence of quality measurement. Moreover, the present review finds a virtual absence of high-quality treatment-related research published within this time frame. Implications of these findings for both clinical practice and future research are discussed.
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Balcioglu YH, Dogan M, Incı I, Solmaz M. Sexual Behavioral Disinhibition Associated with Nucleus Lentiformis Lesion: A Forensic Neuroscience Perspective Through a Case. J Forensic Sci 2020; 65:1779-1783. [PMID: 32525581 DOI: 10.1111/1556-4029.14477] [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: 04/21/2020] [Revised: 05/08/2020] [Accepted: 05/21/2020] [Indexed: 11/30/2022]
Abstract
Organic brain disturbances particularly related to frontal cortex structures and subcortical areas including the basal ganglia may play a role in behavioral disinhibition disorders. Kluver-Bucy syndrome (KBS), which is one of the better knowns of these syndromes, includes hyperorality, visual agnosia, and hypersexuality, has been reported to occur after temporal lobe and amygdala lesions; however, several patients who had focal lesions in areas other than the temporal cortex and amygdala have been reported to present partial KBS symptoms. Nucleus lentiformis refers to a large portion of the basal ganglia including the putamen and globus pallidus, and specific structures within this broad area are known to be important for reward and value-based decision making. To date, KBS symptoms including hypersexual behavior associated with nucleus lentiformis lesions have never been reported. Here, we present a 38-year-old male patient who developed increased sexual interest and hyperorality after infarctions in the right lenticular nucleus and right occipitotemporal region and committed a first-degree sexual assault. He was sent to our institution for the assessment of criminal responsibility to the index sexual crime. According to a comprehensive and thorough forensic psychiatric evaluation, he was diagnosed as having an organic personality disorder with partial KBS symptoms. To the best of our knowledge, this is the first reported case of deviant sexual behavior and hyperorality developing after nucleus lentiformis infarction. We aimed to discuss possible neurobiologic explanations of late-onset deviant sexual behavior, which resulted in sexual criminal behavior following a cerebrovascular infarction.
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Affiliation(s)
- Yasin Hasan Balcioglu
- Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Forensic Psychiatry Unit, Istanbul, Turkey
| | - Mehmet Dogan
- Ministry of Justice, The Council of Forensic Medicine, Istanbul, Turkey
| | - Ipek Incı
- Ministry of Justice, The Council of Forensic Medicine, Istanbul, Turkey
| | - Mustafa Solmaz
- Ministry of Justice, The Council of Forensic Medicine, Istanbul, Turkey.,Department of Psychiatry, Bagcilar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Castro-Calvo J, Gil-Llario MD, Giménez-García C, Gil-Juliá B, Ballester-Arnal R. Occurrence and clinical characteristics of Compulsive Sexual Behavior Disorder (CSBD): A cluster analysis in two independent community samples. J Behav Addict 2020; 9:446-468. [PMID: 32554840 PMCID: PMC8939411 DOI: 10.1556/2006.2020.00025] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 04/05/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND AIMS Compulsive Sexual Behavior Disorder (CSBD) is characterized by a persistent failure to control intense and recurrent sexual impulses, urges, and/or thoughts, resulting in repetitive sexual behavior that causes a marked impairment in important areas of functioning. Despite its recent inclusion in the forthcoming ICD-11, concerns regarding its assessment, diagnosis, prevalence or clinical characteristics remain. The purpose of this study was to identify participants displaying CSBD through a novel data-driven approach in two independent samples and outline their sociodemographic, sexual, and clinical profile. METHODS Sample 1 included 1,581 university students (females = 56.9%; Mage = 20.58) whereas sample 2 comprised 1,318 community members (females = 43.6%; Mage = 32.37). First, we developed a new composite index to assess the whole range of CSBD symptoms based on three previously validated scales. Based on this new composite index, we subsequently identified individuals with CSBD through a cluster analytic approach. RESULTS The estimated occurrence of CSBD was 10.12% in sample 1 and 7.81% in sample 2. Participants with CSBD were mostly heterosexual males, younger than respondents without CSBD, reported higher levels of sexual sensation seeking and erotophilia, an increased offline and especially online sexual activity, more depressive and anxious symptoms, and poorer self-esteem. CONCLUSIONS This research provides further evidence on the occurrence of CSBD based on an alternative data-driven approach, as well as a detailed and nuanced description of the sociodemographic, sexual, and clinical profile of adults with this condition. Clinical implications derived from these findings are discussed in detail.
