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Wizła M, Lewczuk K. The Associations Between Attachment Insecurity and Compulsive Sexual Behavior Disorder or Problematic Pornography Use: The Mediating Role of Emotion Regulation Difficulties. ARCHIVES OF SEXUAL BEHAVIOR 2024:10.1007/s10508-024-02904-7. [PMID: 38898361 DOI: 10.1007/s10508-024-02904-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 04/25/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024]
Abstract
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.
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Affiliation(s)
- Magdalena Wizła
- Institute of Psychology, Cardinal Stefan Wyszynski University, Wóycickiego 1/3, 01-938, Warsaw, Poland.
| | - Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Wóycickiego 1/3, 01-938, Warsaw, Poland
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2
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Du R, Knight RA. The Structure of Hypersexuality and Its Relation to Impulsivity. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2277-2290. [PMID: 38589743 DOI: 10.1007/s10508-024-02828-2] [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: 02/14/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 04/10/2024]
Abstract
Among the multiple controversies surrounding hypersexuality is the important issue of whether it constitutes a univocal construct. Although an initial study supported its homogeneity, more resent research has identified two separate subcomponents-problematic sexuality and sexual drive. The present survey study addressed this issue in a sample that included both in-person tested college students (n = 69) and online respondents (n = 339). A factor analysis of scales attempting to capture the indicators of each subcomponent of hypersexuality yielded two correlated, but separate factors. Whereas Problematic Sexuality (PS) comprised scales measuring sexual compulsivity, using sex as a coping mechanism, and the negative consequences of sexual behavior, Sexual Drive (SD) was defined by frequent sexual activity, preoccupation with sexual fantasies, a predilection for impersonal sexual behavior, and facile sexual arousal. These two subcomponents of hypersexuality were found to covary with different types of impulsivity, further supporting their discrimination and providing external validation for their differentiation. Contrary to a priori hypotheses, however, PS correlated highly with Callous/Manipulative/Risk-Taking as well as with a predicted Affective Instability/Behavioral Disinhibition factor, suggesting that PS may constitute an equifinality of separate developmental trajectories for those high on both subtypes of hypersexuality.
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Affiliation(s)
- Rui Du
- Department of Psychology, Brandeis University, Waltham, MA, 02453, USA.
| | - Raymond A Knight
- Department of Psychology, Brandeis University, Waltham, MA, 02453, USA
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3
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Tarchi L, Merola GP, Baccaredda-Boy O, Arganini F, Cassioli E, Rossi E, Maggi M, Baldwin DS, Ricca V, Castellini G. Selective serotonin reuptake inhibitors, post-treatment sexual dysfunction and persistent genital arousal disorder: A systematic review. Pharmacoepidemiol Drug Saf 2023; 32:1053-1067. [PMID: 37294623 DOI: 10.1002/pds.5653] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/14/2023] [Accepted: 06/07/2023] [Indexed: 06/11/2023]
Abstract
PURPOSE Adverse effects of selective serotonin reuptake inhibitors (SSRIs) on sexual function have been an important area of research for many years. However, the duration of SSRI-associated sexual adverse effects, and their possible persistence after treatment discontinuation, is still uncertain. The aims of the current systematic review were first to identify existing evidence of sexual dysfunction following SSRI discontinuation, and to provide an account of reported symptoms and proposed treatment options; and second, to establish whether current literature allows accurate estimates of the prevalence of such sexual dysfunction. METHODS A systematic review was conducted on PubMed, Embase, and Google Scholar; papers with clinical data regarding patients with persistent sexual dysfunction after SSRI treatment suspension were included. RESULTS Overall, two retrospective interventional studies, six observational studies and 11 case reports were judged eligible for inclusion. It was not possible to determine reliable estimates of prevalence. Similarly, a cause-effect relationship between SSRI exposure and persistent sexual impairment could not be ascertained. Nonetheless, the potential for continued sexual disturbances despite discontinuation could not be entirely ruled out. CONCLUSIONS There is a need to investigate a possible dose-response relationship between SSRI exposure and persistent sexual adverse effects. Treatment options for persistent dysfunctions remain limited, but novel therapeutic approaches may be required in order to address an otherwise neglected need for sexual well-being.
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Affiliation(s)
- Livio Tarchi
- Psychiatry Unit, Department of Health Science, University of Florence, Florence, Italy
| | | | - Ottone Baccaredda-Boy
- Psychiatry Unit, Department of Health Science, University of Florence, Florence, Italy
| | - Francesca Arganini
- Psychiatry Unit, Department of Health Science, University of Florence, Florence, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Science, University of Florence, Florence, Italy
| | - Eleonora Rossi
- Psychiatry Unit, Department of Health Science, University of Florence, Florence, Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Rome, Italy
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
- University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Science, University of Florence, Florence, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Science, University of Florence, Florence, Italy
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Lewczuk K, Wizła M, Glica A, Dwulit AD. Compulsive Sexual Behavior Disorder and Problematic Pornography Use in Cisgender Sexual Minority Individuals: The Associations with Minority Stress, Social Support, and Sexualized Drug Use. JOURNAL OF SEX RESEARCH 2023:1-15. [PMID: 37676791 DOI: 10.1080/00224499.2023.2245399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Compulsive Sexual Behavior Disorder (CSBD), recently recognized in the ICD-11 as an independent disorder, has been shown to be more prevalent in sexual minorities. However, we still lack studies investigating which factors contribute to CSBD and related behaviors in this group. In our cross-sectional study, we investigated the relationships between characteristics potentially contributing to CSBD and problematic pornography use (PPU) in sexual minority individuals: sexual minority stress (internalized sexual stigma, discrimination experiences, and openness about one's sexual orientation), perceived social support, and sexualized drug use (also more prevalent in sexual minorities). We adjusted for gender, age, sexual orientation, and the frequency of sexual behaviors. Cisgender sexual minority participants (n = 198, 72.7% men, 27.3% women; Mage = 27.13, SD = 7.78) completed an online survey. We conducted a two-step linear regression. In the first step, we introduced sociodemographic variables and the frequency of sexual activities. In the second step, we placed the predictors of main interest: perceived social support, minority stress measures, and the frequency of sexualized drug use. Our results showed that social support was negatively related to CSBD, while experiences of discrimination due to sexual orientation and engagement in sexualized drug use were associated with higher CSBD symptom severity. Internalized sexual stigma related to greater PPU severity. The discussed relationships were weak to moderate in strength. Implications of current results for therapy and diagnosis of CSBD in sexual minorities are discussed. The role of minority stressors and other factors specific to sexual minorities requires further exploration to design well-suited therapeutic interventions.
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Affiliation(s)
- Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University
| | - Magdalena Wizła
- Institute of Psychology, Cardinal Stefan Wyszynski University
| | - Agnieszka Glica
- Institute of Psychology, Cardinal Stefan Wyszynski University
- Laboratory of Language Neurobiology, Nencki Institute of Experimental Biology, Polish Academy of Sciences
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Rosa PJ, Peixoto MM, Carvalho J. Measuring Sexual Motivation as a Trait Dimension: A multisample study of the Portuguese (European) Version of the Trait Sexual Motivation Questionnaire. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:960-977. [PMID: 37963196 DOI: 10.1080/0092623x.2023.2226130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
The current study aimed at translating and validating the TSMQ into Portuguese-European (TSMQ-PT) and to investigate its psychometric properties. Three online studies were conducted with independent samples collected between September 2020 and March 2022. Study 1 tested the exploratory factorial structure (N = 325; 206 women); Study 2 explored the confirmatory factorial structure and construct validity (N = 450; 230 women); and Study 3 examined the temporal stability of the TSMQ-PT (N = 30; 15 women). Participants completed the TSMQ-PT for all three studies. In study 2, further completed the Sexual Compulsivity Scale, the Sexual Sensation Seeking Scale, and the Sexual Desire Inventory. Data revealed that the TSMQ-PT yielded a four-structure model, (i.e., Sexually Oriented, Comparison with Others, Seeking for Sexual Encounters, and Importance of Sex) comprising 13 items, with seven additional items for assessing existence and number of sexual partners, and frequency of sexual behaviors. The TSMQ-PT achieved good internal consistency levels (McDonald's omega ranged from .71 to .89) and construct validity, and temporal stability over 10-11 months (values ranged from .80 to .87) supporting the trait-dimension of sexual motivation. Current findings support a brief, valid, and reliable self-report instrument for assessing sexual motivation in the Portuguese context.
