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Marchetti I. The Structure of Compulsive Sexual Behavior: A Network Analysis Study. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1271-1284. [PMID: 36735169 PMCID: PMC10102046 DOI: 10.1007/s10508-023-02549-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 05/11/2023]
Abstract
Compulsive sexual behavior is a phenomenon characterized by a persistent failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behavior that causes marked distress or impairment in personal, familial, social, educational, or occupational areas of functioning. Despite its major impact on mental health and quality of life, little is known about its internal structure and whether this phenomenon differs across genders, age groups, and risk status. By considering a large online sample (n = 3186; 68.3% males), ranging from 14 to 64 years old, compulsive sexual behavior was explored by means of network analysis. State-of-the-art analytical techniques were adopted to investigate the pattern of association among the different elements of compulsive sexual behavior, identify possible communities of nodes, pinpoint the most central nodes, and detect differences between males and females, among different age groups, as well as between individuals at low and high risk of developing a full-blown disorder. The analyses revealed that the network was characterized by three communities, namely Consequence, Preoccupation, and Perceived Dyscontrol, and that the most central node was related to (perceived) impulse dyscontrol. No substantial differences were found between males and females and across age. Failing to meet one's own commitments and responsibilities was more central in individuals at high risk of developing a full-blown disorder than in those at low risk.
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Affiliation(s)
- Igor Marchetti
- Department of Life Sciences, Psychology Unit, University of Trieste, 34128, Trieste, Italy.
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2
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Ibáñez-Tomás E, Ballester-Arnal R, Elipe-Miravet M, Gasch-Gallén À. Psychometric Properties of the Sexual Compulsivity Scale in Men Who Have Sex with Men in Spanish Population. AIDS Behav 2023; 27:1211-1221. [PMID: 36125565 PMCID: PMC10036450 DOI: 10.1007/s10461-022-03858-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
The Sexual Compulsivity Scale (SCS) has been translated, adapted and validated in general Spanish population, making its application difficult in certain groups, such as men who have sex with men (MSM). This paper evaluates the psychometric properties of the SCS in a sample of MSM in Spain. The SCS was administered to 881 participants. The factorial structure of the SCS was examined with an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Both EFA and CFA confirmed a two-factor structure: (1) Interference of sexual behavior, and (2) Failure to control sexual impulses. Internal consistency was really good for the scale and also for both factors. The SCS also presented adequate psychometric properties. Thus, it is an appropriate measure for assessing sexual compulsivity in MSM, and a tool to be taken into account in future researches to reduce sexual risk behaviors in the MSM Spanish population.
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Affiliation(s)
- Eduardo Ibáñez-Tomás
- Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
- Servicio Aragonés de Salud (SALUD), Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I de Castellón, Castellón de la Plana, Spain.
| | - Marcel Elipe-Miravet
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I de Castellón, Castellón de la Plana, Spain
| | - Àngel Gasch-Gallén
- Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
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3
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Snaychuk LA, Ferrão YA, Fontenelle LF, Miguel EC, de Mathis MA, Scanavino MDT, Kim HS. Co-Occurring Obsessive-Compulsive Disorder and Compulsive Sexual Behavior: Clinical Features and Psychiatric Comorbidities. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:4111-4123. [PMID: 36066680 DOI: 10.1007/s10508-022-02412-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Obsessive-compulsive disorder (OCD) commonly co-occurs with other psychiatric conditions. Though research is limited, there is preliminary evidence that OCD also co-occurs with compulsive sexual behavior (CSB). Yet, few studies have investigated the demographic, clinical, and psychiatric comorbidities associated with co-occurring OCD and CSB. To address this gap, the current study aimed to evaluate rates of co-occurring OCD and CSB, identify demographic and clinical factors associated with comorbid OCD and CSB, and assess associated psychiatric comorbidity. Participants (N = 950) were patients of a large multisite treatment for OCD. Standardized self-report measures were used to assess demographic and clinical characteristics such as anxiety, depression, and severity and dimensions of OCD. Semi-structured interviews including the SCID were used to assess psychiatric comorbidities. A total of 36 (3.8%) of participants met the criteria for CSB. Binary logistic regression analysis revealed that males were significantly more likely to present with CSB than females and CSB was associated with greater psychiatric comorbidity, particularly impulse control disorders. These findings suggest that individuals with co-occurring OCD and CSB may have more complex treatment needs, and more tailored interventions may be necessary.
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Affiliation(s)
- Lindsey A Snaychuk
- Department of Psychology, Toronto Metropolitan University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada
| | - Ygor A Ferrão
- Clinical Neurosciences Department, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Leonardo F Fontenelle
- Departamento de Psiquiatria e Medicina Legal, Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB/UFRJ) e Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | | | - Maria A de Mathis
- Institute of Psychiatry, Universidade de São Paulo, São Paulo, Brazil
| | | | - Hyoun S Kim
- Department of Psychology, Toronto Metropolitan University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, Canada.
