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Childhood Characteristics and Personal Dispositions to Sexually Compulsive Behavior Among Young Adults
Abstract
This study explored possible associations between two personal tendencies “sexual compulsivity” and “sexual sensation seeking,” and self-esteem, family environmental conditions and sexual abuse experiences during childhood in a sample of 539 young adults in a mid-western university. A cross-sectional survey design was employed and data were collected using self-report, anonymous questionnaires. Men scored higher on the measures of sexual compulsivity and sexual sensation seeking than women. Mean scores on the measure of sexual compulsivity and sexual sensation seeking in this young adult college sample were lower when compared with high risk groups such as men living with HIV. Sex abuse experiences and poor family environment during childhood were associated with sexual sensation seeking and sexual compulsive tendencies. Neither sexual compulsivity nor sexual sensation seeking was associated with childhood self-esteem. Further, the results of this study suggest that sexual compulsive behavior compared to sexual sensation seeking, has much stronger connection with childhood etiological factors investigated in this study. Thus, as suggested by other sex researchers, those who are challenged by compulsive behaviors may need long-term treatment, but sensation seekers could possibly be effectively treated with short-term behavioral interventions. Causal relationships between childhood etiological factors and out-of-control behaviors, and subsequent risky sexual behaviors, as well as their implications for health promotion programs targeted at young adults, need to be investigated using longitudinal and qualitative research methods.
... In a study measuring CSBD with a composite index based on previously validated scales (HBI, SCS and SAST), the number decreased to 10.1% of students (of which 30.6% were female) endorsing CSBD [28]. Nevertheless, the gender effect with higher indices for males was reported in numerous student samples and with a variety of measurements (HDSI, [30]; HD and HBCS [31]; SCS [32,33]). ...
... In an attempt to further conceptualize CSB, many studies regarding psychiatric comorbidities and psychological traits have been conducted. In the studies reviewed CSB has been reported to have correlations with perfectionism [45], paraphilias and sexual dysfunction [30,46], mood disorders (e.g., anxiety and depression) [26,35,38,41,47,48], experience of childhood sexual abuse [47,49,50], OCD [35,41], Autism Spectrum Disorder [42], general emotional dysregulation [31], substance abuse [43,44], maladaptive schemata [51], excitement seeking in general [45,52], compulsivity and impulsivity [47,49,53], high sexual arousal/excitation [25], higher neuroticism [47], avoidant coping mechanisms [54], high rates of psychiatric comorbidity in general [38], high distress rates and negative emotions [14], boredom [48], general childhood adversities and trauma [30,33,43,49,[55][56][57][58][59], pathological buying [37], insecure attachment style [60][61][62] and risky sexual behavior [32] in both genders. ...
... Often discussed antecedents to CSB include childhood adversities and trauma, which were investigated in ten of the reviewed studies [30,33,43,49,[55][56][57][58][59] of which six investi-gated gender differences. One study [30] found a correlation between the HDSI and a history of sexual abuse (β = 0.144 and p = 0.001) in women but not in men. ...
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.
... Additionally, researchers have yet to investigate potential gender differences in the relationships between dispositional mindfulness facets and CSB. Theory and prior research indicated that the clinical presentation of CSB may vary by gender (Ferree 2001;McKeague 2014;Perera et al. 2009). For instance, women with CSB endorsed more frequent, and more severe, childhood trauma histories than did men with CSB (Perera et al. 2009) and were motivated to engage in CSB in response to feeling lonely, abandoned, and powerless (Ferree 2001). ...
... Theory and prior research indicated that the clinical presentation of CSB may vary by gender (Ferree 2001;McKeague 2014;Perera et al. 2009). For instance, women with CSB endorsed more frequent, and more severe, childhood trauma histories than did men with CSB (Perera et al. 2009) and were motivated to engage in CSB in response to feeling lonely, abandoned, and powerless (Ferree 2001). Furthermore, fMRI data indicated that men with problematic pornography use, a facet of CSB, reacted to external erotic cues more readily than did men without problematic pornography use despite equally liking the erotic content (Gola et al. 2017). ...
... Gender differences in the relationships between mindfulness facets and CSB were minimal; nonetheless, treatment studies may wish to evaluate the utility of attending to gender-specific experiences related to CSB among individuals with comorbid CSB and SUD. For instance, women with CSB presented with a clinical profile that differed from their male counterparts' (e.g., higher prevalence of sexual assault; Perera et al. 2009), which may have implications for mindfulness-based approaches to treatment. It should be noted that mindfulness-based approaches were not adequately evaluated for CSB treatment. ...
Objectives
Compulsive sexual behavior (CSB) is overrepresented among adults with substance use disorders (SUD), yet there is no empirically supported CSB treatment for this population. Cross-sectional and single case designs supported dispositional mindfulness as a potential CSB intervention target. However, the relations between CSB and each of the five dispositional mindfulness facets remain unknown.
Methods
Extending prior research to inform intervention efforts, we reviewed medical records for 1993 adults (77.6% male) in residential treatment for SUD to examine gender differences in the relations between dispositional mindfulness facets (acting with awareness, observation of experience, describing with words, nonjudging of inner experience, and nonreactivity to inner experience) and five CSB indicators (loss of control, relationship disturbance, preoccupation, affect disturbance, and internet problems).
Results
For men, path analyses revealed that acting with awareness, nonjudging of inner experience, describing with words, nonreactivity to inner experience, alcohol/drug use and problems, and depression and anxiety symptoms related to CSB (p range .00–.04). For women, acting with awareness, nonjudging of inner experience, alcohol/drug use and problems, and depression symptoms related to several CSB indicators (p range .00–.04).
Conclusions
Mindfulness-based CSB interventions should evaluate the benefit of increasing intentional responses towards present-moment experiences among adults with SUD. Targeting alcohol/drug misuse, negative affect, and judgment towards thoughts and emotions may be beneficial.
... In examining etiological factors of sex addiction, four main areas were focused on: trauma, attachment, shame, and cultural contributions. There are alarmingly high rates of childhood traumas in the backgrounds of those with sex addiction, but for women the rates and severity of traumas are much higher (Carnes, 1991;Griffee et al., 2012;Opitz et al., 2009;Perera, Reece, Monahan, Billingham, & Finn, 2009;Ross, 1996;Schwartz & Southern, 2000;Tedesco & Bola, 1997;Weiss, 2000). In particular, sexual abuse is the form of trauma that is most often studied and discussed. ...
... men). In a larger study of 539 undergraduate students (69.2% female, 30.8% male), Perera et al. (2009) looked at the relationship among childhood sexual abuse, family environment, and self-esteem, and later disposition toward compulsive sexual behaviors. They found that, "sexual abuse experiences and poor family relationships during childhood enhance vulnerability to initiate and maintain out-of-control sexual behaviors" (Perera et al., 2009, p. 141). ...
... They found that, "sexual abuse experiences and poor family relationships during childhood enhance vulnerability to initiate and maintain out-of-control sexual behaviors" (Perera et al., 2009, p. 141). They also found that the men scored higher, on average, than the women on the measures of sexual compulsivity and sexual sensation-seeking (Perera et al., 2009). Aaron (2012) interprets this finding to mean that women are less likely than men to experience sexual addiction but that when they do childhood sexual abuse may be highly correlated. ...
This literature review focuses on gender differences to delineate the etiology, presentation, and treatment needs of women with sex addiction. Empirical and clinical data show that women experience more childhood traumas and damage from attachment ruptures. Shame is the core affect of sex addiction and is compounded for women by negative cultural messages. Women's sexually addictive behaviors are more relationally motivated. With these gender differences of etiology and presentation as a foundation, recommendations specific to the treatment of women with sexual addiction are provided and placed within a multimodal therapeutic milieu.
... The mean SCS score for males was 16.94 and for females was 12.96. These are similar to the means found in a community sample of US college students (Perera, 2009) in which the mean for males was 16.36 and for females was 12.42. Table 2 below shows data on the percentage of participants classified as potential addicts based on the cut-off points employed in previous literature and set out above. ...
... The present research supports such findings, as significant associations were found between childhood emotional abuse and exposure to sexual material during childhood with sexual compulsivity. However, the majority of previous literature in this field has focussed on the relationship between sexual compulsivity and childhood sexual or physical abuse, whilst ignoring the impact of emotional abuse and neglect (Carnes, 1991;Perera et al, 2009). The finding that childhood emotional abuse and not child sexual or physical abuse was related to sexual compulsivity in this research thus requires discussion. ...
