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Briken P, Bőthe B, Carvalho J, Coleman E, Giraldi A, Kraus SW, Lew-Starowicz M, Pfaus JG. Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective. Sex Med Rev 2024; 12:355-370. [PMID: 38529667 PMCID: PMC11214846 DOI: 10.1093/sxmrev/qeae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/02/2024] [Accepted: 02/03/2024] [Indexed: 03/27/2024]
Abstract
INTRODUCTION The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed "hypersexual disorder," "sexual addiction," "porn addiction," "sexual compulsivity," and "out-of-control sexual behavior." OBJECTIVES To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them. METHODS A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues. RESULTS CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent "unhealthy" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed. CONCLUSIONS Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related "out-of-control sexual behaviors" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
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Affiliation(s)
- Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center, Hamburg-Eppendorf, Hamburg 20251, Germany
| | - Beáta Bőthe
- Department of Psychology, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre de Recherche Interdisciplinaire Sur Les Problèmes Conjugaux Et Les Agressions Sexuelles, Montréal, QC H3C 3J7, Canada
| | - Joana Carvalho
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro 3810-193, Portugal
| | - Eli Coleman
- Eli Coleman Institute for Sexual and Gender Health, University of Minnesota, Minneapolis, MN 55454, United States
| | - Annamaria Giraldi
- Sexological Clinic, Mental Health Center, Copenhagen University Hospital, Mental Health Services, Copenhagen CPH 2200, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Shane W Kraus
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV 5030, United States
| | - Michał Lew-Starowicz
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw 01-809, Poland
| | - James G Pfaus
- Center for Sexual Health and Intervention, Czech National Institute of Mental Health, Klecany 25067, Czech Republic
- Department of Psychology and Life Sciences, Faculty of Humanities, Charles University, Prague 18200, Czech Republic
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Villena-Moya A, Granero R, Chiclana-Actis C, Potenza MN, Blycker GR, Demetrovics Z, Bőthe B, Steward T, Fernández-Aranda F, Jiménez-Murcia S, Mestre-Bach G. Spanish Validation of the Long and Short Versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6) in Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:673-687. [PMID: 37845419 DOI: 10.1007/s10508-023-02700-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 06/26/2023] [Accepted: 09/06/2023] [Indexed: 10/18/2023]
Abstract
Although 1-14% of adolescents may experience problematic pornography use (PPU), psychometrically sound instruments for assessing PPU in Spanish-speaking adolescents are scarce. Given the advantages of the different forms of the Problematic Pornography Consumption Scale (PPCS), the aim of the present study was to assess the psychometric properties of the PPCS and PPCS-6, and to examine associations between PPU and age among boys and girls. Two school-based adolescent samples were recruited in Spain (n = 650; Mage = 16.0 [SD = 1.1]; 50% girls and 50% boys) and Mexico (n1, 160; Mage = 15.8 [SD = 1.1]; 68% girls) to assess the psychometric properties of the PPCS and PPCS-6. Confirmatory factor analysis was applied and convergent and discriminant validity with other measures related to PPU was also tested. The results provided empirical support for the six-factor structure of the PPCS and the one-factor structure of the PPCS-6. Boys with older age showed higher levels of tolerance than girls on the PPCS in both countries. Both the PPCS and the PPCS-6 may be considered valid psychometric instruments for the assessment of PPU in Spanish-speaking adolescents from Spain and Mexico.
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Affiliation(s)
- Alejandro Villena-Moya
- Centro de Investigación, Transferencia e Innovación, Universidad Internacional de la Rioja, La Rioja, 26006, Spain
- Unidad de Sexología Clínica y Salud Sexual de la Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Chiclana-Actis
- Centro de Investigación, Transferencia e Innovación, Universidad Internacional de la Rioja, La Rioja, 26006, Spain
- Unidad de Sexología Clínica y Salud Sexual de la Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
| | - Gretchen R Blycker
- College of Nursing, University of Rhode Island, Kingston, RI, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, QC, Canada
- Département de Psychologie, Université du Québec á Trois-Rivières, Trois-Rivières, QC, Canada
| | - Trevor Steward
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Barcelona, Spain
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Barcelona, Spain
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Centro de Investigación, Transferencia e Innovación, Universidad Internacional de la Rioja, La Rioja, 26006, Spain.
