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Du R, Knight RA. The Structure of Hypersexuality and Its Relation to Impulsivity. Arch Sex Behav 2024:10.1007/s10508-024-02828-2. [PMID: 38589743 DOI: 10.1007/s10508-024-02828-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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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Akbari M, Jamshidi S, Sheikhi S, Alijani F, Kafshchi P, Taylor D. Aripiprazole and its adverse effects in the form of impulsive-compulsive behaviors: A systematic review of case reports. Psychopharmacology (Berl) 2024; 241:209-223. [PMID: 38227009 DOI: 10.1007/s00213-024-06529-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/06/2024] [Indexed: 01/17/2024]
Abstract
Aripiprazole is an efficacious treatment for both the positive and negative symptoms of schizophrenia and is also commonly used as a mood stabilizer. It is associated with better tolerability compared with other antipsychotics. However, there are reports of patients who experience problem gambling, hypersexuality, obsessive-compulsive symptoms, and other impulsive and/or compulsive behaviors as a result of aripiprazole administration and/or dosage increase. We aimed to do a systematic review of case reports published in this regard. After screening more than 6000 titles and abstracts in ten scientific search engines, we found 35 related records comprising 59 cases. The majority of cases (n = 42, 71.18%) were male, the mean age was 33.83 years (± 13.40), and the average daily dose of aripiprazole was 11.63 mg (± 6.94). The results of our review showed that the most frequently published impulsivity adverse effect of aripiprazole is gambling, followed by hypersexuality, obsessive-compulsive symptoms/disorder, problem eating, trichotillomania, problem shopping, and kleptomania. These symptoms were experienced both by patients who had previous problems in these areas and those who did not. In the majority of cases, the symptoms appeared within 30 days after aripiprazole administration started and ceased within 30 days of its discontinuation and/or dose decrease. Clinicians should be aware of impulsivity adverse effects, monitor them, and educate both patients and the family about them.
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Affiliation(s)
- Mehdi Akbari
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, No.43. South Mofatteh Ave, Tehran, Iran.
| | - Shiva Jamshidi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, No.43. South Mofatteh Ave, Tehran, Iran
| | - Sonay Sheikhi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, No.43. South Mofatteh Ave, Tehran, Iran
| | - Farhad Alijani
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, No.43. South Mofatteh Ave, Tehran, Iran
| | - Parsa Kafshchi
- Department of Human Sciences, Faculty of Psychology, Islamic Azad University, Zanjan, Iran
| | - David Taylor
- Pharmacy Department, Maudsley Hospital, Denmark Hill, London, SE5 8AF, England, UK
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Roza TH, Noronha LT, Shintani AO, Massuda R, Lobato MIR, Kessler FHP, Passos IC. Treatment Approaches for Problematic Pornography Use: A Systematic Review. Arch Sex Behav 2024; 53:645-672. [PMID: 37880509 DOI: 10.1007/s10508-023-02699-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/11/2022] [Revised: 05/30/2023] [Accepted: 09/06/2023] [Indexed: 10/27/2023]
Abstract
Problematic pornography use (PPU) is an emerging condition associated with several negative psychological and sexual outcomes. This study aimed to systematically review treatment approaches for PPU. Potentially eligible studies were searched for in PubMed/MEDLINE, Embase, PsycINFO, and Web of Science up to April 1, 2023. The quality of the evidence was assessed with the use of the Joanna Briggs Institute's checklists, the Cochrane risk-of-bias tools, and the GRADE approach. A total of 8936 references were retrieved, and 28 studies were included in the systematic review (n = 500 participants). Included studies were case reports (k = 16), case series (k = 1), quasi-experimental investigations (k = 7), and randomized clinical trials (k = 4). The majority of included studies presented overall low quality and significant risk of bias, with all interventions receiving a low or very low rating according to the GRADE approach. Most studies investigated psychological interventions, with the predominance of second and third wave cognitive behavioral therapy interventions. Pharmacological treatments included opioid antagonists (naltrexone in most cases) and antidepressants, while one study investigated a protocol that included rTMS. Several investigations described the combination of psychological and pharmacological approaches. Most studies did not report on side effects, with online and self-help interventions presenting significant issues in terms of treatment adherence. Even though there are promising options that may have efficacy for the treatment of patients with PPU, the literature in the topic still presents significant limitations that compromise the reaching of more definitive conclusions.
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Affiliation(s)
- Thiago Henrique Roza
- Department of Psychiatry, Universidade Federal do Paraná, Rua Padre Camargo, 280, Curitiba, PR, CEP: 80060-240, Brazil.
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Lucas Tavares Noronha
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Augusto Ossamu Shintani
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Raffael Massuda
- Department of Psychiatry, Universidade Federal do Paraná, Rua Padre Camargo, 280, Curitiba, PR, CEP: 80060-240, Brazil
| | - Maria Inês Rodrigues Lobato
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felix Henrique Paim Kessler
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Schreck B, Forcier C, Balem M, Cabelguen C, Leboucher J, Grall-Bronnec M, Challet-Bouju G. Frequency of and Factors Associated with the Presence of a History of Probable Attention-Deficit Hyperactivity Disorder in a Population of Patients with Sex Addiction. Eur Addict Res 2023:1-10. [PMID: 37088070 DOI: 10.1159/000530110] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/12/2022] [Accepted: 03/06/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Since the first description of sex addiction (SA) by Carnes, research on this problematic behaviour has continued to grow, and the association with attention-deficit hyperactivity disorder (ADHD) appears to be frequent. This study aimed to estimate the frequency of a history of probable ADHD in a population of patients with SA and to explore the factors associated with it. METHODS One hundred 85 patients referred to the Nantes University Hospital for SA between 2011 and 2020 were included. Patients completed the Sexual Addiction Screening Test (SAST) or its revised version (SAST-R) to establish the presence of SA. As the SAST-R was not validated in French, we conducted a validation study for the French version. ADHD was screened using the Wender-Utah Rating Scale in childhood and the Adult ADHD Self-Report Scale in adulthood. A multivariate logistic regression model was used to identify factors associated with the presence of a history of probable ADHD. RESULTS Childhood ADHD was identified in 36% of patients with SA. Factors associated with the presence of a history of probable ADHD were a low education level, an earlier age of onset of problematic sexual behaviour, another addictive disorder, an anxiety disorder, impulsivity (high negative urgency score), and high scores on harm avoidance and novelty-seeking temperament scales. Furthermore, the French version of the SAST-R displayed good psychometric properties, especially excellent sensitivity. CONCLUSION The frequency of a history of probable ADHD among patients with SA is consistent with the literature and close to the highest range. Specific personality traits in patients with both SA and a history of probable ADHD could induce lasting problems of adaptation, which may precipitate the development of SA or maintain it.
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Affiliation(s)
- Benoît Schreck
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-centered outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Camille Forcier
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
| | - Marianne Balem
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-centered outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Clémence Cabelguen
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
| | - Juliette Leboucher
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
| | - Marie Grall-Bronnec
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-centered outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Gaëlle Challet-Bouju
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-centered outcomes and HEalth ResEarch, SPHERE, Nantes, France
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Marchetti I. The Structure of Compulsive Sexual Behavior: A Network Analysis Study. Arch Sex Behav 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Krogh HB, Vinberg M, Mortensen GL, Skakke D, Nielsen D, Giraldi A. Bipolar disorder and sexuality: a preliminary qualitative pilot study. Int J Bipolar Disord 2023; 11:5. [PMID: 36735118 PMCID: PMC9898481 DOI: 10.1186/s40345-023-00285-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Individuals with mental health disorders have a higher risk of sexual problems impacting intimate relations and quality of life. For individuals with bipolar disorder (BD) the mood shifts might to a particular degree affect their sexual function with possible hypersexual interest during manic episodes and low sexual interest during depressive episodes. The diagnosis is often given in late adolescence, which may impact sexual identity and development. Only a few studies have looked at BD and sexual life, with no qualitative research on the topic. We conducted a qualitative pilot study exploring sexuality in connection to mood swings in five participants with BD. RESULTS Thematic content analysis revealed five themes: (1) sexual drive and impulses, (2) sexual behavior, (3) thoughts and feelings in relation to sexual issues, (4) intimate relationships, and (5) sexuality and identity. During manic episodes the participants described having a higher sexual drive, leading for some to more sexual interactions. During depressed episodes, the sexual drive in the three female participants was low, however, in the two men, rather than a reduced sexual drive, a more self-destructive way of engaging in sex prevailed. The sexual outgoing behavior during manic phases was described as joyful, with no feelings of shame connected to it. However, the shifts in sexual drive connected to mood shifts affected the participants' relationships negatively. Further, all the participants described having outgoing sexual behavior in their youth. CONCLUSIONS Overall, changes in sexual drive may act as a trigger or early warning symptoms of new episodes, pinpointing the clinical relevance of addressing sexuality in individuals with BD. In general, sexual drive followed affective episodes. However, during depressive episodes sex could be, instead of reduced drive, associated with negative feelings. All participants described having an outgoing sexual behavior in their youth before the onset of BD, which might be essential to consider if there is a clinical suspension of BD in an individual.