... It is important to note that our sample was a community sample of self-identified 'addicts', rather than a sample of previous inpatient sex addicts (as in Carnes & Delmonico, 1996) or a sample of college students (as in Perera, 2009) which may account for differences in findings. It is also worth noting that childhood emotional abuse may be considered difficult to quantify in the same way as physical or sexual abuse and this may account for the lack of feelings of control and empowerment, may then serve to defend against the anxious feelings aroused by intimacy, and so serves to counter disturbed internal templates of relating. ...
There is a lack of evidence regarding the nature of the relationship between childhood trauma and sexual compulsivity in adulthood. Participants (n = 348) were users of support websites relating to drug, alcohol, gambling, and sexual addictions who completed an online survey including addiction questionnaires, the Sexual Compulsivity Scale, and the Early Trauma Inventory (Short Form). Multiple regression modeling indicated that gender, sexual orientation, childhood emotional abuse, childhood exposure to pornography, and parental sex addiction were associated with sexual compulsivity in adulthood (R2 = 0.23). Childhood sexual or physical abuse and addictions to other behaviors (alcohol, drugs, gambling) were not associated with adult sexual compulsivity.
... The mean SCS score for males was 16.94 and for females was 12.96. These are similar to the means found in a community sample of US college students (Perera, 2009) in which the mean for males was 16.36 and for females was 12.42. Table 2 below shows data on the percentage of participants classified as potential addicts based on the cut-off points employed in previous literature and set out above. ...
... The present research supports such findings, as significant associations were found between childhood emotional abuse and exposure to sexual material during childhood with sexual compulsivity. However, the majority of previous literature in this field has focussed on the relationship between sexual compulsivity and childhood sexual or physical abuse, whilst ignoring the impact of emotional abuse and neglect (Carnes, 1991;Perera et al, 2009). The finding that childhood emotional abuse and not child sexual or physical abuse was related to sexual compulsivity in this research thus requires discussion. ...
... It is important to note that our sample was a community sample of self-identified 'addicts', rather than a sample of previous inpatient sex addicts (as in Carnes & Delmonico, 1996) or a sample of college students (as in Perera, 2009) which may account for differences in findings. It is also worth noting that childhood emotional abuse may be considered difficult to quantify in the same way as physical or sexual abuse and this may account for the lack of feelings of control and empowerment, may then serve to defend against the anxious feelings aroused by intimacy, and so serves to counter disturbed internal templates of relating. ...
There is a lack of evidence regarding the nature of the relationship between childhood trauma and sexual compulsivity in adulthood. Participants (n=348) were users of support websites relating to drug, alcohol, gambling and sexual addictions who completed an online survey including addiction questionnaires, the Sexual Compulsivity Scale and the Early Trauma Inventory (Short Form). Multiple regression modelling indicated that gender, sexual orientation, childhood emotional abuse, childhood exposure to pornography and parental sex addiction were associated with sexual compulsivity in adulthood (R 2 =0.23). Childhood sexual or physical abuse and addictions to other behaviors (alcohol, drugs, gambling) were not associated with adult sexual compulsivity.
... Dans le cas des comportements sexuels problématiques, plusieurs études ont mis en évidence des associations entre ces conduites et des antécédents traumatiques, notamment la présence d'abus sexuels (Carnes, 1991;Ferree, 2003;Labadie et al., 2018;Perera et al., 2009;Schwartz & Southern, 2000). Kor et collègues (2014) ont montré que l'utilisation problématique de pornographie en ligne était associée à des niveaux plus élevés d'antécédents traumatiques et à des relations affectives plus insécures à l'âge adulte (conséquences fréquentes du traumatisme et de l'abus; Cassidy & Mohr, 2001). ...
... Dès lors, le travail sur la conscientisation par la personne du sens et de l'utilité de son comportement sexuel en ligne est nécessaire. Cela permet notamment à la personne de réaliser que ce comportement vise à une réduction des émotions négatives à court terme, mais qu'il engendre une série de conséquences négatives à moyen et à long terme (par exemple des difficultés 8 WÉRY, MAURAGE ET BILLIEUX relationnelles et/ou sexuelles avec le partenaire, ou une réactivation du sentiment de honte, Brand et al., 2016;Parker & Guest, 2003;Perera et al., 2009). ...
Depuis l’apparition et le développement d’Internet, de nombreux sites à caractère sexuel ont vu le jour et sont utilisés par de multiples usagers. Une partie de ces utilisateurs présentent une utilisation problématique de cybersexualité et développent des comportements sexuels en ligne de nature excessive et/ou addictive. Un champ de recherche focalisé sur cette population a récemment émergé, notamment afin d’identifier les facteurs de risques impliqués et les processus psychologiques sous-jacents. Cependant, ces facteurs sont souvent étudiés isolement, ne permettant pas d’aboutir à une description exhaustive et intégrée de ce comportement problématique multi-déterminé. L’objectif central du présent article est dès lors de proposer, sur base de la littérature existante, un modèle intégratif et processuel des facteurs psychologiques impliqués dans l’utilisation problématique de cybersexualité et ce, afin de permettre d’une part de structurer les recherches futures sur la thématique en ciblant les processus centralement impliqués, et d’autre part de mieux évaluer et prendre en charge, en contexte clinique, les personnes présentant ce type de problématique.
... Another study of 539 self-identified "sex addicts" also found that 78% of individuals were CSA survivors. 20 Additionally, as indicated in a recent review, 1 studies have found positive links between sexual abuse and hypersexual behavior among general community samples, 21 men who have sex with men, 22 individuals incarcerated for sexual offenses, 23 individuals with sexual trauma, 24 U.S. military veterans, 25 and university students. 20 In this work, there is a wide range of estimates for correlations between sexual abuse and hypersexuality, partly due to differences in measurements of both hypersexuality and sexual abuse across studies. 1 Multiple measures of hypersexuality exist, 26 with some studies defining it subjectively or continuously and others focusing only on individuals who meet a suggested threshold or criteria for disordered behavior. ...
... 20 Additionally, as indicated in a recent review, 1 studies have found positive links between sexual abuse and hypersexual behavior among general community samples, 21 men who have sex with men, 22 individuals incarcerated for sexual offenses, 23 individuals with sexual trauma, 24 U.S. military veterans, 25 and university students. 20 In this work, there is a wide range of estimates for correlations between sexual abuse and hypersexuality, partly due to differences in measurements of both hypersexuality and sexual abuse across studies. 1 Multiple measures of hypersexuality exist, 26 with some studies defining it subjectively or continuously and others focusing only on individuals who meet a suggested threshold or criteria for disordered behavior. Estimates of hypersexuality have been reported to range from approximately 3% to 6% of U.S. adults, 27 with some authors reporting hypersexuality in 3% of men and 1% of women. ...
Background
Individuals with histories of sexual abuse may be more likely to experience sexual-related problems including hypersexuality, but gender-related differences remain unclear.
Aim
This online study examined sexual abuse history and hypersexuality by gender among 16,823 Hungarian adults, adjusting for age, sexual orientation, relationship status, education, employment status, and residence.
Methods
An online questionnaire on one of the largest Hungarian news portals advertised this study examining sexual activities in January 2017. 3 categorizations of age-related sexual abuse were examined: child sexual abuse (CSA) occurring at age 13 and earlier (compared to no abuse), adolescent/adult sexual abuse (AASA; compared to no abuse), and CSA and AASA (CSA/AASA; compared to one age-related category of abuse or the other).
Outcomes
The outcome variable, hypersexuality, was examined as a continuous variable due to the low prevalence of clinical hypersexuality in this sample. 3 multivariate linear regression analyses adjusting for covariates aimed to predict hypersexuality from each category of abuse, along with gender and its interaction with each category.
Results
In all models, younger age, non-heterosexual sexual orientation, male gender, single relationship status, less than full-time work, and living in a capital city were associated with hypersexuality, and education was not a significant predictor. CSA, AASA, and CSA/AASA predicted hypersexuality in both men and women. There was a significant interaction between CSA/AASA and gender, such that the relationship between CSA/AASA and hypersexuality was stronger in men than in women.
Clinical Translation
Sexual abuse at each developmental time-point may influence hypersexuality among men and women, although the cumulative impact of CSA and AASA on hypersexuality may be particularly relevant among men.
Strengths & Limitations
This is one of the largest studies to examine gender-related differences in the relationship between sexual abuse and hypersexuality. Nevertheless, our study is cross-sectional, and longitudinal work is needed to determine how sexual abuse affects children, adolescents, and adults throughout their lives.
Conclusion
Developmental impacts of sexual abuse may be considered in a gender-informed fashion in order to develop and optimize effective prevention and treatment strategies for hypersexuality.
Slavin MN, Blycker GR, Potenza MN, et al. Gender-Related Differences in Associations Between Sexual Abuse and Hypersexuality. J Sex Med 2020;XX:XXX–XXX.