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Luo R, Xie Z, Silenzio VMB, Kuang Y, Luo D. Gay App Use, Sexuality Traits, and High-Risk Sexual Behaviors Among Men Who Have Sex With Men in China: Mediation Analysis. J Med Internet Res 2023; 25:e49137. [PMID: 37910154 PMCID: PMC10652192 DOI: 10.2196/49137] [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: 05/18/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Gay geosocial networking apps, also known as "gay apps," have gained increasing popularity in the men who have sex with men (MSM) community. Certain sexuality traits and gay app use are both associated with high-risk sexual behaviors among MSM. However, little is known about the underlying mechanism of such relationships. OBJECTIVE Based on the uses and gratifications theory, this study aimed to test the mediation effect of gay app use on the relationship between sexuality traits (sexual compulsivity and sexual sensation seeking) and high-risk sexual behaviors (multiple sexual partners and unprotected anal intercourse) among MSM. METHODS A cross-sectional, multicenter study was conducted in Wuhan and Changsha, China, from August to October 2020. A representative sample of 402 MSM was recruited through respondent-driven sampling. A self-administered web-based structured questionnaire was used to collect data on sociodemographic information, high-risk sexual behaviors, gay app use, sexual compulsivity, and sexual sensation seeking. Path analysis was conducted to assess the mediation effect. RESULTS Our study revealed that 67.42% (n=271) of MSM used gay apps for seeking potential sexual partners, with 37.06% (n=149) of them engaging in unprotected anal intercourse, and 45.42% (n=218) of them having multiple sexual partners. Of the participants, 17.16% (n=69) reported significant sexual compulsivity, while 29.10% (n=117) reported significant sexual sensation seeking. Notably, gay app usage partially mediated the relationship between sexual compulsivity and multiple sexual partners but fully mediated the relationship between sexual compulsivity and unprotected anal intercourse. Furthermore, gay app usage partially mediated the relationship between sexual sensation seeking and multiple sexual partners but fully mediated the relationship between sexual sensation seeking and unprotected anal intercourse. CONCLUSIONS High-risk sexual behaviors are common among MSM. Most MSM rely on gay apps to find sexual partners, which, when combined with higher levels of sexual compulsivity and sexual sensation seeking, can increase the likelihood of engaging in high-risk sexual behaviors. Therefore, interventions aimed at reducing these behaviors among MSM should focus on addressing the use of gay apps, while also considering the influence of their sexuality traits on gay app use.
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Affiliation(s)
- Rui Luo
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhi Xie
- Changsha Center for Disease Control and Prevention, Changsha, China
| | - Vincent M B Silenzio
- Department of Urban-Global Public Health, Rutgers School of Public Health, Rutgers University, Newark, NJ, United States
| | - Yun Kuang
- Changsha Zonda-sunshine Social Work Center, Changsha, China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Basting EJ, Barrett ME, Garner AR, Florimbio AR, Sullivan JA, Medenblik AM, Stuart GL. Sexual Narcissism and Hypersexuality Relate to Sexual Coercion in Hookups among U.S. University Students. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2577-2588. [PMID: 36947326 DOI: 10.1007/s10508-023-02580-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
Sexual violence remains a prevalent issue on college campuses. Sexual coercion, a form of sexual violence, is frequently employed within casual sexual encounters (i.e., hookups). The present study investigated hypersexuality and sexual narcissism as unique predictors of sexual coercion and examined whether there were gender differences in these associations. Participants (N = 793, ages 18-25) were undergraduate students at a large southeastern university who have: (1) engaged in sexual activity within the past six months and (2) had at least one prior hookup experience. Respondents completed surveys online assessing levels of sexual narcissism, hypersexuality, and sexual coercion perpetration in hookups. Participants primarily identified as female (71.7%), White (84.2%), and heterosexual (86.6%), with an average of 9.77 sexual engagements per month. Bivariate correlations and independent samples t-tests were conducted to examine associations between and gender differences across study variables, respectively. We assessed the factor structure of study variables using confirmatory factor analysis and tested hypotheses using structural equation modeling. Compared to women, men scored higher on sexual exploitation and all hypersexuality subscales. After establishing good-fitting measurement models, we found that both sexual narcissism and hypersexuality predicted increased sexual coercion perpetration and that gender did not moderate these associations. Study findings demonstrated that sexual narcissism and hypersexuality are risk factors for sexual coercion perpetration in hookups across gender. Although associations were consistent across gender, men may report higher levels of sexual coercion perpetration risk factors. Future researchers could focus on gender differences in the etiology of sexual coercion risk factors.
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Affiliation(s)
- Evan J Basting
- Department of Psychology, University of Tennessee, 204 Austin Peay Building, Knoxville, TN, 37996, USA.
