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Engel J, Gkavanozi A, Veit M, Kneer J, Kruger TH, Sinke C. Alterations in voxel based morphometry and resting state functional connectivity in men with compulsive sexual behavior disorder in the Sex@Brain study. J Behav Addict 2023; 12:1032-1045. [PMID: 37874642 PMCID: PMC10786231 DOI: 10.1556/2006.2023.00056] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/07/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Aim Compulsive Sexual Behavior Disorder (CSBD) is a new category in ICD-11. Research examining underlying brain mechanisms is sparse. Research into neurobiological differences can be helpful in advancing the possibilities of new diagnostic approaches and therapeutic methods. The present study aimed to examine brain matter volume and resting state functional connectivity (rs-FC) in CSBD. Methods Structural and rs-FC magnetic resonance imaging and data from questionnaires were collected in 30 men with CSBD and 32 age- and education-matched controls. Whole brain voxel based morphometry (VBM) and seed based rs-FC in a-priori defined seeds were analyzed. Results Structural analyses showed that men with CSBD had significantly increased gray matter volume in the right cerebellum, middle occipital and superior frontal lobe. No differences in rs-FC could be detected when using these brain structures as seed regions in rs-FC. In contrast, literature based rs-FC analysis revealed decreased rs-FC between the right orbital middle frontal cortex (mOFC) and the right gyrus rectus, as well as between left pallidum and right post/precentral gyrus in men with CSBD. In the left amygdala we observed increased rs-FC with precuneus in this group. In addition, most of these measures correlated with symptom severity. Conclusion Structural findings may underscore the idea that the cerebellum plays an important role in sexual arousal and CSBD. Perhaps, a simultaneous activation of the left amygdala and the precuneus reflects a constant sexual occupation of men with CSBD. Furthermore, lower connectivity between mOFC and gyrus rectus in CSBD may support the assumption that sexual stimuli are evaluated more positively because inhibition is decreased.
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Affiliation(s)
- Jannis Engel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Athina Gkavanozi
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Maria Veit
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Jonas Kneer
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Tillmann H.C. Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
- Center for Systems Neuroscience, Hanover, Germany
| | - Christopher Sinke
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
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Engel J, Carstensen M, Veit M, Sinke C, Kneer J, Hartmann U, Kruger THC. Personality dimensions of compulsive sexual behavior in the Sex@Brain study. J Behav Addict 2023; 12:408-420. [PMID: 37384566 DOI: 10.1556/2006.2023.00029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/22/2022] [Revised: 02/03/2023] [Accepted: 05/30/2023] [Indexed: 07/01/2023] Open
Abstract
Background and aims Hypersexual disorder is characterized by recurrent and intense sexual fantasies, sexual urges, or sexual behaviors that can lead to clinically relevant levels of distress and adverse consequences for affected individuals. Earlier research has established a connection between sexual phenomena, such as compulsive sexual behavior, and personality features. The aim of the present study was to gain further insights into the associations of personality maladjustment and HD. Methods The present study applied the dimensional approach of personality maladjustment presented in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to connect compulsive sexual behavior to personality maladjustment. We investigated 47 men suffering from HD (age: M = 36.51, SD = 11.47) and 38 matched men without HD (age: M = 37.92, SD = 12.33) regarding personality maladjustment using a 100-item version of the Personality Inventory for DSM-5 (PID-5-BF). Results The men with HD showed higher levels of personality maladjustment regarding all PID-5-BF domains (negative affect, detachment, psychoticism, antagonism, and disinhibition) and significantly differentiated from men without HD in the level of subordinate facets. However, no domain of personality differentiated significantly between groups using a binary stepwise logistic regression analysis. Discussion and conclusions In sum, the findings of the study underline the extent of personality maladjustment in men with HD. Interpersonal difficulties which men with HD frequently experience can contribute to clinically relevant levels of distress and adverse consequences reported by affected individuals.