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de Assis Brasil ML, Zakhour S, Figueira GL, Pires PP, Nardi AE, Sardinha A. Sexuality Assessment of the Brazilian Population: An Integrative Review of the Available Instruments. JOURNAL OF SEX & MARITAL THERAPY 2022; 48:757-774. [PMID: 35195053 DOI: 10.1080/0092623x.2022.2035869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This paper provides an integrative review of psychometric instruments targeting sexual function and clinical measures of sexuality available to the Brazilian population. Our aim was to summarize the existing measures, indicating current development needs related to the quality of psychometric evidence, research design and untapped theoretical ground that could be relevant for clinical practice and research in sexuality. Electronic databases were searched. Additional records were found through a manual search. The general search terms and operators were (scale OR inventory OR questionnaire) AND (validation) AND (sexual beliefs OR sexuality OR sexual behavior OR sexual function OR sexual satisfaction) AND (Brazil or Brazilian). The results indicate a total of 18 developed or transculturally adapted and/or validated scales and questionnaires available in Brazilian Portuguese, covering sexual dysfunctions and clinical measures. Despite development, adaptation and validation efforts, there is a critical need for better psychometric and sampling strategies as well as norms for the clinical interpretation of test results. Ecological validity is also a challenge. At present, sexual assessments in Brazil offer some useful information, but reaching the applied clinical field remains a challenge.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2022.2035869 .
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Affiliation(s)
| | - Stephanie Zakhour
- Treatment Resistant Depression Laboratory (DeReTrat), Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Gabriel L Figueira
- Graduate School Psychology Program (PPGP), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Psychology, Celso Lisboa University, Rio de Janeiro, Brazil
| | - Pedro P Pires
- Department in the Institute of Psychology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - A E Nardi
- Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Aline Sardinha
- Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Olver ME, Kingston DA, Laverty EK, Seto MC. Psychometric Properties of Common Measures of Hypersexuality in an Online Canadian Sample. J Sex Med 2022; 19:331-346. [PMID: 34987002 DOI: 10.1016/j.jsxm.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/26/2021] [Accepted: 12/06/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hypersexuality has been posited as the central defining feature of Compulsive Sexual Behavior Disorder, and although the acceptance and inclusion of this construct in psychiatric nosologies provides some legitimacy, concerns surrounding terminology, assessment, and diagnosis remain. AIM The present study was an independent psychometric examination of 2 of the most commonly used measures of Compulsive Sexual Behavior Disorder; specifically, the gender invariance of the latent structure, reliability (test retest, internal consistency), and external correlates (concurrent validity) of these measures. METHODS The Sexual Compulsivity Scale and the Hypersexual Behavior Inventory were completed by 2 nonclinical online community samples of cisgender women (ns = 525 and 359), cisgender men (ns = 419 and 364), and transgender or non-binary individuals (ns = 38 and 11). OUTCOMES Criterion based measures of sexual history and total sexual outlet (number of orgasms per week) were gathered to validate Sexual Compulsivity Scale and Hypersexual Behavior Inventory total and factor scores. RESULTS Results supported the factorial validity of both assessment measures: correlated 3 factor solutions were established through exploratory factor analysis of 1 sample, and confirmatory factor analysis in the second sample. Multiple group confirmatory factor analysis, conducted on the 2 combined samples, also supported the gender invariance of the 3-factor solutions. Additional basic psychometric indices of test-retest and internal consistency reliability and criterion-related (concurrent) validity conducted across the 2 online samples were supported. CLINICAL IMPLICATIONS Common measures of hypersexuality have potential for use in its assessment, treatment, and management. STRENGTHS & LIMITATIONS Study strengths include: the inclusion of 2 fairly large and diverse online samples, thorough checks for insufficient effort/validity of responding, validity and reliability methodology (ie, measurement at multiple time points, obtaining behavioral indicators of sexual health), and a comprehensive set of psychometric analyses to inform conclusions regarding the external validity, reliability, and latent structure of hypersexuality measures across gender groups. Study limitations include: potential concerns related to validity and accuracy of responding owing to a reliance on self-report, the potential for selection bias, and limiting the examination of the latent structure of hypersexuality to cisgender men and women such that the results may not generalize to gender diverse populations. CONCLUSION Hypersexuality is a multidimensional construct, with a common latent structure among cisgender men and women, consistency in measurement over time, and meaningful concurrent associations with behavioral criteria that have relevance for sexual health. Olver ME, Kingston DA, Laverty EK, et al. Psychometric Properties of Common Measures of Hypersexuality in an Online Canadian Sample. J Sex Med 2022;19:331-346.
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Affiliation(s)
- Mark E Olver
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Drew A Kingston
- HOPE Program, San Diego, CA, USA; The Royal's Institute of Mental Health Research, Ottawa, ON, Canada.
