Is Compulsive Sexual Behavior Different in Women Compared to Men?

Sexual trauma and compulsive sexual behavior in young men and women: A network analysis involving two samples

Background and aims

Sexual trauma is associated with multiple negative health and social conditions, including compulsive sexual behavior. The present study examined network structures involving sexual trauma history, psychological distress (defined as depression and/or anxiety symptoms), substance use, transactional sex, and compulsive sexual behavior. Prior network analysis work in this area is limited.

Methods

We drew upon two samples of young adults (Sample 1: n = 1,884, 69.3% women; Sample 2: n = 2,337, 69.7% women) recruited from universities in the United States in 2020-2022.

Results

Findings support relationships between sexual trauma and compulsive sexual behavior. Relationships between elements of compulsive sexual behavior, timing of trauma, psychological distress, substance use, engagement in transactional sex, and gender differences were identified. Significant edge strength differences between men and women were observed; distress was a more central node for men, trauma was a more central node for women (Sample 1). When examining elements of CSB, significant gender differences in edge strength were also observed (e.g. connections between dissatisfaction and relapse for men, dissatisfaction and negative consequences for women).

Discussion and conclusions

Specific aspects of CSB closely related to sexual trauma history (e.g., dissatisfaction) and co-occurring psychopathology or clinical concerns (e.g., depression, anxiety, substance use, and engagement in transactional sex) and warrant further attention and study.

Compulsive sexual behavior and paraphilic interests in adults with chronic tic disorders and Tourette syndrome: a survey-based study

Early research suggested that compulsive sexual behavior (CSB) and paraphilic interests (PI) are more prevalent in adults with primary tic disorders compared to the general population. However, recent data on this topic remain scarce. We conducted an anonymous online survey capturing data on CSB and PI in adult patients with primary tic disorders. We also explored the role of antipsychotic tic medication and the impact of neuropsychiatric comorbidities like attention-deficit hyperactivity disorder and depression. In total, 62 participants (26 females/36 males) completed the survey. The prevalence of CSB and PI were 12.9% and 19.4%, respectively. There was no association with antipsychotic medication nor with symptoms of depression. However, the presence of attention-deficit hyperactivity disorder was associated with a higher prevalence of both CSB and PI. The current results contrast with earlier reports and show that in adults with primary tic disorders, the prevalence of CSB and PI is not overly prominent.

Metacognitive beliefs and desire thinking as potential maintenance factors of compulsive sexual behavior

Using the Elaborated Intrusion Theory of Desire and the Self-Regulatory Executive Function model of psychopathology as bases, this study explored whether metacognitive beliefs and desire thinking (DT) are associated with higher levels of Compulsive Sexual Behavior (CSB). A total of 1185 participants from the general population were included in the study (mean ± SD age = 25.32 years ± 5.58; age range = 18-19 years; females = 76.7 %). Metacognitive beliefs, DT, CSB, anxiety and depressive symptoms were assessed. Correlation analyses and path analyses were run. Results of the path analysis showed that positive metacognitive beliefs about DT were associated with DT-Imaginal Prefiguration (DT-IP), which in turn was positively associated with DT-Verbal Perseveration (DT-VP). The latter was strongly and positively associated with negative metacognitive beliefs about DT, which in turn was linked to CSB. Moreover, DT-VP was also found to be directly linked to the outcome variable and positive metacognitive beliefs about DT were also directly linked to DT-VP and negative metacognitive beliefs about DT. The total Coefficient of Determination (0.45) indicated a good fit to the observed data. Metacognitive beliefs and DT may be potential maintenance factors in CSB. Metacognitive beliefs and DT could also be considered as potential therapeutic targets in clinical interventions aimed at reducing the severity of CSB.

Spanish Validation of the Brief Pornography Screen Within a Clinical Sample of Individuals with Gambling Disorder

Problematic pornography use (PPU) shares characteristics with behavioral addictions, such as gambling disorder (GD), and PPU and GD may frequently co-occur. In order to fill existing gaps in screening instruments for PPU validated in GD, the study examined the psychometric properties of the Spanish version of the Brief Pornography Screen (BPS) within a clinical sample of individuals with GD. A total of 200 individuals seeking treatment for GD were consecutively recruited. The psychometric properties of the BPS were examined by performing confirmatory factor analysis (CFA) and testing for evidence of convergent and discriminant validity. The CFA supported a one-factor solution showing high internal consistency (α = 0.81). The BPS showed convergent validity and correlated with psychological distress, general psychopathology, impulsive tendencies, and low self-directedness. The BPS demonstrated adequate psychometric properties and is therefore recommended as a brief screening tool for identifying probable PPU in individuals seeking treatment for GD.