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Affiliation(s)
- Jannis Engel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Marie Carstensen
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Maria Veit
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Christopher Sinke
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Jonas Kneer
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Uwe Hartmann
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Tillmann H C Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
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3
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Görts P, Savard J, Görts-Öberg K, Dhejne C, Arver S, Jokinen J, Ingvar M, Abé C. Structural brain differences related to compulsive sexual behavior disorder. J Behav Addict 2023; 12:278-287. [PMID: 36943775 DOI: 10.1556/2006.2023.00008] [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: 11/13/2022] [Revised: 01/16/2023] [Accepted: 02/25/2023] [Indexed: 03/23/2023] Open
Abstract
Background and aims Compulsive sexual behavior disorder (CSBD) has been included as an impulse control disorder in the International Classification of Diseases (ICD-11). However, the neurobiological mechanisms underlying CSBD remain largely unknown, and given previous indications of addiction-like mechanisms at play, the aim of the present study was to investigate if CSBD is associated with structural brain differences in regions involved in reward processing. Methods We analyzed structural MRI data of 22 male CSBD patients (mean = 38.7 years, SD = 11.7) and 20 matched healthy controls (HC; mean = 37.6 years, SD = 8.5). Main outcome measures were regional cortical thickness and surface area. We also tested for case-control differences in subcortical structures and the effects of demographic and clinical variables, such as CSBD symptom severity, on neuroimaging outcomes. Moreover, we explored case-control differences in regions outside our hypothesis including white matter. Results CSBD patients had significantly lower cortical surface area in right posterior cingulate cortex than HC. We found negative correlations between right posterior cingulate area and CSBD symptoms scores. There were no group differences in subcortical volume. Conclusions Our findings suggest that CSBD is associated with structural brain differences, which contributes to a better understanding of CSBD and encourages further clarifications of the neurobiological mechanisms underlying the disorder.
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Affiliation(s)
- Per Görts
- 1Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
| | - Josephine Savard
- 1Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
- 2ANOVA Clinic, Karolinska University Hospital, Stockholm, Sweden
- 3Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Katarina Görts-Öberg
- 2ANOVA Clinic, Karolinska University Hospital, Stockholm, Sweden
- 3Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Dhejne
- 2ANOVA Clinic, Karolinska University Hospital, Stockholm, Sweden
- 3Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Arver
- 2ANOVA Clinic, Karolinska University Hospital, Stockholm, Sweden
- 3Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Jussi Jokinen
- 1Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
- 4Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Martin Ingvar
- 4Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Christoph Abé
- 4Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- 5Quantify Research, Stockholm, Sweden
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Rasul TF, Schwartz KR, Qureshi F, Eachus E, Henderson A. The Potential Cutaneous Effects of Pornography Addiction: A Narrative Review. Cureus 2022; 14:e33066. [PMID: 36721540 PMCID: PMC9883107 DOI: 10.7759/cureus.33066] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Pornography addiction is an area of increasing concern, particularly due to the ubiquitous nature of pornographic material on the Internet. Even so, there is no formal Diagnostic and Statistical Manual of Mental Disorders (DSM-5) inclusion of compulsive pornography use as a behavioral addiction. Although the psychosocial impacts of pornography addiction have been studied, the risk of direct skin injuries and behavioral changes brought about by excessive pornography usage remain to be seen. Adult males constitute the majority of cases of engaging in risky and violent sexual behaviors with an unclear association with pornography consumption. Adult females may be likely to copy pubic hair trimming patterns analogous to those seen in pornographic content, even though attitudes towards labiaplasty are unclear. Finally, adolescents regularly exposed to pornography have been found to replicate sexual activity seen in pornographic material and have earlier sexual activity. In the literature evaluated, an association between pornographic material and direct cutaneous disease remains a major area of further research.
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Affiliation(s)
- Taha F Rasul
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Kayla R Schwartz
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Farhan Qureshi
- Department of Urology, University of Miami Miller School of Medicine, Miami, USA
| | - Emily Eachus
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Armen Henderson
- Department of Internal Medicine, University of Miami Health System, Miami, USA
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5
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Liberg B, Görts-Öberg K, Jokinen J, Savard J, Dhejne C, Arver S, Fuss J, Ingvar M, Abé C. Neural and behavioral correlates of sexual stimuli anticipation point to addiction-like mechanisms in compulsive sexual behavior disorder. J Behav Addict 2022; 11:520-532. [PMID: 35895609 PMCID: PMC9295238 DOI: 10.1556/2006.2022.00035] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/25/2022] [Accepted: 04/21/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Compulsive sexual behavior disorder (CSBD) is characterized by persistent patterns of failure to control sexual impulses resulting in repetitive sexual behavior, pursued despite adverse consequences. Despite previous indications of addiction-like mechanisms and the recent impulse-control disorder classification in the International Classification of Diseases (ICD-11), the neurobiological processes underlying CSBD are unknown. METHODS We designed and applied a behavioral paradigm aimed at disentangling processes related to anticipation and viewing of erotic stimuli. In 22 male CSBD patients (age: M = 38.7, SD = 11.7) and 20 healthy male controls (HC, age: M = 37.6, SD = 8.5), we measured behavioral responses and neural activity during functional magnetic resonance imaging (fMRI). The main outcomes were response time differences between erotic and non-erotic trials and ventral striatum (VS) activity during anticipation of visual stimuli. We related these outcomes with each other, to CSBD diagnosis, and symptom severity. RESULTS We found robust case-control differences on behavioral level, where CSBD patients showed larger response time differences between erotic and non-erotic trials than HC. The task induced reliable main activations within each group. While we did not observe significant group differences in VS activity, VS activity during anticipation correlated with response time differences and self-ratings for anticipation of erotic stimuli. DISCUSSION AND CONCLUSIONS Our results support the validity and applicability of the developed task and suggest that CSBD is associated with altered behavioral correlates of anticipation, which were associated with ventral striatum activity during anticipation of erotic stimuli. This supports the idea that addiction-like mechanisms play a role in CSBD.