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Affiliation(s)
- Helle B. Krogh
- grid.4973.90000 0004 0646 7373Sexological Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital, Ole Maaloes 14, 2100 Copenhagen, Denmark
| | - Maj Vinberg
- grid.4973.90000 0004 0646 7373Mental Health Center, Northern Zealand, Copenhagen University Hospital, Mental Health Services CPH, Hillerød, Denmark ,grid.475435.4Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
| | | | - Ditte Skakke
- grid.4973.90000 0004 0646 7373Sexological Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital, Ole Maaloes 14, 2100 Copenhagen, Denmark
| | - Dorthe Nielsen
- grid.7143.10000 0004 0512 5013Odense University Hospital, Odense, Denmark
| | - Annamaria Giraldi
- grid.4973.90000 0004 0646 7373Sexological Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital, Ole Maaloes 14, 2100 Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Lewczuk K, Wizła M, Gola M. The Relation of Sexual Attitudes to Hypersexuality and Problematic Pornography Use. Arch Sex Behav 2023; 52:411-430. [PMID: 35896936 PMCID: PMC9328619 DOI: 10.1007/s10508-022-02358-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 05/02/2023]
Abstract
Previous studies have shown that specific attitudes related to moral convictions can have an important role in the development and maintenance of problematic sexual behavior symptoms. However, although other types of attitudes, like sexual attitudes, are potentially highly relevant, they have not yet been studied in this role. We investigated how four dimensions of sexual attitudes: Permissiveness, Birth Control, Communion and Instrumentality, contribute to problematic pornography use (PPU) and hypersexual disorder (HD) symptoms, controlling for religiosity, sex, age and relationship status. The study was administered through an online questionnaire and based on a representative sample of n = 1036 (Mage = 43.28, SD = 14.21; 50.3% women) Polish adult citizens. When adjusting for other variables, higher sexual Permissiveness positively predicted HD and PPU among both men (HD: β = .26, p < .001; PPU: β = .22, p < .001) and women (HD: β = .44, p < .001; PPU: β = .26; p < .001). Sexual Instrumentality positively, although weakly, contributed to HD severity among men (β = .11, p < .05). Attitudes reflecting higher support for responsible sexuality (Birth Control subscale) negatively and weakly predicted HD among women (β = - .11, p < .05). Permissiveness was also the only sexual attitude dimension that consistently predicted a higher frequency of sexual activity among men and women. Based on the cutoff criteria proposed by the authors of the used screening instruments (≥ 53 points for the Hypersexual Behavior Inventory and ≥ 4 points for the Brief Pornography Screen), the prevalence of being at risk for HD was 10.0% (men: 11.4%, women: 8.7%) and for PPU was 17.8% (men: 26.8%, women: 9.1%). Our results point to a significant contribution of sexual attitudes to problematic sexual behavior symptoms, which was not encapsulated by the previously studied influence of religious beliefs, although most of the obtained relationships were relatively weak. Particularly, a consistent link between permissive attitudes and both HD and PPU among men and women may indicate that permissive attitudes can potentially contribute to the development and maintenance of problematic sexual behavior. The prevalence of being at risk for PPU (and to some degree HD) in the current representative sample was high. Such results raise questions about the appropriateness of the proposed cutoff criteria and the risk of overpathologizing normative sexual activity, if the cutoff thresholds are not tailored adequately. The results have implications for the assessment, diagnosis and theory of problematic sexual behavior.
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Affiliation(s)
- Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Wóycickiego 1/3, 01-938, Warsaw, Poland.
| | - Magdalena Wizła
- Institute of Psychology, Cardinal Stefan Wyszynski University, Wóycickiego 1/3, 01-938, 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
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Qasrawi SO, BaHammam AS. An Update on Kleine-Levin Syndrome. Curr Sleep Med Rep 2023; 9:35-44. [PMID: 36590182 DOI: 10.1007/s40675-022-00246-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/28/2022]
Abstract
Purpose of Review Kleine-Levin syndrome (KLS) is a rare relapsing-remitting sleep disorder distinguished by recurrent periods of severe hypersomnia accompanied by cognitive, mood, and behavioral changes. This review focuses mainly on the most recent developments and articles concerning this illness in the preceding five years while attempting to provide a basic overview of KLS. Recent Findings Genetic links were reported in some patients with KLS, like variation in TRANK1 in a worldwide case-control genome-wide association in patients with KLS, in addition to several uncommon variations in the LMOD3 gene, some of which are likely to be pathogenic, discovered by linkage analysis and exome sequencing in a sizable Saudi Arabian family with KLS and a European cohort of KLS patients. Additionally, recent data indicate that the amplitude of the circadian active/rest cycles significantly decreased during hypersomnia attacks, but during asymptomatic periods, it did not differ significantly from the controls. Moreover, patients with KLS are at a higher risk of developing emerging psychiatric disorders during follow-up. Recent data also points to possible discoveries of diagnostic-potential dysregulated proteomic patterns in KLS. Finally, new data suggest that functional imaging studies are often abnormal in KLS both during and between episodes. Summary KLS is an uncommon, severe, and uniform illness. When it comes to the diagnosis and treatment of KLS, these characteristics offer both opportunities and challenges. Over the past five years, some promising work has appeared in genetics, functional imaging, and biomarker identification; nevertheless, these areas still need more focus to advance the detection and treatment of patients suffering from KLS.
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Jepsen D, Brzank PJ. Hypersexual behaviour among young adults in Germany: characteristics and personality correlates. BMC Psychiatry 2022; 22:804. [PMID: 36536318 DOI: 10.1186/s12888-022-04370-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hypersexual behaviour (HB) is characterized by recurring unsuccessful efforts to control intense, repetitive sexual impulses that result in sexual activities and manifest in the behaviour of the concerning individual over an extended period. This study aims to describe the characterization of HB among the target group, identify personality correlates, and associations between HB and a lack of sexual education and reflection during school time. METHODS A cross-sectional design was used to survey the participants (age 18-27; n = 609) online who were recruited via a web forum for addiction selfcare, a website for casual sex dating, Facebook and the mail distribution of the University of Applied Science Nordhausen (Germany). Standardised questionnaires were used to measure the key variables in the study. The sexual behaviour (masturbation, pornography consumption, promiscuity), several personality tendencies, and retrospective information about sexual education of the participants during school time were investigated. Correlation and binomial logistic regression were used to analyse the data with HB as the outcome variable. RESULTS 10.5% (n = 64) of the participants were identified as hypersexual. The assignment to male sex, a problematic pornography consumption, and impulsive tendencies were determined as predictors of HB. Strong correlates were identified between HB and promiscuity, and impairments in important areas of life. Weak to moderate correlates comprise between HB and all investigated personality traits, and several aspects of sexual risk behaviour. No association was found between HB and a lacking sexual education during school time. The descriptive analysis revealed further sexual problems within the sample (e.g. feelings of shame and guilt, sexual risk behaviour, sexual dysfunction). CONCLUSION Young adults should get more attention as a vulnerable group for the development of hypersexuality in sexual education, prevention and therapy. Regarding to its treatment, HB therefore should be considered together with its associations with sociodemographic information, personality traits, and psychosocial factors.
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Korchia T, Boyer L, Deneuville M, Etchecopar-Etchart D, Lancon C, Fond G. ADHD prevalence in patients with hypersexuality and paraphilic disorders: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2022; 272:1413-1420. [PMID: 35551451 DOI: 10.1007/s00406-022-01421-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/22/2022] [Indexed: 11/30/2022]
Abstract
Hypersexuality and paraphilic disorders have been associated with increased ADHD in several studies. To determine the prevalence of ADHD in hypersexuality and paraphilic disorders. Three databases (Medline, Web of Science and Google Scholar) were explored. Using random effects models, we calculated the pooled estimate of ADHD prevalence. The leave-1-out method and subgroup analyses were carried out to identify sources of heterogeneity. Seven studies from three countries (N = 730 patients with hypersexuality) were included (including five US studies). The overall estimate of the prevalence of ADHD in patients with hypersexuality or paraphilic disorders was 22.6% (95% interval: 17-29.4) with high heterogeneity (I2 = 63%). No publication bias was observed according to Egger's test. We found no significant difference in ADHD prevalence between the following subgroups: hypersexuality vs. paraphilic disorders, studies exploring the history of childhood ADHD vs. adult ADHD, US studies vs. others. The French study was a source of heterogeneity with a much lower rate than others (4.5%) but did not significantly change the prevalence estimate. Removing this study increases the prevalence to 25%. We found no association between the year of publication and ADHD prevalence. ADHD is much more frequent in populations with hypersexuality or paraphilic disorders compared to the general population. It should be systematically screened. The subgroup analyses were not sufficient to identify all sources of heterogeneity, other sources should be explored in further studies.
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Affiliation(s)
- Théo Korchia
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Laurent Boyer
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Manon Deneuville
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Damien Etchecopar-Etchart
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Christophe Lancon
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Guillaume Fond
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France.
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Rosansky JA, Borgogna NC, Kraus SW, Grubbs JB. Cross-Sectional and Longitudinal Associations Between Posttraumatic Stress Symptoms and Hypersexual Behaviors Among Individuals Who have Gambled in Their Lifetimes. J Sex Med 2022; 19:1813-1823. [PMID: 36216746 DOI: 10.1016/j.jsxm.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/12/2022] [Accepted: 09/05/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Exposure to traumatic experiences represent one factor that may contribute to the development of hypersexual behaviors. AIM We investigated the associations between posttraumatic stress symptoms and hypersexual behaviors by analyzing survey data from 2 samples. METHOD The first sample consisted of n = 585 college students, and the second consisted of n = 786 adults recruited via Amazon's Mechanical Turk (MTurk), n = 337 of whom completed a 6-month follow-up survey. We conducted 3 hierarchical regression analyses adjusting for age, gender, sexual orientation, impulsivity, drug use, alcohol use, and gambling. OUTCOMES The primary outcomes for this investigation were associations between posttraumatic stress symptoms, measured using the PTSD Checklist for DSM-IV and DSM-5 (PCL-C and PCL-5), and hypersexual behaviors, measured using the Hypersexual Behavior Inventory (HBI). RESULTS A significant regression, R2 = 0.230, R2adjusted = 0.211, F (14,570) = 12.17, P < .001, revealed posttraumatic stress symptoms were associated with hypersexual behaviors in the university student sample (β = 0.154). A significant regression using the MTurk sample, R2 = 0.403, R2adjusted = 0.392, F (14,771) = 37.13, P < .001, confirmed this finding (β = 0.259). In addition, a significant regression, R2 = 0.562, R2adjusted = 0.541, F (15,321) = 27.42, P < .001, indicated that posttraumatic stress symptoms were longitudinally associated with increased hypersexual behaviors (β = .190) after adjusting for all variables, including baseline hypersexuality. CLINICAL TRANSLATION Results suggest that individuals experiencing posttraumatic stress symptoms are at increased risk for current and future hypersexual behaviors. STRENGTHS & LIMITATIONS This investigation involved secondary analyses of adults who had gambled at least once in their lives and findings may not generalize to those who have never gambled. Furthermore, longitudinal findings may be impacted by selection bias (42% completion rate) and may not generalize to follow up periods longer than 6-months. CONCLUSION This study provides support for the hypothesis that posttraumatic stress symptoms are associated with increased hypersexual behavior, and further research is indicated to explore the etiology and directionality of this relationship. Rosansky JA, Borgogna NC, Kraus SW, et al. Cross-Sectional and Longitudinal Associations Between Posttraumatic Stress Symptoms and Hypersexual Behaviors Among Individuals Who have Gambled in Their Lifetimes. J Sex Med 2022;19:1813-1823.
