What is Normal Pornography Use in a Highly Religious Area? Exploring Patterns of Pornography Use in Utah

BACKGROUND

Pornography has become mainstream in society, including in the state of Utah, which is a highly religious, conservative state.

AIM

The purpose of this study is to gather basic descriptive norms for pornography use in the state of Utah (given its unique religious profile), establish clinical cutoffs based on frequency and duration of pornography consumption, and begin to establish a clinical picture of problematic pornography use in a regionally representative sample.

METHODS

We recruited a representative sample of 892 Utahns via CloudResearch.com. Participants completed the following measures: Consumption of Pornography - General (COPS); Problematic Pornography Use Scale; Clear Lake Addiction to Pornography Scale; The Inventory of Depression and Anxiety Symptoms (Second Version).

OUTCOME

Documentation of pornography use norms among Utahns.

RESULTS

In our sample, 79% reported viewing pornography in their lifetime (85% of men, 75% of women). The most common frequency of pornography viewing was weekly or monthly among men, and monthly or every 6 months among women, which is comparable to national averages. Men and women showed significantly different pornography use frequencies. We demonstrate a relationship between higher levels of pornography use and higher perceived levels of pornography use as a problem or "addiction" and depression scores and explore the typical demographics of our highest pornography users.

CLINICAL TRANSLATION

This study will aid clinicians in using the COPS to derive normal pornography use compared to above average pornography use among pornography users from a religious background, especially for clinicians who seek to provide normative data to clients presenting with problematic pornography use like in motivational interviewing interventions.

STRENGTHS AND LIMITATIONS

Strengths include our measures generally demonstrated strong validity, we provide the beginnings of sound clinical implementation of the COPS for benchmarking pornography use in a clinical setting in Utah, and that our sample was representative of the state of Utah according to current census data. Limitations include those commonly seen in survey-based data collection methods, and that findings from our unique Utah sample may not be as relevant among other religious or cultural samples.

CONCLUSION

Our findings provide an updated picture of pornography use in the state of Utah and suggest that even those high in religiosity continue to use pornography. Our results can provide a spectrum of pornography use, aiding a pornography user in treatment to be able to compare his or her use to this norm. Esplin CR, Hatch SG, Ogles BM, et al. What is Normal Pornography Use in a Highly Religious Area? Exploring Patterns of Pornography Use in Utah. J Sex Med 2022;19:823-833.

Sexual Addiction, Hypersexual Behavior and Relative Psychological Dynamics during the Period of Social Distancing and Stay-at-Home Policies Due to COVID-19

During the COVID-19 pandemic, increased stress factors affected people's motivations to engage in potentially addictive behaviors. Sexuality, understood as one of the psychological aspects to be investigated to explore the level of psychological well-being of a person, has suffered considerable repercussions due to the pandemic. A growing body of evidence suggests an unprecedented increase in Internet use and online pornography consumption during the pandemic. Since March 2020, during the lockdown period, Pornhub has seen a worldwide increase in pornography use of 11.6% compared to the previous average days. This research was conducted with the aim of exploring the possible increasing use of pornographic material during the lockdown period, in order to assess whether dysfunctional behaviors, such as compulsive behaviors, and thoughts of sex-related obsessives can lead to hypersexual behavior or a more severe Sexual Addiction. The individuals who participated in our research were 18 years of age or older (mean 23.1, s.d. 5.8), and 48% male and 52% females and were recruited online to complete a self-report questionnaire in the period between April 2020 and April 2021. The questionnaires were delivered via main social networks. The tool used for our survey was the SAST (Sexual Addiction Screening Test), a questionnaire including socio-demographic data and data relating to sexual practices, such as sexual orientation and time spent on the Internet for sexual activities. The results revealed significant differences concerning the various factors investigated such as loss of control, addictive symptoms and hide score.

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.

The Link Between Boredom and Hypersexuality: A Systematic Review

BACKGROUND

Some conceptualizations of hypersexuality posit boredom as a possible trigger of hypersexual behavior.

AIM

This work aims to review published articles addressing the link between boredom and hypersexuality to investigate if this relationship can yet be established based on current empirical data.

METHODS

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies, published until September 2019, were retrieved from EBSCO, Scopus, Web of Science, and PubMed. A systematic search was conducted using an exhaustive list of key terms combining "boredom" with "hypersexuality," "sexual impulsivity," "sexual compulsivity," and "sexual addiction." Only articles presenting empirical results concerning the relationship between boredom and hypersexuality were considered.

RESULTS

From the initial poll of 76 articles, only 19 articles were included in our final selection. Of the total studies, 16 were quantitative studies and 3 were qualitative studies. 4 studies were validation studies of hypersexuality-related measures, 11 studies concerned online sexual activity, and 3 reported sexual boredom. 7 studies with men used non-heterosexual samples. 5 studies used samples with both women and men, and 1 study used a sample of women only. Most studies indicate a positive association between boredom and hypersexuality, although 4 did not.

IMPLICATIONS

Further studies with diversified samples are still indispensable, as female samples are not portrayed and research is much focused on online sexual activity. Future research should explore the relationship between boredom and hypersexuality within specific behavioral specifiers including masturbation, pornography use, sexual behavior with consenting adults, cybersex, telephone sex, and strip clubs.

STRENGTHS AND LIMITATIONS

To the authors' knowledge, this is the first review looking at the possible link between boredom and hypersexuality. Investigation on the topic is scarce, and several of the studies included in this review correspond to anecdotal evidences of the phenomenon, as only few studies used appropriate measures of boredom.