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Affiliation(s)
- Benny Liberg
- Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden
| | - Katarina Görts-Öberg
- ANOVA Clinic, Karolinska University Hospital, Stockholm, Sweden,Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Jussi Jokinen
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Josephine Savard
- ANOVA Clinic, Karolinska University Hospital, Stockholm, Sweden,Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
| | - Cecilia Dhejne
- ANOVA Clinic, Karolinska University Hospital, Stockholm, Sweden,Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Arver
- ANOVA Clinic, Karolinska University Hospital, Stockholm, Sweden,Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Johannes Fuss
- Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Martin Ingvar
- Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden
| | - Christoph Abé
- Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden,Quantify Research, Stockholm, Sweden,Corresponding author. Tel.: +468 52483265. E-mail:
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6
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Flanagan J, Chatzittofis A, Boström ADE, Hallberg J, Öberg KG, Arver S, Jokinen J. High Plasma Oxytocin Levels in Men With Hypersexual Disorder. J Clin Endocrinol Metab 2022; 107:e1816-e1822. [PMID: 35108393 PMCID: PMC9016473 DOI: 10.1210/clinem/dgac015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Indexed: 01/23/2023]
Abstract
CONTEXT Hypersexual disorder (HD) involves excessive, persistent sexual behaviors related to various mood states and the diagnosis compulsive sexual behavior disorder is included as an impulse control disorder in the 11th revision of the International Classification of Diseases. Although the neurobiology behind the disorder is not clear, some studies suggest dysregulated hypothalamic-pituitary-adrenal axis. Oxytocin acts as counterregulatory neuroendocrine hormone to cortisol and is also involved in sexual behavior. OBJECTIVE We hypothesized that oxytocin may play a role in the pathophysiology of HD with compensatory actions to cortisol. DESIGN Longitudinal. SETTING ANOVA clinic (Karolinska University Hospital). PATIENTS OR OTHER PARTICIPANTS 64 males with HD and 38 age-matched healthy volunteers. MAIN OUTCOME MEASURES Plasma oxytocin levels, measured with radioimmunoassay; Hypersexual Disorder Screening Inventory; and Hypersexual Disorder: Current Assessment Scale for assessing hypersexual symptoms. INTERVENTIONS A patient subgroup (n = 30) completed the manual-based group-administered cognitive-behavioral therapy (CBT) program for HD, and posttreatment oxytocin levels were measured. RESULTS Hypersexual men (n = 64) exhibited significantly higher oxytocin plasma levels (mean ± SD: 31.0 ± 9.9 pM) compared with healthy volunteers (16.9 ± 3.9 pM; P < 0.001). There were significant positive correlations between oxytocin levels and the rating scales measuring hypersexual behavior. Patients who completed CBT treatment (n = 30) had a significant reduction of oxytocin plasma levels from pretreatment (30.5 ± 10.1 pM) to posttreatment (20.2 ± 8.0 pM; P < 0.001). CONCLUSIONS The results suggest that the hyperactive oxytocinergic system in hypersexual men may be a compensatory mechanism to attenuate hyperactive stress.
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Affiliation(s)
- John Flanagan
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Andreas Chatzittofis
- Medical School, University of Cyprus, Nicosia, Cyprus
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå,Sweden
- Correspondence: Andreas Chatzittofis, MD, PhD, University of Cyprus, Medical School, Palaios dromos Lefkosias Lemesou No.215/6 2029 Aglantzia, Nicosia, Cyprus.