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Affiliation(s)
- Joseph A Rosansky
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychology, Bowling Green State University, Bowling Green, OH, USA.
| | - Nicholas C Borgogna
- Department of Psychological Science, Texas Tech University, Lubbock, TX, USA
| | - Shane W Kraus
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Joshua B Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
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Blum AW, Grant JE. N-acetylcysteine in the treatment of compulsive sexual behavior disorder: A case series. J Psychiatr Res 2022; 154:203-206. [PMID: 35952519 DOI: 10.1016/j.jpsychires.2022.07.066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/07/2022] [Revised: 07/16/2022] [Accepted: 07/25/2022] [Indexed: 01/11/2023]
Abstract
Although compulsive sexual behavior disorder (CSBD) is a relatively common disorder with an estimated prevalence of at least 3%, clinicians currently have limited evidence and no FDA-approved drugs to guide their treatment of this condition. N-acetylcysteine (NAC), an amino acid that seems to restore extracellular levels of glutamate in the nucleus accumbens, has previously demonstrated efficacy in treating multiple psychiatric disorders, including substance use disorders and putative behavioral addictions. However, no study has assessed the use of NAC (or any other glutamatergic agent, for that matter) in the treatment of CSBD. Here, we present data from a case series of 8 male patients with CSBD treated with NAC in routine clinical practice in a specialty outpatient clinic. Of these 8 patients, all of whom had previously been treated for CSBD with medications, therapy, or both, 5 had marked clinical improvement (>35% improvement on a modified version of Yale-Brown Obsessive Compulsive Scale) on NAC, and 3 showed minimal or no improvement (<15%). These findings suggest that NAC may be a potentially promising, well-tolerated treatment option for patients with CSBD, including those who have failed more traditional therapies.
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Affiliation(s)
- Austin W Blum
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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14
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Draps M, Adamus S, Wierzba M, Gola M. Functional Connectivity in Compulsive Sexual Behavior Disorder - Systematic Review of Literature and Study on Heterosexual Males. J Sex Med 2022; 19:1463-1471. [PMID: 35831231 DOI: 10.1016/j.jsxm.2022.05.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Compulsive Sexual Behavior Disorder (CSBD) was recently included in ICD-11 as a new impulse control disorder. While this certainly improved the diagnosis of CSBD, the underlying brain mechanisms of the disorder are still poorly understood. Better description of brain functional deficits is required. AIM Here we investigate patterns of resting-state brain functional connectivity (fc) in a group of CSBD patients compared to a group of healthy controls (HC). METHODS A MATLAB toolbox named CONN functional connectivity toolbox was employed to study patterns of brain connectivity. Also correlation between fc and severity of CSBD symptoms and other psychological characteristics, assessed with questionnaires, were examined. OUTCOMES We collected resting-state functional magnetic resonance imaging data from 81 heterosexual males: 52 CSBD patients and 29 HC. RESULTS We found increased fc between left inferior frontal gyrus and right planum temporale and polare, right and left insula, right Supplementary Motor Cortex (SMA), right parietal operculum, and also between left supramarginal gyrus and right planum polare, and between left orbitofrontal cortex and left insula when compared CSBD and HC. The decreased fc was observed between left middle temporal gyrus and bilateral insula and right parietal operculum. No significant correlations between psychological questionnaires assessing CSBD symptoms and resting-state functional connectivity were observed. CLINICAL IMPLICATIONS Results from our study extend the knowledge of brain mechanisms differentiating CSBD from HC. STRENGTHS & LIMITATIONS The study was the first large sample study showing 5 distinct functional brain networks differentiating CSBD patients and HC. However, the sample was limited only to heterosexual men, in the future a greater diversity in studied sample and longitudinal studies are needed. Also, the present study examined functional connectivity at the level of regions of interest (ROIs). Future studies could verify these results by examining functional connectivity at the voxel level. CONCLUSION The identified functional brain networks differentiate CSBD from HC and provide some support for incentive sensitization as mechanism underlying CSBD symptoms. The correlation between psychological assessment (ie, severity of CSBD, depression and anxiety symptoms, level of impulsivity and compulsivity) and resting-state functional connectivity need further examination. Draps M, Adamus S, Wierzba M, et al. Functional Connectivity in Compulsive Sexual Behavior Disorder - Systematic Review of Literature and Study on Heterosexual Males. J Sex Med 2022;19:1463-1471.
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Affiliation(s)
- Małgorzata Draps
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
| | - Sylwia Adamus
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland; Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Małgorzata Wierzba
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Mateusz Gola
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland; Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, CA, USA
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15
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Peters JR, Pullman LE, Kingston DA, Lalumière ML. Orgasm Frequency (Total Sexual Outlet) in a National American Sample. Arch Sex Behav 2022; 51:1447-1460. [PMID: 35165803 DOI: 10.1007/s10508-021-02241-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/29/2020] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 06/14/2023]
Abstract
There has been renewed interest in the conceptualization and diagnosis of conditions marked by excessive sexuality. Researchers and clinicians have often utilized orgasm frequency (e.g., total sexual outlet) as an indicator of hypersexuality. Indeed, some have proposed seven or more (7+) orgasms by any means in a typical week as indicating hypersexuality. Most studies utilizing this criterion, however, have examined clinical or judicial samples of men, as opposed to general population samples. The purpose of the current study was to provide representative population data of total sexual outlet (TSO) for people varying in age, relationship status, and sex, while also examining the impact of the phrasing of the questions (i.e., time frame). A total of 1029 participants were recruited online via a Qualtrics panel, consisting of 442 males and 587 females, from diverse regions across the USA. Results indicated that between 10.3 and 16.7% of the sample met the 7+ criterion for hypersexuality, with considerable variation by age, relationship status, sex, and less variation by wording of the question. Results are discussed in terms of the applicability of the 7+ cut-off for identifying elevated TSO. Results from this survey could be useful to researchers and clinicians looking for comparison data for their research and clinical assessment results.
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Affiliation(s)
- Joshua R Peters
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Lesleigh E Pullman
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada
| | - Drew A Kingston
- HOPE Program, San Diego, CA, USA
- Institute of Mental Health Research, Royal Ottawa Health Care Group, Ottawa, ON, Canada
- Department of Psychiatry, McMaster University, Hamilton, ON, Canada
| | - Martin L Lalumière
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
- Institute of Mental Health Research, Royal Ottawa Health Care Group, Ottawa, ON, Canada.
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16
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Irincu L, Ivan I, Diaconu Ș, Falup-Pecurariu C. Impulse control disorders, dopamine dysregulation syndrome and sex dysfunction in Parkinson's disease. Int Rev Neurobiol 2022; 162:117-134. [PMID: 35397783 DOI: 10.1016/bs.irn.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Hypersexuality (HS), characterized by an aberrant, compulsive and inappropriate sexual drive, is an underreported and undermanaged complication of the treatment with dopamine agonists in patients with Parkinson's disease (PD). HS is part of the spectrum of impulse control disorders (ICDs). The failure to control these addictive behaviors is distressing for the patient and it is associated with important consequences. Reports of the prevalence of HS showed different results, due to the lack of standardized diagnostic criteria, but also due to the embarrassment or guilt feelings that patients experience regarding their sexual behaviors. Overall, it is considered that HS may occur in 1.92-22.8% of PD patients and the main risk factors involved could be male sex and genetic susceptibility. The pathophysiology of HS is unknown, but several degenerative mechanisms were proposed, involving dopaminergic, serotoninergic and noradrenergic pathways in cerebral regions responsive for planning and rewarding. There are no standardized tools for the assessment of HS in PD patients; however, several scales and questionnaires were developed with the aim of screening and rating the severity of ICDs, including HS. The management of HS is challenging. Discontinuation or reducing the dopaminergic treatment was effective in some cases, but it might lead to worsening of the motor function. A multidisciplinary approach is mandatory to manage the other associated aspects, such as psychological and social consequences of HS.