... Studies included in this review involved participants from several distinct populations. Six studies examined general community participants [57,64,75,85,92,93], four involved men who have sex with men (MSM; [8,[70][71][72]), three examined incarcerated individuals who committed sexual offenses [22,50,61], three investigated individuals in treatment or seeking treatment for CSB and/or other addictions [17, 62, [27,67], two involved mostly university students [38,74], and one examined US military Veterans [86]. Among the seven studies examining community samples, all contained both men and women and each supported a relationship between CSA and CSB. ...
... The 21 studies varied in measurements of CSA and CSB. Definitions of CSA included contact and sometimes noncontact sexual incidents using a range of age cut-points from below age 18 [8,57,64] to below age 12 [74]. Additionally, there were different versions of the word "contact," with some researchers defining only genital contact as CSA [85]. ...
Purpose of Review Information on potential risk factors and clinical correlates of compulsive sexual behavior (CSB) may help
inform more effective prevention and treatment measures. Sexual victimization, specifically, child sexual abuse (CSA), has been
associated with CSB.
Recent Findings This systematic review describes 21 studies on the relationship between CSA and CSB. Most studies identified a
significant association between CSA and CSB. However, variability in measurements, potential differences in links among
community versus clinical samples, relevance of research among college samples, lack of support for gender-related differences,
and the need for more longitudinal designs were identified.
Summary Research would benefit from more formalized assessments of CSB across different populations. Prevention efforts
should be aimed toward individuals who experienced CSA and/or other abuse, particularly if they report engaging in risky sexual
behavior. Individuals with CSB who have experienced sexual abuse may benefit from trauma-focused treatment.
... A mixed-method study conducted in the United States on 183 homosexual and bisexual men (Parsons et al., 2008) reported the factors associated with compulsive sexual behaviour to include genetic predisposition, emotional neglect, sexual abuse and easy access to sexual partners. Perera et al. (2009) conducted a study in North America and examined the relationship of the family environment, self-esteem and child sexual abuse with compulsive sexual tendencies in adulthood. The findings of their study suggest that the experience of sexual abuse and poor family relations in childhood increase vulnerability to the initiation and continuation of out-of-control sexual behaviours (ibid.). ...
... Some studies suggest that increased parental control can lead to low self-esteem, self-efficacy and self-concept in children (Manzi, Parise, Iafrate, Sedikides, & Vignoles, 2015). Perera et al. (2009) have also proposed the lack of self-confidence during childhood as a predictor of hyper-sexuality. A meta-analysis study shows that having over-controlling and oppressive fathers are related significantly to relational aggression among young girls (Kawabata et al., 2011). ...
Abstract
Compulsive sexual behaviour is a disorder causing substantial social damage. Understanding the experiences of individuals with this disorder can help prevent and mitigate its consequences. Researchers conducted an independent content analysis of the data obtained through qualitative methods in the cities of Shiraz and Tehran in Iran. A total of 19 women aged 20–35 years receiving treatment for their sexual compulsivity as well as a therapist were interviewed. Five main categories emerged from the data, including the resentful emotional duality (having contradictory or paradoxical emotions simultaneously, such as love versus hate and rage versus fear) felt towards their father and men in general, an early aberrant social experience (premature exposure to sexual relations) and an abnormal perception of love. It appears that the weak cultural and educational structures in place and interpersonal communication disorders contribute significantly to the formation of hyper-sexuality.
Keywords Compulsive sexual behaviour, childhood experiences, women, Iran
... Addictive sexual activities have also been linked to a history of trauma and post-traumatic stress disorder (Giugliano, 2006;Kor et al., 2014;Perera, Reece, Monahan, Billingham, & Finn, 2009) and to insecure attachment styles (Faisandier, Taylor, & Salisbury, 2012;Kor et al., 2014;Zapf, Greiner, & Carroll, 2008). They have also been related to coping motives (i.e., sexual behaviors are displayed to reduce aversive thoughts, sensations, or adverse emotional states; Ross et al., 2012;Wéry & Billieux, 2016). ...
... The role played by past traumatic experiences and negative life events in sexual addiction has been extensively studied. Numerous data support A c c e p t e d M a n u s c r i p t the observation that people with sex addiction have had a traumatic history, especially sexual abuse (Ferree, 2003;Giugliano, 2006;Kor et al., 2014;Perera et al., 2009;Schwartz & Southern, 2000). Moreover, the development of insecure attachment styles and feelings of shame is known to be a common consequence of trauma and abuse (Cassidy & Mohr, 2001), which fosters a negative view of the self as defective and shameful and a view of others as unreliable and abusive (Whiffen & MacIntosh, 2005). ...
Dysfunctional use of cybersex has often been conceptualized as a ‘behavioral addiction’ sharing common traits with substance addiction. We describe the case of a treatment-seeking man, who displayed addictive use of pornography. The case is presented from two perspectives: (1) a symptom-based approach inspired by the addiction model of excessive sexual behaviors and (2) a process-based approach aimed to identify the psychological processes and risk factors that may foster the development of addiction-like symptoms. This article shows how case conceptualization according to a process-based approach is likely to result in psychological intervention that targets the specific processes and risk factors involved in addictive cybersex use.
... Leur prévalence est de 29.6 % chez les sujets victimes d'abus physiques (contre 18.2 % chez les sujets n'ayant pas été victimes d'abus physiques) et de 26.2 % dans le groupe des sujets victimes d'abus sexuels (17.2 % chez les sujets n'ayant pas été victimes d'abus sexuels). De façon générale, nos résultats vont dans le même sens que ceux trouvés dans les études sur le lien existant entre les abus sexuels durant l'enfance et la dépendance sexuelle à l'âge adulte (Carnes, 1991 ;Ferree, 2003 ;Giugliano, 2006 ;Perera et al., 2009). Cependant, Carnes (1991 rapporte chez des sujets présentant une dépendance sexuelle des antécédents d'abus sexuels bien plus importants que dans notre échantillon (81 %). ...
... Cependant, Carnes (1991 rapporte chez des sujets présentant une dépendance sexuelle des antécédents d'abus sexuels bien plus importants que dans notre échantillon (81 %). Perera et al. (2009) ont également trouvé une prévalence élevée (78 %) chez des sujets ayant vécu des scènes d'abus sexuels et qui présentent une dépendance sexuelle. Les abus sexuels sont plus fréquemment retrouvés que les abus physiques et ces études ne portent pas spécifiquement sur la dépendance cybersexuelle. ...
Introduction: Problematic cybersexual behaviours, including addiction and addiction risk, are a mental health reality, despite conceptual difficulties and diagnostic questions related to them. The literature underlines etiological factors such as childhood trauma, borderline personality disorder and certain sociodemographic factors. Methods: A survey was carried among 235 voluntary participants (66% women, n=154) recruited online, with an average age of 22.8 years (±6.2). Participants completed a sociodemographic questionnaire - the Addictive Behaviours Test (TCA) - which is suitable for cybersexual addiction, a subscale of the Personality Disorder Questionnaire 4 (PDQ-4 +), evaluating Borderline Personality Disorder, and three subscales of the Childhood Experience of Care and Abuse (CECA) Interview to assess childhood trauma. Results: The results confirm our hypotheses that traumatic life events and Borderline Personality Disorder are linked to problematic cybersexual behaviours. Discussion: Our results underline the links between cybersexual addiction, borderline personality disorder and traumatic life events. They open up new avenues for research and clinical issues.
... Recent reviews of the CSA literature suggest that sexual betrayal of a close partner may emerge as a result of overwhelming sexual compulsions developed in the context of past sexual trauma (Aaron, 2012;Colangelo & Keefe-Cooperman, 2012). Although this proposition remains untested within the context of CSA, sexual compulsivity has been conceptualized as a sexual coping mechanism designed to temporarily relieve intolerable inner tensions (Briere & Scott, 2014;Opitz, Tsytsarev, & Froh, 2009;Perera, Reece, Monahan, Billingham, & Finn, 2009;Plant, Plant, & Miller, 2005). Repetitive or indiscriminant sexual behavior may address some CSA survivors' feelings of sexual inadequacy; fill a need for attention, validation, or love; or provide a sexual sense of power and control (Bergner, 2002;Price, 2003;Zapf, Greiner, & Carroll, 2008). ...
... Although past studies indicate that sexual compulsivity is a common coping mechanism primarily for male survivors of CSA (Opitz et al., 2009;Plant et al., 2005;Perera et al., 2009), the mediation model presented here was invariant across women and men. This finding supports a gender similarity hypothesis, whereby most of the long-term repercussions of CSA converge for both men and women (Dube et al., 2005;Maikovich-Fong & Jaffee, 2010). ...
