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Ciocca G, Pelligrini F, Mollaioli D, Limoncin E, Sansone A, Colonnello E, Jannini EA, Fontanesi L. Hypersexual behavior and attachment styles in a non-clinical sample: The mediation role of depression and post-traumatic stress symptoms. J Affect Disord 2021; 293:399-405. [PMID: 34246948 DOI: 10.1016/j.jad.2021.06.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/24/2021] [Accepted: 06/27/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Hypersexuality is a complex behavioral dysfunction concerning the excess of sexual activities. In this study, we aim to investigate the role of attachment styles, post-traumatic and depression symptoms in hypersexual behavior. METHODS We recruited through an online platform a snowball convenience sample of 1025 subjects (females: n=731; 71.3%; males: 294; 28.7%; age: 29.62±10.90) and we administered them a sociodemographic questionnaire, with a psychometric protocol composed by the Hypersexual Behavior Inventory (HBI) to assess hypersexuality, the Relationship Questionnaire (RQ) for the attachment styles, the International Trauma Questionnaire (ITQ) to evaluate the trauma and Patient Health Questionnaire (PHQ) for depression. RESULTS We found a significant and predictive impact of preoccupied and fearful attachment styles on hypersexual behavior (β=.116; p<.0001 and β=.121p<.0001, respectively). The categorical analysis of RQ confirmed also statistically significant differences between secure attachment style with fearful and preoccupied ones in terms of HBI levels (secure=30.01±10.79; preoccupied=35.50±14.46; fearful=36.57±13.50). Moreover, we found that depression symptoms and the total score of ITQ also resulted predictive for hypersexuality (β=.323; p<.0001 and β=.063; p<.04). However, in our model, depression and post-traumatic symptoms played a mediation role between insecure attachment and hypersexual behavior. CONCLUSION This study found a fundamental role of insecure attachment styles, post-traumatic and depression symptoms in the development of problematic sexuality. Hypersexual behavior is related in a causal manner with an insecure attachment style, fearful and preoccupied attachment, particularly. Nevertheless, the traumatic core of personality together with depression symptoms could play a mediation role towards the hypersexual behavior.
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Affiliation(s)
- Giacomo Ciocca
- Department of Dynamic and Clinical Psychology, and Health Studies, "Sapienza" University of Rome, Rome, Italy.
| | - Fabiana Pelligrini
- Department of Dynamic and Clinical Psychology, and Health Studies, "Sapienza" University of Rome, Rome, Italy
| | - Daniele Mollaioli
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Erika Limoncin
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Sansone
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Elena Colonnello
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Lilybeth Fontanesi
- Department of Psychological, Health, and Territorial Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Abstract
This special issue addresses the affective and cognitive processes and their interactions potentially reflecting mechanisms underlying the development, maintenance of, or recovery from behavioral addictions. Various specific types of behavioral addictions will be considered, including those already in ICD-11 (gambling disorder, gaming disorder), but also new phenomena that are not yet classified (e.g., buying-shopping disorder, social-network-disorder) and phenomena potentially belonging to behavioral addictions although they are currently classified elsewhere (e.g., compulsive sexual behavior disorder). The articles included in this special issue directly investigate affective processes (e.g., cue-reactivity, craving, mood, stress, social interactions) and/or cognitive processes (e.g., executive functions, attention, memory). The studies involve experimental paradigms, neuropsychological tasks, psychophysiological measures, and neuroimaging techniques. Specific articles also deal with the relationship between affective and cognitive processes. The special issue is complemented by articles covering current debates and reviewing current empirical findings in the field.
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Larsen SE. Hypersexual Behavior as a Symptom of PTSD: Using Cognitive Processing Therapy in a Veteran with Military Sexual Trauma-Related PTSD. Arch Sex Behav 2019; 48:987-993. [PMID: 30783872 DOI: 10.1007/s10508-018-1378-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/08/2018] [Accepted: 12/13/2018] [Indexed: 06/09/2023]
Abstract
Hypersexual behavior is a construct that is well recognized yet vaguely conceptualized, leading to some arguments that it may be comprised of multiple etiologies. Childhood sexual abuse is often acknowledged as a common experience among those with sexually addictive behaviors, yet the intersection between PTSD and sexual addiction has not been fully explored. This case illustrates the use of Cognitive Processing Therapy, an empirically supported treatment for PTSD, as a means to treat both PTSD symptoms and hypersexual behaviors in a veteran who had experienced military sexual trauma. Treatment led to a meaningful decrease in both types of symptoms, even in the absence of a structured treatment approach for sexual addiction. It is argued that differential diagnosis, including functional analysis of hypersexual behaviors, is crucial in treatment planning. Further, attention to trauma and PTSD is important in veterans and others for whom PTSD is part of the etiology of hypersexual behavior; trauma-focused CBT therapies can provide a useful treatment approach in these cases.
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Affiliation(s)
- Sadie E Larsen
- Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA.
- Department of Psychiatry, Medical College of Wisconsin, 1155 North Mayfair Road, Milwaukee, WI, 53226, USA.