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Affiliation(s)
| | | | - Ștefania Diaconu
- County Clinic Hospital, Brașov, Romania; Faculty of Medicine, Transilvania University, Brașov, Romania
| | - Cristian Falup-Pecurariu
- County Clinic Hospital, Brașov, Romania; Faculty of Medicine, Transilvania University, Brașov, Romania
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17
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Abstract
Sexual dysfunction is a common, poorly recognized, poorly discussed (often because of cultural perceptions and sensitivities), bothersome and neglected aspect of the range of non-motor symptoms of Parkinson's disease (PD). The spectrum of sexual dysfunction in PD ranges from hyposexuality-based disturbances to hypersexuality-dominated behaviors in the context of drug-induced impulse control disorder. The pathophysiological mechanisms underlying PD-related sexual dysfunction, specifically for hyposexual disorders, are thus heterogeneous and still not fully understood. However, central and peripheral neural mechanisms secondary to the hallmark pathological alterations of the disease (alpha-synuclein deposition and nigrostriatal degeneration) and to the associated network and neurotransmitter dysfunctions, together with the effects of dopaminergic therapies, seem to play an important role in the development of sexual disturbances. In this chapter, we therefore review the neuroanatomical and neurophysiological basis of sexual function in humans, and we provide insights on the pathophysiological mechanisms of hyposexuality and hypersexuality in PD.
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Affiliation(s)
- Lucia Batzu
- Clinical Director Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Nataliya Titova
- Department of Neurology, Neurosurgery and Medical Genetics, Federal State Autonomous Educational Institution of Higher Education "N.I. Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation, Moscow, Russia; Department of Neurodegenerative Diseases, Federal State Budgetary Institution 'Federal Center of Brain and Neurotechnologies' of the Ministry of Health of the Russian Federation, Moscow, Russia
| | | | - K Ray Chaudhuri
- Clinical Director Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom.
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18
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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19
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Lewczuk K, Wójcik A, Gola M. Increase in the Prevalence of Online Pornography Use: Objective Data Analysis from the Period Between 2004 and 2016 in Poland. Arch Sex Behav 2022; 51:1157-1171. [PMID: 34750777 PMCID: PMC8888374 DOI: 10.1007/s10508-021-02090-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 05/04/2023]
Abstract
Despite the considerable amount of attention presently devoted to the high accessibility of online pornography, very little formal analyses have been carried out to show how the advent and proliferation of Internet technology has changed the prevalence of pornography use in populations. We conducted a preliminary analysis based on objective website traffic data, representing the changes in the number of (1) Internet users generally and (2) online pornography users specifically, between 2004 and 2016 in Poland. We observed a clear increase in the estimated number of people using online pornography in the analyzed period. The estimated number of general population members viewing pornography on the Internet increased over three times (310%) between October 2004 and October 2016-starting from an estimated 2.76 million in the first period to 8.54 million in the last. At the same time, we did not observe a clear increase in the percentage of Internet users who viewed online pornography in the same time period. Additionally, pornography viewership on the Internet was almost 2 times more prevalent among male (47%) than female Internet users (27%), and most popular in the 18-27 age group. Since our analysis is based on objective data, it does not share the limitations inherent in self-reports. However, our approach also has several important limitations (e.g., the analysis does not include online activity generated on mobile devices and under a private browsing mode); thus, the results should be interpreted with caution.
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Affiliation(s)
- Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | | | - Mateusz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computation, University of California, San Diego, 9500 Gilman Drive, San Diego, CA 92093-0559 USA
- Institute of Psychology, Polish Academy of Science, Warsaw, Poland
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20
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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. Arch Sex Behav 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] [What about the content of this article? (0)] [Affiliation(s)] [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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21
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Cedergren Weber G, Odin P. Diagnostic work up: Laboratory and biomarkers. Int Rev Neurobiol 2022; 162:53-96. [PMID: 35397789 DOI: 10.1016/bs.irn.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This chapter will focus on the diagnostic work around sexual dysfunction in Parkinson's disease, especially laboratory tests and biomarkers. A number of methods to analyze if sexual dysfunction is caused by neural pathology, vascular dysfunction or other mechanisms are now available. Other methods can be used to differentiate between psychogenic/functional reasons behind sexual dysfunction and organic ones. The role of biomarkers for diagnosis, but also for understanding the reason behind and for counteracting sexual dysfunction is becoming more evident. There is also a rich and increasing number of scales and other instruments available for detecting and quantifying sexual hypo- and hyperactivity. When investigating the reason behind sexual dysfunction in patients with Parkinson's disease comorbidities should also be considered. Finally, early and pronounced sexual dysfunction might in some cases be an indication that differential diagnosis, like Multisystem Atrophy, should be thought about. All these aspects of the diagnostic procedures around sexual dysfunction in Parkinson's disease will be covered in this chapter.
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Affiliation(s)
- Gustav Cedergren Weber
- Division of Neurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
| | - Per Odin
- Division of Neurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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Markantes GK, Stamou MI, Barouti K, Georgakopoulou D, Vasileiou V, Georgopoulos NA. A manless adultery: the story of Bassa as related in a Marcus Valerius Martialis' epigram. Hormones (Athens) 2021; 20:825-829. [PMID: 34297347 DOI: 10.1007/s42000-021-00310-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/12/2021] [Indexed: 11/26/2022]
Abstract
During the Golden Age of the Roman Empire, Rome was transformed into a magnificent city where architecture, the arts, and commerce flourished. An inconceivable amount of wealth was accumulated by a handful of noble families, while the masses starved. In such a context, moral values inevitably decline, while sexual mores are liberalized and ever more veer towards salacity. This reality was elegantly illustrated in short, often sarcastic poems known as epigrams. Herein, we present a case of a woman with enigmatic appearance of the external genitalia, exhibiting unrestrained homosexual activity, as described in an epigram by Marcus Valerius Martialis (a contemporary poet who lived in the 1st century AD). Based on the information provided in the ancient text, we formulate a differential diagnosis and deduce that this woman was, in fact, a case of congenital adrenal hyperplasia (CAH). To our knowledge, this is the earliest literary description worldwide of a case of CAH as a cause of homosexuality and unquenchable lust.
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Affiliation(s)
- Georgios K Markantes
- Division of Endocrinology, Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece
| | - Maria I Stamou
- Harvard Reproductive Sciences Center, Massachusetts General Hospital, Boston, MA, USA
- Mount Auburn Hospital, Harvard Medical School Teaching Hospital, Cambridge, MA, USA
| | - Konstantina Barouti
- Division of Endocrinology, Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece
| | - Danai Georgakopoulou
- Division of Endocrinology, Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece
| | - Vasiliki Vasileiou
- Department of Endocrinology, Diabetes and Metabolism, Evangelismos General Hospital, Athens, Greece
| | - Neoklis A Georgopoulos
- Division of Endocrinology, Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece.
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Lampalzer U, Tozdan S, von Franqué F, Briken P. Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study. Sex Med 2021; 9:100429. [PMID: 34509753 PMCID: PMC8498949 DOI: 10.1016/j.esxm.2021.100429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/24/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Studies on characteristics of self-referred men with sexual interest in minors (SIM) and treatment approaches in this group of patients are still relatively rare. Aim The aim of this exploratory pilot study was to investigate hypersexuality and impulsivity as 2 dynamic risk factors that could possibly change during treatment in self-referred men with SIM. Methods Data were collected at the “Kein Täter Werden (means: not become an offender)” network site in Hamburg. Using self-report questionnaires, the extent of hypersexuality and impulsivity was analyzed with the samples’ pretreatment data via descriptive statistics and compared with nonclinical samples of other studies. The relation between hypersexuality and impulsivity was analyzed via Spearman's correlation coefficient with pretreatment data (N = 77). Intragroup analysis compared hypersexuality and impulsivity from pre- and posttreatment (n = 29). Main Outcome Measures Hypersexual Behavior Inventory and Barratt Impulsiveness Scale Version 11. Results The degree of generalized impulsivity in the SIM group was comparable to that in nonclinical samples while the degree of hypersexuality was considerably higher than in nonclinical samples. Sixty-four percent of the participants were in the range of clinically relevant hypersexuality. Impulsivity and hypersexuality were weakly positively correlated with each other. During treatment hypersexuality significantly decreased while impulsivity did not differ significantly between before beginning treatment and after (partial) completion. Conclusion Hypersexuality, but not impulsivity, was pronounced in the group of self-referred men with SIM and should be targeted in treatment. In order to improve treatment outcome regarding risk reduction in self-referred men with SIM, a focus on treatment approaches that were developed to treat hypersexuality can be expected to be effective while focusing on generalized impulsivity may be less relevant. Lampalzer U, Tozdan S, von Franqué F, et al. Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study. Sex Med 2021;9:100429.
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Affiliation(s)
- Ute Lampalzer
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Safiye Tozdan
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fritjof von Franqué
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Knack N, Holmes D, Hammond C, Fedoroff JP. What's in a Name? A Phenomenological Exploration of Hypersexuality Narratives. Int J Sex Health 2021; 34:319-336. [PMID: 38596526 PMCID: PMC10903681 DOI: 10.1080/19317611.2021.1974144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/12/2021] [Accepted: 08/21/2021] [Indexed: 04/11/2024]
Abstract
Objective We explored men's subjective experiences of hypersexuality, including the underlying factors they believed contributed to their sexuality. Methods: We interviewed 32 Canadian men with self-reported concerns related to hypersexuality. Interviews were analyzed using Interpretative Phenomenological Analysis and narrative analysis. Results Participants' (hyper)sexual experiences revealed complex histories of desire, life disruptions, and hopes to re-story their sexual lives. Similar (sexual and non-sexual) desires were often attributed to different expressions of hypersexuality. Conclusion Assessment and treatment protocols for hypersexuality should account for the social and cultural factors that shape sexuality, and the broader field of desire extending beyond just sexual forms.
