Basic science and neurobiological research: potential relevance to sexual compulsivity

Development of a structure-validated hypersexuality scale in Chinese university students

BACKGROUND

Hypersexuality is associated with many psychiatric disorders and creates enormous burden for the affected individual, family and society. There are numerous inventories measuring behavioral, emotional or stressful features of hypersexuality, we still need a structure-validated questionnaire to measure hypersexuality in a comprehensive way.

METHODS

Based on previous inventories and related clinical descriptions of hypersexuality, we designed a matrix of 72 items related to hypersexual experience, and we invited 282 heterosexual university students who experienced hypersexuality at least once life-long to answer the matrix.

RESULTS

Through exploratory factor analyses and exploratory structural equation modeling, we constructed a Hypersexuality Scale, with a satisfactory model structure of five factors (or scales, 4 items for each scale) of hypersexuality, and named them as the Negative Impact, Emotional Coping, Uncontrolled Behavior, Post-sex Regret, and Increased Interest. Most inter-correlations of these factors were significant but in low or medium levels in all participants. Male students scored significantly higher on Negative Impact and Increased Interest than females did.

CONCLUSIONS

The five scales described in this study might help to understand hypersexuality, and the Hypersexuality Scale might be applied to the clinical conditions related to hypersexuality.

Is Hypersexuality Dimensional or Categorical? Evidence From Male and Female College Samples

The recent attempt to introduce hypersexual disorder into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has increased empirical scrutiny of the construct. Consensus on its definition and underlying structure remains elusive. Whereas some conceptualizations favor a categorical latent structure, others speculate that hypersexual behavior is dimensional. Research on the latent structure of hypersexual behavior, however, has been sparse. This is unfortunate, because determination of the latent structure can contribute to more accurate assessment, diagnosis, and understanding of etiological process. To date the only study on hypersexuality's latent structure found consistent evidence of a dimensional structure for males but less clear results for females. In the present study the Multidimensional Inventory of Development, Sex, and Aggression (MIDSA), a self-report, contingency-based inventory, was administered to 1,146 college students. Four indices of hypersexual behavior and six indices of sexual compulsivity were analyzed, using three taxometric methods (mean above minus below a cut [MAMBAC], maximum covariance [MAXCOV], and latent mode factor analysis [L-Mode]). Evidence supported a dimensional latent structure for hypersexuality in male and female samples. Future assessments of hypersexuality must focus on adequate reliability and discriminant validity across the continuum of sexual behavior rather than on attempts to differentiate between arbitrarily developed diagnostic categorizations.

PATHOS: a brief screening application for assessing sexual addiction

Sexual addiction is estimated to afflict up to 3% to 6% of the population. However, many clinicians lack clear criteria for detecting potential cases.

OBJECTIVES

The present studies were conducted to assess the effectiveness of a brief sexual addiction screening instrument (ie, PATHOS Questionnaire) to correctly classify patients being treated for sex addiction and healthy volunteers.

METHODS

In study 1, a 6-item questionnaire, which utilizes the mnemonic "PATHOS," was examined in regard to sensitivity and specificity using a sample combining patients being treated for sex addiction and healthy volunteers (970 men/80.2% patients; 938 women/63.8% patients). In study 2, a cross-validation sample of 672 men (93% patients) and 241 women (35.3% patients) completed the PATHOS screener.

RESULTS

Results of receiver operating characteristics analyses in study 1 demonstrated that the PATHOS captured 92.6% of the area under the curve and achieved 88.3% sensitivity and 81.6% specificity for classifying the male sample (n = 963) as patients and healthy subjects using a cutoff score of 3. Similarly, the PATHOS captured 90.2% of the area under the curve and, with a cutoff of 3, achieved 80.9% sensitivity and 87.2% specificity for the female sample (n = 808). In study 2, results of receiver operating characteristics analyses indicated that the PATHOS captured 85.1% of the area under the curve, with sensitivity of 70.7% and specificity of 86.9% for men (cutoff of 3). For women, the PATHOS captured 80.9% of the area under the curve and achieved 69.7% sensitivity and 85.1% specificity with the cutoff of 3.

CONCLUSIONS

These studies provide support for the use of the PATHOS as a screening instrument to detect potential sexual addiction cases in clinical settings.

Diagnosis, assessment, and treatment of hypersexuality

This article reviews the current evidence base for the diagnosis, assessment, and treatment of hypersexual conditions. Controversy concerning this diagnosis is discussed. Terminology and diagnostic criteria, as well as psychological, psychopharmacological, and other treatment approaches, are presented.