| | - Maya E Barrett
- Department of Psychology, University of Tennessee, 204 Austin Peay Building, Knoxville, TN, 37996, USA
| | - Alisa R Garner
- Department of Psychology, University of Tennessee, 204 Austin Peay Building, Knoxville, TN, 37996, USA
| | | | - Jacqueline A Sullivan
- Department of Psychology, University of Tennessee, 204 Austin Peay Building, Knoxville, TN, 37996, USA
| | - Alyssa M Medenblik
- Department of Psychology, University of Tennessee, 204 Austin Peay Building, Knoxville, TN, 37996, USA
| | - Gregory L Stuart
- Department of Psychology, University of Tennessee, 204 Austin Peay Building, Knoxville, TN, 37996, USA
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Ortega-Otero M, Montesinos F, Charrabe L. Influence of psychological inflexibility and mindfulness on hypersexuality and sexual satisfaction in a Spanish sample. Front Psychol 2023; 14:1182222. [PMID: 37546467 PMCID: PMC10400090 DOI: 10.3389/fpsyg.2023.1182222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/22/2023] [Indexed: 08/08/2023] Open
Abstract
Sexual satisfaction is tremendously relevant to wellbeing and quality of life. Inversely, hypersexuality may increase the risk of psychological distress, unprotected sex, and marital problems. This study attempts to explore the sociodemographic variables related to hypersexuality and the relationship between hypersexuality and sexual dissatisfaction with psychological inflexibility, cognitive fusion, body awareness, bodily dissociation, and mindfulness skills in the Spanish population. The sample was made up of 530 participants between 18 and 67 years of age. In total, 5.5% displayed hypersexuality, more likely in males, lesbians and gay men, singles, and students. An online survey was conducted including standardized questionnaires as follows: AAQ-II, CFQ, SBC, MAAS, NSSS-S, and HBI. Significant moderate positive correlations were found between hypersexuality and psychological inflexibility, cognitive fusion, and bodily dissociation, and an inverse moderate correlation with mindfulness skills. Moderate negative correlations were found between sexual satisfaction and bodily dissociation. Linear regression showed psychological inflexibility was the variable with the most weight on hypersexuality, while bodily dissociation was the variable with the most influence on sexual dissatisfaction. This study suggests lesbians and gay men, males, and singles may show an increased vulnerability toward engaging in hypersexual behavior and provides justification for interventions focused on psychological inflexibility and mindfulness skills to treat hypersexuality and improve sexual satisfaction.
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Lee BN, Grubbs JB. Problem gambling within sexual and gender minorities: A systematic review. Addict Behav 2023; 144:107742. [PMID: 37121088 DOI: 10.1016/j.addbeh.2023.107742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/24/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
A body of literature now suggests that sexual and gender minorities (SGMs) experience a distinct set of stressors in the form of minority stress, which may function as a risk factor for the development of negative psychological and behavioral health outcomes. A systematic review of the literature was conducted through June 1st, 2022. Inclusion was limited to peer-reviewed publications in academic journals, with prospective and retrospective studies of a quantitative nature included for synthesis. Articles were required to contain an empirical measure of gambling cognitions, behaviors, motives, or outcomes. Studies that did not include sexual minorities within the sample or did not provide quantitative results which shed light on gambling in sexual minorities were excluded from the present review.In total, 12 eligible studies were identified for the current review. In general, this review highlighted methodological weaknesses within the literature and suggested that little is known about gambling in this population. Given conflicting findings across studies, further research is necessary to understand gambling in sexual and gender minorities. From a methodological standpoint, there is a need for clearer conceptualization and standardized measurement of gambling-related variables in vulnerable populations. Further, longitudinal research would be beneficial to understand the nuances of gambling disorder across sexual orientations and gender identities, as well as aid in the development of holistic intervention options that meet the needs of these more vulnerable groups.
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Affiliation(s)
- Brinna N Lee
- Department of Psychology, 822 E Merry Ave, Bowling Green State University, Bowling Green, OH 43403, USA.
| | - Joshua B Grubbs
- Department of Psychology, 822 E Merry Ave, Bowling Green State University, Bowling Green, OH 43403, USA
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7
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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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Kamolova M, Chen YL, Etuk R, Sacco SJ, Kraus SW. Differences within: Hypersexuality, Sensation Seeking and Pornography Viewing Behaviors in a Sample of Heterosexual, Gay, Bisexual, and Uncertain Men. SEXUAL HEALTH & COMPULSIVITY 2022. [DOI: 10.1080/26929953.2022.2162652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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9
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Hypersexual behaviour among young adults in Germany: characteristics and personality correlates. BMC Psychiatry 2022; 22:804. [PMID: 36536318 PMCID: PMC9762014 DOI: 10.1186/s12888-022-04370-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hypersexual behaviour (HB) is characterized by recurring unsuccessful efforts to control intense, repetitive sexual impulses that result in sexual activities and manifest in the behaviour of the concerning individual over an extended period. This study aims to describe the characterization of HB among the target group, identify personality correlates, and associations between HB and a lack of sexual education and reflection during school time. METHODS A cross-sectional design was used to survey the participants (age 18-27; n = 609) online who were recruited via a web forum for addiction selfcare, a website for casual sex dating, Facebook and the mail distribution of the University of Applied Science Nordhausen (Germany). Standardised questionnaires were used to measure the key variables in the study. The sexual behaviour (masturbation, pornography consumption, promiscuity), several personality tendencies, and retrospective information about sexual education of the participants during school time were investigated. Correlation and binomial logistic regression were used to analyse the data with HB as the outcome variable. RESULTS 10.5% (n = 64) of the participants were identified as hypersexual. The assignment to male sex, a problematic pornography consumption, and impulsive tendencies were determined as predictors of HB. Strong correlates were identified between HB and promiscuity, and impairments in important areas of life. Weak to moderate correlates comprise between HB and all investigated personality traits, and several aspects of sexual risk behaviour. No association was found between HB and a lacking sexual education during school time. The descriptive analysis revealed further sexual problems within the sample (e.g. feelings of shame and guilt, sexual risk behaviour, sexual dysfunction). CONCLUSION Young adults should get more attention as a vulnerable group for the development of hypersexuality in sexual education, prevention and therapy. Regarding to its treatment, HB therefore should be considered together with its associations with sociodemographic information, personality traits, and psychosocial factors.