We tested a mediation model in which the relationship between child sexual abuse (CSA) severity and extradyadic sexual involvement (ESI) is explained through sexual compulsivity. Participants were 669 adults currently involved in an intimate relationship who completed self-report questionnaires. Prevalence of ESI was 32% in women and 57% in men survivors, more than twice the rates among participants with no CSA history. Sexual compulsivity was significantly higher in participants with multiple extradyadic partners as compared to participants reporting only one extradyadic relationship, who nevertheless scored higher than participants reporting no extradyadic partner. The hypothesized structural equation model (SEM) was invariant across men and women and indicated CSA severity was positively and significantly associated with sexual compulsivity, which, in turn, predicted ESI. However, there was also a direct association between CSA and ESI. High CSA severity, directly and through high sexual compulsivity, led to the highest probability of ESI.
... It has been estimated that 3% to 8% of Americans meet the criteria for sexual compulsivity (Carnes, 1991;Coleman, 1992;Earle & Crowe, 1990), however there have been few studies conducted on which to base a current and accurate estimate of sexual compulsion within the overall population of the United States (Kaplan & Krueger, 2010). Existing data suggest a higher prevalence of sexual compulsion among men, compared to women (Daneback, Ross, & Månsson, 2006;Dodge, Reece, Cole, & Sandfort, 2004;Gullette & Lyons, 2005;Kalichman & Cain, 2004;Kuzma & Black, 2008;Perera, Reece, Monahan, Billingham, & Finn, 2009;Wetterneck, Burgess, Short, Smith, & Cervantes, 2012). Research findings also suggest that sexual compulsivity is more prevalent among gay and bisexual men, compared to heterosexual men (Cooper, Delmonico, & Burg, 2000;Daneback et al., 2006;Gullette & Lyons, 2005;Missildine, Feldstein, Punzalan, & Parsons, 2005). ...
... However, Torres and Gore-Felton (2007) conceptualized feelings of loneliness may lead to compulsive behavior and sexual risk-taking among men who have sex with men. It is not surprising that low self-esteem predicted sexual compulsivity because previous studies have generated similar results (Kalichman et al., 1994;Perera et al., 2009;Semple et al., 2006). Another interesting finding is that not disclosing same-sex attractions to one's mother significantly predicted higher sexual compulsivity scores among this sample of gay and bisexual men. ...
The purpose of this study was to explore the influence of loneliness, self-esteem, disclosure of sexual orientation, and other personal characteristics on sexual compulsivity. Using data from 305 gay and bisexual men, results indicated not coming out to one's mother was significantly associated with higher sexual compulsivity scores. Self-esteem was significantly associated with current HIV serostatus and date of last HIV test. Stepwise regression analyses suggest loneliness, self-esteem, and non-disclosure of sexual orientation to one's mother have the capacity to predict sexual compulsivity among gay and bisexual men. Based on these results, counseling and sexual health practice implications are presented.
... Increased anxiety and shame or low self-esteem and self-confidence can increase the sense of inability to control behaviour and the likelihood of repeating the action to reduce negative feelings (Bancroft, 2008;Perera et al., 2009). As people face threats to their self-confidence, some become depressed and attempt to control this threat through their behavioural responses. ...
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.
... Several authors have reported that 80% of people [17] who experienced child sexual abuse (CSA) developed compulsive sexual behavior and sexual addiction in adulthood. Pereira et al. [18] confirmed the relationship between childhood sexual abuse and a later disposition toward compulsive sexual behaviors. They found that sexual abuse experiences and poor family relationships during childhood enhance vulnerability to initiating and maintaining out-of-control sexual behaviors. ...
Children and adolescents are too often victims of sexual abuse and harassment. According to the World Health Organization (WHO), approximately 150 million girls and 73 million children <18 have been victims of violence and sexual exploitation during their childhood. Data show that females are more likely to be a victim of abuse and violence than males (20% vs. 5-10%). Such abuses lead to long-term psychophysical and relational consequences and victims are often afraid of asking for support from both parents and professionals. This case report shows the story of a 17-year-old adolescent, Sara, involved by her mother in a strategic counseling process, to solve BDSM-type sexual addiction (slavery and discipline, domination and submission, sadism and masochism), self-aggressive behavior, and alcohol abuse issues. The strategic counseling process is structured in 15 sessions and was based on problem-solving techniques and corrective behavioral strategies. During the sessions, it emerged that Sara had been a victim of sexual violence at the age of 6 and that she had never talked about the rape with anyone. At the age of 12, she began to experience social anxiety and shame, feelings that led her to use alcohol and seek violent sexual partners and bondage relationships. During the counseling sessions, Sara elaborated on her trauma, becoming more aware of her resources and her desires, and she learned to manage the sense of guilt and shame associated with the violence suffered, through alternative strategies. At the end of the process, Sara normalized her relationship with sex and alcohol, regaining her identity.
... [174][175][176][177][178] Some researchers proposed that CSB symptoms occur as a form of regulatory behavior of coping with stressors related to CSA and negative emotions. 135,[179][180][181][182][183][184] As noted by others, 185 longitudinal studies using a cohort design are needed to assess the trajectory of sexually related responses (ie, sexual avoidance, compulsivity, and ambivalence) across the lifespan for women and men reporting histories of CSA or other forms of child maltreatment. ...
Purpose of review:
World Health Organization recently included compulsive sexual behavior disorder (CSBD) to the upcoming 11th edition of International Classification of Diseases (6C72). Despite the potential benefits of this decision (eg, the acceleration of research in the field will allow the development of effective treatments), previous research focused mainly on men, and as a result, we do not have an accurate clinical picture of compulsive sexual behavior (CSB) among women. Therefore, in this systematic review, we aim to present available knowledge on this topical subject. Literature search was conducted in the guideline of PRISMA methodology. Studies were identified from multiple databases including Academic Search Ultimate, SocINDEX, PsycARTICLES, PsycINFO, PubMed, and MEDLINE. Out of a total of 10,531 articles identified and screened, 58 were included in this review. Included studies covered the following topics: prevalence and etiology of CSB, behavioral and cognitive processes involved, comorbidities, personality traits, psychosocial and interpersonal difficulties, traumatic experiences, and treatments.
Recent findings:
Available studies indicate that CSB symptom severity is lower in women than in men. Overall, women reported consuming pornography less often than men and exhibit lower rates of feeling urges to these materials. CSB symptoms (including problematic pornography use) have been found to be positively related to trait psychopathy, impulsivity, sensation seeking, attention-deficit/hyperactivity disorder symptoms, obsessive-compulsive disorder, pathological buying, sexual dysfunctions, general psychopathology, child sexual abuse, while negatively related to dispositional mindfulness.
Summary:
Conclusions that can be drawn from prior studies are considerably limited. There are no accurate estimates of the CSB prevalence or severity among women, and studies have been mostly conducted on non-clinical populations, which has limited application for women diagnosed with CSBD.
... These results suggest that a significant number of male CSA survivors may have polarized and troublesome sexual self-concept and sexual functioning, while female survivors seem to display more "normative" sexual self-concept and sexual functioning. Furthermore, the finding that a higher proportion of men can be found in the sexually Hyperconfident and preoccupied profile is consistent with previous studies on CSA indicating that men are more likely to follow a hypersexual and compulsive trajectory than women (Labadie, Godbout, Vaillancourt-Morel, & Sabourin, 2018;Perera, Reece, Monahan, Billingham, & Finn, 2009;Vaillancourt-Morel et al., 2015); iand to report ongoing preoccupations about sexuality (Aaron, 2012;Wiederman & Allgeier, 1993). Hence, men may be more likely to cope with experience of CSA by acting out sexually and externalizing their distress (Meyer, Cohn, Robinson, Muse, & Hughes, 2017). ...
Background
Child sexual abuse (CSA) can impact survivor’s sexuality, notably regarding sexual self-concept, a key component of sexual well-being. Yet, sexual self-concept has been understudied among CSA survivors and gender differences have been sparsely investigated.
Objective
The current study aimed to identify CSA survivors’ distinct profiles according to their sexual self-concept, and compare these profiles based on factors such as CSA characteristics, gender, current age, sexual functioning and adult sexual assault (ASA).
Participants and setting
A total of 176 CSA survivors (60 % women, 40 % men), recruited through community organizations for CSA victims and social media publications, completed an online survey.
Methods
Hierarchical cluster analysis was performed using the Sexuality Scale (Snell & Papini, 1989). Chi-square and ANOVA tests were used to compare the groups on external variables.