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Grubbs JB, Exline JJ, Pargament KI, Volk F, Lindberg MJ. Internet Pornography Use, Perceived Addiction, and Religious/Spiritual Struggles. Arch Sex Behav 2017; 46:1733-1745. [PMID: 27351579 DOI: 10.1007/s10508-016-0772-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 12/15/2015] [Accepted: 05/10/2016] [Indexed: 05/10/2023]
Abstract
Prior work has demonstrated that religious beliefs and moral attitudes are often related to sexual functioning. The present work sought to examine another possibility: Do sexual attitudes and behaviors have a relationship with religious and spiritual functioning? More specifically, do pornography use and perceived addiction to Internet pornography predict the experience of religious and spiritual struggle? It was expected that feelings of perceived addiction to Internet pornography would indeed predict such struggles, both cross-sectionally and over time, but that actual pornography use would not. To test these ideas, two studies were conducted using a sample of undergraduate students (N = 1519) and a sample of adult Internet users in the U.S. (N = 713). Cross-sectional analyses in both samples found that elements of perceived addiction were related to the experience of religious and spiritual struggle. Additionally, longitudinal analyses over a 1-year time span with a subset of undergraduates (N = 156) and a subset of adult web users (N = 366) revealed that perceived addiction to Internet pornography predicted unique variance in struggle over time, even when baseline levels of struggle and other related variables were held constant. Collectively, these findings identify perceived addiction to Internet pornography as a reliable predictor of religious and spiritual struggle.
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Affiliation(s)
- Joshua B Grubbs
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA.
- Department of Psychology, Bowling Green State University, Bowling Green, OH, 43403, USA.
| | - Julie J Exline
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Kenneth I Pargament
- Department of Psychology, Bowling Green State University, Bowling Green, OH, 43403, USA
| | - Fred Volk
- Department of Counselor Education and Family Studies, Liberty University, Lynchburg, VA, USA
| | - Matthew J Lindberg
- Department of Psychology, Youngstown State University, Youngstown, OH, USA
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Walton MT, Cantor JM, Lykins AD. An Online Assessment of Personality, Psychological, and Sexuality Trait Variables Associated with Self-Reported Hypersexual Behavior. Arch Sex Behav 2017; 46:721-733. [PMID: 26502283 DOI: 10.1007/s10508-015-0606-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 07/09/2015] [Accepted: 08/10/2015] [Indexed: 05/03/2023]
Abstract
"Hypersexual" behavior represents a perceived inability to control one's sexual behavior. To investigate hypersexual behavior, an international sample of 510 self-identified heterosexual, bisexual, and homosexual men and women completed an anonymous online self-report questionnaire battery. In addition to age and sex (male), hypersexual behavior was related to higher scores on measures of sexual excitation, sexual inhibition due to the threat of performance failure, trait impulsivity, and both depressed mood and anxiety. In contrast, hypersexual behavior was related to lower scores on sexual inhibition due to the threat of performance consequences. Higher neuroticism and extraversion, as well as lower agreeableness and conscientiousness, also predicted hypersexual behavior. Interestingly, interactions among the variables assessed did not significantly predict hypersexual behavior, suggesting the possible existence of multiple and predominantly independent taxa for various persons reporting hypersexual behavior. Core personality features may also be present in persons with hypersexual behavior. Clinical implications and future research directions are discussed.
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Affiliation(s)
- Michael T Walton
- Discipline of Psychology, School of Behavioral, Cognitive, and Social Sciences, University of New England, Armidale, NSW, 2351, Australia
| | - James M Cantor
- Law and Mental Health Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Amy D Lykins
- Discipline of Psychology, School of Behavioral, Cognitive, and Social Sciences, University of New England, Armidale, NSW, 2351, Australia.
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Reid RC, Cyders MA, Moghaddam JF, Fong TW. Psychometric properties of the Barratt Impulsiveness Scale in patients with gambling disorders, hypersexuality, and methamphetamine dependence. Addict Behav 2014; 39:1640-1645. [PMID: 24314714 DOI: 10.1016/j.addbeh.2013.11.008] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 11/04/2013] [Accepted: 11/11/2013] [Indexed: 11/16/2022]
Abstract
Although the Barratt Impulsiveness Scale (BIS; Patton, Stanford, & Barratt, 1995) is a widely-used self-report measure of impulsivity, there have been numerous questions about the invariance of the factor structure across clinical populations (Haden & Shiva, 2008, 2009; Ireland & Archer, 2008). The goal of this article is to examine the factor structure of the BIS among a sample consisting of three populations exhibiting addictive behaviors and impulsivity: pathological gamblers, hypersexual patients, and individuals seeking treatment for methamphetamine dependence to determine if modification to the existing factors might improve the psychometric properties of the BIS. The current study found that the factor structure of the BIS does not replicate in this sample and instead produces a 12-item three-factor solution consisting of motor-impulsiveness (5 items), non-planning impulsiveness (3 items), and immediacy impulsiveness (4 items). The clinical utility of the BIS in this population is questionable. The authors suggest future studies to investigate comparisons with this modified version of the BIS and other impulsivity scales such as the UPPS-P Impulsive Behavior Scale in clinical populations when assessing disposition toward rash action.
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Affiliation(s)
- Rory C Reid
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States.
| | - Melissa A Cyders
- Department of Psychology, Indiana University-Purdue University, Indianapolis, United States
| | - Jacquelene F Moghaddam
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States
| | - Timothy W Fong
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States
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