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Affiliation(s)
- J. Castro-Calvo
- Dpto. Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Estudi General, Valencia, Spain,Correspondence author. Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Av. Blasco Ibáñez, 21, Valencia, 46010, Spain. Tel.: +34 963 983395; fax: +34 963 864669. E-mail:
| | - M. D. Gil-Llario
- Dpto. Psicología Evolutiva y de la Educación, Universitat de València, Estudi General, Valencia, Spain
| | - C. Giménez-García
- Dpto. Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Castellón, Spain
| | - B. Gil-Juliá
- Dpto. Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Estudi General, Valencia, Spain
| | - R. Ballester-Arnal
- Dpto. Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Castellón, Spain
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Lew-Starowicz M, Lewczuk K, Nowakowska I, Kraus S, Gola M. Compulsive Sexual Behavior and Dysregulation of Emotion. Sex Med Rev 2020; 8:191-205. [DOI: 10.1016/j.sxmr.2019.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 10/03/2019] [Accepted: 10/11/2019] [Indexed: 02/08/2023]
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17
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de Oliveira L, Carvalho J. The Link Between Boredom and Hypersexuality: A Systematic Review. J Sex Med 2020; 17:994-1004. [PMID: 32165100 DOI: 10.1016/j.jsxm.2020.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/27/2020] [Accepted: 02/08/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Some conceptualizations of hypersexuality posit boredom as a possible trigger of hypersexual behavior. AIM This work aims to review published articles addressing the link between boredom and hypersexuality to investigate if this relationship can yet be established based on current empirical data. METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies, published until September 2019, were retrieved from EBSCO, Scopus, Web of Science, and PubMed. A systematic search was conducted using an exhaustive list of key terms combining "boredom" with "hypersexuality," "sexual impulsivity," "sexual compulsivity," and "sexual addiction." Only articles presenting empirical results concerning the relationship between boredom and hypersexuality were considered. RESULTS From the initial poll of 76 articles, only 19 articles were included in our final selection. Of the total studies, 16 were quantitative studies and 3 were qualitative studies. 4 studies were validation studies of hypersexuality-related measures, 11 studies concerned online sexual activity, and 3 reported sexual boredom. 7 studies with men used non-heterosexual samples. 5 studies used samples with both women and men, and 1 study used a sample of women only. Most studies indicate a positive association between boredom and hypersexuality, although 4 did not. IMPLICATIONS Further studies with diversified samples are still indispensable, as female samples are not portrayed and research is much focused on online sexual activity. Future research should explore the relationship between boredom and hypersexuality within specific behavioral specifiers including masturbation, pornography use, sexual behavior with consenting adults, cybersex, telephone sex, and strip clubs. STRENGTHS AND LIMITATIONS To the authors' knowledge, this is the first review looking at the possible link between boredom and hypersexuality. Investigation on the topic is scarce, and several of the studies included in this review correspond to anecdotal evidences of the phenomenon, as only few studies used appropriate measures of boredom. CONCLUSION Although current literature identifies a link between boredom and hypersexuality, further substantive research is still much needed to clarify the associations between the 2 constructs. de Oliveira L, Carvalho J. The Link Between Boredom and Hypersexuality: A Systematic Review. J Sex Med 2020;17:994-1004.
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Affiliation(s)
- Leonor de Oliveira
- Faculty of Psychology and Educational Sciences, Center for Psychology at University of Porto, University of Porto, Porto, Portugal.
| | - Joana Carvalho
- School of Psychology and Life Sciences, Lusófona University of Humanities and Technologies, Lisbon, Portugal; HEI-Lab: Digital Human-Environment and Interactions Labs, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
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18
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Efrati Y, Gola M. The Effect of Early Life Trauma on Compulsive Sexual Behavior among Members of a 12-Step Group. J Sex Med 2019; 16:803-811. [DOI: 10.1016/j.jsxm.2019.03.272] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/07/2019] [Accepted: 03/21/2019] [Indexed: 11/26/2022]
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19
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Same Same but Different: A Clinical Characterization of Men with Hypersexual Disorder in the Sex@Brain Study. J Clin Med 2019; 8:jcm8020157. [PMID: 30704084 PMCID: PMC6406591 DOI: 10.3390/jcm8020157] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/23/2019] [Accepted: 01/28/2019] [Indexed: 11/17/2022] Open
Abstract
Problems arising from hypersexual behavior are often seen in clinical settings. We aimed to extend the knowledge about the clinical characteristics of individuals with hypersexual disorder (HD). A group of people who fulfilled the proposed diagnostic criteria for HD (men with HD, n = 50) was compared to a group of healthy controls (n = 40). We investigated differences in sociodemographic, neurodevelopmental, and family factors based on self-report questionnaires and clinical interviews. Men with HD reported elevated rates of sexual activity, paraphilias, consumption of child abusive images, and sexual coercive behavior compared to healthy controls. Moreover, rates of affective disorders, attachment difficulties, impulsivity, and dysfunctional emotion regulation strategies were higher in men with HD. Men with HD seem to have experienced various forms of adverse childhood experiences, but there were no further differences in sociodemographic, neurodevelopmental factors, and family factors. Regression analyses indicated that attachment-related avoidance and early onset of masturbation differentiated between men with HD and healthy controls. In conclusion, men with HD appear to have the same neurodevelopment, intelligence levels, sociodemographic background, and family factors compared to healthy controls, but they report different and adverse experiences in childhood, problematic sexual behavior, and psychological difficulties.