Exploring the Interplay of problematic pornography use, sexism, and rape myth acceptance: An Italian cross-sectional study

The relationships among pornography use, sexist ideology and false or stereotypical ideas about rape are controversial. This study specifically examines the associations of problematic pornography use (PPU) with sexism and rape myth acceptance among both male and female participants within the Italian context utilizing a cross-sectional methodology. Based on data from 815 participants collected through an online questionnaire, the study identifies significant gender-based differences, with men typically exhibiting higher scores on sexism, rape myth acceptance, and token resistance beliefs. Correlation analysis revealed that in men, there was a positive relationship between pornography cravings and sexist beliefs but not between pornography cravings and minimizing rape or accusations of lying (rape myth). Women showed significant positive correlations across all problematic pornography use dimensions with sexist ideology, although the relationship with rape myth acceptance varied. These findings underscore the critical need for acknowledging these relationships to enhance strategies for preventing gender-based violence.

Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective

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.

How much online pornography is too much? A comparison of two theoretically distinct assessment scales

BACKGROUND

Online pornography use, an ever more common activity, has raised myriad psychosocial and clinical concerns. While there is a need to screen for and measure its problematic dimension, there is a debate about the adequacy of existing assessment tools.

OBJECTIVE

The study compares two instruments for measuring pathological online pornography use (POPU) that are based on different theoretical frameworks-one in line with DSM-5 criteria and the six-component addiction model and one in line with ICD-11 criteria.

METHODS

An international sample of 1,823 adults (Mean age = 31.66, SD = 6.74) answered an online questionnaire that included the Short Version of the Problematic Pornography Consumption Scale (PPCS-6) and the Assessment of Criteria for Specific Internet-Use Disorders (ACSID-11). Factorial, correlational, and network analyses were conducted on the data.

RESULTS

Both tools adequately screened for online "addictive" behavior, but the ACSID-11 was superior in assessing the degree of clinical risk.

CONCLUSION

Depending on the specific aim of the assessment (screening vs. clinical diagnostics), both online pornography measurement tools may be useful.

Compulsive sexual behavior disorder: The importance of research on women

The current understanding of compulsive sexual behavior disorder (CSBD) is primarily based on studies involving non-clinical samples of heterosexual men, resulting in significant gaps in knowledge regarding women with CSBD. The commentary highlights the domains where further research is necessary, including incidence and prevalence, etiology, diagnostic criteria, comorbidities, sexual patterns, personality profiles, and barriers to help-seeking among women with CSBD. Bridging this research gap is essential for improving clinical care, developing tailored interventions, and increasing awareness about CSBD in women among healthcare providers, policymakers, and the general public.

Identifying Relationships Between Difficulties with Emotion Regulation and Compulsive Sexual Behavior

Emotion dysregulation is an associated feature of compulsive sexual behavior disorder (CSBD), now recognized by the World Health Organization. Previous studies have identified associations between trait emotion dysregulation and CSBD. Given that difficulties with emotion regulation (DERS) is comprised of several facets (e.g., difficulty with impulse control and lacking awareness of one's feelings when upset), and that these facets differentially relate to other mental health concerns, the present study aimed to examine how DERS facets relate to compulsive sexual behavior (CSB). The present study also considered interpersonal emotion regulation via attachment avoidance and attachment anxiety. Hierarchical regression was conducted, first accounting for demographic covariates, then adding attachment styles, and finally all DERS subscales. Results indicated that, among a large, diverse, online U.S. sample (N = 915; Mage = 39.21, SD = 0.81; 54.3% men), difficulty controlling impulses when upset, difficulty with clarity of emotions, and non-acceptance of emotions were significantly positively associated with CSB (small to moderate effects). Attachment anxiety and avoidance were also significantly positively associated with CSB, although their effects were minimal when adding DERS facets. Overall, this study supports the theorized impact of emotion dysregulation on CSB. Assessment of individual differences in DERS and intervening on these concerns are important for treating CSB.

