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Golder S, Markert C, Psarros R, Discher JP, Walter B, Stark R. Two subtypes of compulsive sexual behavior disorder. Front Psychiatry 2023; 14:1248900. [PMID: 38025451 PMCID: PMC10666180 DOI: 10.3389/fpsyt.2023.1248900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Models explaining addictive behaviors such as the Interaction of Person-Affect-Cognition-Execution (I-PACE) model emphasize the importance of reinforcement mechanisms for developing and maintaining these behaviors, including compulsive sexual behavior disorder (CSBD) as well as personal characteristics as vulnerability factors. This study aimed to determine whether there are CSBD subtypes distinguished by reinforcement sensitivity. We hypothesize that one subtype is sensitive to positive reinforcement (C+subtype) and one is sensitive to negative reinforcement (Ȼ-subtype). We calculated a cluster analysis with data from 62 patients with CSBD and tested differences between the identified clusters by t-test. The sample consisted only of men. Cluster variables were: the sensitivity to the Behavioral Inhibition and Approach System (BIS/BAS), the severity of depressive symptoms (BDI-II), the severity of Trait Anxiety (STAI-T), Sexual Sensation Seeking (SSSS), Thrill- and Adventure-Seeking (SSS-V subscale), Disinhibition (SSS-V subscale), Experience Seeking (SSS-V subscale), and Boredom Susceptibility (SSS-V subscale). Between-cluster differences were analyzed for Trait Sexual Motivation (TSMQ) and Sexual Compulsivity (SCS). The results showed a two-cluster solution with cluster 1 representing patients sensitive to negative reinforcement (Ȼ-subtype) and cluster 2 representing patients sensitive to positive reinforcement (C+subtype). No significant difference in symptom severity of Sexual Compulsivity between clusters was found. Cluster 2 showed higher Importance of Sex and a higher motivation to seek sexual encounters than cluster 2. We found a two-cluster solution regarding reinforcement sensitivity in patients with CSBD. This may have clinical implications regarding individual therapy by focusing on the underlying maintenance mechanisms.
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Affiliation(s)
- Sarah Golder
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
| | - Charlotte Markert
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen, Germany
| | - Rhea Psarros
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
| | - Julian Peter Discher
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
| | - Bertram Walter
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen, Germany
| | - Rudolf Stark
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen, Germany
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