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Affiliation(s)
- Pedro J Rosa
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
- Instituto Superior Manuel Teixeira Gomes (ISMAT), Portimão, Portugal
| | - Maria Manuela Peixoto
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences , University of Porto, Porto, Portugal
| | - Joana Carvalho
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences , University of Porto, Porto, Portugal
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
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Marchetti I. The Structure of Compulsive Sexual Behavior: A Network Analysis Study. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1271-1284. [PMID: 36735169 PMCID: PMC10102046 DOI: 10.1007/s10508-023-02549-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 05/11/2023]
Abstract
Compulsive sexual behavior is a phenomenon characterized by a persistent failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behavior that causes marked distress or impairment in personal, familial, social, educational, or occupational areas of functioning. Despite its major impact on mental health and quality of life, little is known about its internal structure and whether this phenomenon differs across genders, age groups, and risk status. By considering a large online sample (n = 3186; 68.3% males), ranging from 14 to 64 years old, compulsive sexual behavior was explored by means of network analysis. State-of-the-art analytical techniques were adopted to investigate the pattern of association among the different elements of compulsive sexual behavior, identify possible communities of nodes, pinpoint the most central nodes, and detect differences between males and females, among different age groups, as well as between individuals at low and high risk of developing a full-blown disorder. The analyses revealed that the network was characterized by three communities, namely Consequence, Preoccupation, and Perceived Dyscontrol, and that the most central node was related to (perceived) impulse dyscontrol. No substantial differences were found between males and females and across age. Failing to meet one's own commitments and responsibilities was more central in individuals at high risk of developing a full-blown disorder than in those at low risk.
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Affiliation(s)
- Igor Marchetti
- Department of Life Sciences, Psychology Unit, University of Trieste, 34128, Trieste, Italy.
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Castro-Calvo J, Giménez-García C, García-Barba M, Gil-Llario MD, Ballester-Arnal R. Atypical Sexual Interests in Compulsive Sexual Behavior: Results From a Phallometric Study. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2023; 35:164-187. [PMID: 35482997 DOI: 10.1177/10790632221098358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The link between Compulsive Sexual Behavior (CSB) and atypical sexual interests is elusive. This study aimed to provide preliminary insights into the relationship between both aspects. The study sample comprised 61 self-identified straight men. CSB was measured through a composite self-report index assessing symptoms of CSB, whereas sexual interests -atypical and normophilic- were assessed objectively through penile plethysmography. The CSB index had small, non-significant correlation with greater sexual response to different sexual stimuli (rgeneral sexual responsiveness=.127 [95% CI: -.137, .384]). In terms of overall sexual interest, increased scores on the CSB index had small, non-significant correlation with a higher preference for younger sexual stimuli (r = -.098 [95% CI: -.499, .215]) and persuasive sex (r = .10 [95% CI: -.168, .316]). Finally, CSB had a moderate correlation with sexual response when presented with stimuli depicting "female toddler coercive" (r = .27 [95% CI: -.083, .544]). We conclude that our findings do not support the hypotheses that CSB is significantly related to an increased arousability across sexual stimuli. The study findings also suggest that CSB may be, to a small degree, predisposed to experience sexual attraction toward children. Given the preliminary nature of the study, these conclusions warrant further research. Alternative explanations for the study findings related to the particular components of CSB that may be related to typical and atypical sexual interests are also considered.
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Affiliation(s)
- Jesús Castro-Calvo
- Dpto. Personalidad, Evaluación y Tratamientos Psicológicos, 16781Universitat de València, Estudi General, Spain
| | - Cristina Giménez-García
- Dpto. Psicología Básica, Clínica y Psicobiología, 16748Universitat Jaume I, Castellón, Spain
| | - Marta García-Barba
- Dpto. Psicología Básica, Clínica y Psicobiología, 16748Universitat Jaume I, Castellón, Spain
| | - María Dolores Gil-Llario
- Dpto. Psicología Evolutiva y de la Educación, 16781Universitat de València. Estudi General, Spain
| | - Rafael Ballester-Arnal
- Dpto. Psicología Básica, Clínica y Psicobiología, 16748Universitat Jaume I, Castellón, Spain
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Stigmatisation of People with Deviant Sexual Interest: A Comparative Study. SEXES 2022. [DOI: 10.3390/sexes4010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Pedophilia is a deviant sexual interest subject to more public stigma and punitive attitudes than others. Pedophilia has received a disproportionate amount of scholarly attention in comparison to other deviant sexual interests. To address this, the present study offers a comparison of the public stigma and punitive attitudes associated with pedophilia, fetishism, and hypersexuality. Methods: Recruited in Australia, one-hundred and twelve individuals participated in an anonymous online survey. Stigmatising and punitive attitudes toward pedophilia, fetishism, and hypersexuality were assessed via sub-scales of perceived dangerousness, deviance, intentionality, and punitive attitudes. Results: Participants held harsher punitive attitudes toward people with pedophilia and thought them to be more deviant and dangerous than people with fetishism and hypersexuality. Participants perceived hypersexuality to be more dangerous and deviant than fetishism. No consistent combination of perceived dangerousness, deviance, and intentionality predicted punitive attitudes toward all conditions. Rather, combinations of punitive attitude predictors were unique across conditions. Conclusions: This research articulates the unparalleled public stigma and punitive attitudes faced by people with pedophilia, compared to people with fetishism and hypersexuality. Findings which suggest that public stigma is stronger for hypersexuality than it is for fetishism are relatively novel, as are the observed predictors of punitive attitudes toward each condition. Knowledge produced by this study contributes to an improved conceptualisation of how the public views individuals who experience deviant sexual interests.
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9
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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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Limoncin E, Ciocca G, Castellini G, Sansone A, Cavalieri F, Cavallo F, Cocchiaro T, Ricca V, di Lorenzo G, Rossi A, Fisher AD, Rochira V, Corona G, Jannini EA. Hypersexuality as a tip of the iceberg of a primary psychopathology: a joined position statement of the Italian Society of Andrology and Sexual Medicine (SIAMS) and of the Italian Society of Psychopathology (SOPSI). J Endocrinol Invest 2022; 45:1787-1799. [PMID: 35527295 DOI: 10.1007/s40618-022-01798-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
In the last years, hypersexual behavior has been broadly scientifically studied. The interest in this topic, belonging to psycho-sexology and sexual medicine, has been due to its still unclear aetiology, nature, and its manifestation in relationship with several organic and psychopathological conditions. So, the specialist (the psychologist, psychiatrist, endocrinologist, neurologist) may encounter some difficulties in diagnosing and managing this symptom. The first main objective of this position statement, which has been developed in collaboration between the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Psychopathology (SOPSI) is to give to the reader evidence about the necessity to consider hypersexuality as a symptom related to another underlying condition. Following this consideration, the second main objective is to give specific statements, for the biopsychosocial assessment and the diagnosis of hypersexual behavior, developed on the basis of the most recent literature evidence. To develop a psycho-pharmacological treatment tailored on patients' needs, our suggestion is to assess the presence of specific comorbid psychopathological and organic conditions, and the impact of pharmacological treatments on the presence of an excess of sexual behavior. Finally, a suggestion of a standardized psychometric evaluation of hypersexuality will be given.
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Affiliation(s)
- E Limoncin
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University Tor Vergata, E Tower South. Floor 4, Room E413, Via Montpellier 1, 00133, Rome, Italy
- Department of Dynamic, Clinical Psychology and Health, University Sapienza, Rome, Italy
| | - G Ciocca
- Department of Dynamic, Clinical Psychology and Health, University Sapienza, Rome, Italy
| | - G Castellini
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - A Sansone
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University Tor Vergata, E Tower South. Floor 4, Room E413, Via Montpellier 1, 00133, Rome, Italy
| | - F Cavalieri
- Department of Medicine, Unit of Andrology and Reproduction Medicine, University of Padova, Padua, Italy
| | - F Cavallo
- Spinal Unit, San Raffaele Institute of Sulmona, Sulmona, Italy
| | - T Cocchiaro
- Department of Gender, Parenting, Child and Adolescent Medicine, Unit of Reproductive Pathophysiology and Andrology, "Sandro Pertini" Hospital, Rome, Italy
| | - V Ricca
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - G di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Psychiatry and Clinical Psychology Unit, Section of Psychiatry, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - A Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - A D Fisher
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - V Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - G Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Bologna, Italy
| | - E A Jannini
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University Tor Vergata, E Tower South. Floor 4, Room E413, Via Montpellier 1, 00133, Rome, Italy.