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Ekmekçi Ertek İ, Bozdağ MÇ, Ünler M, Yurtseven ÇH, Candansayar S. Clinical Presentations of Female Hypersexuality on a Psychiatry Outpatient Clinic in Turkey: A Retrospective Analysis of Patients in the Concept of Diagnosis and Trauma. SEXUAL HEALTH & COMPULSIVITY 2022. [DOI: 10.1080/26929953.2022.2143460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- İrem Ekmekçi Ertek
- Gazi University Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | - Meltem Çınar Bozdağ
- Gazi University Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | - Mehmet Ünler
- Gaziantep 25 Aralık State Hospital, Psychiatry Clinic, Gaziantep, Turkey
| | | | - Selçuk Candansayar
- Gazi University Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
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Briken P, Wiessner C, Štulhofer A, Klein V, Fuß J, Reed GM, Dekker A. Who feels affected by "out of control" sexual behavior? Prevalence and correlates of indicators for ICD-11 Compulsive Sexual Behavior Disorder in the German Health and Sexuality Survey (GeSiD). J Behav Addict 2022; 11:900-911. [PMID: 36006765 PMCID: PMC9872532 DOI: 10.1556/2006.2022.00060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND AIMS The purpose of this study was to examine the prevalence and correlates of indicators consistent with Compulsive Sexual Behavior Disorder (CSBD)-defined and operationalized according to the ICD-11 guidelines-in a large (n = 4,633; 50.5% male; 49,5% female) probability-based German national sample. METHODS Participants were asked if they had ever experienced "intense and recurring sexual impulses or sexual urges that I had difficulty controlling and resulted in sexual behavior" over a period of several months. Those who reported this experience were queried about the associated distress. RESULTS Overall, 4.9% of men [95% CI = 3.9-6.1] and 3.0% of women [95% CI = 2.3-3.9] reported experiences consistent with ICD-11 diagnostic requirements for lifetime diagnosis. In the 12 months preceding the study, 3.2% of men [95% CI = 2.4-4.2] and 1.8% of women [95% CI = 1.2-2.5] reported experiences consistent with CSBD requirements. Compared to controls and participants who reported elements of compulsive sexuality but without accompanying distress, strict religious upbringing was most prevalent in the CSBD group. The CSBD group was more likely to view sexual practices like men having sex with men as unacceptable and to report the belief that pornography has negative impacts on their sex life and life in general. Compared to the other two groups, the CSBD group was significantly more likely to have received psychiatric treatment for depression or another mental health problem during the past 12 months. DISCUSSION AND CONCLUSIONS The current study provides novel and important insights into the prevalence and characteristics of CSBD in the general population.
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Affiliation(s)
- Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical-Centre Hamburg-Eppendorf, Germany,Corresponding author. Tel.: +49 (40) 7410-54564; fax: +49 (40) 7410-56406. E-mail:
| | - Christian Wiessner
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical-Centre Hamburg-Eppendorf, Germany,Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Aleksander Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia
| | - Verena Klein
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical-Centre Hamburg-Eppendorf, Germany
| | - Johannes Fuß
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical-Centre Hamburg-Eppendorf, Germany,Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Geoffrey M. Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA,Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Arne Dekker
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical-Centre Hamburg-Eppendorf, Germany
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Nolin MC, Bőthe B, Bergeron S, Godbout N, Daspe MÈ, Vaillancourt-Morel MP. Social Reactions to Disclosure of Sexual Violence in Adulthood and Women's Sexuality: The Mediating Role of Shame and Guilt. JOURNAL OF SEX & MARITAL THERAPY 2022; 49:270-286. [PMID: 35848486 DOI: 10.1080/0092623x.2022.2099495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study examined the mediating role of emotions related to sexual violence in adulthood in the associations between social reactions to sexual violence disclosure and sexual outcomes. Self-reported data were collected from 324 women reporting sexual violence and path analyses were conducted among the 264 women (81.5%) who disclosed their most recent sexual violence experience. Results showed that emotional support was associated with higher sexual satisfaction. Victim blame was associated with greater guilt related to the sexual violence, which, in turn, was associated with higher sexual compulsivity. Stigmatization was associated with greater shame related to the sexual violence, which, in turn, was associated with higher sexual distress and avoidance, and lower sexual satisfaction and function. Our findings highlight the importance of social reactions to sexual violence disclosure in women's sexuality.