Results
Cluster analysis revealed the best overall fit for a three-group model. The Confident and non-preoccupied profile (48 %) is characterized by a moderate score on sexual esteem and the lowest scores of sexual preoccupation and depression. The Demeaning and depressive (37 %) profile is characterized by the lowest scores on sexual esteem and the highest scores on sexual depression. The Hyperconfident and preoccupied profile (15 %) shows the highest scores on sexual esteem and sexual preoccupation.
Conclusion
Sexual self-concept is an important component of sexuality that needs to be addressed by practitioners working with CSA survivors. Given heterogeneity and gender differences among survivors, identification of profiles is relevant for adapting interventions and clinical care.
... Professionals and also researchers in empirical and qualitative research mention some gender differences in the long-term consequences of exposure to CSA in men, including undermined masculine identity, confused sexuality, difficulties in partnership relationships, and fear of the perpetrator (76). According to the results of studies conducted to date, CSA is linked to sexual addiction (77,78). ...
The aim of this article is to present a review of the research surrounding the short-term and long-term psychological and health consequences of child abuse and neglect. Research papers related to the consequences of child abuse and neglect and published in leading academic journals were identified and reviewed. We found that most of the available research suggests that there is a variety of negative outcomes among those exposed to physical, sexual and emotional abuse, neglect, witnessing domestic violence and multi-type childhood abuse. Specifically, there was evidence of significant short-term and long-term consequences encompassing physical and mental health difficulties, subsequent perpetrations, social and cognitive difficulties, and attachment. Conclusion – The results of this review confirm that there is a wide range of short-term and long-term difficulties that are associated with child abuse and neglect. This variety of difficulties should be taken into account in approaching complex and multidisciplinary assessment and treatment.
... Professionals and also researchers in empirical and qualitative research mention some gender differences in the long-term consequences of exposure to CSA in men, including undermined masculine identity, confused sexuality, difficulties in partnership relationships, and fear of the perpetrator (76). According to the results of studies conducted to date, CSA is linked to sexual addiction (77,78). ...
The aim of this article is to present a review of the research surrounding the short-term and long-term psychological and health consequences of child abuse and neglect. Research papers related to the consequences of child abuse and neglect and published in leading academic journals were identified and reviewed. We found that most of the available research suggests that there is a variety of negative outcomes among those exposed to physical, sexual and emotional abuse, neglect, witnessing domestic violence and multi-type childhood abuse. Specifically, there was evidence of significant short-term and long-term consequences encompassing physical and mental health difficulties, subsequent perpetrations, social and cognitive difficulties, and attachment. Conclusion-The results of this review confirm that there is a wide range of short-term and long-term difficulties that are associated with child abuse and neglect. This variety of difficulties should be taken into account in approaching complex and multidisciplinary assessment and treatment.
... Leur prévalence est de 29.6 % chez les sujets victimes d'abus physiques (contre 18.2 % chez les sujets n'ayant pas été victimes d'abus physiques) et de 26.2 % dans le groupe des sujets victimes d'abus sexuels (17.2 % chez les sujets n'ayant pas été victimes d'abus sexuels). De façon générale, nos résultats vont dans le même sens que ceux trouvés dans les études sur le lien existant entre les abus sexuels durant l'enfance et la dépendance sexuelle à l'âge adulte (Carnes, 1991 ;Ferree, 2003 ;Giugliano, 2006 ;Perera et al., 2009) (Adams et Robinson, 2001). Ce sentiment de honte étant au coeur de toutes les addictions, les personnes qui en sont profondément marquées seraient plus vulnérables aux addictions sexuelles (Carnes, 1991 ;Schaef, 1989). ...
... In a study about compulsive cybersex, Schwartz and Southern (2007) reported 76% of women and 58% of men were the victims of abuse in childhood (21 female, 19 male). A study with 539 undergraduate students found a relationship between childhood abuse and PATHS TO SEX ADDICTION IN A GENDER-BALANCED SAMPLE 5 later disposition toward compulsive sexual behaviours (Perera, Reece, Monahan, Billingham, & Finn, 2009). Adverse childhood experience enhances long-term hyperarousal, which victims may attempt to neutralise by engaging in addictive behaviours (van der Kolk, 1989) including exposing themselves to a situation reminiscent of the original trauma (van der Kolk et al., 2005) (H1a). ...
Research about sex addiction and its relationships with other constructs remains unexplored. We recruited a gender-balanced sample (53 men, 51 women) who responded to measures of sex addiction, adverse childhood experience, adult attachment, narcissism, self-compassion and motivation. Sex addiction was found to be statistically significantly associated with these constructs. Anxious attachment statistically significantly mediated the relationship between adverse childhood experience and sex addiction and the relationship between narcissism and sex addiction. Self-compassion did not statistically significantly moderate the relationship between anxious attachment and sex addiction. Therapeutic approaches targeting attachment and narcissism such as relation-based or mindfulness-based interventions are recommended.
... Leur prévalence est de 29.6 % chez les sujets victimes d'abus physiques (contre 18.2 % chez les sujets n'ayant pas été victimes d'abus physiques) et de 26.2 % dans le groupe des sujets victimes d'abus sexuels (17.2 % chez les sujets n'ayant pas été victimes d'abus sexuels). De façon générale, nos résultats vont dans le même sens que ceux trouvés dans les études sur le lien existant entre les abus sexuels durant l'enfance et la dépendance sexuelle à l'âge adulte (Carnes, 1991 ;Ferree, 2003 ;Giugliano, 2006 ;Perera et al., 2009) (Adams et Robinson, 2001). Ce sentiment de honte étant au coeur de toutes les addictions, les personnes qui en sont profondément marquées seraient plus vulnérables aux addictions sexuelles (Carnes, 1991 ;Schaef, 1989). ...
... Regarding psychopathological correlates, some studies focusing on excessive sexuality or "sexual addiction" (not specifically related to online content) revealed that this disorder is frequently comorbid with emotional disorders such as anxiety and depression [11,[23][24][25][26] or with other types of substance abuse and addictive disorders [27][28][29]. Some studies also indicated that traumatic history and post-traumatic stress disorder are prevalent in people displaying excessive sexual behaviors [30][31][32][33][34]. In addition, a growing number of studies were interested in the psychological factors associated with addictive use of OSA (see [18] for a review) and emphasized the importance of insecure attachment styles [32,35,36], or the individual correlates fueling OSA use [3,5,16]. ...
The interest in studying addictive use of online sexual activities (OSA) has grown sharply over the last decade. Despite the burgeoning number of studies conceptualizing the excessive use of OSA as an addictive disorder, few have tested its relations to impulsivity, which is known to constitute a hallmark of addictive behaviors. To address this missing gap in the literature, we tested the relationships between addictive OSA use, impulsivity traits, and affect among a convenience sample of men (N = 182; age, M = 29.17), building upon a theoretically driven model that distinguishes the various facets of impulsivity. Results showed that negative urgency (an impulsivity trait reflecting the tendency to act rashly in negative emotional states) and negative affect interact in predicting addictive OSA use. These results highlight the pivotal role played by negative urgency and negative affect in addictive OSA use, supporting the relevance of psychological interventions that focus on improving emotional regulation (e.g., to reduce negative affect and learn healthier coping strategies) to mitigate excessive use of OSA.
... Of the studies which have examined gender differences in CSB, women with CSB reported experiencing more and greater severity of aversive affective experiences, including childhood trauma (e.g., sexual abuse) than did men with CSB (Perera et al. 2009). Furthermore, loneliness, abandonment, and powerlessness were common motivations for women to engage in CSB (Ferree 2001). ...
Compulsive sexual behaviors (CSB) are prevalent among populations with substance use disorders (SUD). The risk of relapse following SUD treatment is increased if CSB are not addressed. Despite this risk, few studies have examined protective factors for CSB among individuals with SUD, and none have examined protective factors unique to women with CSB and SUD. Women’s CSB are believed to be motivated by efforts to avoid painful affective experiences (e.g., trauma symptoms, loneliness, and shame). Dispositional mindfulness was shown to reduce one’s risk for engaging in maladaptive responses to aversive experiences. Thus, we hypothesized that dispositional mindfulness would negatively relate to CSB among women with SUD. For the present study, we reviewed cross-sectional, self-report measures which were included in the medical records of 429 women in residential treatment for SUD. Results of hierarchical multiple regression analyses revealed that, controlling for age, and drug and alcohol problems and use, dispositional mindfulness negatively related to the core dimensions of CSB. These findings suggest that women with CSB and SUD are less likely to willingly approach present-moment experiences with acceptance. These preliminary findings suggest that researchers and clinicians should consider the utility of mindfulness-based approaches in treating women with CSB and SUD.