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11
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Kürbitz LI, Wiessner C, Schoon W, Briken P, Schöttle D, Schröder J. Gender differences in the association of psychological distress and sexual compulsivity before and during the COVID-19 pandemic. J Behav Addict 2022; 11:533-543. [PMID: 35895475 PMCID: PMC9295247 DOI: 10.1556/2006.2022.00046] [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: 11/18/2021] [Revised: 02/20/2022] [Accepted: 05/31/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic had numerous consequences for general, mental and sexual health. As gender differences in sexual compulsivity (SC) have been reported in the past and SC has been connected to adverse events and psychological distress, the current study aims at investigating associations between these factors in the context of contact restrictions in the course of the COVID-19 pandemic in Germany. METHODS We collected data for five time points in four retrospective measurement points in an online convenience sample (n T0 = 399, n T4 = 77). We investigated the influence of gender, several pandemic-related psychosocial circumstances, sensation seeking (Brief Sensation Seeking Scale), and psychological distress (Patient-Health-Questionnaire-4) on the change of SC (measured with an adapted version of the Yale-Brown Obsessive Compulsive Scale) between T0 and T1 (n = 292) in a linear regression analysis. Additionally, the course of SC over the time of the pandemic was explored with a linear mixed model. RESULTS Male gender was associated with higher SC compared to female gender over all measurement points. An older age, being in a relationship, having a place to retreat was associated with a change to lower SC during the first time of the pandemic. Psychological distress was associated with SC in men, but not in women. Men, who reported an increase of psychological distress were also more likely to report an increase of SC. DISCUSSION The results demonstrate that psychological distress seems to correlate with SC differently for men and women. This could be due to different excitatory and inhibitory influences on men and women during the pandemic. Furthermore, the results demonstrate the impact of pandemic related psychosocial circumstances in the times of contact restrictions.
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Affiliation(s)
- Laura I. Kürbitz
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Corresponding author. E-mail:
| | - Christian Wiessner
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wiebke Schoon
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel Schöttle
- Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johanna Schröder
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Department of Psychology, Medical School Hamburg, Hamburg, Germany
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Wizła M, Kraus SW, Lewczuk K. Perspective: Can psychedelic-assisted therapy be a promising aid in compulsive sexual behavior disorder treatment? Compr Psychiatry 2022; 115:152303. [PMID: 35334305 DOI: 10.1016/j.comppsych.2022.152303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/24/2021] [Accepted: 03/01/2022] [Indexed: 11/03/2022] Open
Abstract
Recently, there has been an increase in studies yielding evidence for psychedelics' anxiolytic and anti-depressive qualities. Preliminary evidence for treatment in substance addiction is also available. In our manuscript, we present a perspective on the possible effectiveness and mechanisms of action of psychedelics' introduction in the treatment of Compulsive Sexual Behavior Disorder (CSBD) and other p roblematic sexual behaviors, which are considered representative of the so-called "behavioral addiction" category. Evidence for the efficacy of Mindfulness Based Interventions in CSBD treatment is promising. Psychedelics- and mindfulness-induced states share common characteristics on both a subjective and objective level. One of the proposed mechanisms regards reduction of experiential avoidance through the promotion of exposure and acceptance. On the neurophysiological level, a shift from higher- to lower-level association regions and an impact on 5- HT2A receptors is observed. Elaborated mechanisms explain the possible enhancement of therapeutic processes by psychedelics. Psychedelics' relative safety and low addictive potential support their introduction into traditional forms of therapy for CSBD and other out of control behaviors.
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Affiliation(s)
- Magdalena Wizła
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland.
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA.
| | - Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland.
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Ronis ST, Knight RA, Vander Molen L. The Covariation of Sexual Fantasies and Behaviors Among Self-Identified Sexually Aggressive Criminal and Noncriminal Samples. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:517-537. [PMID: 31884839 DOI: 10.1177/0306624x19895905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study examined the association of sexually appetitive fantasies and sexually coercive behaviors among adult men convicted of nonsexual crimes (n = 159) and adult men with no criminal histories (n = 219). Individuals completed the Multidimensional Assessment of Sex and Aggression (MASA) and, on the basis of these reports, were classified whether or not they had ever attempted to assault or coerce someone sexually. Consistent with fewer opportunities to engage in sexual behavior, individuals with criminal histories reported generally less preoccupation, compulsivity, and frequency than did noncriminal individuals. Regardless of criminal history, self-identified sexually coercive men reported significantly more sexually appetitive fantasy and behavior in general and sexually deviant behavior in particular than did noncoercive males. Implications of these findings for research, theory, and dispositional decisions are discussed.
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Olver ME, Kingston DA, Laverty EK, Seto MC. Psychometric Properties of Common Measures of Hypersexuality in an Online Canadian Sample. J Sex Med 2022; 19:331-346. [PMID: 34987002 DOI: 10.1016/j.jsxm.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/26/2021] [Accepted: 12/06/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hypersexuality has been posited as the central defining feature of Compulsive Sexual Behavior Disorder, and although the acceptance and inclusion of this construct in psychiatric nosologies provides some legitimacy, concerns surrounding terminology, assessment, and diagnosis remain. AIM The present study was an independent psychometric examination of 2 of the most commonly used measures of Compulsive Sexual Behavior Disorder; specifically, the gender invariance of the latent structure, reliability (test retest, internal consistency), and external correlates (concurrent validity) of these measures. METHODS The Sexual Compulsivity Scale and the Hypersexual Behavior Inventory were completed by 2 nonclinical online community samples of cisgender women (ns = 525 and 359), cisgender men (ns = 419 and 364), and transgender or non-binary individuals (ns = 38 and 11). OUTCOMES Criterion based measures of sexual history and total sexual outlet (number of orgasms per week) were gathered to validate Sexual Compulsivity Scale and Hypersexual Behavior Inventory total and factor scores. RESULTS Results supported the factorial validity of both assessment measures: correlated 3 factor solutions were established through exploratory factor analysis of 1 sample, and confirmatory factor analysis in the second sample. Multiple group confirmatory factor analysis, conducted on the 2 combined samples, also supported the gender invariance of the 3-factor solutions. Additional basic psychometric indices of test-retest and internal consistency reliability and criterion-related (concurrent) validity conducted across the 2 online samples were supported. CLINICAL IMPLICATIONS Common measures of hypersexuality have potential for use in its assessment, treatment, and management. STRENGTHS & LIMITATIONS Study strengths include: the inclusion of 2 fairly large and diverse online samples, thorough checks for insufficient effort/validity of responding, validity and reliability methodology (ie, measurement at multiple time points, obtaining behavioral indicators of sexual health), and a comprehensive set of psychometric analyses to inform conclusions regarding the external validity, reliability, and latent structure of hypersexuality measures across gender groups. Study limitations include: potential concerns related to validity and accuracy of responding owing to a reliance on self-report, the potential for selection bias, and limiting the examination of the latent structure of hypersexuality to cisgender men and women such that the results may not generalize to gender diverse populations. CONCLUSION Hypersexuality is a multidimensional construct, with a common latent structure among cisgender men and women, consistency in measurement over time, and meaningful concurrent associations with behavioral criteria that have relevance for sexual health. Olver ME, Kingston DA, Laverty EK, et al. Psychometric Properties of Common Measures of Hypersexuality in an Online Canadian Sample. J Sex Med 2022;19:331-346.
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Affiliation(s)
- Mark E Olver
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Drew A Kingston
- HOPE Program, San Diego, CA, USA; The Royal's Institute of Mental Health Research, Ottawa, ON, Canada.
| | - Erin K Laverty
- The Canadian Public Health Association, Ottawa, ON, Canada
| | - Michael C Seto
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
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15
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Koós M, Fuss J, Klein V, Demetrovics Z, Bőthe B. Sexual Motivations Underlying Compulsive Sexual Behavior in Women and Men From Germany and Hungary. J Sex Med 2022; 19:170-181. [PMID: 34906543 DOI: 10.1016/j.jsxm.2021.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 10/26/2021] [Accepted: 11/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND There are ongoing debates about conflicting models on how to conceptualize compulsive sexual behavior. At the heart of these discussions is the question about the sexual motivations underlying compulsive sexual behavior, as different models assume different motivations. AIM The aim of the present study was to understand sexual motivations underlying compulsive sexual behavior and their relation to the most prominent conceptualizations of compulsive sexual behavior (eg, compulsive sexual behavior disorder [CSBD], sex addiction). METHODS We used self-reported data from 2 large samples of Hungarian and German populations (N = 9814). The Sexual Motivation Scale (SexMS), a 24-item self-report measure based on self-determination theory, was used to assess a diverse set of sexual motivations. Compulsive sexual behavior was assessed with the 19-item Compulsive Sexual Behavior Disorder Scale (CSBD-19), that is based on the ICD-11 diagnostic guidelines of CSBD. We used structural equation modeling to examine the hypothesized associations between sexual motivations and compulsive sexual behavior and examined potential gender differences in these associations. OUTCOMES Compulsive sexual behavior was assessed in relation to a set of sexual motivations. RESULTS Amotivation had the strongest positive association with compulsive sexual behavior, but integrated, introjected, and intrinsic motivations were also positively related to it. Importantly, these associations did not differ for women and men, and between the 2 samples. CLINICAL IMPLICATIONS Future research and treatment should also consider sexual motivations that are not listed among the ICD-11 guidelines for CSBD, including high levels of sexual interest, continuing the behavior despite having little satisfaction from it and coping with sex. STRENGTHS & LIMITATIONS Although we used large samples of general populations in 2 Western countries, this motivational background of compulsive sexual behavior awaits replication in a clinical sample of individuals experiencing CSBD. CONCLUSION The identified sexual motivations underlying compulsive sexual behavior are relevant for assessing and treating patients as motivations may be integrated into psychotherapeutic interventions. Koós M, Fuss J, Klein V, et al. Sexual Motivations Underlying Compulsive Sexual Behavior in Women and Men From Germany and Hungary. J Sex Med 2022;19:170-181.