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Affiliation(s)
- Natasha Knack
- Forensic Research Unit, The Royal’s Institute of Mental Health Research, Ottawa, Canada
| | - Dave Holmes
- School of Nursing, University of Ottawa, Ottawa, Canada
| | - Chad Hammond
- School of Nursing, University of Ottawa, Ottawa, Canada
| | - J. Paul Fedoroff
- Forensic Research Unit, The Royal’s Institute of Mental Health Research, Ottawa, Canada
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Nowosielski K, Kurpisz J, Kowalczyk R, Lew-Starowicz M. Sexual Inhibition and Sexual Excitation Scales in Men: Psychometric Properties of a Polish Adaptation. Arch Sex Behav 2021; 50:2741-2753. [PMID: 32964350 PMCID: PMC8416830 DOI: 10.1007/s10508-020-01837-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 09/06/2020] [Accepted: 09/07/2020] [Indexed: 06/04/2023]
Abstract
The present study aimed to develop a Polish version of the Sexual Inhibition/Sexual Excitation Scale (SIS/SES-PL) and explore its psychometric validity in a sample of 498 men aged between 18 and 55 years. We used exploratory and confirmatory factor analyses to obtain the best model fit. Out of the 45 items in the original scale, 32 items with eight subscales and three higher-order factors: (sexual excitation [SES], sexual inhibition due to performance failure [SIS1], and sexual inhibition due to performance consequences [SIS2]) were included in the SIS/SES-PL. The SIS/SES-PL was found to have a good and satisfactory fit (comparative fit index = .87; Tucker-Lewis Index = .85; root mean square error of approximation = .054; χ2 = 1108.7; p < .001; test-retest reliability Cronbach's alpha = .93). A small correlation between age and the SIS1 and SIS2 scores was detected. However, forward multiple regression analysis revealed a significant correlation only between age and SIS1 [β = .23, p < .001, R2 for model = .05; F(1, 494) = 27.52, p < .001]. Furthermore, a moderate correlation between SIS1 and SES2, as well as SIS1 and general inhibition properties (measured using the Behavioral Inhibition Scale), was noted. In the case of SIS2, only small effects were observed, with the highest values for engaging in risky sexual behavior. Out of the total number of 42 variables, a moderate correlation between SES and the following was described: importance of sex, hypersexual behaviors, frequency of masturbation, frequency of sexual activities per month, sexual risk-taking, high promiscuity (measured using the Sociosexual Orientation Inventory Revised-Drive), general activation properties (measured using the Behavioral Activation Scale), neuroticism, and erotophilic tendencies (measured using the Sexual Opinion Survey-Short Form). The results of the study allowed us to conclude that the SIS/SES-PL might be a useful tool for tailoring therapy for men with sexual problems, as well as in the field of clinical research on sexual inhibition and excitation. Furthermore, it is a reliable and useful tool for measuring propensities for sexual excitement and inhibition.
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Affiliation(s)
| | - Jacek Kurpisz
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Robert Kowalczyk
- Department of Sexology, Andrzej Frycz Modrzewski Cracow University, Kraków, Poland
| | - Michał Lew-Starowicz
- Institute of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
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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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Bőthe B, Vaillancourt-Morel MP, Bergeron S. Hypersexuality in Mixed-Sex Couples: A Dyadic Longitudinal Study. Arch Sex Behav 2021; 50:2139-2150. [PMID: 34189627 DOI: 10.1007/s10508-021-01959-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/19/2019] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 06/13/2023]
Abstract
Emotion dysregulation and intimacy problems are theoretically underpinned correlates of hypersexuality (i.e., uncontrollable sexual urges, fantasies, and behaviors resulting in distress and impairment in different areas of functioning), but the directionality of these associations has not been established, as work in this area has relied on cross-sectional designs. Moreover, although hypersexuality may have significant adverse effects on romantic relationships and approximately half of treatment-seeking individuals are in a relationship, prior studies almost exclusively involved samples of men, regardless of their relationship status. The aim of the present study was to examine the directionality of associations between both partners' emotion dysregulation, physical (i.e., partnered sexual frequency) and relationship intimacy, and hypersexuality using a longitudinal, dyadic framework. Self-reported data of 267 mixed-sex couples (Mage_men = 29.9 years, SD = 8.2; Mage_women = 27.7 years, SD = 6.7) at baseline (T1) and six-month follow-up (T2) were analyzed using a crossed-lagged model within an actor-partner interdependence framework. Prior greater emotion dysregulation (T1) in both men and women was associated with their own later greater hypersexuality (T2). Women's prior greater hypersexuality (T1) was associated with their later lower relationship intimacy (T2). Lower levels of intimacy were not significantly associated with later hypersexuality. No partner effects were found in relation to hypersexuality. Findings suggest that men and women may use sexual behaviors to cope with negative emotions, which could, in turn, lead to hypersexuality. Intimacy problems did not precede hypersexuality, although women's hypersexuality may reduce their own relationship intimacy over time.
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Affiliation(s)
- Beáta Bőthe
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | | | - Sophie Bergeron
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
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30
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Jogu SS, Singanamalla B, Madaan P, Sharma A, Saini L. Kluver-Bucy syndrome: A rare aftermath of tubercular meningitis. Indian J Tuberc 2021; 68:281-282. [PMID: 33845966 DOI: 10.1016/j.ijtb.2020.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 08/20/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Suchit S Jogu
- Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
| | - Bhanudeep Singanamalla
- Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Priyanka Madaan
- Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | | | - Lokesh Saini
- Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
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Fontanesi L, Marchetti D, Limoncin E, Rossi R, Nimbi FM, Mollaioli D, Sansone A, Colonnello E, Simonelli C, Di Lorenzo G, Jannini EA, Ciocca G. Hypersexuality and Trauma: a mediation and moderation model from psychopathology to problematic sexual behavior. J Affect Disord 2021; 281:631-637. [PMID: 33229025 DOI: 10.1016/j.jad.2020.11.100] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 08/03/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION . Hypersexuality is a clinical condition regarding the psychopathology of sexual behavior. In this study, we aimed to investigate the role of trauma, through the post-traumatic stress-disorder (PTSD), depression, shame and guilt on the hypersexual behavior. METHODS . Through an online platform, a convenience sample of 1025 subjects was recruited (females: n=731; 71.3%; males: 294; 28.7%; age: 29.62±10.90). Recruited subjects compiled a psychometric protocol composed by the Hypersexual Behavior Inventory (HBI) to assess hypersexuality, the International Trauma Questionnaire (ITQ) for PTSD, the Patient Health Questionnaire (PHQ-9) to evaluate depression and the State Shame and Guilt Scale (SSGS) for shame and guilt. Then a mediation/moderation model was performed for the data analysis. RESULTS . There was a statistically significant direct effect of post-traumatic symptoms (ITQTotal) on hypersexual behavior (HBTotal). Furthermore, indirect effects were also statistically significant, providing support to the hypothesis that depression and guilt would be serial mediators of trauma-hypersexual behavior relations. The paths through depression and guilt have been found to be the most significant with moderate and high indirect effects on hypersexuality. Moreover, male gender, as covariate variable, is a relevant risk factor for hypersexual behavior. CONCLUSION . We found the relationship between hypersexuality and trauma describing a possible etiological pathway mainly involving depression, shame and guilt. Hypersexuality can be considered as a reactive form of a major affective psychopathology representing a tip of the iceberg hiding the real issues of a suffering personality. Clinicians and researchers should therefore consider hypersexual behavior in the light of a symptomatic manifestation of a major psychopathology involving the affective aspects of personality.
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Affiliation(s)
- Lilybeth Fontanesi
- Department of Psychological, Health and Territorial Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Daniela Marchetti
- Department of Psychological, Health and Territorial Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Erika Limoncin
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Rodolfo Rossi
- Chair of Psychiatry Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Filippo M Nimbi
- Department of Dynamic and Clinical Psychology, 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
| | - 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
| | - Chiara Simonelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Giorgio Di Lorenzo
- Chair of Psychiatry 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
| | - Giacomo Ciocca
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy.
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Santa Rosa Malcher CM, Roberto da Silva Gonçalves Oliveira K, Fernandes Caldato MC, Lopes Dos Santos Lobato B, da Silva Pedroso J, de Tubino Scanavino M. Sexual Disorders and Quality of Life in Parkinson's Disease. Sex Med 2021; 9:100280. [PMID: 33429240 PMCID: PMC7930860 DOI: 10.1016/j.esxm.2020.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/11/2020] [Accepted: 10/19/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Sexual disorders are the most neglected nonmotor symptoms in Parkinson's disease (PD). Although doctors seek greater priority to motor manifestations, which are the basis for the diagnosis of PD, the nonmotor symptoms deserve to be highlighted as much as the motor problems because of their strong presence and discomfort in the patients, causing the important impairment in the quality of life (QoL) of the individual with PD. Aim Provide the prevalence of sexual disorders among patients with PD and alert the medical profession to investigate and be familiar with problems related to QoL and sexual disorders in PD. Methods This is a large literature review on sexual disorders in PD and impaired QoL. Main Outcome Measures Sexual disorders in PD and prevalence between genders have been described in epidemiological studies. Neuroanatomy, pathophysiology, risk factors, QoL, and etiologies were reviewed. Results The estimate of the prevalence of sexual dysfunction in the form of compulsive sexual behavior in PD is higher in men by 5.2% than in women by 0.5%. This diagnosis is a determinant of intense and persistent suffering and is related to several health problems of a social, economic, personal, family, psychological, and occupational nature, which can even culminate in sexual abuse. It is most commonly associated with the use of drugs commonly used in PD therapy in 98.1% of cases. In addition to this serious public health problem, another common condition of sexual dysfunction occur with the decreased libido by loss of the neurotransmitter dopamine proper of the pathophysiology of PD. Conclusion The presence of sexual disorders in PD should be tracked and monitored because of its harmful consequences, whether due to increased sexual behavior or associated psychological distress, as well as the impacts on QoL. Early recognition and adequate treatment of PD in its fullness and richness of associated symptoms are essential for improving QoL. Santa Rosa Malcher CM, Roberto da Silva Gonçalves Oliveira K, Fernandes Caldato MC, et al. Sexual Disorders and Quality of Life in Parkinson's Disease. Sex Med 2021;9:100280.