| | - Erin K Laverty
- The Canadian Public Health Association, Ottawa, ON, Canada
| | - Michael C Seto
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
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Torres TS, Jalil EM, Coelho LE, Bezerra DRB, Jalil CM, Hoagland B, Cardoso SW, Arayasirikul S, Veloso VG, Wilson EC, McFarland W, Grinsztejn B. A Technology-Based Intervention Among Young Men Who Have Sex With Men and Nonbinary People (The Conectad@s Project): Protocol for A Vanguard Mixed Methods Study. JMIR Res Protoc 2022; 11:e34885. [PMID: 35023848 PMCID: PMC8796043 DOI: 10.2196/34885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 01/25/2023] Open
Abstract
Background In many parts of the world, including Brazil, uptake for biomedical interventions has been insufficient to reverse the HIV epidemic among key populations at high risk for HIV, including men who have sex with men. Young MSM (YMSM), particularly Black YMSM, have high HIV incidence, low viral suppression, and low preexposure prophylaxis (PrEP) uptake and adherence. Therefore, novel approaches to increase the HIV biomedical interventions uptake by YMSM are urgently needed. Objective We describe the Conectad@s Project, which aims to: (1) estimate the prevalence and incidence of HIV and other sexually transmitted infections, the onset of sexual risk behavior, and barriers to biomedical interventions among YMSM aged 18 to 24 years in Rio de Janeiro, Brazil; and (2) conduct a technology-based adherence intervention study to promote a rapid linkage of YMSM to HIV care or prevention, and support and sustain adherence. Methods A cross-sectional survey will be conducted with 400 YMSM recruited using respondent-driven sampling (RDS) adapted for social media-based sampling, preceded by a formative phase. HIV and sexually transmitted infections testing will be conducted, including early HIV infection biomarker detection. Behavioral, partnership, network, and structural measures will be collected through structured questionnaires. All individuals recruited for the survey will have access to HIV risk assessment, antiretroviral therapy (ART), PrEP, prevention counseling, and a technology-based adherence intervention. Those who accept the adherence intervention will receive weekly text messages via a social networking app (WhatsApp) for 24 weeks, with follow-up data collected over 48 weeks. Results The Conectad@s project has been approved by our local institutional review board (#CAAE 26086719.0.0000.4262) in accordance with all applicable regulations. Questionnaires for the RDS survey and intervention were developed and tested in 2020, formative interviews were conducted in January and February 2021 to guide the development of the RDS, and enrollment is planned to begin in early 2022. Conclusions The Conectad@s Project is a vanguard study that, for the first time, will apply digital RDS to sample and recruit YMSM in Brazil and rapidly connect them to ART, PrEP, or prevention counseling through a technology-based adherence intervention. RDS will allow us to estimate HIV prevalence among YMSM and measure HIV infection biomarkers in the context of the onset of risky behavior. The data will lay the groundwork to adapt and implement HIV prevention strategies, identify barriers to the earliest HIV infection diagnosis, immediate ART or PrEP initiation, and detect new clusters of HIV transmission. International Registered Report Identifier (IRRID) DERR1-10.2196/34885
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Affiliation(s)
- Thiago Silva Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Emilia Moreira Jalil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Lara Esteves Coelho
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Cristina Moreira Jalil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Brenda Hoagland
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sandra Wagner Cardoso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sean Arayasirikul
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | | | - Erin C Wilson
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Willi McFarland
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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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] [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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D T Scanavino M, Ventuneac A, Caramelli B, Naufal L, S D Santos Filho C, Nisida IVV, Amaral MLS, Vieira JC, Parsons JT. Cardiovascular and psychopathological factors among non-sexually compulsive, sexually compulsive, and hypersexual individuals in Sao Paulo, Brazil. PSYCHOL HEALTH MED 2019; 25:121-129. [PMID: 31713436 DOI: 10.1080/13548506.2019.1687916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We decided to explore the frequency of cardiovascular risk factors, according to three levels of severity of compulsive sexual behavior (CSB), namely, non-sexually compulsive (1), sexually compulsive (2), and sexually compulsive, and hypersexual (3). We also investigated the impact of a psychiatric co-morbidity on the Framingham heart risk score (FRS). 94 non-sexually compulsive, 57 sexually compulsive, and 60 hypersexual individuals underwent psychiatric interview, blood collection, self-responsiveness, and anthropometric measurement. The analyses were repeated with individuals aged up to 44 and aged more than 44 years old. Regarding the total sample, we observed significant association among those sexually compulsive, and hypersexual participants with presenting the HIV serologic status, and a greater proportion of psychiatric conditions as much as the severity of CSB increases. Individuals with substance-related disorder predicted higher Framingham scores. The analyses with people aged more than 44 years old presented some different results, such as association among presenting low FRS and the sexually compulsive participants, and sexual compulsivity predicted lower scores of the Framingham. The study points out to the relevance of comprehensive psychiatric examination of whom presenting CSB and opens an avenue forward investigation of the effect of high rates of sexual activity on cardiovascular risk.
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Affiliation(s)
- Marco D T Scanavino
- Excessive Sexual Drive and Prevention of Negative Outcome Associated with Sexual Behavior Outpatient Unit AISEP, Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ana Ventuneac
- Hunter College Center for HIV/AIDS Educational Studies and Training (CHEST), City University of New York (CUNY), New York, NY, USA
| | - Bruno Caramelli
- Interdisciplinary Medicine in Cardiology Unit, Heart Institute INCOR, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Lucas Naufal
- Excessive Sexual Drive and Prevention of Negative Outcome Associated with Sexual Behavior Outpatient Unit AISEP, Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Carlos S D Santos Filho
- Institute of Physical Medicine and Rehabilitation IMREA, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Isabelle V V Nisida
- Excessive Sexual Drive and Prevention of Negative Outcome Associated with Sexual Behavior Outpatient Unit AISEP, Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.,Rape Care Unit. Infectious Disease Division. Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Maria L S Amaral
- Excessive Sexual Drive and Prevention of Negative Outcome Associated with Sexual Behavior Outpatient Unit AISEP, Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Julie C Vieira
- Excessive Sexual Drive and Prevention of Negative Outcome Associated with Sexual Behavior Outpatient Unit AISEP, Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Jeffrey T Parsons
- Hunter College Center for HIV/AIDS Educational Studies and Training (CHEST), City University of New York (CUNY), New York, NY, USA.,Department of Psychology, Hunter College and the Graduate Center, City University of New York (CUNY), New York, NY, USA
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Rendina HJ, Millar BM, Dash G, Feldstein Ewing SW, Parsons JT. The Somatic Marker Hypothesis and Sexual Decision Making: Understanding the Role of Iowa Gambling Task Performance and Daily Sexual Arousal on the Sexual Behavior of Gay and Bisexual Men. Ann Behav Med 2019; 52:380-392. [PMID: 29684131 DOI: 10.1093/abm/kax006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The sexual decision-making literature suggests that sexual arousal and behavior are associated. The somatic marker hypothesis suggests that individual neuropsychological differences in decision making, as measured by the Iowa Gambling Task (IGT), may moderate these associations; however, this hypothesis has yet to be tested with event-level sexual behavior data. Purpose We hypothesized that (a) daily sexual arousal would be positively associated with likelihood of engaging in sex and condomless anal sex (CAS) and (b) IGT scores would moderate these associations such that the associations would be stronger among those with higher IGT scores. Methods We used daily diary data from 334 highly sexually active gay and bisexual men to examine the main and interaction effects of sexual arousal and IGT scores on sexual engagement and CAS. Results As hypothesized, daily sexual arousal was positively associated with greater odds of both sexual engagement and CAS with casual male partners. Individual-level IGT performance significantly moderated the day-level association between arousal and sexual engagement, which was stronger for men with higher IGT scores. There was no main effect of IGT scores on either sexual behavior outcome, nor did it moderate the association between arousal and CAS. Conclusions These findings highlight the influence of sexual arousal on sexual engagement, which differed by IGT scores; the effect of arousal on CAS was much less variable and may not be moderated by neurocognitive factors. This study supports the importance of exploring integrated behavioral/biomedical interventions to improve individual decision making to prevent HIV infection.