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Affiliation(s)
- Marie-Chloé Nolin
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Beáta Bőthe
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
| | - Sophie Bergeron
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
| | - Natacha Godbout
- Department of Sexology, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Marie-Ève Daspe
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
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Briken P, Turner D. What does "Sexual" mean in compulsive sexual behavior disorder? •. J Behav Addict 2022; 11:222-225. [PMID: 35895459 PMCID: PMC9295231 DOI: 10.1556/2006.2022.00026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 11/28/2022] Open
Abstract
This paper comments three recent publications in the Journal of Behavioral Addictions (Brand et al., 2022; Gola et al., 2022; Sassover & Weinstein, 2022). It shortly discusses (1) the role of researcher biases and the significance of the naming of a disorder (here "sexual addiction" and "pornography use disorder") for stigma and treatment, (2) the development and course of CSBD and its significance for research results, (3) the role of "Sexual" in CSBD. The paper concludes that the guidelines for CSBD give a precise description and the authors plea for an exchange between disciplines and a sex positive treatment approach.
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Affiliation(s)
- Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany,Corresponding author. Tel.: +49-40-7410-52225, fax: +49-40-7410-56406. E-mail:
| | - Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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14
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Reed GM, First MB, Billieux J, Cloitre M, Briken P, Achab S, Brewin CR, King DL, Kraus SW, Bryant RA. Emerging experience with selected new categories in the ICD-11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. World Psychiatry 2022; 21:189-213. [PMID: 35524599 PMCID: PMC9077619 DOI: 10.1002/wps.20960] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Among the important changes in the ICD-11 is the addition of 21 new mental disorders. New categories are typically proposed to: a) improve the usefulness of morbidity statistics; b) facilitate recognition of a clinically important but poorly classified mental disorder in order to provide appropriate management; and c) stimulate research into more effective treatments. Given the major implications for the field and for World Health Organization (WHO) member states, it is important to examine the impact of these new categories during the early phase of the ICD-11 implementation. This paper focuses on four disorders: complex post-traumatic stress disorder, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. These categories were selected because they have been the focus of considerable activity and/or controversy and because their inclusion in the ICD-11 represents a different decision than was made for the DSM-5. The lead authors invited experts on each of these disorders to provide insight into why it was considered important to add it to the ICD-11, implications for care of not having that diagnostic category, important controversies about adding the disorder, and a review of the evidence generated and other developments related to the category since the WHO signaled its intention to include it in the ICD-11. Each of the four diagnostic categories appears to describe a population with clinically important and distinctive features that had previously gone unrecognized as well as specific treatment needs that would otherwise likely go unmet. The introduction of these categories in the ICD-11 has been followed by a substantial expansion of research in each area, which has generally supported their validity and utility, and by a significant increase in the availability of appropriate services.
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Affiliation(s)
- Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Michael B First
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals, Lausanne, Switzerland
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care, Menlo Park, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sophia Achab
- Outpatient Treatment Unit for Addictive Behaviors ReConnecte, Geneva University Hospitals, Geneva, Switzerland
- Psychological and Sociological Research and Training Unit, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Chris R Brewin
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Daniel L King
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
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15
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Koós M, Orosz G, Demetrovics Z, Bőthe B. Present hedonism and future time perspectives predicting hypersexuality and problematic pornography use. Front Psychiatry 2022; 13:914919. [PMID: 36081467 PMCID: PMC9447492 DOI: 10.3389/fpsyt.2022.914919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022] Open
Abstract
The Time Perspective (TP) theory (i.e., the psychological experience regarding time) was often examined in association with different addictive behaviors, and the different TPs (i.e., Past Positive, Past Negative, Present Hedonistic, Present Fatalistic, and Future TPs) demonstrated different relationship patterns with them. However, most studies were conducted in relation to substance use-related disorders, leaving crucial knowledge gaps concerning the associations between TPs and potential behavioral addictions. The aim of the present study was to examine the associations between the five TP dimensions, hypersexuality, and problematic pornography use (PPU), considering potential gender differences. Participants from two independent samples (N1 = 554; N2 = 453) completed a self-report survey on TPs and sexual behaviors. Structural equation modeling results indicated that the Present Hedonistic TP had a positive, moderate, and the Future TP had a negative, weak association with hypersexuality in both samples. Only the Present Hedonistic TP had a significant, positive, weak-to-moderate association with PPU across the samples. The explained variances of the models were higher in case of hypersexuality (28 and 27%, respectively), than in case of PPU (1 and 14%, respectively). No significant gender differences were observed. In line with previous findings concerning other predictors of hypersexuality and PPU, the results of the present study suggest that hypersexuality and PPU may differ from each other in terms of their TP background. Yet, present hedonism, which is related to impulsivity, may play an important role in both problematic sexual behaviors, suggesting that interventions focusing on this TP might be successful in reducing hypersexuality and PPU.