CONCLUSION

Although current literature identifies a link between boredom and hypersexuality, further substantive research is still much needed to clarify the associations between the 2 constructs. de Oliveira L, Carvalho J. The Link Between Boredom and Hypersexuality: A Systematic Review. J Sex Med 2020;17:994-1004.

Investigating Clinically and Scientifically Useful Cut Points on the Compulsive Sexual Behavior Inventory

INTRODUCTION

One of the major obstacles to conducting epidemiologic research and determining the incidence and prevalence of compulsive sexual behavior (CSB) has been the lack of relevant empirically derived cut points on the various instruments that have been used to measure the concept.

AIM

To further develop the Compulsive Sexual Behavior Inventory (CSBI) through exploring predictive validity and developing an empirically determined and clinically useful cut point for defining CSB.

METHODS

A sample of 242 men who have sex with men was recruited from various sites in a moderate-size Midwestern city. Participants were assigned to a CSB group or a control group using an interview for the diagnosis that was patterned after the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition. The 22-item CSBI was administered as part of a larger battery of self-report inventories.

MAIN OUTCOME MEASURES

Receiver operating characteristic analyses were used to compute area-under-the-curve measurements to ascertain the predictive validity of the total scale, the control subscale, and the violence subscale. Cut points were determined through consensus of experts balancing sensitivity and specificity as determined by receiver operating characteristic curves.

RESULTS

Analyses indicated that the 22-item CSBI was a good predictor of group membership, as was the 13-item control subscale. The violence subscale added little to the predictive accuracy of the instrument; thus, it likely measures something other than CSB. Two relevant cut points were found, one that minimized false negatives and another, more conservative cut point that minimized false positives.

CONCLUSION

The CSBI as currently configured measures two different constructions and only the control subscale is helpful in diagnosing CSB. Therefore, we decided to eliminate the violence subscale and move forward with a 13-item scale that we have named the CSBI-13. Two cut points were developed from this revised scale, one that is useful as a clinical screening tool and the other, more conservative measurement that is useful for etiologic and epidemiologic research. Miner MH, Raymond N, Coleman E, Swinburne Romine R. Investigating Clinically and Scientifically Useful Cut Points on the Compulsive Sexual Behavior Inventory. J Sex Med 2017;14:715-720.

Understanding the Personality and Behavioral Mechanisms Defining Hypersexuality in Men Who Have Sex With Men

INTRODUCTION

Hypersexuality has been conceptualized as sexual addiction, compulsivity, and impulsivity, among others, in the absence of strong empirical data in support of any specific conceptualization.

AIM

To investigate personality factors and behavioral mechanisms that are relevant to hypersexuality in men who have sex with men.

METHODS

A sample of 242 men who have sex with men was recruited from various sites in a moderate-size mid-western city. Participants were assigned to a hypersexuality group or a control group using an interview similar to the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition. Self-report inventories were administered that measured the broad personality constructs of positive emotionality, negative emotionality, and constraint and more narrow constructs related to sexual behavioral control, behavioral activation, behavioral inhibition, sexual excitation, sexual inhibition, impulsivity, attention-deficit/hyperactivity disorder, and sexual behavior.

MAIN OUTCOME MEASURES

Hierarchical logistic regression was used to determine the relation between these personality and behavioral variables and group membership.

RESULTS

A hierarchical logistic regression controlling for age showed a significant positive relation between hypersexuality and negative emotionality and a negative relation with constraint. None of the behavioral mechanism variables entered this equation. However, a hierarchical multiple regression analysis predicting sexual behavioral control indicated that lack of such control was positively related to sexual excitation and sexual inhibition owing to the threat of performance failure and negatively related to sexual inhibition owing to the threat of performance consequences and general behavioral inhibition

CONCLUSION

Hypersexuality was found to be related to two broad personality factors that are characterized by emotional reactivity, risk taking, and impulsivity. The associated lack of sexual behavior control is influenced by sexual excitatory and inhibitory mechanisms, but not by general behavioral activation and inhibitory mechanisms.

Self-reported indicators of hypersexuality and its correlates in a female online sample

INTRODUCTION

Hypersexual behavior has been a controversial and much disputed issue in the field of sexual medicine. However, only little attention has been paid to hypersexual behavior in women. Therefore, to date there is limited knowledge on the behavioral patterns of hypersexuality in women.

AIMS

The purpose of the present study was to examine which sexual behavioral patterns are associated with self-reported indicators of hypersexuality in a female online sample. The second aim was to evaluate the association between hypersexuality and sexual risk behavior in women.

METHODS

In total, 988 women participated in an online survey. Logistic regression analysis was conducted to examine the association between sexual behavioral patterns and hypersexuality. Furthermore, correlation analyses were calculated in order to identify the relationship between sexual risk behavior and hypersexuality.

MAIN OUTCOME MEASURES

Indicators of hypersexual behavior were measured by the Hypersexual Behavior Inventory (HBI). In addition, current and present impersonal sexual activities were investigated. Sexual risk behavior was assessed using the Sexual Sensation Seeking Scale (SSSS).

RESULTS

High masturbation frequency, number of sexual partners, and pornography use were associated with a higher degree of hypersexual behavior in women. Furthermore, the HBI total score was positively correlated to sexual risk behavior.

CONCLUSION

The results of the current study do not support the idea of previous research that hypersexual women are typically engaged in more passive forms of sexual behavior. Rather female hypersexuality seems to be more characterized by impersonal sexual activity. An association between hypersexual behavior and sexual risk behavior was identified. The implications of these findings for potential prevention strategies and therapeutic interventions are discussed.