... Thus, SCB may serve as a strategy to regulate emotions. Individuals engaging in the SCB cycle often experience poor self-image and self-esteem and may feel worthless or helpless to control the behaviors (Perera, Reece, Monahan, Billingham, & Finn, 2009). SCB has been correlated with CSA in cross-sectional studies (Kuzma & Black, 2008;Parsons, Grov, & Golub, 2012). ...
Child sexual abuse has the potential to cause distress for the victim across the lifespan. Romantic relationships may be particularly difficult for victims of child sexual abuse. This retrospective study examined differences in adult romantic attachment, sexually compulsive behaviors, and emotion regulation by history of child sexual abuse in a large, nonclinical sample. Those with a history of child sexual abuse reported more attachment anxiety in romantic relationships and engaged in more sexually compulsive behaviors. Overall, males displayed more sexually compulsive behaviors than females regardless of history of sexual abuse. Males with a history of sexual abuse displayed the greatest number of sexually compulsive behaviors. Surprisingly, no differences were observed in emotion regulation or attachment avoidant behaviors by history of child sexual abuse. Future research should seek to replicate current findings and examine emotion regulation difficulties experienced as a result of trauma.
... Individuals engaging in SCB often experience poor self-image and self-esteem and they may feel worthless or helpless (Perera, Reece, Monahan, Billingham, & Finn, 2009). ...
The prevalence and rampant growth of sexually compulsive behaviors is recognized as a significant social problem affecting those who struggle with the behaviors, their romantic partners, their families, and other individuals in their social network. The current study investigated the role of attachment, early life stressors (ELS), age, and behavioral religiosity in sexually compulsive behaviors. Results suggested attachment anxiety, ELS, and behavioral religiosity were positively associated with sexually compulsive behaviors while age was negatively associated with sexually compulsive behaviors. Those participants high in sexually compulsive behaviors reported more attachment insecurity and ELS.
... More recently, Kor et al. (2014) found that problematic pornography use was associated with higher levels of emotional insecurities, either attachment anxiety or avoidance, and more history of traumatic events. These initial findings were corroborated by recent studies, which found associations between sexual addiction symptoms (not restricted to cybersex) and a history of sexual abuse (Ferree, 2003;Giugliano, 2006;Perera, Reece, Monahan, Billingham, & Finn, 2009), as well as with insecure attachment styles, which is a common consequence of trauma and abuse (Cassidy & Mohr, 2001). It is worth noting that both trauma history and insecure attachment were also related to excessive involvement in online activities in general, i.e., not necessarily sexual online activities (Schimmenti, Guglielmucci, Barbasio, & Granieri, 2012;Schimmenti, Passanisi, Gervasi, Manzella, & Famà, 2013;Schimmenti et al., 2015). ...
... Child Sexual Abuse (CSA) (n = 90) also was entered in as a covariate because empirical evidence has linked CSA to risky sexual behavior and HIV infection (Jinich et al., 1998) and sexual compulsivity/sexual addiction (Carnes, 1991;Katehakis, 2009;Maltz, 2002;Perera, Reece, Monahan, Billingham, & Finn, 2009). The assessment of CSA asked participants''In childhood, did you ever experience what you consider to be sexual abuse?''and their answer was rated on a 2-point yes or no Likert scale.Finally,adiagnosisof bipolar disorder(n = 21) was entered as a covariate because manic and hypomanic episodes in persons with bipolar disorder can precipitate hypersexual behavior (Amer-icanPsychiatricAssociation,2013;Kafka,2010).Bipolardisorder was assessed by asking participants''Have you been diagnosed with bipolar disorder?'' ...
"Hypersexual" behavior represents a perceived inability to control one's sexual behavior. To investigate hypersexual behavior, an international sample of 510 self-identified heterosexual, bisexual, and homosexual men and women completed an anonymous online self-report questionnaire battery. In addition to age and sex (male), hypersexual behavior was related to higher scores on measures of sexual excitation, sexual inhibition due to the threat of performance failure, trait impulsivity, and both depressed mood and anxiety. In contrast, hypersexual behavior was related to lower scores on sexual inhibition due to the threat of performance consequences. Higher neuroticism and extraversion, as well as lower agreeableness and conscientiousness, also predicted hypersexual behavior. Interestingly, interactions among the variables assessed did not significantly predict hypersexual behavior, suggesting the possible existence of multiple and predominantly independent taxa for various persons reporting hypersexual behavior. Core personality features may also be present in persons with hypersexual behavior. Clinical implications and future research directions are discussed.
... Reid, Harper, & Anderson (2009) found that individuals with high scores in hypersexuality had higher levels of shame, blaming self, and blaming others. Perera, Reece, Monohan, Billingham, & Finn (2009) found that compulsive sexual behaviors were associated with childhood sexual abuse and a dysfunctional family environment. The focus of this paper is the confluence of substance use disorders with Orford's concept of sexual addiction (1978). ...
Little research has focused on the risk of sexual addiction within an inpatient drug and alcohol treatment facility. The present study compared the rate and severity of sexual addiction in three chemical dependency units (30-day primary, 30-day relapse, and 90-day extended). A total of 485 participants completed the Sexual Addiction Screening Test-Revised (SAST-R). Demographic variables and substance and psychiatric diagnoses were gathered through patient chart review. Prevalence rates by unit were Primary Care 18%, Relapse 18.6%, and Extended Care 29.0%. Participants in Extended Care had a significantly higher prevalence of being identified as at risk for sexual addiction than either Relapse or Primary Care. Results showed significant differences in scores on the SAST-R in individuals in Extended Care as compared to individuals in either the Primary or Relapse units. Significant gender differences also emerged overall and by unit. Higher rates of diagnoses of certain chemical substances and psychiatric disorders emerged between the individuals at risk for sexual addiction versus those not at risk. This study is the first to explore risk for sexual addiction in inpatient substance use disorder treatment at different levels of care, and it demonstrates the need for further research that can differentiate between substance use disorders and sexual addiction in order to provide early intervention to improve treatment outcomes and prevent relapse.
... Une fois la prise de conscience opérée, le clinicien permet à la personne de se rendre compte que la compulsion sexuelle sert à réduire les émotions négatives à court terme, mais qu'elle engendre une variété de conséquences négatives à moyen et long terme, favorisant ainsi la répétition constante du passage à l'acte cybersexuel (Codina, 2012;Venisse & Grall-Bronnec, 2012). La dépendance cybersexuelle ne doit donc pas être uniquement perçue comme le problème, mais comme la solution à un problème sous-jacent, un moyen pour l'individu de réguler ses états internes (Adams & Robinson, 2001;Codina, 2012;Parker & Guest, 2003;Perera et al., 2009;Meili & Pfeifer, 2011;Southern, 2008;Young, 2007). ...
Reports an error in "Conceptualisation, évaluation et traitement de la dépendance cybersexuelle : Une revue de la littérature" by Aline Wéry, Laurent Karila, Pascal De Sutter and Joël Billieux ( Canadian Psychology/Psychologie canadienne , 2014[Nov], Vol 55[4], 266-281). There was an error in the author note. The first paragraph should have read “Aline Wéry, Laboratoire de psychopathologie expérimentale, Institut de recherche en sciences psychologiques, Université catholique de Louvain; Laurent Karila, Hôpital universitaire Paul-Brousse, Villejuif, France; Pascal De Sutter, École de Sexologie et des Sciences de la famille, Institut de recherche en sciences psychologiques, Université catholique de Louvain Joël Billieux, Laboratoire de psychopathologie expérimentale, Université catholique de Louvain.” (The following abstract of the original article appeared in record 2014-50698-005 .) The purpose of this article is to propose a critical review of current knowledge concerning cybersexual dependence (definition, epidemiology, evaluation and treatment). There is, in fact, a lack of consensus concerning the conceptualization of this disorder. This lack of conceptual clarity is largely due to the existence of a multitude of definitions of the disorder, a significant variety of sexual behaviours concerned and of symptomatologies, and because of methodological problems in the existing research (samples and evaluation tools that are strongly heterogeneous in different studies). Given the context, this article seeks to clarify the state of knowledge concerning cybersexual dependence. We will also make an inventory of empirically validated treatment methods for sexual and cybersexual dependence and we will propose approaches for future research. A non-systematic narrative review was conducted to examine and summarize the English and French literature dealing with cybersexual dependence. That review was carried out using a keyword search for sexual and cybersexual dependence in the data bases of PsycINFO, ISI Web of Science and Francis. Particular attention was paid to articles evaluating risk factors involved in sexual dependence, as well as articles that suggest treatment approaches for the disorder. (PsycINFO Database Record (c) 2015 APA, all rights reserved)
... Some studies have approximated that 3% to 6% of the general population struggle with sexual compulsivity (Black, 1998; Coleman et al., 2003 ). Men are more likely than women to meet criteria for sexual compulsivity (Kuzma & Black, 2008; Perera, Reece, Monahan, Billingham, & Finn, 2009). Moreover, it has been reported that gay and bisexual men are more likely to be sexually compulsive compared to their heterosexual counterparts (Cooper et al., 2000; Missildine, Feldstein, Punzalan, & Parsons, 2005) and compared to lesbian and bisexual women (Kelly, Bimbi, Nanin, Izienicki, & Parsons, 2009). ...