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Affiliation(s)
- Mónika Koós
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, Faculty of Education and Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Gábor Orosz
- Université d'Artois, Unité de Recherche Pluridisciplinaire Sport Santé Société, France
| | - Zsolt Demetrovics
- Institute of Psychology, Faculty of Education and Psychology, Eötvös Loránd University, Budapest, Hungary.,Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Beáta Bőthe
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,Département de Psychologie, Université de Montréal, Montreal, QC, Canada
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16
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Bőthe B, Koós M, Nagy L, Kraus SW, Potenza MN, Demetrovics Z. International Sex Survey: Study protocol of a large, cross-cultural collaborative study in 45 countries. J Behav Addict 2021; 10:632-645. [PMID: 34534102 PMCID: PMC8997233 DOI: 10.1556/2006.2021.00063] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/17/2021] [Accepted: 08/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Limitations of research into sexuality and compulsive sexual behavior disorder (CSBD) include the use of simplistic methodological designs and the absence of quality and unified measurements, empirically supported theoretical models, and large, collaborative studies between laboratories. We aim to fill these gaps with the International Sex Survey (ISS, http://internationalsexsurvey.org/). METHODS The ISS is a large-scale, international, multi-lab, multi-language study using cross-sectional survey methods, involving more than 40 countries. Participants responding to advertisements complete a self-report, anonymous survey on a secure online platform. Collaborators from each country collect a community sample of adults with a minimum sample size of 2,000 participants with a gender ratio of approximately 50-50% men and women, including diverse individuals with respect to sexuality and gender. The ISS includes a wide range of sociodemographic questions and scales assessing a diverse set of sexual behaviors, pornography use, psychological characteristics, and potential comorbid disorders. Analyses are conducted within a structural equation modeling framework, including variable (e.g., measurement invariance tests) and person-centered approaches (e.g., latent profile analysis). DISCUSSION AND CONCLUSIONS The ISS will provide well-validated, publicly available screening tools, helping to eliminate significant measurement issues in the field of sexuality research and health care. It will provide important insights to improve the theoretical understanding of CSBD as well as help to identify empirically supported treatment targets for prevention and intervention programs. Following open-science practices and making study materials open-access, the ISS may serve as a blueprint for future large-scale research in addiction and sexuality research.
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Affiliation(s)
- Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, Canada,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Corresponding author. E-mail: ,
| | - Mónika Koós
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Léna Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Shane W. Kraus
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Marc N. Potenza
- Yale University School of Medicine, New Haven, CT, USA,Connecticut Council on Problem Gambling, Wethersfield, CT, USA,Connecticut Mental Health Center, New Haven, CT, USA
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
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17
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Perales JC, Maldonado A, López-Quirantes EM, López-Torrecillas F. Association patterns of cannabis abuse and dependence with risk of problematic non-substance-related dysregulated and addictive behaviors. PLoS One 2021; 16:e0255872. [PMID: 34375360 PMCID: PMC8354435 DOI: 10.1371/journal.pone.0255872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 07/27/2021] [Indexed: 11/19/2022] Open
Abstract
Co-occurrence of drug misuse with other dysregulated behaviors is common. This study was aimed at exploring the associations between the risk of presenting a clinically relevant condition involving non-substance-related addictive or dysregulated behaviors (as measured by the MultiCAGE CAD-4 screening), and cannabis abuse/dependence (CAST/SDS) scores, and the role of gender therein. Participants were recruited using stratified probabilistic sampling at the University of Granada. Mann-Whitney’s U tests were used to compare male and female students in SDS and CAST scores. Associations between gender and MultiCAGE scores were estimated using the γ ordinal correlation index, and tested with χ2. For each MultiCAGE dimension, a Poisson-family mixed-effects model was built with either SDS or CAST as the main input variable, while controlling for nicotine and alcohol dependence, and relevant sociodemographic variables. Incidence rate ratios (IRR) were computed for SDS/CAST effects, and the significance threshold was family-wise Bonferroni-corrected. Gender differences were significant for cannabis dependence/abuse and all MultiCAGE scores for non-substance-related conditions, with males showing higher risk scores for excessive gambling, excessive internet use, excessive video gaming, and hypersexuality, and females presenting higher scores in dysregulated eating and compulsive buying. Cannabis dependence and abuse were significantly associated with a higher risk of problematic video gaming. These associations were mostly driven by males. Importantly, although risk of problematic video gaming was specifically associated with cannabis abuse/dependence, there was only a weak non-significant association between problematic video gaming and alcohol use scores. Risk of alcohol use problems, in turn, was strongly associated with all other non-substance-related problems (problematic gambling, excessive Internet use, dysregulated eating, compulsive buying, and hypersexuality). These differential associations can cast light on the etiological similarities and dissimilarities between problematic substance use and putative addictive behaviors not involving drugs.