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Affiliation(s)
- H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), Park Avenue, New York, NY, USA.,Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Brett M Millar
- Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Genevieve Dash
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | | | - Jeffrey T Parsons
- Department of Psychology, Hunter College of the City University of New York (CUNY), Park Avenue, New York, NY, USA.,Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
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10
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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] [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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Cowie ME, Kim HS, Hodgins DC, McGrath DS, Scanavino MDT, Tavares H. Demographic and psychiatric correlates of compulsive sexual behaviors in gambling disorder. J Behav Addict 2019; 8:451-462. [PMID: 31416337 PMCID: PMC7044634 DOI: 10.1556/2006.8.2019.35] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND AIMS Gambling disorder (GD) and compulsive sexual behavior (CSB) may commonly co-occur. Yet, the psychiatric correlates of these co-occurring disorders are an untapped area of empirical scrutiny, limiting our understanding of appropriate treatment modalities for this dual-diagnosed population. This study examined the demographic and clinical correlates of CSB in a sample of treatment-seeking individuals with GD (N = 368) in São Paulo, Brazil. METHODS Psychiatrists and psychologists conducted semi-structured clinical interviews to identify rates of CSB and other comorbid psychiatric disorders. The Shorter PROMIS Questionnaire was administered to assess additional addictive behaviors. The TCI and BIS-11 were used to assess facets of personality. Demographic and gambling variables were also assessed. RESULTS Of the total sample, 24 (6.5%) met diagnostic criteria for comorbid CSB (GD + CSB). Compared to those without compulsive sexual behaviors (GD - CSB), individuals with GD + CSB were more likely to be younger and male. No differences in gambling involvement emerged. Individuals with GD + CSB tended to have higher rates of psychiatric disorders (depression, post-traumatic stress disorder, and bulimia nervosa) and engage in more addictive behaviors (problematic alcohol use, drug use, and exercise) compared to GD - CSB. Those with GD + CSB evidenced less self-directedness, cooperativeness, self-transcendence, and greater motor impulsivity. Logistic regression showed that the predictors of GD + CSB, which remained in the final model, were being male, a diagnosis of bulimia, greater gambling severity, and less self-transcendence. DISCUSSION AND CONCLUSION Given those with GD + CSB evidence greater psychopathology, greater attention should be allocated to this often under studied comorbid condition to ensure adequate treatment opportunities.
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Affiliation(s)
- Megan E. Cowie
- Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Calgary, AB, Canada,Corresponding author: Megan E. Cowie; Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Room AD 240, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; Phone: +1 403 210 9580; E-mail:
| | - Hyoun S. Kim
- Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - David C. Hodgins
- Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Daniel S. McGrath
- Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Marco D. T. Scanavino
- Outpatient Unit for Excessive Sexual Drive and Prevention of Negative Outcomes Associated with Sexual Behavior, Institute of Psychiatry, Clinicas’ Hospital, University of São Paulo Medical School, São Paulo, Brazil,Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil,Experimental Pathophysiology, Post-Graduation Program, Medical School, University of São Paulo, São Paulo, Brazil
| | - Hermano Tavares
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil,Impulse Control Disorders and Behavioral Addictions Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil
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Ballester-Arnal R, Castro-Calvo J, Gil-Julia B, Giménez-García C, Gil-Llario MD. A Validation Study of the Spanish Version of the Hypersexual Behavior Inventory (HBI): Paper-and-Pencil Versus Online Administration. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:283-302. [PMID: 30657020 DOI: 10.1080/0092623x.2018.1518886] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Hypersexuality is a problematic behavior characterized by the combination of an excessive sexual desire and the pathological inability to control it. This study presents the psychometric properties of the Spanish paper-and-pencil and online versions of the Hypersexual Behavior Inventory (HBI), one of the most popular scales to assess this issue. A total of 2,250 participants (1,070 men) completed a translated version of the HBI (1,450 in paper-and-pencil; 800 online). The exploratory factor analysis yielded three factors that explained 67.53% of total variance for the HBI paper-and-pencil version. This factor structure was confirmed in the HBI online version through confirmatory factor analysis (CFA). Factorial, structural, scalar and error variance-invariance according to gender was also confirmed through multigroup CFA. Reliability of the total score and subscales ranged between .89 and .96. Likewise, correlations with other related scales were positive and significant (r between .511 and .743). Temporal stability one year after the first application was .77 (paper-and-pencil format) and .68 (online version). These results support the reliability and validity of the HBI and justify its use in the assessment of hypersexuality in Spanish-speaking countries.