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Affiliation(s)
- Mónika Koós
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Johannes Fuss
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute of Forensic Psychiatry and Sex Research, University Duisburg-Essen, Essen, Germany
| | - Verena Klein
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, Canada
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Levaque E, Dawson SJ, Wan C, Lalumière ML. Sex Drive as a Possible Mediator of the Gender Difference in the Prevalence of Paraphilic Interests in a Nonclinical Sample. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:867-877. [PMID: 34750773 DOI: 10.1007/s10508-021-02074-w] [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: 06/21/2018] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
There is a general gender difference in paraphilic interests, such that men report more interest (and greater engagement) in a variety of paraphilic behaviors. Using a nonclinical sample, Dawson et al. (Sexual Abuse, 28(1):20-45, 2016, https://doi.org/10.1177/1079063214525645 ) found that the gender difference in paraphilic interests was eliminated when scores on measures of sex drive were used as mediators. However, their measures of sex drive were about more than just sex drive and included a measure of hypersexuality (i.e., distress, perceived lack of control, and problematic consequences of one's sexuality). This study had two aims: to replicate Dawson et al.'s mediation results (using the same measures and scoring methods), and to discern the effect of sex drive itself (by replacing their measure of hypersexuality with a measure of sex drive). A nonclinical sample of 517 men and 615 women completed an online questionnaire. As expected, men reported less repulsion than women for most paraphilic themes. The gender difference in paraphilic interests was reduced (but not eliminated) both when reproducing Dawson et al.'s analysis and when examining a mediation model focused on sex drive specifically. The same results were obtained when examining the paraphilic interest with the largest gender difference (i.e., voyeurism). A full mediation effect was obtained in an unplanned supplementary analysis using a factor score (derived from eight measures) putatively assessing sex drive. While the main findings are consistent with Dawson et al.'s conclusions that sex drive is a possible mediator, they also suggest that other factors need to be considered to help explain the gender difference in the prevalence of paraphilic interests.
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Affiliation(s)
- Enya Levaque
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada
| | - Samantha J Dawson
- Department of Psychology, Queen's University, Kingston, ON, Canada
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Cynthia Wan
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada
- National Research Council of Canada, Ottawa, ON, Canada
| | - Martin L Lalumière
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
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Jennings TL, Lyng T, Gleason N, Finotelli I, Coleman E. Compulsive sexual behavior, religiosity, and spirituality: A systematic review. J Behav Addict 2021; 10:854-878. [PMID: 34971357 PMCID: PMC8987424 DOI: 10.1556/2006.2021.00084] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS In recent years, increasing attention has been given to the relationship between compulsive sexual behavior (CSB), religiosity, and spirituality. This review summarizes research examining the relationship CSB has with religiosity and spirituality, clarifying how these constructs inform the assessment and treatment of this syndrome. METHODS The present paper reviews research published through August 1, 2021, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Only studies providing quantitative analyses were included. RESULTS This review identified 46 articles, subsuming 59 studies, analyzing the relationship between CSB and religiosity or spirituality. Most studies used cross-sectional designs with samples primarily composed of heterosexual White men and women. Generally, the studies found small to moderate positive relationships between religiosity and CSB. Studies considering the mediating or moderating role of moral incongruence identified stronger, indirect relationships between religiosity and problematic pornography use (PPU), a manifestation of CSB. Few studies examined the association between spirituality and CSB, but those that did either reported negative relationships between indicators of spiritual well-being and CSB or positive relationships between CSB and aspects of spiritual struggles. DISCUSSION AND CONCLUSIONS Although research examining CSB and religiosity has flourished, such growth is hampered by cross-sectional samples lacking in diversity. Moral incongruence assists in explaining the relationship between religiosity and PPU, but future research should consider other manifestations of CSB beyond PPU. Attention should also be given to examining other religiosity and spirituality constructs and obtaining more diverse samples in research on CSB, religiosity, and spirituality.
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Affiliation(s)
- Todd L. Jennings
- Department of Psychology, University of Nevada, Las Vegas, United States
| | - Tayler Lyng
- Department of Psychology, Minnesota State University, Mankato, United States
| | - Neil Gleason
- Department of Psychology, University of Washington, United States
| | - Itor Finotelli
- The Institute for Sexual and Gender Health, University of Minnesota Medical School, University of Minnesota, United States
| | - Eli Coleman
- The Institute for Sexual and Gender Health, University of Minnesota Medical School, University of Minnesota, United States,Corresponding author. E-mail:
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18
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van 't Hof SR, Cera N. Specific factors and methodological decisions influencing brain responses to sexual stimuli in women. Neurosci Biobehav Rev 2021; 131:164-178. [PMID: 34560132 DOI: 10.1016/j.neubiorev.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/29/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022]
Abstract
Most of the neuroimaging studies on sexual behavior have been conducted with male participants, leading to men-based models of sexual arousal. Here, possible factors and methodological decisions that might influence brain responses to sexual stimuli, specifically for the inclusion of women, will be reviewed. Based on this review, we suggest that future studies consider the following factors: menstrual phase, hormonal contraception use, history of sexual or psychiatric disorders or diseases, and medication use. Moreover, when researching sexual arousal, we suggest future studies assess sexual orientation and preferences, that women should select visual sexual stimuli, and a longer duration than commonly used. This review is thought to represent a useful guideline for future research in sexual arousal, which hopefully will lead to a higher inclusion of women and therefore more accurate neurobiological models of sexual arousal.
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Affiliation(s)
| | - Nicoletta Cera
- Centre for Psychology at University of Porto -CPUP, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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19
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Soraci P, Melchiori FM, Del Fante E, Melchiori R, Guaitoli E, Lagattolla F, Parente G, Bonanno E, Norbiato L, Cimaglia R, Campedelli L, Abbiati FA, Ferrari A, Griffiths MD. Validation and Psychometric Evaluation of the Italian Version of the Bergen-Yale Sex Addiction Scale. Int J Ment Health Addict 2021; 21:1-27. [PMID: 34393683 PMCID: PMC8351585 DOI: 10.1007/s11469-021-00597-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 11/06/2022] Open
Abstract
Excessive problematic sexual behavior in the form of compulsive sexual behavior disorder (CSBD), hypersexuality (HS), and sex addiction has gained increasing credibility in recent years and has led to the development of various psychometric instruments to assess such behavior. However, there is still considerable controversy over the operational definition of such concepts and whether they can be used interchangeably to describe the behavior. One recently developed tool is the Bergen-Yale Sex Addiction Scale (BYSAS) based on the "components model of addiction." The present study validated the Italian version of the BYSAS. The BYSAS was administered to a large Italian-speaking sample of Italian adults [N = 1230, aged 18 to 67 years] along with psychometric instruments assessing the "Big Five" personality traits, self-esteem, depression, and two other measures of addictive sexual behavior (i.e., PATHOS and Shorter PROMIS Questionnaire-Sex Subscale). Confirmatory factorial analysis supported a one-factor solution. Furthermore, the scale had good internal consistency (Cronbach's α = 0.787). The BYSAS was positively associated with extroversion, openness to experience, depression, and problematic sexual behavior, and negatively associated with self-esteem, conscientiousness, emotional stability, agreeableness, and age. Based on the findings, the BYSAS is a brief, psychometrically reliable and valid measure for assessing sex addiction among Italian adults.