Mapping the links between sexual addiction and gambling disorder: A Bayesian network approach

Contemporary literature and recent classification systems have expanded the field of addictions to include problematic behaviours such as gambling and sexual addiction. However, conceptualisation of behavioural addictions is poorly understood and gender-based differences have emerged in relation to how these behaviours are expressed. The current research conducted partial-correlation and Bayesian network analyses to assess the symptomatic structure of gambling disorder and sexual addiction. Convenience community sampling recruited 937 adults aged 18 to 64 years (315 females, Mage = 30.02; 622 males, Mage = 29.46). Symptoms of problematic behaviours were measured using the Online Gambling Disorder Questionnaire (OGDQ) and the Bergen Yale Sex Addiction Scale (BYSAS). Results indicate distinct gender-based differences in the symptom networks of sexual addiction and gambling disorder, with a more complex network observed amongst men for both conditions. Addiction salience, withdrawal and dishonesty/deception were important components of the addictive network. Interpersonal conflict was more central for women while intrapsychic conflict a more prominent issue for men. Differences in the two symptom networks indicate separate disorders as opposed to a single underlying construct. Treating practitioners and community initiatives aimed at addressing sexual addiction and disordered gambling should consider gender, when designing educational or therapeutic interventions.

Decision making and executive functions in problematic pornography use

Introduction

Previous research on cognitive functions in Compulsive Sexual Behavior Disorder (CSBD) and problematic pornography use (PPU) reported inconsistent findings and mostly included sexual pictures in the used tasks. The role of general executive functions and cognitive competences (without the presence of appetitive stimuli) in the context of PPU is largely unexplored.

Methods

This study investigated differences between individuals with high versus low problem severity of PPU regarding decision making and executive functions. The sample of the laboratory study consisted of N = 102 male adults. Besides measures of trait impulsivity, we used standard neuropsychological tests (Trail Making Test and three-back working memory task) and an intertemporal risky choice paradigm, the Cards & Lottery Task (CLT).

Results

The results show heightened impulsivity (urgency and deficits in perseverance) in individuals with high PPU, but no differences regarding performance in the CLT and executive function tasks.

Discussion

The findings indicate that PPU might be associated with impulsive behavior when experiencing strong emotions (urgency) and deficient cognitive performance especially in the presence of sexual stimuli but not in general.

The Structure of Compulsive Sexual Behavior: A Network Analysis Study

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.

Obsessive-compulsive, harm-avoidance and persistence tendencies in patients with gambling, gaming, compulsive sexual behavior and compulsive buying-shopping disorders/concerns

BACKGROUND AND AIMS

There is a growing interest in determining the specific role of obsessive-compulsive features in different behavioral addictions. However, more studies comparing sizable clinical populations with different addictions are needed.Therefore, a main aim of the present study was to explore the presence of obsessive-compulsive features among people with different behavioral addictions (gambling disorder, internet gaming disorder, compulsive sexual behavior disorder and compulsive buying-shopping concerns). Through a clustering procedure, the existence of empirical clusters among treatment-seeking patients based on obsessive-compulsive measures was explored.

MATERIALS AND METHODS

The Symptom Checklist-Revised, and the Temperament and Character Inventory-Revised were obtained from 4,010 treatment-seeking patients. Obsessive-compulsive features were measured with the obsessive-compulsive subscale of the Symptom Checklist-Revised and the harm avoidance and persistence dimensions of the Temperament and Character Inventory-Revised. Cluster analysis was applied to explore the existence of empirical groups based on obsessive-compulsive features.

RESULTS

Patients with compulsive sexual behavior disorder and compulsive buying-shopping disorder reported the highest scores on the obsessive-compulsive subscale, while patients with gambling disorder showed the lowest scores on harm avoidance, and patients with internet gaming disorder the lowest scores on persistence. Two mutually exclusive clusters were identified. Cluster 1 exhibited a more maladaptive psychopathological and personality profile than cluster.

DISCUSSION AND CONCLUSIONS

These results provide new evidence regarding obsessive-compulsive features in specific behavioral addictions. Therapeutic approaches should consider that different addictions may present distinct levels of obsessive-compulsive features.