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Affiliation(s)
- Rafael Ballester-Arnal
- a Departmento de Psicología Básica, Clínica y Psicobiología, Universiat , Jaume I , Castellón , Spain
| | - Jesús Castro-Calvo
- a Departmento de Psicología Básica, Clínica y Psicobiología, Universiat , Jaume I , Castellón , Spain
- b Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg , Esch-sur-Alzette , Luxembourg
| | - Beatriz Gil-Julia
- c Departamento de Personalidad, Evaluación y Tratamientos Psicológicos , Universitat de València , Estudi General , Spain
| | - Cristina Giménez-García
- a Departmento de Psicología Básica, Clínica y Psicobiología, Universiat , Jaume I , Castellón , Spain
| | - María Dolores Gil-Llario
- d Departamento de Psicología Evolutiva y de la Educación , Universitat de València , Estudi General, Spain
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Health-related quality of life assessment among people living with HIV in Rio de Janeiro, Brazil: a cross-sectional study. Qual Life Res 2018; 28:1035-1045. [PMID: 30415417 DOI: 10.1007/s11136-018-2044-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE To assess health-related quality of life (HRQoL) and its associated factors among people living with HIV/AIDS (PLWHA) in Rio de Janeiro, Brazil. METHODS A cross-sectional study including PLWHA receiving usual HIV-care at Instituto Nacional de Infectologia Evandro Chagas (INI/Fiocruz) was conducted between 2014 and 2016 in Rio de Janeiro, Brazil. The EQ-5D-3L assessed HRQoL; PHQ-2 and ASSIST were used for screening depression and substance use, respectively. Clinical variables were obtained from the INI/Fiocruz cohort database, and structured questions evaluated intimate partner violence, sexual abstinence and relationship status. Data were analysed using multivariable Tobit regression model. RESULTS A total of 1480 PLWHA were included: 64.7% were male at birth (38.4% men who have sex with men [MSM], 24.3% heterosexual men and 2% transgender women [TGW]); median age was 43.1 years, and 95.8% were receiving antiretroviral therapy. The median EQ-5D-3L utility score was 0.801. Results showed that the following factors: MSM and women; older age; lower educational level; no engagement in a relationship; depression screening positive; polysubstance use; and, detectable viral load were independently associated with worse HRQoL. CONCLUSIONS PLWHA under care at INI/Fiocruz presented good HRQoL. Polysubstance use, depression and lower educational level were among the factors negatively associated with HRQoL. This was the first time that the EQ-5D-3L utility scores were calculated for a considerable number of PLWHA in Brazil, which is a fundamental piece of information for future cost-effectiveness analysis.
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Dickenson JA, Gleason N, Coleman E, Miner MH. Prevalence of Distress Associated With Difficulty Controlling Sexual Urges, Feelings, and Behaviors in the United States. JAMA Netw Open 2018; 1:e184468. [PMID: 30646355 PMCID: PMC6324590 DOI: 10.1001/jamanetworkopen.2018.4468] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 09/13/2018] [Indexed: 11/29/2022] Open
Abstract
Importance The veracity, nomenclature, and conceptualizations of sex addiction, out-of-control sexual behavior, hypersexual behavior, and impulsive or compulsive sexual behavior are widely debated. Despite such variation in conceptualization, all models concur on the prominent feature: failing to control one's sexual feelings and behaviors in a way that causes substantial distress and/or impairment in functioning. However, the prevalence of the issue in the United States is unknown. Objective To assess the prevalence of distress and impairment associated with difficulty controlling sexual feelings, urges, and behaviors among a nationally representative sample in the United States. Design, Setting, and Participants This survey study used National Survey of Sexual Health and Behavior data to assess the prevalence of distress and impairment associated with difficulty controlling sexual feelings, urges, and behaviors and determined how prevalence varied across sociodemographic variables. Participants between the ages of 18 and 50 years were randomly sampled from all 50 US states in November 2016. Main Outcomes and Measures Distress and impairment associated with difficulty controlling sexual feelings, urges, and behavior were measured using the Compulsive Sexual Behavior Inventory-13. A score of 35 or higher on a scale of 0 to 65 indicated clinically relevant levels of distress and/or impairment. Results Of 2325 adults (1174 [50.5%] female; mean [SD] age, 34.0 [9.3] years), 201 [8.6%] met the clinical screen cut point of a score of 35 or higher on the Compulsive Sexual Behavior Inventory. Gender differences were smaller than previously theorized, with 10.3% of men and 7.0% of women endorsing clinically relevant levels of distress and/or impairment associated with difficulty controlling sexual feelings, urges, and behavior. Conclusions and Relevance The high prevalence of this prominent feature associated with compulsive sexual behavior disorder has important implications for health care professionals and society. Health care professionals should be alert to the high number of people who are distressed about their sexual behavior, carefully assess the nature of the problem within its sociocultural context, and find appropriate treatments for both men and women.