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Soldati L, Bianchi-Demicheli F, Schockaert P, Köhl J, Bolmont M, Hasler R, Perroud N. Association of ADHD and hypersexuality and paraphilias. Psychiatry Res 2021; 295:113638. [PMID: 33333439 DOI: 10.1016/j.psychres.2020.113638] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/07/2020] [Indexed: 12/15/2022]
Abstract
Subjects with ADHD suffer from inattention, hyperactivity, and impulsivity. Clinicians often assume that specific symptoms of ADHD are bound to affect sexual desire by increasing the frequency of hypersexuality. There is a lack of knowledge about the comorbidity between ADHD, hypersexuality, and paraphilias. The aim of this article was to provide a review of the literature on the association of ADHD and hypersexuality and paraphilias and to discuss the screening and the management of these syndromes when associated with ADHD. A systematic review of the literature was performed in PubMed, PsychInfo, and Embase databases. The studies reviewed show that some individuals who suffer from ADHD report hypersexuality and paraphilias, but no clear data emerged supporting the idea that hypersexuality and paraphilias are more frequent in an ADHD population. On the other hand, some studies showed a high prevalence of ADHD in hypersexual and paraphilic subjects. This is the first systematic review of hypersexuality and paraphilias in individuals with ADHD. However, the results are limited by differences in the methodology and measurement instruments for hypersexuality and paraphilias as well as by the small number of studies and the small sample sizes of many studies.
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Latella D, Maggio MG, Andaloro A, Marchese D, Manuli A, Calabrò RS. Hypersexuality in neurological diseases: do we see only the tip of the iceberg? J Integr Neurosci 2021; 20:477-487. [PMID: 34258950 DOI: 10.31083/j.jin2002051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/02/2021] [Accepted: 04/19/2021] [Indexed: 11/06/2022] Open
Abstract
The purpose of this commentary is to investigate the pathophysiological mechanisms underlying hypersexuality and its manifestation in neurological diseases through a meta-analysis. Studies were identified by searching on PubMed, Web of Science and Cochrane databases. All results of each database between 2014 and 2020 were evaluated for possible inclusion. After an accurate revision of complete manuscripts, forty articles satisfied the inclusion/exclusion criteria. Data from our meta-analysis indicated hypersexuality to be a frequent sexual disorder in patients with neurological disorders, especially neurodegenerative ones. Hypersexuality could negatively affect a patient's management and outcomes. This commentary discusses studies that are often incomplete for evaluation measures or sample selection. In our opinion, it is necessary to consider hypersexuality with particular attention, so more extensive sample studies are needed to find the most appropriate treatment to improve the quality of life for both the patient and the caregiver.
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Affiliation(s)
- Desiree Latella
- IRCCS Centro Neurolesi "Bonino-Pulejo" S.S. 113, Contrada Casazza, 98124 Messina, Italy
| | - Maria Grazia Maggio
- Department of Biomedical and Biotechnological Science, University of Catania, Via S. Sofia, 98, 95123 Catania CT., Italy
| | - Adriana Andaloro
- tudio di Riabilitazione Nutrizionale e Cognitiva, Via Sant'Agostino, 14, 98121, Messina, Italy
| | | | - Alfredo Manuli
- OU Policlinico G. Martino, Via Consolare Valeria, 1, 98124 Messina, Italy
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Slavin MN, Blycker GR, Potenza MN, Bőthe B, Demetrovics Z, Kraus SW. Gender-Related Differences in Associations Between Sexual Abuse and Hypersexuality. J Sex Med 2020; 17:2029-2038. [PMID: 32792283 PMCID: PMC7875089 DOI: 10.1016/j.jsxm.2020.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 04/14/2020] [Revised: 06/11/2020] [Accepted: 07/06/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Individuals with histories of sexual abuse may be more likely to experience sexual-related problems including hypersexuality, but gender-related differences remain unclear. AIM This online study examined sexual abuse history and hypersexuality by gender among 16,823 Hungarian adults, adjusting for age, sexual orientation, relationship status, education, employment status, and residence. METHODS An online questionnaire on one of the largest Hungarian news portals advertised this study examining sexual activities in January 2017. 3 categorizations of age-related sexual abuse were examined: child sexual abuse (CSA) occurring at age 13 and earlier (compared to no abuse), adolescent/adult sexual abuse (AASA; compared to no abuse), and CSA and AASA (CSA/AASA; compared to one age-related category of abuse or the other). OUTCOMES The outcome variable, hypersexuality, was examined as a continuous variable due to the low prevalence of clinical hypersexuality in this sample. 3 multivariate linear regression analyses adjusting for covariates aimed to predict hypersexuality from each category of abuse, along with gender and its interaction with each category. RESULTS In all models, younger age, non-heterosexual sexual orientation, male gender, single relationship status, less than full-time work, and living in a capital city were associated with hypersexuality, and education was not a significant predictor. CSA, AASA, and CSA/AASA predicted hypersexuality in both men and women. There was a significant interaction between CSA/AASA and gender, such that the relationship between CSA/AASA and hypersexuality was stronger in men than in women. CLINICAL TRANSLATION Sexual abuse at each developmental time-point may influence hypersexuality among men and women, although the cumulative impact of CSA and AASA on hypersexuality may be particularly relevant among men. STRENGTHS & LIMITATIONS This is one of the largest studies to examine gender-related differences in the relationship between sexual abuse and hypersexuality. Nevertheless, our study is cross-sectional, and longitudinal work is needed to determine how sexual abuse affects children, adolescents, and adults throughout their lives. CONCLUSION Developmental impacts of sexual abuse may be considered in a gender-informed fashion in order to develop and optimize effective prevention and treatment strategies for hypersexuality. Slavin MN, Blycker GR, Potenza MN, et al. Gender-Related Differences in Associations Between Sexual Abuse and Hypersexuality. J Sex Med 2020;17:2029-2038.
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Affiliation(s)
| | - Gretchen R Blycker
- College of Nursing, University of Rhode Island, Kingston, RI, USA; HäIsosam Therapy, Jamestown, RI, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Yale University Department of Neuroscience and Child Study Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA
| | - Beáta Bőthe
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Département de Psychologie, Université de Montréal, Montréal, Canada
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
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Grubbs JB, Hoagland KC, Lee BN, Grant JT, Davison P, Reid RC, Kraus SW. Sexual addiction 25 years on: A systematic and methodological review of empirical literature and an agenda for future research. Clin Psychol Rev 2020; 82:101925. [PMID: 33038740 DOI: 10.1016/j.cpr.2020.101925] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 12/16/2022]
Abstract
In 1998, Gold and Heffner authored a landmark review in Clinical Psychology Review on the topic of sexual addiction that concluded that sexual addiction, though increasingly popular in mental health settings, was largely based on speculation, with virtually no empirical basis. In the more than two decades since that review, empirical research around compulsive sexual behaviors (which subsumes prior research about sexual addiction) has flourished, ultimately culminating in the inclusion of a novel diagnosis of Compulsive Sexual Behavior Disorder in the eleventh edition of the World Health Organization's International Classification of Diseases. The present work details a systematic review of empirical research published between January 1st, 1995 and August 1st, 2020 related to compulsive sexual behaviors, with a specific focus on evaluating the methodologies of that literature. This review yielded 371 papers detailing 415 individual studies. In general, the present review finds that, although research related to compulsive sexual behaviors has proliferated, much of this work is characterized by simplistic methodological designs, a lack of theoretical integration, and an absence of quality measurement. Moreover, the present review finds a virtual absence of high-quality treatment-related research published within this time frame. Implications of these findings for both clinical practice and future research are discussed.
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Janssen E, Prause N, Swinburne Romine R, Raymond N, MacDonald A, Coleman E, Miner MH. Sexual Responsivity and the Effects of Negative Mood on Sexual Arousal in Hypersexual Men Who Have Sex With Men (MSM). J Sex Med 2020; 17:1751-1760. [PMID: 32653392 DOI: 10.1016/j.jsxm.2020.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/20/2020] [Accepted: 05/05/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND A number of studies have found that hypersexuality is associated with a high propensity for sexual excitation. In comparison, less is known about the relationship between hypersexuality and sexual arousal at the state level. Also, previous research has revealed a relationship between hypersexuality and negative mood. However, the possibility that sexual response might not be as negatively impacted by negative mood in hypersexual individuals has, as yet, not been tested. AIM The purpose of this study was to investigate sexual responsivity and the effects of negative mood on sexual arousal in hypersexual men who have sex with men (MSM). METHODS A total of 211 MSM were assigned to a hypersexuality (N = 81) or a control (N = 130) group using an interview patterned with a semi-structured Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders format. Participants filled out questionnaires and were shown neutral, sexual, and anxiety- and sadness-inducing films. OUTCOMES Changes in penile circumference and self-reported sexual arousal were the primary outcomes analyzed in this study. RESULTS Controlling for age and HIV status, no differences were found in genital response between hypersexual and non-hypersexual men. Also, the 2 groups did not differ in subjective sexual arousal. Moreover, no effects of negative mood were found. Time series clustering analyses revealed 3 groups-low responders and slow and fast high responders. Sexual excitation, but not sexual compulsivity or pornography use, predicted cluster membership. CLINICAL TRANSLATION Hypersexual MSM may benefit more from an exploration of motivational and behavioral, as compared to psychophysiological, mechanisms underlying possible links between (negative) mood and sexual behavior. STRENGTHS & LIMITATIONS Strengths of the study include its sample size, making it one of the larger psychophysiological sex studies; the use of clinical interviews for group assignment; the inclusion of genital response measures; and the application of time series clustering to examine differences among participants. Limitations include possible sample heterogeneity and the reliance on researcher-selected stimuli. CONCLUSION Given the lack of any effects of negative mood on sexual response in hypersexual MSM, future studies could explore in more depth possible motivational and behavioral effects, including, for example, the impact of negative mood on the tendency to seek out sex as a form of distraction or for validation or emotional support. Janssen E, Prause N, Romine RS, et al. Sexual Responsivity and the Effects of Negative Mood on Sexual Arousal in Hypersexual Men Who Have Sex With Men (MSM). J Sex Med 2020;17:1751-1760.