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Affiliation(s)
- José C. Perales
- Department of Experimental Psychology, University of Granada, Granada, Spain
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Antonio Maldonado
- Department of Experimental Psychology, University of Granada, Granada, Spain
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Eva M. López-Quirantes
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
| | - Francisca López-Torrecillas
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
- * E-mail:
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18
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Carvalho J, Rosa PJ, Štulhofer A. Exploring Hypersexuality Pathways From Eye Movements: The Role of (Sexual) Impulsivity. J Sex Med 2021; 18:1607-1614. [PMID: 37057434 DOI: 10.1016/j.jsxm.2021.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/18/2021] [Accepted: 06/28/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Impulsivity is regarded as a key factor underpinning hypersexuality like-conditions. However, impulsivity is a multifaceted construct, and existing research has not been capturing such complexity, which includes the effects of domain-general and domain-specific impulsivity in hypersexuality. AIM The aim of this study was to test the predictive role of specific impulsivity domains, ie, domain-general and domain-specific, in hypersexuality and its associated consequences. METHODS Fifty-five men and 58 women went through an emotional Go/-no-Go task (including sexual, high-valence positive, and neutral pictures), aimed at capturing domain-general and domain-specific impulsivity. Ocular metrics were further considered in order to increase the validity of the experimental task, and provide a metric of attention capturing. The study was carried out in a community sample. OUTCOMES Self-reported (general)impulsivity and commission errors toward high-valence positive and sexual pictures (signaling domain-general and domain-specific impulsivity, respectively) were settled as independent variables, along with Time to First Fixation to stimuli, capturing early/uncontrolled attention. Scores on hypersexuality and negative consequences emerging from hypersexual behavior were settled as outcome variables. RESULTS Self-reported (general)impulsivity was the only predictor of hypersexuality scores, while negative consequences were best accounted by higher fixation time to sexual pictures. In all, findings did not support the role of domain-specific impulsivity (ie, sexual impulsivity) in hypersexuality. CLINICAL TRANSLATION Findings tentatively suggest that hypersexuality, as captured at the community level, may be best positioned within the general spectrum of psychopathology, thus influencing educational and clinical intervention protocols aimed at addressing hypersexuality related complaints. Protocols would be expected to primarily target general psychopathology phenomena, rather than specific sexual aspects. STRENGTHS & LIMITATIONS This study implemented an innovative approach to capture different impulsivity domains, thus adding to previous literature in the field. However, the current study precludes the generalization of findings to clinical samples, where psychological comorbidities are expected to impact results. Further, findings must be read with caution given to limited effect sizes. CONCLUSION While hypersexuality was related to self-reported (general) impulsivity, findings on the negative consequences associated with hypersexual behavior mirrored response patterns found in depression. Such evidence aligns with the assumption that hypersexuality related phenomena might be better positioned in the psychopathology domain, rather than simply framed as a specific sexual problem. Carvalho J, Rosa PJ, Štulhofer A. Exploring Hypersexuality Pathways From Eye Movements: The Role of (Sexual) Impulsivity. J Sex Med 2021;18:1607-1614.
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Affiliation(s)
- Joana Carvalho
- CPUP: Center for Psychology of Porto University, Faculty of Psychology and Educational Sciences, Porto University, Porto, Portugal.
| | - Pedro J Rosa
- Lusófona University, Digital Human-Environment Interaction Lab (HEI-lab), Lisbon, Portugal; ISMAT, Transdisciplinary Research Center (ISHIP), Portimão, Portugal
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
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19
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Kürbitz LI, Briken P. Is Compulsive Sexual Behavior Different in Women Compared to Men? J Clin Med 2021; 10:jcm10153205. [PMID: 34361988 PMCID: PMC8348482 DOI: 10.3390/jcm10153205] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/14/2021] [Accepted: 07/19/2021] [Indexed: 12/16/2022] Open
Abstract
The inclusion of Compulsive Sexual Behavior Disorder (CSBD) in the ICD-11 has sparked research interest on this topic in recent years. This review aims to investigate gender differences in Compulsive Sexual Behavior (CBD) and persons with CSBD. While impulsivity and psychiatric comorbidity play a role in persons with CSBD regardless of gender, some gender differences can be identified. CSBD is more prevalent in men, with a higher rate of reported sexual behaviors and higher scores on questionnaires measuring CSBD related symptoms. Neuroticism and stress vulnerability seem to play a more important role in the symptomatology of CSBD in women. While it seems plausible that childhood adversities play a role in the development of CSB, the manner with respect to how these adversities affect men and women differently is still to be explored. More clinical studies including the female CSBD population are required to infer clinical implications.