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Affiliation(s)
- Janna A. Dickenson
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
| | - Neil Gleason
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
| | - Eli Coleman
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
| | - Michael H. Miner
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
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Scanavino MD, Ventuneac A, Abdo CH, Tavares H, Amaral ML, Messina B, Reis SC, Martins JP, Parsons JT. Sexual compulsivity, anxiety, depression, and sexual risk behavior among treatment-seeking men in São Paulo, Brazil. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2018; 40:424-431. [PMID: 29898197 PMCID: PMC6899385 DOI: 10.1590/1516-4446-2017-2476] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/07/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE There is a lack of studies on negative mood states and sexual risk behavior in men of all sexual orientations who seek treatment for excessive sexual behavior (ESB). We aim to examine sexual compulsivity (SC), anxiety, depression, and sexual risk behavior in a treatment-seeking sample of men and controls. METHODS We enrolled 88 (37 [42%] gay or bisexual and 51 [58%] heterosexual) ESB outpatients and 64 controls. Assessments included the Sexual Compulsivity Scale (SCS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and sexual risk behaviors. RESULTS Compared to controls, ESB outpatients showed increased SC, anxiety, and depression, which were correlated. Regarding sex with casual partners, ESB outpatients reported more sexual intercourse, a greater number of partners, more anal intercourse, and unprotected anal intercourse. Anxiety, depression, and SC were associated with protected vaginal intercourse with a main partner, whereas they were associated with unprotected anal intercourse with a casual partner. Depression was associated with unprotected vaginal intercourse with a casual partner. Condomless anal intercourse was predicted by SC and was also reported by the heterosexual ESB outpatients (36%). CONCLUSION The data contribute to the field by providing information on men of all sexual orientations who are searching for mental healthcare. The connections among these psychopathological factors and sexual risk behavior have implications for public health, clinicians, and research.
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Affiliation(s)
- Marco D.T. Scanavino
- Ambulatório de Impulso Sexual Excessivo e Prevenção de Desfechos Negativos Associados ao Comportamento Sexual (AISEP), Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
- Departamento de Psiquiatria, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Ana Ventuneac
- Center for HIV Educational Studies & Training (CHEST), New York, NY, USA
| | - Carmita H.N. Abdo
- Departamento de Psiquiatria, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Hermano Tavares
- Departamento de Psiquiatria, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Maria L.S. Amaral
- Ambulatório de Impulso Sexual Excessivo e Prevenção de Desfechos Negativos Associados ao Comportamento Sexual (AISEP), Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Bruna Messina
- Ambulatório de Impulso Sexual Excessivo e Prevenção de Desfechos Negativos Associados ao Comportamento Sexual (AISEP), Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Sirlene C. Reis
- Ambulatório de Impulso Sexual Excessivo e Prevenção de Desfechos Negativos Associados ao Comportamento Sexual (AISEP), Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
- Departamento de Psiquiatria, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - João P.L.B. Martins
- Ambulatório de Impulso Sexual Excessivo e Prevenção de Desfechos Negativos Associados ao Comportamento Sexual (AISEP), Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Jeffrey T. Parsons
- Center for HIV Educational Studies & Training (CHEST), New York, NY, USA
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center, CUNY, New York, NY, USA
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Castro-Calvo J, Ballester-Arnal R, Billieux J, Gil-Juliá B, Gil-Llario MD. Spanish validation of the Sexual Addiction Screening Test. J Behav Addict 2018; 7:584-600. [PMID: 30273048 PMCID: PMC6426369 DOI: 10.1556/2006.7.2018.57] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/22/2018] [Accepted: 05/28/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND AIMS Sexual addiction is a pathological behavior characterized by a combination of excessive sexual desire and impaired ability to control it. Its incidence ranges between 1.2% and 32.2%, although this number may vary depending on the screening tool used. This wide variability is largely due to the use of non-validated instruments (e.g., structural validity relying on exploratory analyses, instruments translated without an additional validation process, or instruments validated in another format). To deal with these limitations, this study tested the psychometric properties of the Spanish paper-and-pencil and online versions of the Sexual Addiction Screening Test (SAST). METHODS A total of 2,528 participants (1,163 males) completed the Spanish version of the SAST, along with other instruments assessing sexual compulsivity (1,585 = paper-and-pencil, 943 = online). RESULTS The exploratory factor analysis yielded a four-factor structure explaining 57.39% of the variance for the SAST paper-and-pencil version. This factor structure was then verified for the online version through the use of confirmatory factor analysis [χ2(264) = 441.59; χ2/df = 1.66; RMSEA = 0.02; CFI = 0.94; IFI = 0.94]. This methodology was also used to support measurement invariance (configural, metric, and scalar invariance) according to gender. The reliability of the total score ranged from .82 to .85. Similarly, correlations with related scales were positive and significant (r between .22 and .71). Temporal stability 1 year after the first application was 0.65 (paper-and-pencil format) and 0.60 (online version). CONCLUSION These results, together with the absence of questionnaires translated into Spanish to assess this construct, justify the use of the SAST in the evaluation of sexual addiction in Spanish-speaking countries.
