A Biopsychosocial Model of Hypersexual Disorder/Sexual Addiction

The Associations Between Attachment Insecurity and Compulsive Sexual Behavior Disorder or Problematic Pornography Use: The Mediating Role of Emotion Regulation Difficulties

Compulsive sexual behavior disorder (CSBD) was previously considered an attachment disorder, while emotion dysregulation was thought to potentially be a key characteristic of it. However, this theoretical model was not tested in previous empirical research. In our cross-sectional study, we tested whether emotional regulation (ER) difficulties can be adopted as an explanatory mechanism for the relationships between attachment avoidance and anxiety, as well as CSBD and its most prevalent behavioral presentation-problematic pornography use (PPU). Participants (n = 1002; Mage = 50.49 years, SD = 13.32; men: 50.2%) completed an online survey regarding the investigated variables. In mediation analyses, attachment avoidance and anxiety were treated as simultaneous predictors, ER difficulties as a mediating variable, with CSBD/PPU severity as dependent variables. Emotion regulation difficulties and attachment anxiety had a direct positive effect on both CSBD and PPU. The direct effect of attachment avoidance on PPU was non-significant, and significant for CSBD depending on the measure used. Moreover, all the relationships between both insecure attachment dimensions and CSBD/PPU symptom severity were at least partially mediated by ER difficulties. Our results corroborate the theoretical claim that ER difficulties may be a useful framework for explaining the impact of attachment insecurity on CSBD/PPU. Theoretical and practical implications of the findings are discussed.

The moral maze of sex & porn addiction

Sex addiction, a term first coined in the early 80s, has always been met with controversy. Some say the label of addiction is an excuse used by those who have lost their moral compass or refuse to accept responsibility for their sexual choices. Others claim the label is used to pass moral judgement on those whose sex lives or internet viewing habits do not fit societally prescribed norms. The acceptance by WHO of CSBD (Compulsive Sexual Behaviour Disorder) into ICD11 was heralded as a moral victory by the sex addiction naysayers who claimed WHO's position 'proved' it wasn't an addiction; conversely sex addiction professionals claimed victory saying that finally this was a step in the right direction. This paper will explore the divide and provide insight on how using a pure medical model of addiction has contributed and fueled the debate. An alternative model for conceptualization from a biopsychosocial perspective will be provided to suggest ways of moving forward that could ease the controversies as well as opening new areas for research and most importantly, greater understanding and empathy for clients.

What's in a Name? A Phenomenological Exploration of Hypersexuality Narratives

Objective

We explored men's subjective experiences of hypersexuality, including the underlying factors they believed contributed to their sexuality. Methods: We interviewed 32 Canadian men with self-reported concerns related to hypersexuality. Interviews were analyzed using Interpretative Phenomenological Analysis and narrative analysis.

Results

Participants' (hyper)sexual experiences revealed complex histories of desire, life disruptions, and hopes to re-story their sexual lives. Similar (sexual and non-sexual) desires were often attributed to different expressions of hypersexuality.

Conclusion

Assessment and treatment protocols for hypersexuality should account for the social and cultural factors that shape sexuality, and the broader field of desire extending beyond just sexual forms.

Clinicians' Beliefs, Observations, and Treatment Effectiveness Regarding Clients' Sexual Addiction and Internet Pornography Use

This study addressed how sex addiction and problematic IP use present to mental health professionals (MHPs), and how MHPs conceptualize and treat these issues. MHPs (N = 183) reported on beliefs about, experiences with, and treatment of problematic sexual behaviors (PBS). Most MHPs saw clients with PBS, but most do not feel competent to treat PBS. Specialized MHPs endorsed seeing more clients with PBS and feeling more effective than nonspecialists. Sexual addiction and problematic IP use share similarities, but differ in etiology and co-occurring problems. Diagnostic ambiguity, insufficient knowledge, and limited dissemination may hinder MHPs ability to assess and treat PBSs.