| | - Adrian Desai E Boström
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå,Sweden
- Neuropaediatric Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Hallberg
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Katarina Görts Öberg
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Stefan Arver
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jussi Jokinen
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå,Sweden
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden
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Gola M, Lewczuk K, Potenza MN, Kingston DA, Grubbs JB, Stark R, Reid RC. What should be included in the criteria for compulsive sexual behavior disorder? J Behav Addict 2020; 11:160-165. [PMID: 34329192 PMCID: PMC9295236 DOI: 10.1556/2006.2020.00090] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/15/2020] [Accepted: 10/25/2020] [Indexed: 11/24/2022] Open
Abstract
Compulsive sexual behavior disorder (CSBD) is currently defined in the eleventh revision of the International Classification of Diseases (ICD-11) as an impulse control disorder. Criteria for hypersexual disorder (HD) had been proposed in 2010 for the fifth revision of Diagnostic and Statistical Manual (DSM-5). In this article, we compare differences between HD and CSBD and discuss their relevance.Significant differences between HD and CSBD criteria include: (1) the role of sexual behavior as a maladaptive coping and emotion regulation strategy listed in criteria for HD but not in those for CSBD; (2) different exclusionary criteria including bipolar and substance use disorders in HD but not in CSBD, and (3) inclusion of new considerations in CSBD, such as moral incongruence (as an exclusion criterion), and diminished pleasure from sexual activity. Each of these aspects has clinical and research-related implications. The inclusion of CSBD in the ICD-11 will have a significant impact on clinical practice and research. Researchers should continue to investigate core and related features of CSBD, inlcuding those not included in the current criteria, in order to provide additional insight into the disorder and to help promote clinical advances.
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Affiliation(s)
- Mateusz Gola
- University of California, San Diego, United States
- Polish Academy of Sciences, Warsaw, Poland
| | - Karol Lewczuk
- Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Marc N. Potenza
- Yale University School of Medicine, New Haven, United States
| | - Drew A. Kingston
- HOPE Program, San Diego, United States
- University of Ottawa, Institute of Mental Health Research, Canada
| | - Joshua B. Grubbs
- Bowling Green State University, Bowling Green, OH, United States
| | | | - Rory C. Reid
- University of California, Los Angeles, United States
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8
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Boström AE, Chatzittofis A, Ciuculete DM, Flanagan JN, Krattinger R, Bandstein M, Mwinyi J, Kullak-Ublick GA, Öberg KG, Arver S, Schiöth HB, Jokinen J. Hypermethylation-associated downregulation of microRNA-4456 in hypersexual disorder with putative influence on oxytocin signalling: A DNA methylation analysis of miRNA genes. Epigenetics 2019; 15:145-160. [PMID: 31542994 PMCID: PMC6961682 DOI: 10.1080/15592294.2019.1656157] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Hypersexual disorder (HD) was proposed as a diagnosis in the DSM-5 and the classification ‘Compulsive Sexual Behavior Disorder’ is now presented as an impulse-control disorder in ICD-11. HD incorporates several pathophysiological mechanisms; including impulsivity, compulsivity, sexual desire dysregulation and sexual addiction. No previous study investigated HD in a methylation analysis limited to microRNA (miRNA) associated CpG-sites. The genome wide methylation pattern was measured in whole blood from 60 subjects with HD and 33 healthy volunteers using the Illumina EPIC BeadChip. 8,852 miRNA associated CpG-sites were investigated in multiple linear regression analyses of methylation M-values to a binary independent variable of disease state (HD or healthy volunteer), adjusting for optimally determined covariates. Expression levels of candidate miRNAs were investigated in the same individuals for differential expression analysis. Candidate methylation loci were further studied for an association with alcohol dependence in an independent cohort of 107 subjects. Two CpG-sites were borderline significant in HD – cg18222192 (MIR708)(p < 10E-05,pFDR = 5.81E-02) and cg01299774 (MIR4456)(p < 10E-06, pFDR = 5.81E-02). MIR4456 was significantly lower expressed in HD in both univariate (p < 0.0001) and multivariate (p < 0.05) analyses. Cg01299774 methylation levels were inversely correlated with expression levels of MIR4456 (p < 0.01) and were also differentially methylated in alcohol dependence (p = 0.026). Gene target prediction and pathway analysis revealed that MIR4456 putatively targets genes preferentially expressed in brain and that are involved in major neuronal molecular mechanisms thought to be relevant for HD, e.g., the oxytocin signalling pathway. In summary, our study implicates a potential contribution of MIR4456 in the pathophysiology of HD by putatively influencing oxytocin signalling.