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Affiliation(s)
- Jesús Castro-Calvo
- Salusex-Unisexsida, Departamento de Psicología Básica, Clínica y Psicobiología, Facultad de Ciencias de la Salud, Universitat Jaume I, Castellón, Spain
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Rafael Ballester-Arnal
- Salusex-Unisexsida, Departamento de Psicología Básica, Clínica y Psicobiología, Facultad de Ciencias de la Salud, Universitat Jaume I, Castellón, Spain
| | - Joel Billieux
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Beatriz Gil-Juliá
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Estudi General, Spain
| | - María Dolores Gil-Llario
- Departamento de Psicología Evolutiva y de la Educación, Universitat de València, Estudi General, Spain
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De Boni RB, Machado IK, De Vasconcellos MTL, Hoagland B, Kallas EG, Madruga JV, Fernandes NM, Cerqueira NB, Moreira RI, Goulart SP, Veloso VG, Grinsztejn B, Luz PM. Syndemics among individuals enrolled in the PrEP Brasil Study. Drug Alcohol Depend 2018; 185:168-172. [PMID: 29454927 DOI: 10.1016/j.drugalcdep.2017.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/30/2017] [Accepted: 12/02/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Concurrent psychosocial problems may synergistically increase the risk of HIV infection (syndemics), representing a challenge for prevention. We aimed to evaluate the prevalence and associated factors of syndemics among men who have sex with men (MSM) and transgender women (TGW) enrolled in the Brazilian pre-exposure prophylaxis demonstration study (PrEP Brasil Study). METHODS Secondary cross-sectional analysis of the PrEP Brasil Study was performed. Of 450 HIV-seronegative MSM/TGW enrolled in the PrEP Brasil Study- conducted at Rio de Janeiro and São Paulo, Brazil- 421 participants with complete data were included in the present analysis. Syndemics was defined as occurrence of ≥2 of the following conditions: polysubstance (≥2) use, binge drinking, positive depression screen, compulsive sexual behavior, and intimate partner violence (IPV). RESULTS The prevalence of recent polysubstance use was 22.8%, binge drinking 51.1%, positive depression screening 5.2%, compulsive sexual behavior 7.1%, and IPV 7.3%. Syndemics prevalence was 24.2%, and associated factors were younger age (adjusted Odds Ratio (aOR) 0.95, 95% Confidence Interval (95% CI) 0.92-0.98 per year increase), TGW vs. MSM (aOR 3.09, 95% CI: 1.2-8.0), some college education or more vs. less than college (aOR 2.49, 95% CI: 1.31-4.75), and multiple male sexual partners in prior 3 months (aOR 1.69, 95% CI: 0.92-3.14). CONCLUSION Given the high prevalence of syndemics, particularly of polysubstance use and binge drinking, PrEP delivery offers an opportunity to diagnose and intervene in mental and social well-being.
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Affiliation(s)
- Raquel B De Boni
- National Institute of Infectology Evandro Chagas, Lapclin STD/AIDS, Avenida Brasil 4.365, Fiocruz, Rio de Janeiro, Brazil
| | - Iona K Machado
- Columbia College of Physicians and Surgeons, 630 W. 168 St., New York City, NY, USA
| | | | - Brenda Hoagland
- National Institute of Infectology Evandro Chagas, Lapclin STD/AIDS, Avenida Brasil 4.365, Fiocruz, Rio de Janeiro, Brazil
| | - Esper G Kallas
- Division of Clinical Immunology and Allergy, University of São Paulo, São Paulo, Brazil
| | - José Valdez Madruga
- Centro de Referencia e Treinamento DST/AIDS, 81 Vila Mariana, São Paulo, Brazil
| | - Nilo M Fernandes
- National Institute of Infectology Evandro Chagas, Lapclin STD/AIDS, Avenida Brasil 4.365, Fiocruz, Rio de Janeiro, Brazil
| | - Natalia B Cerqueira
- Division of Clinical Immunology and Allergy, University of São Paulo, São Paulo, Brazil
| | - Ronaldo I Moreira
- National Institute of Infectology Evandro Chagas, Lapclin STD/AIDS, Avenida Brasil 4.365, Fiocruz, Rio de Janeiro, Brazil
| | - Silvia P Goulart
- Division of Clinical Immunology and Allergy, University of São Paulo, São Paulo, Brazil
| | - Valdilea G Veloso
- National Institute of Infectology Evandro Chagas, Lapclin STD/AIDS, Avenida Brasil 4.365, Fiocruz, Rio de Janeiro, Brazil
| | - Beatriz Grinsztejn
- National Institute of Infectology Evandro Chagas, Lapclin STD/AIDS, Avenida Brasil 4.365, Fiocruz, Rio de Janeiro, Brazil
| | - Paula M Luz
- National Institute of Infectology Evandro Chagas, Lapclin STD/AIDS, Avenida Brasil 4.365, Fiocruz, Rio de Janeiro, Brazil.
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A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study. J Sex Med 2017; 14:950-958. [DOI: 10.1016/j.jsxm.2017.05.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/13/2017] [Accepted: 05/01/2017] [Indexed: 11/18/2022]
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Rendina HJ, Gamarel KE, Pachankis JE, Ventuneac A, Grov C, Parsons JT. Extending the Minority Stress Model to Incorporate HIV-Positive Gay and Bisexual Men's Experiences: a Longitudinal Examination of Mental Health and Sexual Risk Behavior. Ann Behav Med 2017; 51:147-158. [PMID: 27502073 PMCID: PMC5299076 DOI: 10.1007/s12160-016-9822-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Minority stress theory represents the most plausible conceptual framework for explaining health disparities for gay and bisexual men (GBM). However, little focus has been given to including the unique stressors experienced by HIV-positive GBM. PURPOSE We explored the role of HIV-related stress within a minority stress model of mental health and condomless anal sex. METHODS Longitudinal data were collected on a diverse convenience sample of 138 highly sexually active, HIV-positive GBM in NYC regarding sexual minority (internalized homonegativity and gay-related rejection sensitivity) and HIV-related stressors (internalized HIV stigma and HIV-related rejection sensitivity), emotion dysregulation, mental health (symptoms of depression, anxiety, sexual compulsivity, and hypersexuality), and sexual behavior (condomless anal sex with all male partners and with serodiscordant male partners). RESULTS Across both sexual minority and HIV-related stressors, internalized stigma was significantly associated with mental health and sexual behavior outcomes while rejection sensitivity was not. Moreover, path analyses revealed that emotion dysregulation mediated the influence of both forms of internalized stigma on symptoms of depression/anxiety and sexual compulsivity/hypersexuality as well as serodiscordant condomless anal sex. CONCLUSIONS We identified two targets of behavioral interventions that may lead to improvements in mental health and reductions in sexual transmission risk behaviors-maladaptive cognitions underlying negative self-schemas and difficulties with emotion regulation. Techniques for cognitive restructuring and emotion regulation may be particularly useful in the development of interventions that are sensitive to the needs of this population while also highlighting the important role that structural interventions can have in preventing these disparities for future generations.