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Affiliation(s)
- Paolo Soraci
- Associazione Psicoterapia Cognitivo Comportamentale Di Gruppo, Rome, Italy
| | | | - Elena Del Fante
- Department of Psychology, Università degli Studi di Torino–UNITO, Turin, Italy
| | - Roberto Melchiori
- Faculty of Educational Sciences, University Niccolò Cusano, Rome, Italy
| | - Eleonora Guaitoli
- Department of General Surgery, Perrino Hospital Brindisi, Brindisi, Italy
| | - Fulvia Lagattolla
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II” Di Bari, Bari, Italy
| | - Grazia Parente
- Associazione Matrice Orientamento E Formazione Onlus, Bari, Italy
| | - Enrico Bonanno
- Department of Environmental Research and Innovation, Luxembourg Institute of Science and Technology, Belvaux, Luxembourg
| | | | - Roberta Cimaglia
- Istituto Romano Di Psicoterapia Psicodinamica Integrata, Rome, Italy
| | | | | | - Ambra Ferrari
- Department of Human Science for Education, Università Degli Studi Di Milano, Bicocca, Milan Italy
| | - Mark D. Griffiths
- International Gaming Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
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20
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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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21
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Kürbitz LI, Briken P. Is Compulsive Sexual Behavior Different in Women Compared to Men? J Clin Med 2021; 10:jcm10153205. [PMID: 34361988 PMCID: PMC8348482 DOI: 10.3390/jcm10153205] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/14/2021] [Accepted: 07/19/2021] [Indexed: 12/16/2022] Open
Abstract
The inclusion of Compulsive Sexual Behavior Disorder (CSBD) in the ICD-11 has sparked research interest on this topic in recent years. This review aims to investigate gender differences in Compulsive Sexual Behavior (CBD) and persons with CSBD. While impulsivity and psychiatric comorbidity play a role in persons with CSBD regardless of gender, some gender differences can be identified. CSBD is more prevalent in men, with a higher rate of reported sexual behaviors and higher scores on questionnaires measuring CSBD related symptoms. Neuroticism and stress vulnerability seem to play a more important role in the symptomatology of CSBD in women. While it seems plausible that childhood adversities play a role in the development of CSB, the manner with respect to how these adversities affect men and women differently is still to be explored. More clinical studies including the female CSBD population are required to infer clinical implications.
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22
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Knight RA, Du R. The Structure, Covariates, and Etiology of Hypersexuality: Implications for Sexual Offending. Curr Psychiatry Rep 2021; 23:50. [PMID: 34196843 DOI: 10.1007/s11920-021-01260-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW A substantial increase in research on the structure, covariates, and etiology of hypersexuality has emerged during the last decade. It is the goal of this review to summarize and integrate this research and to indicate some practical implications for clinical and forensic practice, especially as applied to those who have sexually offended. RECENT FINDINGS Studies from the last half-decade converge on the conclusion that hypersexuality has both problematic and high sexual drive components. Both aspects have consistently been found to be distributed dimensionally and not categorically. Each subdimension covaries differentially with specific types of impulsivity. In addition to sexual abuse, psychological or emotional abuse has emerged to be a potent developmental antecedent of hypersexuality. Current research has focused on the problematic dimension of hypersexuality and has neglected to specify the criteria for high sexual drive. Lacking are large-scale representative and clinical samples that provide determination of optimal cutoffs for treatment and dispositional decisions for both dimensions of hypersexuality. Research on the etiology of both aspects of hypersexuality is in its infancy, and more differentiated assessments of developmental abuse histories are required.
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Affiliation(s)
- Raymond A Knight
- Department of Psychology, Brandeis University, MS 062, Waltham, MA, 02454-9110, USA.
| | - Rui Du
- Department of Psychology, Brandeis University, MS 062, Waltham, MA, 02454-9110, USA
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23
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Paquette S, Cortoni F. Offence-Supportive Cognitions, Atypical Sexuality, Problematic Self-Regulation, and Perceived Anonymity Among Online and Contact Sexual Offenders Against Children. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2173-2187. [PMID: 33821376 DOI: 10.1007/s10508-020-01863-z] [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: 08/06/2018] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 06/12/2023]
Abstract
Cognitions that support sexual offending, atypical sexuality, and problems with self-regulation are important indicators of offending among men who engage in contact sexual offences against children (e.g., Hanson & Morton-Bourgon, 2005). While sexual interest in children-a major indicator of atypical sexuality-has been identified as a risk factor for online sexual offending against children (Seto & Eke, 2015), several other indicators, such as offence-supportive cognitions, sexual preoccupation, sexual coping, and perceived anonymity-a presumed risk factor for online sexual offending-have not yet been investigated among men who use the internet to solicit children or to consume child sexual exploitation material. This study investigated the associations between offence-supportive cognitions, atypical sexuality, self-regulation using sex, and perceived anonymity with sexual offending behaviors against children in a sample of 241 men convicted of various sexual and non-sexual offences. Results from logistic regressions show that offence-supportive cognitions, sexual interests in children, and sexual coping, but not sexual preoccupation and perceived anonymity, are associated with either or both online and contact sexual offending behaviors against children. Our results support the prior finding showing that men with online sexual offences are more paraphilic or sexually preoccupied then men with only contact offences against children. They also suggest that offence-supportive cognitions, atypical sexual interests, and sexual coping may be motivating factors, and therefore relevant risk factors, for online sexual offending against children.
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Affiliation(s)
- Sarah Paquette
- School of Social Work and Criminology, University Laval, Pavillon Charles-De Koninck, 5444-1030, des Sciences-Humaines, Quebec City, QC, G1V 0A6, Canada.
| | - Franca Cortoni
- School of Criminology, Université de Montréal, Montreal, QC, Canada
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24
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Koós M, Bőthe B, Orosz G, Potenza MN, Reid RC, Demetrovics Z. The negative consequences of hypersexuality: Revisiting the factor structure of the Hypersexual Behavior Consequences Scale and its correlates in a large, non-clinical sample. Addict Behav Rep 2020; 13:100321. [PMID: 33364331 PMCID: PMC7750154 DOI: 10.1016/j.abrep.2020.100321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/03/2020] [Accepted: 11/28/2020] [Indexed: 01/06/2023] Open
Abstract
Introduction Despite the growing literature about hypersexuality and its negative consequences, most studies have focused on the risk of sexually transmitted infections (STI’s), resulting in relatively few studies about the nature and the measurement of a broader spectrum of adverse consequences. Methods The aim of the present study was to examine the validity and reliability of the Hypersexual Behavior Consequence Scale (HBCS) in a large, non-clinical population (N = 16,935 participants; females = 5854, 34.6%; Mage = 33.6, SDage = 11.1) and identify its factor structure across genders. The dataset was divided into three independent samples, taking into consideration gender ratio. The validity of the HBCS was investigated in relation to sexuality-related questions (e.g., frequency of pornography use) and the Hypersexual Behavior Inventory (Sample 3). Results Both the exploratory (Sample 1) and confirmatory (Sample 2) factor analyses (CFI = 0.954, TLI = 0.948, RMSEA = 0.061 [90% CI = 0.059–0.062]) suggested a first-order, four-factor structure that included work-related problems, personal problems, relationship problems, and risky behavior as a result of hypersexuality. The HBCS showed adequate reliability and demonstrated reasonable associations with the examined theoretically relevant correlates, corroborating the validity of the HBCS. Conclusion Findings suggest that the HBCS may be used to assess consequences of hypersexuality. It may also be used in clinical settings to assess the severity of hypersexuality and to map potential areas of impairment, and such information may help guide therapeutic interventions.
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Affiliation(s)
- Mónika Koós
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Beáta Bőthe
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Département de Psychologie, Université de Montréal, Montreal, Canada
| | - Gábor Orosz
- Université Artois, Université Lille, Université Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Atelier Sherpas, F-62800 Liévin, France
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and Child Study Center, Yale School of Medicine, New Haven, CT, United States.,Connecticut Council on Problem Gambling, Wethersfield, CT, United States.,Connecticut Mental Health Center, New Haven, CT, United States
| | - Rory C Reid
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, United States
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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Gola M, Lewczuk K, Potenza MN, Kingston DA, Grubbs JB, Stark R, Reid RC. What should be included in the criteria for compulsive sexual behavior disorder? J Behav Addict 2020; 11:160-165. [PMID: 34329192 PMCID: PMC9295236 DOI: 10.1556/2006.2020.00090] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/15/2020] [Accepted: 10/25/2020] [Indexed: 11/24/2022] Open
Abstract
Compulsive sexual behavior disorder (CSBD) is currently defined in the eleventh revision of the International Classification of Diseases (ICD-11) as an impulse control disorder. Criteria for hypersexual disorder (HD) had been proposed in 2010 for the fifth revision of Diagnostic and Statistical Manual (DSM-5). In this article, we compare differences between HD and CSBD and discuss their relevance.Significant differences between HD and CSBD criteria include: (1) the role of sexual behavior as a maladaptive coping and emotion regulation strategy listed in criteria for HD but not in those for CSBD; (2) different exclusionary criteria including bipolar and substance use disorders in HD but not in CSBD, and (3) inclusion of new considerations in CSBD, such as moral incongruence (as an exclusion criterion), and diminished pleasure from sexual activity. Each of these aspects has clinical and research-related implications. The inclusion of CSBD in the ICD-11 will have a significant impact on clinical practice and research. Researchers should continue to investigate core and related features of CSBD, inlcuding those not included in the current criteria, in order to provide additional insight into the disorder and to help promote clinical advances.