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Affiliation(s)
- Adrian E Boström
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | | | - Diana-Maria Ciuculete
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | - John N Flanagan
- Andrology/Sexual Medicine Group (ANOVA), Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Regina Krattinger
- Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Marcus Bandstein
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | - Jessica Mwinyi
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | - Gerd A Kullak-Ublick
- Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Katarina Görts Öberg
- Andrology/Sexual Medicine Group (ANOVA), Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Arver
- Andrology/Sexual Medicine Group (ANOVA), Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helgi B Schiöth
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden.,Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Jussi Jokinen
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden.,Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden
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9
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Fuss J, Briken P, Stein DJ, Lochner C. Compulsive sexual behavior disorder in obsessive-compulsive disorder: Prevalence and associated comorbidity. J Behav Addict 2019; 8:242-248. [PMID: 31079471 PMCID: PMC7044559 DOI: 10.1556/2006.8.2019.23] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/20/2019] [Accepted: 04/07/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND AIMS Compulsive sexual behavior disorder (CSBD) will be included in ICD-11 as an impulse-control disorder. CSBD also shares clinical features with obsessive-compulsive spectrum disorders (OCSDs) and behavioral addictions. There has been relatively little systematic investigation of CSBD in obsessive-compulsive disorder (OCD), the paradigmatic compulsive disorder. We aimed to determine prevalence of CSBD in OCD, and its associated sociodemographic and clinical features, including associated comorbidity, to learn more about the nature of CSBD. METHODS Adult outpatients with current OCD (N = 539) participated in this study. The Structured Clinical Interview for OCSDs was used to diagnose OCSDs (Tourette's syndrome, compulsive shopping, pathological gambling, kleptomania, pyromania, intermittent explosive disorder, self-injurious behavior, and CSBD). Prevalence rates of OCSDs in male versus female patients as well as comorbid disorders in OCD patients with and without CSBD were compared. RESULTS Lifetime prevalence of CSBD was 5.6% in patients with current OCD and significantly higher in men than women. OCD patients with and without CSBD were similar in terms of age, age of onset of OCD, present OCD illness severity, as well as educational background. Lifetime prevalence rates of several mood, obsessive-compulsive, and impulse-control disorders were considerably elevated in patients with lifetime CSBD. DISCUSSION AND CONCLUSIONS A substantive number of OCD patients suffered from CSBD. CSBD in OCD was more likely comorbid with other mood, obsessive-compulsive, and impulse-control disorders, but not with disorders due to substance use or addictive behaviors. This finding supports conceptualization of CSBD as a compulsive-impulsive disorder.
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Affiliation(s)
- Johannes Fuss
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dan J. Stein
- MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Christine Lochner
- MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
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10
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Abstract
Impulse control and related disorders (ICDs-RD) encompasses a heterogeneous group of disorders that involve pleasurable behaviors performed repetitively, excessively, and compulsively. The key common symptom in all these disorders is the failure to resist an impulse or temptation to control an act or specific behavior, which is ultimately harmful to oneself or others and interferes in major areas of life. The major symptoms of ICDs include pathological gambling (PG), hypersexualtiy (HS), compulsive buying/shopping (CB) and binge eating (BE) functioning. ICDs and ICDs-RD have been included in the behavioral spectrum of non-motor symptoms in Parkinson's disease (PD) leading, in some cases, to serious financial, legal and psychosocial devastating consequences. Herein we present the prevalence of ICDs, the risk factors, its pathophysiological mechanisms, the link with agonist dopaminergic therapies and therapeutic managements.
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Affiliation(s)
- Emilia M Gatto
- Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina.,Instituto de Neurociencias Buenos Aires, Ineba, Buenos Aires, Argentina
| | - Victoria Aldinio
- Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
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Grubbs JB, Kraus SW, Perry SL. Self-reported addiction to pornography in a nationally representative sample: The roles of use habits, religiousness, and moral incongruence. J Behav Addict 2019; 8:88-93. [PMID: 30632378 PMCID: PMC7044607 DOI: 10.1556/2006.7.2018.134] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Despite controversies regarding its existence as a legitimate mental health condition, self-reports of pornography addiction seem to occur regularly. In the United States, prior works using various sampling techniques, such as undergraduate samples and online convenience samples, have consistently demonstrated that some pornography users report feeling dysregulated or out of control in their use. Even so, there has been very little work in US nationally representative samples to examine self-reported pornography addiction. METHODS This study sought to examine self-reported pornography addiction in a US nationally representative sample of adult Internet users (N = 2,075). RESULTS The results indicated that most participants had viewed pornography within their lifetimes (n = 1,461), with just over half reporting some use in the past year (n = 1,056). Moreover, roughly 11% of men and 3% of women reported some agreement with the statement "I am addicted to pornography." Across all participants, such feelings were most strongly associated with male gender, younger age, greater religiousness, greater moral incongruence regarding pornography use, and greater use of pornography. DISCUSSION AND CONCLUSION Collectively, these findings are consistent with prior works that have noted that self-reported pornography addiction is a complex phenomenon that is predicted by both objective behavior and subjective moral evaluations of that behavior.