Time Goes Back-Time Perspective in Polish Men with Compulsive Sexual Behavior Disorder and Risky Sexual Behavior

Many relationships between time perspective and a propensity to engage in risky behaviors or developing addictions have been demonstrated. The aim of our study was to determine the differences in intensity of individual time perspectives in people with compulsive sexual behavior disorder (CSBD) and risky sexual behavior (RSB). The analysis includes 425 men: 98 CSBD (age M = 37.99 years), 63 RSB (age M = 35.70 years), 264 without CSBD and RSB features constituting the control group (age M = 35.08 years). We used the Zimbardo Time Perspective Inventory, the Sexual Addiction Screening Test-Revised, the Risky Sexual Behavior Scale and a self-constructed survey. The comparative analysis showed a higher intensity of past-negative (p = 0.040), a lower of past-positive (p < 0.001) and a present-fatalistic (p = 0.040) outlook in the CSBD group compared to the control group. Compared to the participants with RSB, the CSBD group was characterized by a higher intensity of past-negative (p = 0.010), a lower of past-positive (p = 0.004) and a present-hedonistic perspective (p = 0.014). The RSB group also achieved higher results from the present-hedonistic perspective (p = 0.046) compared to the control group. The CSBD patients indicate a stronger tendency to focus on negative past compared to non-CSBD men, both taking and not taking RSB. The time perspective profiles of RSB men are similar to those who do not engage in RSB. The distinguishing feature of men with RSB without CSBD is a greater ability to enjoy current experiences.

Hypo- or hyperfunction? Differential relationships between compulsive sexual behavior disorder facets and sexual health

BACKGROUND

Previous studies linking compulsive sexual behavior disorder (CSBD) and sexual health have shown mixed results, which could be due to the fact that different CSBD facets may have differential relationships with sexual functioning.

AIM

As CSBD is a multidimensional disorder, we wanted to investigate whether distinct CSBD domains are differentially related to sexual health.

METHODS

Two online studies were conducted-the first on a convenience sample (812 Polish participants; mean [SD] age, 22.07 [5.91] years) and a replication study on a representative sample of Polish adults (n = 1526; 43.02 [14.37]). Hierarchical regression was employed with sexual functioning as a predicted variable and CSBD symptoms as predictors.

OUTCOMES

The Compulsive Sexual Behavior Disorder Scale was used to assess CSBD symptoms, and the Arizona Sexual Experience Scale was used to measure sexual dysfunction.

RESULTS

In study 1, CSBD salience (β = -.20, P < .001) predicted hyperfunction (ie, stronger sex drive, easier sexual arousal, easier vaginal lubrication/penile erection, easier ability to reach an orgasm, and more satisfying orgasms). Yet, CSBD negative consequences (β = .15, P = .001) and dissatisfaction (β = .22, P < .001) predicted hypofunction (ie, weaker sex drive, more difficulties in sexual arousal, greater difficulties in vaginal lubrication/penile erection, less ability to reach an orgasm, and less satisfying orgasms). Similar results were found in study 2: salience (β = -.26, P < .001) and relapse (β = -.11, P = .004) predicted hyperfunction, while negative consequences (β = .12, P < .001) and dissatisfaction (β = .12, P < .001) predicted hypofunction.

CLINICAL IMPLICATIONS

Our results stress the importance of assessing the severity of each group of symptoms in patients with CSBD to better understand possible difficulties in their sexual functioning.

STRENGTHS AND LIMITATIONS

Our studies are the first to evaluate the effects of each CSBD domain on sexual health. We also replicated results obtained from a convenience sample on a representative sample. The cross-sectional design of the current studies does not allow causal relations to be tested, so future longitudinal research should be carried out. We also gathered data from a general population-thus, it is important to replicate these results on patients diagnosed with CSBD.

CONCLUSION

Our research points out the differential impact of CSBD domains on sexual health: salience and relapse are related to sexual hyperfunction, while negative consequences and dissatisfaction to hypofunction.

New Challenges in Sexuality and Sexual Dysfunction

Human sexuality constitutes not only a basic need but also a right that significantly enriches interpersonal relationships, providing mutual satisfaction and pleasure [...].

Withdrawal and tolerance as related to compulsive sexual behavior disorder and problematic pornography use - Preregistered study based on a nationally representative sample in Poland

Background

The addiction model of compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) predicts the presence of withdrawal symptoms and increased tolerance for sexual stimuli in the disorder phenotype. However, clear empirical evidence supporting this claim has largely been lacking.

Methods

In the preregistered, nationally representative survey (n = 1,541, 51.2% women, age: M = 42.99, SD = 14.38), we investigated the role of self-reported withdrawal symptoms and tolerance with respect to CSBD and PPU severity.