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Affiliation(s)
- Mateusz Gola
- University of California, San Diego, United States
- Polish Academy of Sciences, Warsaw, Poland
| | - Karol Lewczuk
- Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Marc N. Potenza
- Yale University School of Medicine, New Haven, United States
| | - Drew A. Kingston
- HOPE Program, San Diego, United States
- University of Ottawa, Institute of Mental Health Research, Canada
| | - Joshua B. Grubbs
- Bowling Green State University, Bowling Green, OH, United States
| | | | - Rory C. Reid
- University of California, Los Angeles, United States
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Sassover E, Weinstein A. Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view. J Behav Addict 2020; 11. [PMID: 32997646 PMCID: PMC9295215 DOI: 10.1556/2006.2020.00055] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/18/2020] [Accepted: 08/18/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Compulsive sexual behavior disorder (CSBD) has been a long debated issue. While formerly the discussion was about whether to regard CSBD as a distinctive disorder, the current debate is dealing with the classification of this phenomenon. One of the prominent voices in this field considers CSBD as a behavioral addiction and proposes CSBD to be called and diagnosed as sexual addiction (SA). This present debate paper will review the existing evidence supporting this view and it will argue against it. RESULTS We have found that a great deal of the current literature is anecdotal while empirical evidence is insufficient. First, the reports about the prevalence of CSBD are contradictory. Additionally, the field mainly suffers from inconsistent defining criteria of CSBD and a consensus which symptoms should be included. As a result, the empirical evidence that does exist is mostly about some symptoms individually and not on the disorder as a whole construct. CONCLUSIONS We conclude that currently, there is not enough data supporting CSBD as a behavioral addiction. Further research has to be done, examining CSBD phenomenology as a whole construct and based on a homogeneous criterion.
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Affiliation(s)
- Eli Sassover
- Department of Behavioral Science, Ariel University, Science Park, Ariel, Israel
- Department of Behavioral Science and Integrative Brain and Cognition Center, Ariel University, Ariel, Israel
| | - Aviv Weinstein
- Department of Behavioral Science, Ariel University, Science Park, Ariel, Israel
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van Tuijl P, Tamminga A, Meerkerk GJ, Verboon P, Leontjevas R, van Lankveld J. Three Diagnoses for Problematic Hypersexuality; Which Criteria Predict Help-Seeking Behavior? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186907. [PMID: 32967307 PMCID: PMC7559359 DOI: 10.3390/ijerph17186907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/16/2020] [Accepted: 09/19/2020] [Indexed: 01/20/2023]
Abstract
This study aimed to assess the best combination of indicators of problematic hypersexuality (PH), in a survey (n = 58,158) targeting individuals wondering if they were sex addicted. The survey allowed for testing of criteria from three theoretical models used to conceptualize PH. Factor analyses for women and men yielded an interpretable grouping of indicators consisting of four factors. In subsequent logistic regressions, these factors were used as predictors for experiencing the need for help for PH. The factors Negative Effects and Extreme positively predicted experiencing the need for help, with Negative Effects as the most important predictor for both women and men. This factor included, among others, withdrawal symptoms and loss of pleasure. The Sexual Desire factor negatively predicted the need for help, suggesting that for the targeted population more sexual desire leads to less PH. The Coping factor did not predict experiencing the need for help. Outcomes show that a combination of indicators from different theoretical models best indicates the presence of PH. Therefore, a measurement instrument to assess existence and severity of PH should consist of such a combination. Theoretically, this study suggests that a more comprehensive model for PH is needed, surpassing existing conceptualizations of PH.
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Affiliation(s)
- Piet van Tuijl
- Department of Psychology, Open Universiteit, 6419 AT Heerlen, The Netherlands; (P.V.); (R.L.); (J.v.L.)
- Correspondence:
| | - Aerjen Tamminga
- Psychologen Nederland (PsyNed), 1062 GD Amsterdam, The Netherlands;
| | - Gert-Jan Meerkerk
- Instituut voor Onderzoek naar Leefwijzen & Verslaving (IVO), 2595 AA Den Haag, The Netherlands;
| | - Peter Verboon
- Department of Psychology, Open Universiteit, 6419 AT Heerlen, The Netherlands; (P.V.); (R.L.); (J.v.L.)
| | - Ruslan Leontjevas
- Department of Psychology, Open Universiteit, 6419 AT Heerlen, The Netherlands; (P.V.); (R.L.); (J.v.L.)
| | - Jacques van Lankveld
- Department of Psychology, Open Universiteit, 6419 AT Heerlen, The Netherlands; (P.V.); (R.L.); (J.v.L.)
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Kowalewska E, Gola M, Kraus SW, Lew-Starowicz M. Spotlight on Compulsive Sexual Behavior Disorder: A Systematic Review of Research on Women. Neuropsychiatr Dis Treat 2020; 16:2025-2043. [PMID: 32943868 PMCID: PMC7478918 DOI: 10.2147/ndt.s221540] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/07/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE OF REVIEW World Health Organization recently included compulsive sexual behavior disorder (CSBD) to the upcoming 11th edition of International Classification of Diseases (6C72). Despite the potential benefits of this decision (eg, the acceleration of research in the field will allow the development of effective treatments), previous research focused mainly on men, and as a result, we do not have an accurate clinical picture of compulsive sexual behavior (CSB) among women. Therefore, in this systematic review, we aim to present available knowledge on this topical subject. Literature search was conducted in the guideline of PRISMA methodology. Studies were identified from multiple databases including Academic Search Ultimate, SocINDEX, PsycARTICLES, PsycINFO, PubMed, and MEDLINE. Out of a total of 10,531 articles identified and screened, 58 were included in this review. Included studies covered the following topics: prevalence and etiology of CSB, behavioral and cognitive processes involved, comorbidities, personality traits, psychosocial and interpersonal difficulties, traumatic experiences, and treatments. RECENT FINDINGS Available studies indicate that CSB symptom severity is lower in women than in men. Overall, women reported consuming pornography less often than men and exhibit lower rates of feeling urges to these materials. CSB symptoms (including problematic pornography use) have been found to be positively related to trait psychopathy, impulsivity, sensation seeking, attention-deficit/hyperactivity disorder symptoms, obsessive-compulsive disorder, pathological buying, sexual dysfunctions, general psychopathology, child sexual abuse, while negatively related to dispositional mindfulness. SUMMARY Conclusions that can be drawn from prior studies are considerably limited. There are no accurate estimates of the CSB prevalence or severity among women, and studies have been mostly conducted on non-clinical populations, which has limited application for women diagnosed with CSBD.
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Affiliation(s)
- Ewelina Kowalewska
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Mateusz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California, San Diego, CA, USA
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Michal Lew-Starowicz
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
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Sexual Desire and Fantasies in the LGBT+ Community: Focus on Lesbian Women and Gay Men. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00263-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Abstract
Purpose of Review
The purpose of this review is to summarize the current knowledge around sexual desire, fantasies, and related biopsychosocial factors that may facilitate or obstruct sexual expressions in lesbian women and gay men.
Recent Findings
Sexual desire levels and related problems do not seem significantly different in people who identify as gay or lesbian compared to their heterosexual counterparts. Evidence has shown lesbian women and gay men may have specific desire expressions and biopsychosocial factors influencing their sexual health. This may suggest the importance of deepening the understanding of the unique factors of LGBT+ sexuality and relationships while paying attention to the sociocultural background in which lesbian and gay people grow and develop their identities.
Summary
A lack of specific and unbiased literature on sexual desire and fantasies in gay and lesbian people is reported. Available evidence is controversial and often biased. LG people showed a variety of sexual expressions that are hard to categorize referring to the heteronormative sexual standards that permeate literature and clinical practice. Implications for future research and clinical practice are discussed.