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20
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Efrati Y, Amichai-Hamburger Y. Adolescents who solely engage in online sexual experiences are at higher risk for compulsive sexual behavior. Addict Behav 2021; 118:106874. [PMID: 33647708 DOI: 10.1016/j.addbeh.2021.106874] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/07/2021] [Accepted: 02/07/2021] [Indexed: 01/20/2023]
Abstract
In addition to its expression offline, sexual behavior is frequently expressed online. Some adolescents solely engage in online sexual activities, whereas others in offline and online activities, or have no sexual experience at all. In the current research, we examined whether those who solely engage in online sexual activities are at greater risk for compulsive sexual behavior. In Study 1 (n = 164), we examined differences in compulsive sexual behavior (CSB) and risky sexual action tendencies between study groups. In Study 2 (n = 713), we statistically replicated the classification into different sexual behaviors and examined differences between the clusters in CSB, social tendencies and socio-demographic measures. Results indicated that adolescents who only engaged in online sexual activities had significantly higher percentage of clinical CSB, were less likely boys and more likely to be religious. There were not more prone to risky sexual behavior, however. The current research expands the knowledge about offline or online sexually related activities among adolescence.
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Affiliation(s)
| | - Yair Amichai-Hamburger
- The Research Center for Internet Psychology (CIP), Sammy Ofer School of Communication, The Interdisciplinary Center (IDC) Herzliya, Herzliya 46150, Israel
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21
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Bőthe B, Vaillancourt-Morel MP, Bergeron S. Hypersexuality in Mixed-Sex Couples: A Dyadic Longitudinal Study. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2139-2150. [PMID: 34189627 DOI: 10.1007/s10508-021-01959-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 06/13/2023]
Abstract
Emotion dysregulation and intimacy problems are theoretically underpinned correlates of hypersexuality (i.e., uncontrollable sexual urges, fantasies, and behaviors resulting in distress and impairment in different areas of functioning), but the directionality of these associations has not been established, as work in this area has relied on cross-sectional designs. Moreover, although hypersexuality may have significant adverse effects on romantic relationships and approximately half of treatment-seeking individuals are in a relationship, prior studies almost exclusively involved samples of men, regardless of their relationship status. The aim of the present study was to examine the directionality of associations between both partners' emotion dysregulation, physical (i.e., partnered sexual frequency) and relationship intimacy, and hypersexuality using a longitudinal, dyadic framework. Self-reported data of 267 mixed-sex couples (Mage_men = 29.9 years, SD = 8.2; Mage_women = 27.7 years, SD = 6.7) at baseline (T1) and six-month follow-up (T2) were analyzed using a crossed-lagged model within an actor-partner interdependence framework. Prior greater emotion dysregulation (T1) in both men and women was associated with their own later greater hypersexuality (T2). Women's prior greater hypersexuality (T1) was associated with their later lower relationship intimacy (T2). Lower levels of intimacy were not significantly associated with later hypersexuality. No partner effects were found in relation to hypersexuality. Findings suggest that men and women may use sexual behaviors to cope with negative emotions, which could, in turn, lead to hypersexuality. Intimacy problems did not precede hypersexuality, although women's hypersexuality may reduce their own relationship intimacy over time.
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Affiliation(s)
- Beáta Bőthe
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | | | - Sophie Bergeron
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
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22
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Sinclair DL, Vanderplasschen W, Savahl S, Florence M, Best D, Sussman S. Substitute addictions in the context of the COVID-19 pandemic. J Behav Addict 2020; 9:1098-1102. [PMID: 33216014 PMCID: PMC8969734 DOI: 10.1556/2006.2020.00091] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/23/2020] [Accepted: 10/25/2020] [Indexed: 12/24/2022] Open
Abstract
The global spread of COVID-19, subsequent stay-at-home requirements, spatial distancing measures, and long-term isolation present additional challenges for persons in recovery. Using an illustrative case from South Africa, we discuss COVID-19 related pornography use through the lens of relapse and substitute addiction. South Africa is the epicenter of the pandemic in Africa, and has issued an alcohol and cigarette ban. Historical examples suggest that responses to forced abstinence may include compliance and abstinence, but also seeking alternatives to the original addiction and substitution. Substitution of alternative activities/objects may provide similar appetitive effects to fill the void of the terminated addictive behavior, temporarily or in the long-term. While substitutes do not necessarily portend a relapse, coupled with isolation and reduced recovery support, they can potentiate relapse to the former or 'new' addictive behavior. Addiction professionals should be aware of the potential for such negative impacts during and after the COVID-19 pandemic.
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Affiliation(s)
- Deborah Louise Sinclair
- Department of Psychology, University of the Western Cape
,
Cape Town
,
South Africa,Department of Special Needs Education, Ghent University
,
Ghent, 9000
,
Belgium,
Corresponding author.
| | | | - Shazly Savahl
- Centre for Interdisciplinary Studies on Children, Families and Society, University of the Western Cape
,
Cape Town
,
South Africa
| | - Maria Florence
- Department of Psychology, University of the Western Cape
,
Cape Town
,
South Africa
| | - David Best
- Department of Criminology and Social Sciences, University of Derby
,
Derby
,
UK
| | - Steve Sussman
- Institute for Health Promotion and Disease Prevention, University of Southern California
,
Los Angeles, CA
,
USA
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