Results

Both withdrawal and tolerance were significantly associated with the severities of CSBD (β = 0.34; P < 0.001 and β = 0.38; P < 0.001, respectively) and PPU (β = 0.24; P < 0.001 and β = 0.27; P < 0.001, respectively). Of the 21 withdrawal symptom types investigated, the most often reported symptoms were frequent sexual thoughts that were difficult to stop (for participants with CSBD: 65.2% and with PPU: 43.3%), increased overall arousal (37.9%; 29.2%), difficult to control level of sexual desire (57.6%; 31.0%), irritability (37.9%; 25.4%), frequent mood changes (33.3%; 22.6%), and sleep problems (36.4%; 24.5%).

Conclusions

Changes related to mood and general arousal noted in the current study were similar to the cluster of symptoms in a withdrawal syndrome proposed for gambling disorder and internet gaming disorder in DSM-5. The study provides preliminary evidence on an understudied topic, and present findings can have significant implications for understanding the etiology and classification of CSBD and PPU. Simultaneously, drawing conclusions about clinical importance, diagnostic utility and detailed characteristics of withdrawal symptoms and tolerance as a part of CSBD and PPU, as well as other behavioral addictions, requires further research efforts.

The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder

OBJECTIVES

The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD.

METHODS

An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews.

RESULTS

Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD.

CONCLUSIONS

An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.

A motivation model of sex addiction - Relevance to the controversy over the concept

An integrative model of sexual addiction is presented, involving a combination of models based upon (i) incentive motivation theory and (ii) the dual organisation of the control of behavior. The model is related to ongoing arguments about the validity of the notion of addiction when applied to sexual behavior. It is suggested that the evidence strongly favors the viability of an addiction model of sex. Strong similarities to the classical addiction to hard drugs are observed and features can be better understood with the help of the model. These include tolerance, escalation and withdrawal symptoms. It is argued that other candidates for accounting for the phenomena, such as obsessive-compulsive behavior, faulty impulse control, high drive and hypersexuality do not fit the evidence. The role of dopamine is central to the model. The model's relevance to stress, abuse, development, psychopathy, fantasy, sex differences, evolutionary psychology and the interaction with drug-taking is shown.

The circle of gain and loss: Iranian women's life stories of suffering from compulsive sexual behaviour

This qualitative study aimed to explore Iranian women's life stories living with compulsive sexual behaviour. Data were collected between 2014 and 2016 in two cities. Forty-four semi-structured interviews were conducted by using theoretical sampling and constant comparative analysis. Four thematic categories were constructed from the data, including "scars left on the spirit and mind,"; "bizarre beliefs regarding sexuality and gender,"; "compensation for emptiness and the loss,"; and "difficulty in emotional regulation." This paper shows how abusive patterns of relationships in childhood could lead to sexual compulsivity. The paper results can direct our attention to the importance of health and social care and training to recognise abusive situations and support these children.

Gender differences in the association of psychological distress and sexual compulsivity before and during the COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic had numerous consequences for general, mental and sexual health. As gender differences in sexual compulsivity (SC) have been reported in the past and SC has been connected to adverse events and psychological distress, the current study aims at investigating associations between these factors in the context of contact restrictions in the course of the COVID-19 pandemic in Germany.

METHODS

We collected data for five time points in four retrospective measurement points in an online convenience sample (n T0 = 399, n T4 = 77). We investigated the influence of gender, several pandemic-related psychosocial circumstances, sensation seeking (Brief Sensation Seeking Scale), and psychological distress (Patient-Health-Questionnaire-4) on the change of SC (measured with an adapted version of the Yale-Brown Obsessive Compulsive Scale) between T0 and T1 (n = 292) in a linear regression analysis. Additionally, the course of SC over the time of the pandemic was explored with a linear mixed model.

RESULTS

Male gender was associated with higher SC compared to female gender over all measurement points. An older age, being in a relationship, having a place to retreat was associated with a change to lower SC during the first time of the pandemic. Psychological distress was associated with SC in men, but not in women. Men, who reported an increase of psychological distress were also more likely to report an increase of SC.

DISCUSSION

The results demonstrate that psychological distress seems to correlate with SC differently for men and women. This could be due to different excitatory and inhibitory influences on men and women during the pandemic. Furthermore, the results demonstrate the impact of pandemic related psychosocial circumstances in the times of contact restrictions.