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Affiliation(s)
- Joshua B. Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA,Corresponding author: Joshua B. Grubbs, PhD; Department of Psychology, Bowling Green State University, 822 E Merry Street, Bowling Green, OH 43403, USA; Phone: +1 419 372 2301; Fax: +1 419 372 6013; E-mail:
| | - Shane W. Kraus
- VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital, University of Massachusetts Medical School, Worcester, MA, USA
| | - Samuel L. Perry
- Department of Sociology, University of Oklahoma, Norman, OK, USA
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12
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Schöttle D, Briken P, Tüscher O, Turner D. Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder. Dialogues Clin Neurosci 2018. [PMID: 29398933 PMCID: PMC5789215 DOI: 10.31887/dcns.2017.19.4/dschoettle] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Like nonaffected adults, individuals with autism spectrum disorders (ASDs) show the entire range of sexual behaviors. However, due to the core symptoms of the disorder spectrum, including deficits in social skills, sensory hypo- and hypersensitivities, and repetitive behaviors, some ASD individuals might develop quantitatively above-average or nonnormative sexual behaviors and interests. After reviewing the relevant literature on sexuality in high-functioning ASD individuals, we present novel findings on the frequency of normal sexual behaviors and those about the assessment of hypersexual and paraphilic fantasies and behaviors in ASD individuals from our own study. Individuals with ASD seem to have more hypersexual and paraphilic fantasies and behaviors than general-population studies suggest. However, this inconsistency is mainly driven by the observations for male participants with ASD. This could be due to the fact that women with ASD are usually more socially adapted and show less ASD symptomatology. The peculiarities in sexual behaviors in ASD patients should be considered both for sexual education and in therapeutic approaches.
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Affiliation(s)
- Daniel Schöttle
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Daniel Turner
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ; Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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13
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Abstract
The letter by Kraus et al. (2018) published recently in World Psychiatry presents diagnostic criteria for compulsive sexual behaviors (CSBs). Here, we discuss the potential impact of including CSB disorder in ICD-11 for four areas: educational efforts related to CSB (for both clinicians and patients), investigation of underlying mechanisms and subtypes, development of personalized treatment frameworks, and answering socially important questions and advancing important prevention efforts and effective policies. Each of these four areas has their own challenges that should be addressed, and we briefly describe and discuss them. We hope that this information will help continue a dialog and provide a framework for moving forward in this area.
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Affiliation(s)
- Mateusz Gola
- Clinical Neuroscience Laboratory, 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,Corresponding author: Mateusz Gola, PhD; Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, 9500 Gilman Drive, San Diego, CA 92093 0559, USA; Phone: +1 858 500 2554; Office phone: +1 858 822 7543; E-mail:
| | - Marc N. Potenza
- Departments of Psychiatry and Neurobiology, Child Study Center and CASAColumbia, Yale School of Medicine, New Haven, CT, USA,Connecticut Mental Health Center, New Haven, CT, USA
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14
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Chatzittofis A, Savard J, Arver S, Öberg KG, Hallberg J, Nordström P, Jokinen J. Interpersonal violence, early life adversity, and suicidal behavior in hypersexual men. J Behav Addict 2017; 6:187-193. [PMID: 28467102 PMCID: PMC5520124 DOI: 10.1556/2006.6.2017.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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] [Indexed: 12/17/2022] Open
Abstract
Background and aims There are significant gaps in knowledge regarding the role of childhood adversity, interpersonal violence, and suicidal behavior in hypersexual disorder (HD). The aim of this study was to investigate interpersonal violence in hypersexual men compared with healthy volunteers and the experience of violence in relation to suicidal behavior. Methods This case-control study includes 67 male patients with HD and 40 healthy male volunteers. The Childhood Trauma Questionnaire - Short Form (CTQ-SF) and the Karolinska Interpersonal Violence Scale (KIVS) were used for assessing early life adversity and interpersonal violence in childhood and in adult life. Suicidal behavior (attempts and ideation) was assessed with the Mini-International Neuropsychiatric Interview (version 6.0) and the Montgomery-Åsberg Depression Rating Scale - Self-rating. Results Hypersexual men reported more exposure to violence in childhood and more violent behavior as adults compared with healthy volunteers. Suicide attempters (n = 8, 12%) reported higher KIVS total score, more used violence as a child, more exposure to violence as an adult as well as higher score on CTQ-SF subscale measuring sexual abuse (SA) compared with hypersexual men without suicide attempt. Discussion Hypersexuality was associated with interpersonal violence with higher total scores in patients with a history of suicide attempt. The KIVS subscale exposure to interpersonal violence as a child was validated using the CTQ-SF but can be complemented with questions focusing on SA for full assessment of early life adversity. Conclusion Childhood adversity is an important factor in HD and interpersonal violence might be related to suicidal behavior in hypersexual men.