The objective of this study was to measure the relationships between
online sexual compulsivity, three dimensions of dissociation (absorption,
depersonalization, and amnesia), and past child abuse
among men who have sex with men (MSM). A total of 517 MSM,
recruited from Internet chat rooms, completed the survey. Results
indicated that past child abuse was significantly related to dissociation
but not online sexual compulsivity. It was also found that
the amount of time MSM spent online in a one-week period, in general
and specifically engaged in sexual activity, was significantly
related to online sexual compulsivity and three dimensions of dissociation.
Online sexual compulsivity was a significant predictor
of absorption, depersonalization, and amnesia. Implications for
clinicians and future research are presented.
... Une fois la prise de conscience opérée, le clinicien permet à la personne de se rendre compte que la compulsion sexuelle sert à réduire les émotions négatives à court terme, mais qu'elle engendre une variété de conséquences négatives à moyen et long terme, favorisant ainsi la répétition constante du passage à l'acte cybersexuel (Codina, 2012;Venisse & Grall-Bronnec, 2012). La dépendance cybersexuelle ne doit donc pas être uniquement perçue comme le problème, mais comme la solution à un problème sous-jacent, un moyen pour l'individu de réguler ses états internes (Adams & Robinson, 2001;Codina, 2012;Parker & Guest, 2003;Perera et al., 2009;Meili & Pfeifer, 2011;Southern, 2008;Young, 2007). ...
L’objectif du présent article est de proposer une recension des connaissances actuelles sur la dépendance
cybersexuelle (définition, épidémiologie, évaluation et traitement). Il existe en effet un manque de
consensus concernant la conceptualisation de ce trouble. Ce flou conceptuel est notamment imputable a`
l’existence d’une multitude de définitions du trouble, d’une importante variété des conduites sexuelles
concernées et des symptomatologies, et de problèmes méthodologiques dans les études existantes
(échantillons et outils d’évaluation fortement hétérogènes dans les différentes études). Dans un tel
contexte, notre article vise a` clarifier l’état des connaissances sur la cyberdépendance sexuelle. Nous
ferons également un état des lieux des modalités de traitements empiriquement validés de la dépendance
sexuelle et cybersexuelle, et proposerons des pistes pour les études futures. Une revue narrative non
systématique a été réalisée afin d’examiner et de résumer la littérature anglophone et francophone portant
sur la dépendance cybersexuelle. Cette revue a été effectuée au moyen de mots-clés désignant la
dépendance sexuelle et cybersexuelle dans les bases de données PsycINFO, ISI Web of Science et
Francis. Une attention particulière a été portée aux articles évaluant les facteurs de risques impliqués dans
la dépendance sexuelle, ainsi qu’a` ceux proposant des pistes de traitement du trouble.
... Research endorses the connection between attachment formation and sexual addiction as 95% of identified sexual addicts are unable to form close attachments with others rooting from childhood issues (Leedes, 2001) a finding supported in a similar study conducted by Zapf, Greiner and Carroll in 2008. In fact, the one commonality among frameworks is that sexual compulsivity is an issue that stems from early years in an individual's development (Adams, 1999;Adams & Robinson, 2001;Creeden, 2004;Perera, Reece, Monahan, Billingham & Finn, 2009;Schwartz & Southern, 1999). This can be seen in Jane's story as well, a childhood characterized by an absence of connectedness with adults or peers and early sexualization. ...
There is evidence that compulsive sexual behavior (CSB) is linked with childhood trauma in women and men. This study has investigated the relationships between childhood abuse and neglect and compulsive sexual behavior in a mostly female sample who use dating applications for sex. Participants were 200 adults (164 women and 36 men) mean age 26.88 years (SD = 6.45) range 19–58, 74% were single, 19.5% married, 6.5% divorced or separated. Questionnaires were administered by Google forms and included a demographic questionnaire, the Sexual Addiction Screening Test (SAST) and the Childhood Trauma Questionnaire (CTQ). There were positive associations between childhood sexual abuse (CSA), physical and mental abuse and physical neglect, (but not emotional neglect) and CSB. Multiple regression analysis revealed that ratings of child abuse (all apart from emotional neglect) have explained 57% of the variance of sexual addiction scores. This study shows that CSA, mental and physical abuse and physical neglect have been related to CSB. These findings may have clinical implications for understanding and treatment of CSB.
Günümüzde bağımlılık olgusunun sadece psikoaktif bir maddeden değil, bazı davranışların yarattığı haz ve rahatlama hissinden
de kaynaklanabileceği bilinmektedir. Terapötik toplumda diğer davranışsal bağımlılıklara göre kabul edilmesi daha zor olan cinsel
bağımlılık psikolojik bir rahatsızlıktır. Bağımlı bireyler ve çevrelerindeki kişiler üzerinde son derece yıkıcı etkilere sahiptir. Oysa
21. yüzyılda kompulsif cinsel davranışlar medikal bağlamda daha iyi anlaşılabilir ve bağımlı kişiler buna göre tedavi edilebilirdi.
2000’ler sonrası uluslararası alanyazında konuyla ilgili yapılan çalışmalar arttığı halde Türkiye’de cinsel bağımlılıkla ilgili neredeyse
hiç çalışma yapılmamıştır. Bu sebeple bu çalışmada cinsel bağımlılık hakkında kapsamlı bir alanyazın taraması yapılmış ve elde
edilen veriler belli bir çerçeve içinde sunulmuştur. Öncelikle cinsel bağımlılık rahatsızlığı açıklanmış, fenomenolojik özellikleri,
karakteristikleri ve tanı kriterleri belirtilmiştir. Daha sonra alanyazındaki isimlendirme anlaşmazlıklarına, alternatif isim önerilerine
ve sınıflandırılma sorunsalına, semptomolojisine, doğurduğu sonuçlar ve etkilerine, tedavi yöntemlerine, etiyolojisi ve etiyolojisine
ilişkin yapılan çalışmalara yer verilmiştir. Etiyolojik çalışmalar kronolojik olarak 70’ler ve 80’ler, 90’lı yıllar ve 2000’ler ve sonrası
olarak gruplandırılmış ve bu şekilde uluslararası alanyazında cinsel bağımlılık olgusuyla ilgili varolan verilere ilişkin gelişme ve
ilerlemenin görülmesi amaçlanmıştır. Bu bilgiler ışığında cinsel bağımlılığın Türkiye’de araştırılmasının gerekliliği tartışılmış ve
önerilerde bulunulmuştur.
Defining and classifying nymphomania has been a challenge for clinicians. It is characterized by an unquenchable urge to engage in repeated sexual contact with many partners without a deep emotional involvement. The sexual drive is unvarying, voracious, impetuous, and unrestrained. The case report describes a young female who presented with increased sexual desires and engaging in excessive sexual activity leading to divorce and marital disharmony in her second marriage. There was a history of childhood sexual abuse. Women developed nymphomania out of engagement in the behavior due to a genetic predisposition or from an environmental stressor such as trauma or sexual abuse. Since sex addiction is not a recognized disorder in DSM-5 or ICD-11, women who have this disorder have difficulty receiving treatment. Proper diagnosis and treatment of such patients will lead to better functioning and quality of life.
Background:
College students are among the heaviest users of smartphones and the Internet, and there is growing concern regarding problematic Internet (PIU) and smartphone use (PSU). A subset of adverse childhood experiences, household dysfunction [(HHD) e.g.; parental substance use, mental illness, incarceration, suicide, intimate partner violence, separation/divorce, homelessness], are robust predictors of behavioral disorders; however, few studies have investigated the link between HHD and PIU and PSU and potential protective factors, such as social support, among students.
Methods:
Data are from a diverse California student sample (N = 1027). The Smartphone Addiction Scale-Short Version and Internet Addiction Test assessed dimensions of addiction. Regression models tested associations between students' level of HHD (No HHD, 1-3 HHD, ≥4 HHD) and PSU and PIU, and the role of extrafamilial social support in these relationships, adjusting for age, gender, ethnicity, SES, employment loss due to COVID-19, and depression.