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Davis KA, Knight RA. The Relation of Childhood Abuse Experiences to Problematic Sexual Behaviors in Male Youths Who Have Sexually Offended. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:2149-2169. [PMID: 30627932 DOI: 10.1007/s10508-018-1279-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/22/2018] [Accepted: 07/15/2018] [Indexed: 06/09/2023]
Abstract
Psychological abuse and sexual abuse, either alone or in combination, have been implicated as developmental antecedents of problematic sexual thoughts and behaviors in studies of sexually aggressive males (Jesperson, Lalumière, & Seto, 2009; Knight & Sims-Knight, 2011; Levenson & Grady, 2016; Seto & Lalumière, 2010). Recently, psychological abuse perpetrated by a male caregiver has emerged as strongly associated with subsequent hypersexuality in adult males who had sexually offended. In a study of 529 adult male sexual offenders, Kingston, Graham, and Knight (2017) found that male caregiver psychological abuse was the most prominent correlate of hypersexual thoughts and behaviors in adulthood, above and beyond the effects of other abuse types, such as physical abuse and sexual abuse. Consequently, we hypothesized that, among juveniles who had sexually offended, higher self-reported levels of childhood psychological and sexual abuse, in contrast to other types of childhood maltreatment experiences, would covary with higher subsequent levels of normophilic sexualized thoughts and behaviors. Consistent with Kingston et al., Male Caregiver Psychological Abuse accounted for a significant amount of the variance in subsequent reported hypersexuality in this juvenile sample. Furthermore, this factor also emerged as a significant correlate of deviant sexual behaviors and fantasies, such as paraphilic interests and pedophilic preference. Sexual Abuse was also found to be significantly associated with hypersexuality. These findings provide additional support for the demonstrated relation between psychological abuse by a male caregiver and subsequent problematic sexual thoughts and behaviors. These data are also consistent with other research that suggests a gender symmetry effect in the impact of parental discipline and the differential effect of male caregiver abuse on male children.
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Affiliation(s)
- Kathryn A Davis
- Department of Psychology, MS 062, Brandeis University, Waltham, MA, 02454-9110, USA
| | - Raymond A Knight
- Department of Psychology, MS 062, Brandeis University, Waltham, MA, 02454-9110, USA.
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31
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Cherkasskaya E, Rosario M. The Relational and Bodily Experiences Theory of Sexual Desire in Women. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1659-1681. [PMID: 29926262 DOI: 10.1007/s10508-018-1212-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 03/22/2018] [Accepted: 04/03/2018] [Indexed: 06/08/2023]
Abstract
We review the theory and research on women's sexual desire and present a theory that incorporates internalized representations of relational and bodily experiences into our understanding of the full range of desire in women. To this end, we move away from the current tendency to focus on low sexual desire in women and instead consider desire on a spectrum or continuum from absent or diminished to high desire across multiple sexual orientations, including heterosexual, bisexual, and lesbian. We review definitions of sexual desire, as well as the epidemiology and etiology of hypoactive sexual desire, the most prevalent sexual complaint in women, including the biological, psychological, and relationship correlates of inhibited sexual desire. Subsequently, we examine the research on highly sexual women, who tend to experience high levels of sexual desire, sexual agency, and sexual esteem, and distinguish between high sexual desire and hypersexuality. We introduce two important constructs that are integrated into the Relational and Bodily Experiences Theory (RBET) of sexual desire in women: attachment and sexual body self-representations, suggesting that women's internalized representations of self and other that stem from childhood and their capacity to embody their sexual bodies are integral to our understanding of the phenomenology of sexual desire in women. RBET calls for further research into the links between attachment, sexual body self-representations, and desire, and suggests that clinical interventions for sexual desire difficulties in women should emphasize internalized working models of relationships (i.e., attachment) and integrate bodily based approaches.
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Affiliation(s)
- Eugenia Cherkasskaya
- Counseling and Psychological Services/Columbia Health, Columbia University, Alfred Lerner Hall, 8th Floor, 2920 Broadway, Mail Code 2606, New York, NY, 10027, USA.
| | - Margaret Rosario
- Department of Psychology, City University of New York-City College and The Graduate Center, New York, NY, USA
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32
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Cherkasskaya E, Rosario M. Relational and Bodily Experiences Theory: Attachment and Sociocultural Influences in a Parsimonious Model of Sexual Desire in Women. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1719-1722. [PMID: 31243618 DOI: 10.1007/s10508-019-01492-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 05/26/2019] [Accepted: 06/07/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Eugenia Cherkasskaya
- Counseling and Psychological Services/Columbia Health, Columbia University, 368 Broadway, Suite 508, New York, NY, 10013, USA.
| | - Margaret Rosario
- Department of Psychology, City University of New York-City College and the Graduate Center, New York, NY, USA
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33
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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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34
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Which psychosocial variables affect drive the most? Analysis of sexual desire in a group of Italian men. Int J Impot Res 2019; 31:410-423. [DOI: 10.1038/s41443-018-0105-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/08/2018] [Accepted: 11/26/2018] [Indexed: 12/25/2022]
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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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36
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McPhail IV, Olver ME, Brouillette-Alarie S, Looman J. Taxometric Analysis of the Latent Structure of Pedophilic Interest. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2223-2240. [PMID: 30014340 DOI: 10.1007/s10508-018-1225-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 04/27/2018] [Accepted: 05/03/2018] [Indexed: 06/08/2023]
Abstract
The present study examined the latent structure of pedophilic interest. Using data from phallometric tests for pedophilic interest across four samples of offenders (ns = 805, 632, 531, 261), taxometric analyses were conducted to identify whether pedophilic interest is best characterized as taxonic or dimensional. Across the samples, the majority of analyses supported taxonic latent structure in pedophilic interest. Visual inspection of taxometric curves indicated trichotomous latent structure (i.e., three-ordered classes) may characterize pedophilic interest in these samples. In a second step of taxometric analysis, the results supported trichotomous latent structure, indicating the presence of a complement taxon and two pedophilic taxa. In comparison with the complement taxon, the men in the first pedophilic taxon were non-exclusively pedophilic and had similar rates of sexual recidivism and sexual compulsivity. The men in the second pedophilic taxon were exclusively pedophilic, had more child victims and total victims, sexually re-offended at a higher rate, and were more sexually compulsive. The finding of trichotomous latent structure in pedophilic interest is both consistent and inconsistent with previous taxometric studies and has implications for research, assessment, and treatment of pedophilic interest.
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Affiliation(s)
- Ian V McPhail
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, S7N 5A5, Canada.
| | - Mark E Olver
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, S7N 5A5, Canada
| | - Sébastien Brouillette-Alarie
- École de Criminologie, Université de Montréal, Montreal, QC, Canada
- International Centre for Comparative Criminology, Université de Montréal, Montreal, QC, Canada
- Institut Philippe-Pinel de Montréal, Montreal, QC, Canada
| | - Jan Looman
- Providence Care Mental Health Services, Kingston, ON, Canada
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37
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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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Kohut T, Štulhofer A. The Role of Religiosity in Adolescents' Compulsive Pornography Use: A Longitudinal Assessment. JOURNAL OF SEX & MARITAL THERAPY 2018; 44:759-775. [PMID: 29676698 DOI: 10.1080/0092623x.2018.1466012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Despite increasing concerns that adolescent men are vulnerable to developing compulsive pornography use, little research has been done in this area. Given recent theorizing and research concerning moral incongruence, we hypothesized that symptoms of compulsive pornography use should generally be associated with higher levels of pornography use and increased growth in male adolescent pornography use over time, but that this pattern would be attenuated among very religious participants. These hypotheses were tested with mixed effects growth models using two independent panel samples of male Croatian adolescents. As expected, adolescent men who reported features of compulsive pornography use tended to exhibited higher levels of pornography use. However, contrary to expectations, increased growth in pornography use was limited to more religious compulsive users. Compared to nonreligious compulsive users, these adolescents started with lower initial levels of pornography use and their use increased over time at a greater rate of change. This study's results are the first to suggest that some adolescent men who report high levels of pornography use tend to exhibit symptoms of compulsive use, which highlights a need for counseling and therapeutic attention. Our findings also have implications for the emerging theory of moral incongruence.