Early-life trauma, negative and positive life events, compulsive sexual behavior disorder and risky sexual action tendencies among young women with substance use disorder

Although significant advances have been made in the field to date, gender-based issues for women remain a neglected area in much of substance abuse research. In the current study we examined two gaps in the literature: the co-occurrence of compulsive sexual behavior disorder (CSBD) and risky sexual action tendencies among women with substance use disorders (SUDs), and their shared antecedents in the form of early life adversity and negative life events. The sample comprised 132 women of whom 62 had substance use disorder (drug and alcohol) and 70 were healthy controls. Each participant completed self-report measures of drug abuse and alcoholism, compulsive sexual behavior disorder and risky sexual action tendencies as well as early-life trauma and negative and positive life events. Results indicate that young women with substance use disorder have higher compulsive sexual behavior disorder symptoms and more prevalent risky sexual action tendencies than controls. Compulsive sexual behavior was also found to mediate the association between substance use and risky sexual action tendencies. In addition, all addictive behaviors were linked with emotional abuse at childhood but not with other types of abuse. Conversely, negative life events in adulthood were only linked with CSBD and not with substance use. The findings provide deeper insights into the comorbidity of addictive behaviors and an opportunity for developing more effective treatments for women who suffer from these addictions.

The Effect of the COVID-19 Pandemic on the Assessment of Sexual Life-Repeated Cross-Sectional Surveys among Polish Adults in 2017, 2020 and 2021

The study aims to investigate whether assessment of sexual life remained stable during the COVID-19 pandemic. Two surveys were conducted among Polish adults aged 18–70 years in June 2020 (n = 2042; perspective of last 2–3 months) and in June 2021 (n = 2418; last 12 months). Data from 2017 (n = 1980) were used as a reference point. Four questions allowed for defining five sexual life assessment profiles (k-means cluster analysis). Their characteristics were presented using 12 variables and 16 factors that contributed to difficulties in sexual life. The 2020 survey showed a temporary increase in the importance of sexual life and the frequency of sexual intercourse. However, the percentage of respondents representing the most favorable profile decreased significantly over the consecutive survey periods (47.1%, 34.2%, and 32.3%, respectively). Pandemic-induced fatigue and stress as well as the permanent presence of others at home were reported as two main factors negatively affecting the frequency of sexual intercourse during the pandemic. Respondents who assessed their sexual life as poor were more likely to consider illness, depression, and low self-esteem as factors negatively impacting their sexual life in 2021 than a year earlier. The results confirmed that as the pandemic drew on, the assessment of sexual life changed compared to the time around the first lockdown.

Sexual Motivations Underlying Compulsive Sexual Behavior in Women and Men From Germany and Hungary

BACKGROUND

There are ongoing debates about conflicting models on how to conceptualize compulsive sexual behavior. At the heart of these discussions is the question about the sexual motivations underlying compulsive sexual behavior, as different models assume different motivations.

AIM

The aim of the present study was to understand sexual motivations underlying compulsive sexual behavior and their relation to the most prominent conceptualizations of compulsive sexual behavior (eg, compulsive sexual behavior disorder [CSBD], sex addiction).

METHODS

We used self-reported data from 2 large samples of Hungarian and German populations (N = 9814). The Sexual Motivation Scale (SexMS), a 24-item self-report measure based on self-determination theory, was used to assess a diverse set of sexual motivations. Compulsive sexual behavior was assessed with the 19-item Compulsive Sexual Behavior Disorder Scale (CSBD-19), that is based on the ICD-11 diagnostic guidelines of CSBD. We used structural equation modeling to examine the hypothesized associations between sexual motivations and compulsive sexual behavior and examined potential gender differences in these associations.

OUTCOMES

Compulsive sexual behavior was assessed in relation to a set of sexual motivations.

RESULTS

Amotivation had the strongest positive association with compulsive sexual behavior, but integrated, introjected, and intrinsic motivations were also positively related to it. Importantly, these associations did not differ for women and men, and between the 2 samples.

CLINICAL IMPLICATIONS

Future research and treatment should also consider sexual motivations that are not listed among the ICD-11 guidelines for CSBD, including high levels of sexual interest, continuing the behavior despite having little satisfaction from it and coping with sex.

STRENGTHS & LIMITATIONS

Although we used large samples of general populations in 2 Western countries, this motivational background of compulsive sexual behavior awaits replication in a clinical sample of individuals experiencing CSBD.

CONCLUSION

The identified sexual motivations underlying compulsive sexual behavior are relevant for assessing and treating patients as motivations may be integrated into psychotherapeutic interventions. Koós M, Fuss J, Klein V, et al. Sexual Motivations Underlying Compulsive Sexual Behavior in Women and Men From Germany and Hungary. J Sex Med 2022;19:170-181.