Sexual narcissism and its association with sexual and well-being outcomes

The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder

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.

Narcissistic Personality Traits and Sexual Dysfunction in Women: The Role of Body Image Self-Consciousness

BACKGROUND

Individuals with narcissistic traits, specifically vulnerable ones, are more prone to experiencing concerns related to self-worth and physical appearance and to showing heightened sensitivity to appearance evaluation. Negative body image and body image self-consciousness may, in turn, undermine sexual functioning, especially when apprehension is related to body appearance in sexual contexts.

METHODS

We aimed to evaluate the associations between self-reported pathological narcissistic traits, both grandiose and vulnerable, and sexual functioning in a large sample of nonclinical women (N = 656). Furthermore, we tested the mediating role of body image self-consciousness in these associations.

OUTCOMES

Sexual functioning was measured through the Female Sexual Function Index.

RESULTS

The results highlight that vulnerable narcissistic traits are associated with lower sexual functioning, this association being mediated by higher levels of body image self-consciousness. Conversely, grandiose narcissistic traits are linked to lower body image self-consciousness and, consequently, higher levels of sexual functioning.

CLINICAL IMPLICATIONS

Considering the link between body image self-consciousness and sexuality is of utmost importance in clinical practice with women, as well as in promoting positive body appreciation. Clinicians working with individuals presenting with pathological personality traits should consider including an assessment of their sexual functioning. S Pavanello Decaro, M Di Sarno, A Anzani, et al. Narcissistic Personality Traits and Sexual Dysfunction in Women: The Role of Body Image Self-Consciousness. J Sex Med 2021;18:1891-1898.

Narcissistic Personality Traits and Sexual Satisfaction in Men: The Role of Sexual Self-Esteem

Research on pathological narcissistic traits and sexuality are mainly focused on the dysfunctional aspects of sexuality. The present study aims to explore the relationship between narcissistic traits and sexual satisfaction in men, testing whether sexual self-esteem mediates this association. Participants included 212 men who completed measures of grandiose and vulnerable narcissistic traits, sexual self-esteem, and sexual satisfaction. Results highlight how vulnerable narcissistic traits are negatively associated with sexual satisfaction. This association is fully mediated by sexual self-esteem. On the contrary, grandiose narcissistic traits are not directly associated with sexual satisfaction, but with sexual self-esteem only, which explains the indirect effect of grandiose traits on sexual satisfaction. In conclusion, sexual self-esteem in personality configurations with high pathological narcissistic traits accounts for the relationship between narcissistic traits and sexual satisfaction.