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Affiliation(s)
- Erick Janssen
- Institute for Family and Sexuality Studies, Department of Neurosciences, University of Leuven, Leuven, Belgium; Kinsey Institute, Indiana University, IN, USA.
| | | | | | - Nancy Raymond
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Angus MacDonald
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Eli Coleman
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Michael H Miner
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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Abstract
PURPOSE OF REVIEW We reviewed recent data on sexual addiction and its treatment. We examined the different definitions of this disorder, related to the pathophysiological mechanisms. We addressed the pharmacological treatment of sexual addiction. RECENT FINDINGS Hypersexual behavior can be considered an addictive disorder. Sexual addiction is accompanied by significant psychiatric and addictive comorbidities and is responsible for life impairment. A comprehensive and efficient treatment must be proposed. Selective serotonin reuptake inhibitors seem the first-line pharmacological treatment for sexual addiction. Naltrexone could be another therapeutic option. Psychotherapy and preferentially cognitive-behavioral therapy should be used in association with pharmacotherapy and treatments of comorbidities.
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Affiliation(s)
- Leo Malandain
- Department of Adult Psychiatry and Medical Psychology, Saint-Antoine Hospital, Sorbonne Université, AP-HP, Paris, France.
| | - Jean-Victor Blanc
- Department of Adult Psychiatry and Medical Psychology, Saint-Antoine Hospital, Sorbonne Université, AP-HP, Paris, France
| | - Florian Ferreri
- Department of Adult Psychiatry and Medical Psychology, Saint-Antoine Hospital, Sorbonne Université, AP-HP, Paris, France
| | - Florence Thibaut
- University Hospital Cochin (site Tarnier), Paris University, AP-HP, Paris, France
- INSERM U1266, Institute of Psychiatry and Neurosciences, Paris, France
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40
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Wang C, Shao X, Jia Y, Ho RC, Harris KM, Wang W. Peripherally Physiological Responses to External Emotions and Their Transitions in Bipolar I Disorder With and Without Hypersexuality. Arch Sex Behav 2020; 49:1345-1354. [PMID: 32133544 DOI: 10.1007/s10508-019-01615-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/02/2019] [Revised: 11/28/2019] [Accepted: 12/17/2019] [Indexed: 06/10/2023]
Abstract
Hypersexuality is associated with psychiatric disorders such as mania; however, it remains unclear whether bipolar I disorder with (BW) or without (BO) hypersexuality demonstrates different responses to external emotional stimuli and their transitions that were composed of pictures and sounds of same domain. In 21 BW patients, 20 BO patients, and 41 healthy volunteers, we administered polygraph tests (electrocardiogram, electromyogram, electrooculogram, and galvanic skin response) to measure transitions from a primer emotion (i.e., external disgust, erotica, fear, happiness, neutral, and sadness) to a noncongruent emotion (out of the remaining five) and to the primer emotion again (repeat-primer). We also evaluated participants' concurrent states of mania, hypomania, and depression. With neutral as the noncongruent emotion, the heart rate difference in BW was greater than in controls when responses to the primer erotica were subtracted from responses to the repeat-primer erotica, or when to the primer sadness were subtracted from the repeat-primer sadness. The difference of the masseter electromyographic activity in BW was lower than in BO and controls when responses to the noncongruent happiness were subtracted from responses to the repeat-primer neutral, and was lower than in BO when to the noncongruent neutral were subtracted from the repeat-primer erotica. The eyeball movement difference was greater in BW than in BO and controls when responses to the noncongruent sadness were subtracted from responses to the repeat-primer neutral. The heart rate difference when responses to the primer happiness were subtracted from responses to the noncongruent neutral was negatively correlated with mania in BO. BW and BO patients behaved differently to external emotions and their transitions, particularly regarding erotica and sadness, which might characterize unique pathophysiological processes of the two bipolar I disorder subtypes.
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Affiliation(s)
- Chu Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Xu Shao
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Yanli Jia
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Keith M Harris
- School of Psychology, Charles Sturt University, Port Macquarie, NSW, Australia
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
- Department of Psychology, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway.
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Abstract
Despite the lack of evidence for negative health effects of masturbation, abstinence from masturbation is frequently recommended as a strategy to improve one's sexual self-regulation. We adopted a framework of perceived problems with pornography to collect first hints about whether abstinence from masturbation stems from a psychological and behavioral "addiction" or conflicting attitudes. In an online questionnaire survey recruited via a non-thematic Reddit thread (n = 1063), most participants reported that they had tried to be abstinent from masturbation. As visible from zero-order correlations and multiple linear regression, motivation for abstinence was mostly associated with attitudinal correlates, specifically the perception of masturbation as unhealthy. While there were associations with hypersexuality, no significant correlation with behavioral markers such as maximum number of orgasms was found. Higher abstinence motivation was related to a higher perceived impact of masturbation, conservatism, and religiosity and to lower trust in science. We argue that research on abstinence from masturbation can enrich the understanding of whether and how average frequencies of healthy behavior are pathologized.
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Affiliation(s)
- Felix Zimmer
- Social and Legal Psychology, Department of Psychology, Johannes Gutenberg University Mainz, Binger Str. 14-16, 55122, Mainz, Germany.
| | - Roland Imhoff
- Social and Legal Psychology, Department of Psychology, Johannes Gutenberg University Mainz, Binger Str. 14-16, 55122, Mainz, Germany
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de Oliveira L, Carvalho J. The Link Between Boredom and Hypersexuality: A Systematic Review. J Sex Med 2020; 17:994-1004. [PMID: 32165100 DOI: 10.1016/j.jsxm.2020.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/27/2020] [Accepted: 02/08/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Some conceptualizations of hypersexuality posit boredom as a possible trigger of hypersexual behavior. AIM This work aims to review published articles addressing the link between boredom and hypersexuality to investigate if this relationship can yet be established based on current empirical data. METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies, published until September 2019, were retrieved from EBSCO, Scopus, Web of Science, and PubMed. A systematic search was conducted using an exhaustive list of key terms combining "boredom" with "hypersexuality," "sexual impulsivity," "sexual compulsivity," and "sexual addiction." Only articles presenting empirical results concerning the relationship between boredom and hypersexuality were considered. RESULTS From the initial poll of 76 articles, only 19 articles were included in our final selection. Of the total studies, 16 were quantitative studies and 3 were qualitative studies. 4 studies were validation studies of hypersexuality-related measures, 11 studies concerned online sexual activity, and 3 reported sexual boredom. 7 studies with men used non-heterosexual samples. 5 studies used samples with both women and men, and 1 study used a sample of women only. Most studies indicate a positive association between boredom and hypersexuality, although 4 did not. IMPLICATIONS Further studies with diversified samples are still indispensable, as female samples are not portrayed and research is much focused on online sexual activity. Future research should explore the relationship between boredom and hypersexuality within specific behavioral specifiers including masturbation, pornography use, sexual behavior with consenting adults, cybersex, telephone sex, and strip clubs. STRENGTHS AND LIMITATIONS To the authors' knowledge, this is the first review looking at the possible link between boredom and hypersexuality. Investigation on the topic is scarce, and several of the studies included in this review correspond to anecdotal evidences of the phenomenon, as only few studies used appropriate measures of boredom. CONCLUSION Although current literature identifies a link between boredom and hypersexuality, further substantive research is still much needed to clarify the associations between the 2 constructs. de Oliveira L, Carvalho J. The Link Between Boredom and Hypersexuality: A Systematic Review. J Sex Med 2020;17:994-1004.
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Affiliation(s)
- Leonor de Oliveira
- Faculty of Psychology and Educational Sciences, Center for Psychology at University of Porto, University of Porto, Porto, Portugal.
| | - Joana Carvalho
- School of Psychology and Life Sciences, Lusófona University of Humanities and Technologies, Lisbon, Portugal; HEI-Lab: Digital Human-Environment and Interactions Labs, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
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Abstract
Sexual dysfunction is a common comorbidity in people with epilepsy (PWE) that adversely affects their quality of life. Nearly one-half of men and women with epilepsy have sexual dysfunction, but in the majority, this often goes unnoticed. The wide variation in the reported prevalence of sexual dysfunction in PWE is due to the significant heterogeneity among the studies with regard to patient population, type and severity of epilepsy, number and type of antiseizure drugs (ASDs) used, and the tools used for assessing sexual dysfunction. Generally, patients with uncontrolled epilepsy, longer duration of epilepsy, focal epilepsy, higher seizure frequency, and those receiving enzyme-inducing and multiple ASDs are more likely to have sexual dysfunction. Women generally have dysfunction in the domains of desire, while males usually have arousal disorders such as erectile dysfunction and premature ejaculation. There is limited evidence to indicate that sexual function improves in patients rendered seizure-free following epilepsy surgery. Multiple mechanisms including direct effects of epilepsy, effects of ASDs, and psychosocial factors contribute to sexual dysfunction in epilepsy. Circumstantial evidence indicates that seizures and interictal epileptiform discharges can directly affect the hypothalamic-pituitary axis as well as production of gonadal steroids. Enzyme-inducing ASDs cause sexual dysfunction by affecting the metabolism of gonadal steroids. Limited data suggest that newer ASDs including oxcarbazepine, lamotrigine, and levetiracetam cause no or minimal sexual dysfunction. Depression and anxiety significantly contribute to sexual dysfunction in PWE. A multipronged and multidisciplinary approach is essential for optimizing the sexual functions. Every effort should be made to identify and treat reversible causes including changing to nonenzyme-inducing ASDs and to provide symptomatic relief. Large, prospective studies are required to improve our understanding on prevalence and mechanisms of sexual dysfunction in PWE.