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Affiliation(s)
- Andreas Chatzittofis
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden,Medical School, University of Cyprus, Nicosia, Cyprus,Corresponding author: Andreas Chatzittofis; Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden; Phone: +46 7 00289786; Fax: +46 8 303706; E-mail:
| | - Josephine Savard
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Stefan Arver
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Katarina Görts Öberg
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jonas Hallberg
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Peter Nordström
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jussi Jokinen
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden,Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
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15
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Reid RC. Additional challenges and issues in classifying compulsive sexual behavior as an addiction. Addiction 2016; 111:2111-2113. [PMID: 27098081 DOI: 10.1111/add.13370] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 02/03/2016] [Accepted: 02/22/2016] [Indexed: 01/06/2023]
Affiliation(s)
- Rory C Reid
- UCLA Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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16
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Abstract
Background Over the last 20 years, behavioral addictions (e.g., addictions to gambling, playing video games, work, etc.) have become more accepted among both public and scientific communities. Addiction to sex is arguably a more controversial issue, but this does not take away from the fact that some individuals seek professional help for problematic excessive sex, irrespective of how the behavior is conceptualized. Empirical evidence suggests that among treatment seekers, men are more likely than women to seek help for sex addiction (SA). Methods Using the behavioral addiction literature and the authors' own expertise in researching female SA, this paper examines potential barriers to the treatment for female sex addicts. Results Four main types of barriers for female sex addicts not seeking treatment were identified. These comprised (a) individual barriers, (b) social barriers, (c) research barriers, and (d) treatment barriers. Conclusions Further research is needed to either confirm or disconfirm the identified barriers that female sex addicts face when seeking treatment, and if conformation is found, interested stakeholders should provide better awareness and/or see ways in which such barriers can be overcome to aid better uptake of SA services.
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Affiliation(s)
- Manpreet K. Dhuffar
- Psychology Department, University of Exeter, Exeter, United Kingdom
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Mark D. Griffiths
- Psychology Department, University of Exeter, Exeter, United Kingdom
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
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17
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Gola M, Skorko M, Kowalewska E, Kołodziej A, Sikora M, Wodyk M, Wodyk Z, Dobrowolski P. Polish adaptation of Sexual Addiction Screening Test - Revised. Psychiatr Pol 2016; 51:95-115. [PMID: 28455898 DOI: 10.12740/pp/onlinefirst/61414] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Addictive sexual behaviours are gaining more and more attention from researchers. There are actually 25 different questionnaires for assessing the level of loss of control over sexual. The main aim of this work was to make such an adaptation of the Sexual Addiction Screening Test-Revised (SAST-R; the most popular and questionnaire). behaviours (LoCoSB). None of them have been adapted and validated in a Polish language version. METHODS For the purpose of psychometric features examination and validation of the Polish version of SAST-R (SAST-PL-M), we recruited 116 heterosexual men receiving psychological treatment due to LoCoSB and meeting the criteria for hypersexual disorder. The control group consisted of 442 heterosexual males having never looked for any psychological or psychiatric help due to LoCoSB. RESULTS SAST-PL-M has high reliability (Cronbach's alpha = 0.904) and good filtering characteristics for identification of people who are potentially experiencing difficulty with control over sexual behaviours (the ROC curve for a threshold of 5 out of a maximum 20 points is characterised by a sensitivity of 99.1% and a specificity of 78.3%). CONCLUSIONS SAST-PL-M can be used as an efficient screening test for symptoms of LoCoSB in clinical and research setups. Results below 5 points indicate a high probability of no problems, while more than 5 points can indicate the need for additional clinical interviews. SAST-PL-M results may be successfully referred to the results of SAST-R when used with heterosexual male populations for research purposes.
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Abstract
BACKGROUND AND AIMS The concept of severity among providers working with hypersexual behavior is frequently used despite a lack of consensus about how severity should be operationalized. The paucity of dialogue about severity for hypersexual behavior is disconcerting given its relevance in determining level of care, risk, allocation of resources, and measuring treatment outcomes in clinical practice and research trials. The aim of the current article is to highlight several considerations for assessing severity based on the proposed DSM-5 criteria for hypersexual disorder. METHODS A review of current conceptualizations for severity among substance-use disorders and gambling disorder in the DSM-5 were considered and challenged as lacking applicability or clinical utility for hypersexual behavior. RESULTS AND CONCLUSIONS The current research in the field of hypersexual behavior is in its infancy. No concrete approach currently exists to assess severity in hypersexual populations. Several factors in operationalizing severity are discussed and alternative approaches to defining severity are offered for readers to consider.