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Affiliation(s)
- H Jonathon Rendina
- Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
| | | | - John E Pachankis
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Ana Ventuneac
- Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Christian Grov
- Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Jeffrey T Parsons
- Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA.
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave., New York, NY, 10065, USA.
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Executive Functioning of Sexually Compulsive and Non-Sexually Compulsive Men Before and After Watching an Erotic Video. J Sex Med 2017; 14:347-354. [PMID: 28117268 DOI: 10.1016/j.jsxm.2016.12.235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/17/2016] [Accepted: 12/16/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Despite the serious behavioral consequences faced by individuals with sexual compulsivity, related neuropsychological studies are sparse. AIM To compare decision making and cognitive flexibility at baseline and after exposure to an erotic video in sexually compulsive participants and non-sexually compulsive controls. METHODS The sample consisted of 30 sexually compulsive men and 30 controls. Cognitive flexibility was investigated through the Wisconsin Card Sorting Test and decision making was examined through the Iowa Gambling Task. MAIN OUTCOME MEASURES Wisconsin Card Sorting Test categories, correct responses, and perseverative errors and Iowa Gambling Task general trends and blocks. RESULTS Sexually compulsive subjects and controls performed similarly at baseline. After watching an erotic video, controls performed better in block 1 of the Iowa Gambling Task (P = .01) and had more correct responses on the Wisconsin Card Sorting Test (P = .01). CONCLUSIONS The controls presented fewer impulsive initial choices and better cognitive flexibility after exposure to erotic stimuli. Messina B, Fuentes D, Tavares H, et al. Executive Functioning of Sexually Compulsive and Non-Sexually Compulsive Men Before and After Watching an Erotic Video. J Sex Med 2017;14:347-354.
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Štulhofer A, Jurin T, Briken P. Is High Sexual Desire a Facet of Male Hypersexuality? Results from an Online Study. JOURNAL OF SEX & MARITAL THERAPY 2016; 42:665-680. [PMID: 26569650 DOI: 10.1080/0092623x.2015.1113585] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Despite a growing number of studies, hypersexuality remains controversial and empirically elusive. Using a group comparison approach, this study revisited the claim that hypersexuality cannot be reliably distinguished from high sexual desire. An online survey, advertised as focusing on pornography use and sexual health, was carried out in 2014 among 1,998 Croatian men aged 18 to 60 years (Mage = 34.7, SD = 9.83). Membership in the hypersexuality group (HYP; n = 57) was determined using the Hypersexual Disorder Screening Inventory and the Hypersexual Behavior Consequences Scale. The highest values on two indicators of sexual desire/interest set membership in the high sexual desire group (HSD; n = 70). The overlap between the groups was negligible (n = 4). Compared to the rest of the sample, men in the HYP group had significantly higher odds of being single, not exclusively heterosexual, religious, depressed, prone to sexual boredom, experiencing substance abuse consequences, holding negative attitudes toward pornography use, and evaluating one's sexual morality more negatively. In contrast, the HSD group differed from controls only in reporting more positive attitudes toward pornography use. The study findings point to a distinct phenomenology of HSD and HYP in men. Clinical implications of the findings are briefly discussed.
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Affiliation(s)
- Aleksandar Štulhofer
- a Department of Sociology , Faculty of Humanities and Social Sciences, University of Zagreb , Zagreb , Croatia
| | - Tanja Jurin
- b Department of Psychology , Faculty of Humanities and Social Sciences, University of Zagreb , Zagreb , Croatia
| | - Peer Briken
- c Institute for Sex Research and Forensic Psychiatry , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Štulhofer A, Bergeron S, Jurin T. Is High Sexual Desire a Risk for Women's Relationship and Sexual Well-Being? JOURNAL OF SEX RESEARCH 2016; 53:882-891. [PMID: 26579557 DOI: 10.1080/00224499.2015.1084984] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Historically, women's sexual desire has been deemed socially problematic. The growing popularity of the concept of hypersexuality-which lists high sexual desire among its core components-poses a risk of re-pathologizing female sexual desire. Data from a 2014 online survey of 2,599 Croatian women aged 18-60 years was used to examine whether high sexual desire is detrimental to women's relationship and sexual well-being. Based on the highest scores on an indicator of sexual desire, 178 women were classified in the high sexual desire (HSD) group; women who scored higher than one standard deviation above the Hypersexual Disorder Screening Inventory mean were categorized in the hypersexuality (HYP) group (n = 239). Fifty-seven women met the classification criteria for both groups (HYP&HSD). Compared to other groups, the HSD was the most sexually active group. Compared to controls, the HYP and HYP&HSD groups-but not the HSD group-reported significantly more negative consequences associated with their sexuality. Compared to the HYP group, women with HSD reported better sexual function, higher sexual satisfaction, and lower odds of negative behavioral consequences. The findings suggest that, at least among women, hypersexuality should not be conflated with high sexual desire and frequent sexual activity.
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Affiliation(s)
- Aleksandar Štulhofer
- a Department of Sociology , Faculty of Humanities and Social Sciences, University of Zagreb
| | | | - Tanja Jurin
- c Department of Psychology , Faculty of Humanities and Social Sciences, University of Zagreb
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