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Affiliation(s)
- Chaturbhuj Rathore
- Department of Neurology, B. K. Shah Medical Institute and Research Center, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Oliver J Henning
- National Centre for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, Norway
| | - Gerhard Luef
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Kurupath Radhakrishnan
- Department of Neurosciences, Avitis Institute of Medical Sciences, Palakkad, Kerala, India.
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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. Arch Sex Behav 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Werner M, Štulhofer A, Waldorp L, Jurin T. A Network Approach to Hypersexuality: Insights and Clinical Implications. J Sex Med 2019; 15:373-386. [PMID: 29502983 DOI: 10.1016/j.jsxm.2018.01.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 12/28/2017] [Accepted: 01/10/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND In spite of a growing interest in research on hypersexuality, consensus about its etiology and best treatment strategy has not been achieved. AIM To further the empirical and clinical understanding of hypersexuality by exploring the structure of its symptoms using a network analytic approach. METHODS In 2014, an online survey advertised as focusing on Internet pornography, sexual health, and relationships was carried out among Croatian men and women aged 18-60 years (Mage = 31.1 years, SD = 9.67). In a sample of 3,028 participants, we applied a network analytic approach to explore the structure of hypersexuality symptoms. In the network, nodes represented hypersexuality symptoms and associated sexual behaviors, while their connections were operationalized as partial correlations. 4 Research questions were addressed: (1) does the hypersexuality network differ between genders; (2) which symptoms are centrally positioned; (3) what is the topological location of pornography use; and (4) are there distinct clusters ("communities") of symptoms in the network? OUTCOMES We estimated and plotted hypersexuality networks by gender using items from the Hypersexual Disorder Screening Inventory and the Hypersexual Behavioral Consequences Scale, as well as indicators of sexual desire, pornography use, sexual intercourse, and masturbation frequency. RESULTS The structure of the hypersexuality network was surprisingly similar in women and men, both in terms of symptom centrality and the clustering of symptoms. Psychological distress and negative emotions triggered by sexual fantasies and/or behaviors, together with a loss of control over sexual feelings, occupied central positions in the networks. Pornography use was located peripherally in both the men's and women's hypersexuality networks. CLINICAL TRANSLATION Psychological distress and negative emotions triggered by sexual fantasies and/or behaviors constituted the core of the hypersexuality network, which makes them potential prime targets for clinical intervention and calls for normalization of (presumably self-stigmatized) sexual expression through affirmative therapy and interventions that enhance self-care, self-compassion, and adaptive coping mechanisms. STRENGTHS & LIMITATIONS This is the first network analytic approach to hypersexuality. Apart from its novel insights about the structure of hypersexuality, the study employed several methods to assure reliability and robustness of findings. Considering that networks were estimated in a convenience-based community sample, the findings might not generalize to clinically distressed individuals. CONCLUSION Our results demonstrate the usefulness of network analytics to hypersexuality in a non-clinical sample and we encourage future clinical and longitudinal explorations of hypersexuality using this novel approach. Werner M, Štulhofer A, Waldorp L, et al. A Network Approach to Hypersexuality: Insights and Clinical Implications. J Sex Med 2018;15:373-386.
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Affiliation(s)
- Marlene Werner
- Department of Psychology, Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, The Netherlands.
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia
| | - Lourens Waldorp
- Department of Psychology, Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, The Netherlands; Program Group: Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Tanja Jurin
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia
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Abstract
Sexuality and intimacy are poorly researched in both people living with Parkinson's and in older people. Triggers for discussion usually centre on sexual dysfunction and hypersexuality in relation to Parkinson's. However, there are many more factors that impact on physical and emotional connectedness. Despite highlighting this unmet need there are limited tools or comprehensive assessments available to help improve quality of life. Further research is required within this field, with emphasis on health professionals' education and on highlighting to patients that they have permission for this topic to be discussed and actioned.
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Affiliation(s)
- Jenny Wright
- Parkinson's Disease Nurse Specialist, Nottingham University Hospitals NHS Trust, Nottingham
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47
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Latella D, Maggio MG, Maresca G, Saporoso AF, Le Cause M, Manuli A, Milardi D, Bramanti P, De Luca R, Calabrò RS. Impulse control disorders in Parkinson's disease: A systematic review on risk factors and pathophysiology. J Neurol Sci 2019; 398:101-106. [PMID: 30690412 DOI: 10.1016/j.jns.2019.01.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 12/29/2018] [Accepted: 01/21/2019] [Indexed: 02/06/2023]
Abstract
AIM Purpose of this review is to evaluate the potential risk factors that may predispose to the development of Impulse control disorders (ICDs) in Parkinson's Disease (PD) patients, including the effects of dopaminergic therapy. METHODS This descriptive review was conducted to identificate risk factors that could cause impulsive control disorders in PD. Studies were found on PubMed (2010-2018), Web Of Science (January 2010-July 2018) and Cochrane (2010-2018) databases. RESULTS The data suggest that intrinsic and extrinsic factors may be involved in the development of behavioral complications. To date, the link between PD and the development of ICDs is not very clear, but studies highlight the existence of a predisposition to ICDs in the presence of risk factors. CONCLUSIONS A better assessment of the behavioral disorders of PD may be useful in the rehabilitative intervention for increasing the quality of life.
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Affiliation(s)
| | | | | | | | | | | | - Demetrio Milardi
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy; AOU, Policlinico G Martino, Messina, Italy
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48
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Blum AW, Chamberlain SR, Grant JE. Quality of life of young adults with non-paraphilic problematic sexual behaviors: An exploratory study. Addict Behav Rep 2018; 8:164-169. [PMID: 30386816 PMCID: PMC6205335 DOI: 10.1016/j.abrep.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 10/08/2018] [Accepted: 10/14/2018] [Indexed: 12/03/2022] Open
Abstract
Introduction Many young adults are unable to control their sexual behavior despite distress or negative consequences created by these activities—a clinical phenomenon described as non-paraphilic problematic sexual behavior (PSB). Little is known about clinical features associated with quality of life in PSB. Methods 54 participants affected by PSB (ages 18–29 years) were recruited for a study on impulsivity in young adults. PSB was defined as the experience of sexual urges, fantasies, or behaviors that feel overwhelming or out of control. Participants were assessed using the Quality of Life Inventory (QOLI), other validated instruments, and questions examining aspects of health and well-being. Clinical measures associated with variation in quality of life were identified using the statistical technique of partial least squares (PLS). Results Lower quality of life in PSB was associated with greater behavioral and self-report measures of impulsivity (specifically, Barratt attentional impulsiveness, lower age at first alcohol use), emotional dysregulation, problematic use of the internet, current suicidality, higher state anxiety and depression, and lower self-esteem. Conclusions Impulsivity and affective problems are correlated with lower quality of life in PSB. These associations may provide a means to distinguish PSB from healthy sexual behavior. Quality of life is understudied in adults with problematic sexual behaviors. Lower quality of life was associated with affective problems and impulsivity. Higher quality of life was predicted by better self-esteem.
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Affiliation(s)
- Austin W Blum
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, UK.,Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
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49
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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. Arch Sex Behav 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] [What about the content of this article? (0)] [Affiliation(s)] [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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50
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Bőthe B, Bartók R, Tóth-Király I, Reid RC, Griffiths MD, Demetrovics Z, Orosz G. Hypersexuality, Gender, and Sexual Orientation: A Large-Scale Psychometric Survey Study. Arch Sex Behav 2018; 47:2265-2276. [PMID: 29926261 DOI: 10.1007/s10508-018-1201-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [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: 09/19/2017] [Revised: 02/15/2018] [Accepted: 03/19/2018] [Indexed: 05/25/2023]
Abstract
Criteria for hypersexual disorder (HD) were proposed for consideration in the DSM-5 but ultimately excluded for a variety of reasons. Regardless, research continues to investigate hypersexual behavior (HB). The Hypersexual Behavior Inventory (HBI) is one of the most robust scales assessing HB, but further examination is needed to explore its psychometric properties among different groups. Therefore, the aim of the present study was to examine the generalizability of the HBI in a large, diverse, non-clinical sample (N = 18,034 participants; females = 6132; 34.0%; Mage = 33.6 years, SDage = 11.1) across both gender and sexual orientation. Measurement invariance testing was carried out to ensure gender- and sexual orientation-based comparisons were meaningful. Results demonstrated when both gender and sexual orientation were considered (i.e., heterosexual males vs. LGBTQ males vs. heterosexual females vs. LGBTQ females), LGBTQ males had significantly higher latent means on the HBI factors. Results also demonstrated LGBTQ males had the highest scores on other possible indicators of hypersexuality (e.g., frequency of masturbation, number of sexual partners, or frequency of pornography viewing). These findings suggest LGBTQ males may be a group most at risk of engaging in hypersexual behavior, and LGBTQ females are at a higher risk of engaging in hypersexual activities due to coping problems. Given the large-scale nature of the study, the findings contribute to the currently growing body of the literature on hypersexuality.
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Affiliation(s)
- Beáta Bőthe
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46., Budapest, 1064, Hungary.
| | - Réka Bartók
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46., Budapest, 1064, Hungary
| | - István Tóth-Király
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46., Budapest, 1064, Hungary
| | - Rory C Reid
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46., Budapest, 1064, Hungary
| | - Gábor Orosz
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46., Budapest, 1064, Hungary
- Institute of Cognitive Neuroscience and Psychology, Hungarian Research Centre for Natural Sciences, Budapest, Hungary
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