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Affiliation(s)
- Rory C. Reid
- Corresponding address: Dr. Rory C. Reid; University of California, Los Angeles, 760 Westwood Boulevard, Suite 38-153, Los Angeles, CA 90024, USA; Phone: +1-310-825-8050; E-mail:
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19
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Dhuffar MK, Pontes HM, Griffiths MD. The role of negative mood states and consequences of hypersexual behaviours in predicting hypersexuality among university students. J Behav Addict 2015; 4:181-8. [PMID: 26551908 PMCID: PMC4627679 DOI: 10.1556/2006.4.2015.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS The issue of whether hypersexual behaviours exist among university students is controversial because many of these individuals engage in sexual exploration during their time at university. To date, little is known about the correlates of hypersexual behaviours among university students in the UK. Therefore, the aims of this exploratory study were two-fold. Firstly, to explore and establish the correlates of hypersexual behaviours, and secondly, to investigate whether hypersexuality among university students can be predicted by variables relating to negative mood states (i.e., emotional dysregulation, loneliness, shame, and life satisfaction) and consequences of hypersexual behaviour. METHODS Survey data from 165 British university students was analysed using regression analyses. RESULTS The full regression model significantly predicted hypersexual behaviours. However, only a small number of predictor variables (i.e., gender, consequences of hypersexual behaviours, life satisfaction and emotional dysregulation) accounted for the significant unique influence on hypersexual behaviours among the sample. CONCLUSIONS The study empirically supported the concept of hypersexual disorder. The implications of these findings are also discussed.
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Affiliation(s)
- Manpreet K. Dhuffar
- Nottingham Trent University, Nottingham, UK,* Corresponding author: Manpreet Dhuffar; Psychology Division, Nottingham Trent University, Burton Street, Nottingham, NG1 4BU, UK; E-mail:
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20
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Crozier MK, Hillock C. Codependence with hypersexual and gambling disorder. J Behav Addict 2013; 2:10-6. [PMID: 26165766 DOI: 10.1556/jba.1.2012.013] [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] [Indexed: 11/19/2022] Open
Abstract
Background The risks of behavioral addictions are well documented. There are biological, medical, social, spiritual, psychological, and safety risks to the individual as well as risks, like ripple effects, to the family and friends with whom the individual with behavioral addictions lives. The phenomenon of collateral damage from addictions, especially alcoholism and substance dependence, is well documented. Aims and methods A selected review of the literature reveals little regarding the risks of collateral damage, in particular codependence, from behavioral addictions on non-addicted family and friends. Results This article theoretically posits the existence of codependence to those with two well documented and researched behavioral addictions, hypersexual and gambling disorder, using the biopsychosocial lens. Conclusions Addictions professionals are encouraged to revisit the literature on codependence and consider its influence on family and friends of those with behavioral addictions when providing services.
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Abstract
Background and aims The past decade has seen an increased interest in understanding hypersexual behavior and its associated features. Beyond the obvious risks for sexually transmitted infections, there is a paucity of literature examining specific challenges encountered by hypersexual individuals. This study investigated and developed a new scale, the Hypersexual Behavior Consequences Scale (HBCS), to assess the various consequences reported among hypersexual patients. Methods Participants were drawn from a sample of patients recruited in a DSM-5 Field Trial for Hypersexual Disorder (HD). Participants completed the Hypersexual Behavior Inventory, a structured diagnostic interview to assess for psychopathology and HD, and self-report measures of personality, life satisfaction, and the initial item pool for the HBCS. Results Factor analysis reduced the HBCS items to a single factor solution which showed high internal consistency and stability over time. Higher HBCS scores were positively correlated with higher levels of emotional dysregulation, impulsivity, and stress proneness and lower levels of satisfaction with life and happiness. HBCS scores among the hypersexual patients were significantly higher than non-hypersexual patients. Conclusions The HBCS possesses good psychometric properties and appears to capture various consequences associated with the DSM-5 proposed criteria for HD. The HBCS can be used to aid clinicians and researchers in identifying consequences associated with hypersexual behavior. The HBCS may also prove a useful tool to guide treatment interventions aimed at reducing the negative impact of hypersexuality in patient populations.
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