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20
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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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22
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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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23
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Reid RC, Grant JE. In Search of a Parsimonious Model to Explain Hypersexual Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2275-2277. [PMID: 28939951 DOI: 10.1007/s10508-017-1074-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 08/31/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Rory C Reid
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 760 Westwood Plaza, Ste 38-153, Los Angeles, CA, 90024, USA.
| | - Jon E Grant
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
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24
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Walton MT, Cantor JM, Bhullar N, Lykins AD. Hypersexuality: A Critical Review and Introduction to the "Sexhavior Cycle". ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2231-2251. [PMID: 28687897 DOI: 10.1007/s10508-017-0991-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 04/03/2017] [Accepted: 04/12/2017] [Indexed: 05/03/2023]
Abstract
An empirical review of hypersexuality is timely as "compulsive sexual behavior" is being considered as an impulse control disorder for inclusion in the forthcoming International Classification of Diseases, 11th ed. Specifically, hypersexuality has been conceptualized in the literature as the inability to regulate one's sexual behavior that is a source of significant personal distress. Various theoretical models have been posited in an attempt to understand the occurrence of hypersexuality, although disagreement about these divergent conceptualizations of the condition has made assessment and treatment of hypersexual clients more challenging. Theories of sexual compulsivity, sexual impulsivity, dual control (sexual inhibition/excitation), and sex addiction are critically examined, as are the diagnostic criteria for clinically assessing hypersexuality as a sexual disorder. Our discussion of hypersexuality covers a diversity of research and clinical perspectives. We also address various challenges associated with reliably defining, psychometrically measuring, and diagnosing hypersexuality. Furthermore, literature is reviewed that expresses concerns regarding whether hypersexuality (conceptualized as a disorder) exists, whether it is simply normophilic behavior at the extreme end of sexual functioning, or alternatively is a presenting problem that requires treatment rather than a clinical diagnosis. Following our literature review, we developed the "sexhavior cycle of hypersexuality" to potentially explain the neuropsychology and maintenance cycle of hypersexuality. The sexhavior cycle suggests that, for some hypersexual persons, high sexual arousal may temporarily and adversely impact cognitive processing (cognitive abeyance) and explain a repeated pattern of psychological distress when interpreting one's sexual behavior (sexual incongruence). We also suggest that further research is required to validate whether hypersexuality is a behavioral disorder (such as gambling), although some presentations of the condition appear to be symptomatic of a heterogeneous psychological problem that requires treatment.
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Affiliation(s)
- Michael T Walton
- School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, NSW, 2351, Australia
| | - James M Cantor
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Navjot Bhullar
- School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, NSW, 2351, Australia
| | - Amy D Lykins
- School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, NSW, 2351, Australia.
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Walton MT, Cantor JM, Bhullar N, Lykins AD. Response to Commentaries: Recognizing Hypersexuality as a Psychosexual Behavioral Problem and Advancing the Sexhavior Cycle of Hypersexuality. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2279-2287. [PMID: 29159752 DOI: 10.1007/s10508-017-1111-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 10/30/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Michael T Walton
- School of Psychology, University of New England, Armidale, NSW, 2351, Australia.
| | - James M Cantor
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Navjot Bhullar
- School of Psychology, University of New England, Armidale, NSW, 2351, Australia
| | - Amy D Lykins
- School of Psychology, University of New England, Armidale, NSW, 2351, Australia
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26
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Kingston DA. Moving Forward on Hypersexuality. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2257-2259. [PMID: 28913564 DOI: 10.1007/s10508-017-1059-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 08/11/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Drew A Kingston
- Integrated Forensic Program, Royal Ottawa Health Care Group, Brockville, ON, K6V 5W7, Canada.
- School of Psychology and Psychiatry, University of Ottawa, Ottawa, ON, Canada.
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L’impulsivité sexuelle et les comportements sexuels problématiques chez les adultes : vers des mesures comportementales spécifiques et innovatrices. SEXOLOGIES 2016. [DOI: 10.1016/j.sexol.2015.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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28
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Carrier Emond F, Nolet K, Cyr G, Rouleau JL, Gagnon J. Sexual impulsivity and problematic sexual behaviors in adults: Towards innovative domain-specific behavioral measures. SEXOLOGIES 2016. [DOI: 10.1016/j.sexol.2015.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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30
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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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