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Affiliation(s)
- Taylor Kohut
- a Department of Psychology , University of Western Ontario , London , Ontario , Canada
- b Department of Sociology , University of Zagreb , Zagreb , Croatia
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Andreassen CS, Pallesen S, Griffiths MD, Torsheim T, Sinha R. The Development and Validation of the Bergen-Yale Sex Addiction Scale With a Large National Sample. Front Psychol 2018; 9:144. [PMID: 29568277 PMCID: PMC5852108 DOI: 10.3389/fpsyg.2018.00144] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/29/2018] [Indexed: 01/20/2023] Open
Abstract
The view that problematic excessive sexual behavior ("sex addiction") is a form of behavioral addiction has gained more credence in recent years, but there is still considerable controversy regarding operationalization of the concept. Furthermore, most previous studies have relied on small clinical samples. The present study presents a new method for assessing sex addiction-the Bergen-Yale Sex Addiction Scale (BYSAS)-based on established addiction components (i.e., salience/craving, mood modification, tolerance, withdrawal, conflict/problems, and relapse/loss of control). Using a cross-sectional survey, the BYSAS was administered to a broad national sample of 23,533 Norwegian adults [aged 16-88 years; mean (± SD) age = 35.8 ± 13.3 years], together with validated measures of the Big Five personality traits, narcissism, self-esteem, and a measure of sexual addictive behavior. Both an exploratory and a confirmatory factor analysis (RMSEA = 0.046, CFI = 0.998, TLI = 0.996) supported a one-factor solution, although a local dependence between two items (Items 1 and 2) was detected. Furthermore, the scale had good internal consistency (Cronbach's α = 0.83). The BYSAS correlated significantly with the reference scale (r = 0.52), and demonstrated similar patterns of convergent and discriminant validity. The BYSAS was positively related to extroversion, neuroticism, intellect/imagination, and narcissism, and negatively related to conscientiousness, agreeableness, and self-esteem. High scores on the BYSAS were more prevalent among those who were men, single, of younger age, and with higher education. The BYSAS is a brief, and psychometrically reliable and valid measure for assessing sex addiction. However, further validation of the BYSAS is needed in other countries and contexts.
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Affiliation(s)
| | - Ståle Pallesen
- Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | | | - Rajita Sinha
- Yale Stress Center, Yale University School of Medicine, New Haven, CT, United States
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Knight RA, Graham FJ. Hypersexuality: Equifinal, Cohesive, Clinical Presentation or Symptom Cluster with Multiple Underlying Mechanisms? ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2261-2264. [PMID: 28986708 DOI: 10.1007/s10508-017-1089-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 09/21/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Raymond A Knight
- Department of Psychology, MS 062, Brandeis University, Waltham, MA, 02454-9110, USA.
| | - Franklyn J Graham
- Department of Psychology, MS 062, Brandeis University, Waltham, MA, 02454-9110, USA
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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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Cranney S, Štulhofer A. "Whosoever Looketh on a Person to Lust After Them": Religiosity, the Use of Mainstream and Nonmainstream Sexually Explicit Material, and Sexual Satisfaction in Heterosexual Men and Women. JOURNAL OF SEX RESEARCH 2017; 54:694-705. [PMID: 27548620 DOI: 10.1080/00224499.2016.1216068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
While previous research has generally found that religiosity is associated with negative attitudes toward sexually explicit material (SEM) and a lower frequency of SEM use, no studies have examined the relationship between SEM type and religiosity. In addition, it is unknown how the interrelations between religiosity and type and frequency of SEM use influence the relationship between SEM use and sexual satisfaction. Here, associations among a multi-item religiosity scale (consisting of measures of self-reported faith in God, religious services attendance, and the religiosity of the respondent's social network), SEM use, type of preferred SEM, and sexual satisfaction were explored using a large online sample of Croatian adults (N = 2,580). In both men and women, religiosity was associated with less frequent SEM use and more SEM-negative attitudes. Guilty feelings following SEM use and SEM-negative attitudes fully mediated the association between religiosity and SEM use among women and partially mediated the relationship for men. Religiosity was also negatively correlated with women's nonmainstream SEM use. For women, religiosity significantly moderated the association between SEM use and sexual satisfaction, as well as the relationship between nonmainstream SEM use and sexual satisfaction. In line with the erotic plasticity theory, the findings suggest that religiosity affects SEM use and related sexual satisfaction more substantially among women than men.
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Affiliation(s)
| | - Aleksandar Štulhofer
- b Department of Sociology, Faculty of Humanities and Social Sciences , University of Zagreb
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Kraus SW, Voon V, Potenza MN. Should compulsive sexual behavior be considered an addiction? Addiction 2016; 111:2097-2106. [PMID: 26893127 PMCID: PMC4990495 DOI: 10.1111/add.13297] [Citation(s) in RCA: 183] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/30/2015] [Accepted: 01/04/2016] [Indexed: 12/16/2022]
Abstract
AIMS To review the evidence base for classifying compulsive sexual behavior (CSB) as a non-substance or 'behavioral' addiction. METHODS Data from multiple domains (e.g. epidemiological, phenomenological, clinical, biological) are reviewed and considered with respect to data from substance and gambling addictions. RESULTS Overlapping features exist between CSB and substance use disorders. Common neurotransmitter systems may contribute to CSB and substance use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases. Similar pharmacological and psychotherapeutic treatments may be applicable to CSB and substance addictions, although considerable gaps in knowledge currently exist. CONCLUSIONS Despite the growing body of research linking compulsive sexual behavior (CSB) to substance addictions, significant gaps in understanding continue to complicate classification of CSB as an addiction.
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Affiliation(s)
- Shane W. Kraus
- VISN 1 Mental Illness Research Education and Clinical Centers, VA Connecticut Healthcare System, West Haven, CT USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Valerie Voon
- University of Cambridge, Cambridge, United Kingdom
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
- Department of Neurobiology, Child Study Center and CASAColumbia, Yale University School of Medicine, New Haven, CT USA
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45
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Walton MT, Lykins AD, Bhullar N. Sexual Arousal and Sexual Activity Frequency: Implications for Understanding Hypersexuality. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:777-782. [PMID: 26969320 DOI: 10.1007/s10508-016-0727-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Michael T Walton
- 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.
| | - Navjot Bhullar
- School of Behavioural Cognitive and Social Sciences, University of New England, Armidale, NSW, 2351, Australia
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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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Blum K, Badgaiyan RD, Gold MS. Hypersexuality Addiction and Withdrawal: Phenomenology, Neurogenetics and Epigenetics. Cureus 2015; 7:e348. [PMID: 26623203 PMCID: PMC4627834 DOI: 10.7759/cureus.348] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Hypersexuality has been defined as abnormally increased sexual activity. Epidemiological and clinical studies have shown that this non-paraphilic condition consists of "excessive" sexual behaviors and disorders accompanied by personal distress and social and medical morbidity. It is a very controversial and political topic in terms of how best to categorize it as similar or not similar to addictive behaviors including substance abuse. Hypersexual disorder is conceptualized as a non-paraphilic sexual desire disorder with impulsivity. Pathophysiological perspectives include dysregulation of sexual arousal and desire, sexual impulsivity, and sexual compulsivity. The nucleus accumbens, situated within the ventral striatum, mediates the reinforcing effects of drugs of abuse, such as cocaine, alcohol, nicotine, and food as well as music. Indeed, it is believed that this structure mandates behaviors elicited by incentive stimuli. These behaviors include natural rewards like feeding, drinking, sexual behavior, and exploratory locomotion. An essential rule of positive reinforcement is that motor responses will increase in magnitude and vigor if followed by a rewarding event. Here, we are hypothesizing that there is a common mechanism of action (MOA) for the powerful effects drugs, music, food, and sex have on human motivation. The human drive for the three necessary motivational behaviors "hunger, thirst, and sex" may all have common molecular genetic antecedents that, if impaired, lead to aberrant behaviors. We hypothesize that based on a plethora of scientific support hypersexual activity is indeed like drugs, food, and music that activate brain mesolimbic reward circuitry. Moreover, dopaminergic gene and possibly other candidate neurotransmitter-related gene polymorphisms affect both hedonic and anhedonic behavioral outcomes. There is little known about both the genetics and epigenetics of hypersexuality in the current literature. However, we anticipate that future studies based on assessments with clinical instruments combined with genotyping of sex addicts will provide evidence for specific clustering of sexual typologies with polymorphic associations. There have been some studies using electrophysiological techniques that do not support the view that hypersexuality is indeed similar to substance abuse and other behavioral addictions. The authors are also encouraging both clinical and academic scientists to embark on research using neuroimaging tools to examine natural dopaminergic agonistic agents targeting specific gene polymorphisms to "normalize" hypersexual behavior.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, McKnight Brain Institute, University of Florida
| | - Rajendra D Badgaiyan
- Department of Psychiatry, and Laboratory of Advanced Radiochemistry, University of Minnesota School of Medicine
| | - Mark S Gold
- Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
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Affiliation(s)
- Nicole Prause
- Psychology, University of California, Los Angeles Los Angeles, CA, USA
| | - James Pfaus
- Psychology, Concordia University Montreal, QC, Canada
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