Results:
Compared to students reporting no HHD, students with ≥4 HHD had twice the odds (AOR: 2.03, 95% CI: 1.21-3.40) of meeting criteria for PSU, while students with 1-3 HHD and ≥4 HHD had three and six times the odds of moderate to severe PIU (AORs: 2.03-2.46, CI:1.21-3.96) after adjusting for covariates. Extrafamilial social support was inversely associated with PIU and moderated the HHD-PSU association for students with 1-3 HHD.
Conclusion:
Students exposed to HHD may be especially vulnerable to developing behavioral addictions such as PSU and PIU. Extrafamilial social support offset the negative effects of HHD for PSU among the moderate risk group; implications for prevention efforts are discussed.
In this chapter we review some of the sexual behaviors that are not regarded as common or “normal.” By attempting to understand them, we hope to gain a better understanding of behaviors that are normally practiced.
Kleinplatz and her research team (Kleinplatz et al., 2009) set out to study what the “sex of our dreams” consists of. They interviewed 67 participants who were in relationships for at least 25 years and identified their sex as “great.” They were aged, on average, 66 years (ranging from 60 to 82), and described various components to their great sexuality:
•Optimal sex requires that the participants be completely present, focused, embodied, and immersed in the experience.
•Partners have a sense of connection, being in sync, and losing of self with one another.
•Deep erotic intimacy is characterized by deep mutual respect, caring, genuine acceptance, and admiration.
•Interpersonal risk-taking through exploration is viewed as fun. Sex is perceived as an adventure, an exploration that expands sexual boundaries together with humor and laughter.
•Participants feel free, during sex, to be themselves, authentic, genuine, uninhibited, and totally free to express their wishes.
•Great sex requires “letting go,” allowing oneself to be vulnerable, reveling in the sensation, and completely surrendering to their partners.
•These sexual experiences are often characterized by a sense of peace, bliss, and a feeling of utter timelessness, growth enhancing and healing, similar to what Maslow (1971) called peak experiences.
This chapter reviews the multitude of sexual dysfunctions that men and women can be faced with. Sexual dysfunction is the umbrella term for the inability, for a variety of reasons, to participate in and enjoy sexual activities. In this chapter we examine the various dysfunctions, their biological, emotional, and psychological origins, and the treatment approaches that may be helpful in addressing them.
In 1998, Gold and Heffner authored a landmark review in Clinical Psychology Review on the topic of sexual addiction that concluded that sexual addiction, though increasingly popular in mental health settings, was largely based on speculation, with virtually no empirical basis. In the more than two decades since that review, empirical research around compulsive sexual behaviors (which subsumes prior research about sexual addiction) has flourished, ultimately culminating in the inclusion of a novel diagnosis of Compulsive Sexual Behavior Disorder in the eleventh edition of the World Health Organization’s International Classification of Diseases. The present work details a systematic review of empirical research published between January 1st, 1995 and April 1st, 2020 related to compulsive sexual behaviors. This review yielded 333 papers detailing 371 individual studies. In general, the present review finds that, although research related to compulsive sexual behaviors has proliferated, much of this work is characterized by simplistic methodological designs, a lack of theoretical integration, and an absence of quality measurement. Moreover, the present review finds a virtual absence of high-quality treatment-related research published within this time frame. Implications of these findings for both clinical practice and future research are discussed.
Introduction
To date, multiple models of problematic pornography use have been proposed, but attempts to validate them have been scarce.
Aim
In our study, we aimed to evaluate the Pornography Problems due to Moral Incongruence model proposing that self-appraisals of pornography addiction stem from (i) general dysregulation, (ii) habits of use, and (iii) moral incongruence between internalized norms and behavior. We investigated whether the model can be used to adequately explain the self-perceptions of addiction to pornography (model 1) and a broader phenomenon of problematic pornography use (model 2).
Methods
An online, nationally representative study was conducted on a sample of 1036 Polish adult participants, of whom, 880 declared a lifetime history of viewing pornography.
Main Outcome Measure
The outcomes were self-perceived pornography addiction, problematic pornography use, avoidant coping, frequency of pornography use, religiosity, moral disapproval of pornography, and related variables.
Results
Our results indicated that avoidant coping (an indicator of general dysregulation), frequency of pornography use (indicator of habits of use), and the distress connected with incongruence between own sexual behavior and internalized norms, attitudes and beliefs positively contributed to self-perceived addiction (model 1) as well as problematic pornography use (model 2). This broadly confirms the basic shape of the PPMI model. There were, however, notable differences between the models. Moral incongruence related distress was only weakly related to self-perceived addiction (β = 0.15, P < .001), with a stronger relation for problematic pornography use (β = 0.31, P < .001). When controlling for other factors, religiosity weakly predicted problematic pornography use (β = 0.13, P < .001), but not self-perceived addiction to pornography (β = 0.03, P = .368). Frequency of pornography use was the strongest predictor of both self-perceived addiction (β = 0.52, P < .001) and problematic pornography use (β = 0.43, P < .001).
Clinical Implications
Factors proposed within the PPMI model are distinctly relevant intervention targets, and they should be considered in the process of diagnosis and treatment.
Strengths & Limitations
The presented study is the first to evaluate PPMI model. Its main limitation is that it has a cross-sectional design.
Conclusion
The PPMI model is a promising framework for investigating the factors related to self-perceived addiction and problematic pornography use. Despite the differences between the models and in the strength of specific predictors, (i) dysregulation, (ii) habits of use, and (iii) moral incongruence all uniquely contribute to self-perceived addiction and problematic pornography use.
Introduction
Dysregulation of emotion (DE) is commonly seen in individuals suffering from compulsive sexual behavior (CSB), as well as represents a crucial element of its common comorbidities like mood, anxiety, and substance use disorders.
Aim
To investigate the links between CSB and DE.
Methods
A review of pertinent literature on CSB and DE was performed using EBSCO, PubMed, and Google Scholar databases.
Main Outcome Measure
Patterns of DE were evaluated as a common clinical feature, underlying mechanisms, as well as a target for psychological and pharmacological interventions in CSB.
Results
Across different conceptualizations of CSB, DE represents the core element of a failure to cope with sexual impulses, thoughts, urges, or resulting uncontrolled sexual behaviors. DE may contribute to the occurrence of CSB while for individuals affected by this condition, sexual arousal and release act as an easier/learned (yet uncontrolled and leading to negative consequences) way of coping with negative mood states. CSB may represent a delusive form of self-regulation. Experience of child sexual abuse and insecure attachment patterns are considered risk factors for CSB (likely to be mediated by DE) but require further investigation. DE is also positively associated with CSB symptom severity. Pharmacological treatments affecting mood regulation, anxiety, impulsivity, and regulation within the brain reward system have been reported to help people with CSB achieve better control over their sexual urges and behavior. However, the available data are scarce and well-powered randomized controlled trials are needed to support these observations. Although improvement in one's emotional self-regulation is considered as an important healing factor in treatment, its benefit in psychological therapies specific to CSB requires further investigation.
Conclusion
DE represents a core symptom of compulsive sexual behavior disorder and related comorbidities as well as a predisposing factor to the development of compulsive sexual behavior disorder. Addressing DE may facilitate better treatment outcomes for patients with CSB.
Objective
Untreated compulsive sexual behaviour (CSB) poses a risk to efficacious substance use disorder (SUD) treatment. Yet the ways in which CSB manifests in women with SUDs remains poorly understood. Shame and trauma exposure are well‐documented correlates for women's CSB. Prior theory suggested women with shame and trauma‐related symptoms may engage in CSB in an effort to escape aversive internal experiences. Thus, the present study examined experiential avoidance as a mediator of the relationship between defectiveness/shame beliefs, post‐traumatic stress disorder symptoms, and CSB in a sample of women with SUDs.
Method
Cross‐sectional, self‐report data were collected from 446 women (M age = 37.40) in residential treatment for SUDs.
Results
Experiential avoidance partially mediated the relationship between both post‐traumatic stress disorder symptoms and defectiveness/shame beliefs and CSB.
Conclusions
These results extend theoretical conceptualizations of women's CSB to a treatment population. CSB intervention efforts may benefit from targeting women's avoidance of painful experiences.
This is the first study in Iran to explore the facilitators of and barriers to compulsive sexual behavior from the perspectives of Iranian women. This qualitative study using the conventional content analysis approach was conducted in two urban areas of Iran. Data collection was performed using 31 in-depth individual interviews and three group interviews. It was found that facilitators were “family structure and strict rules,” “personal capacity and vulnerability,” “needs and motivations,” and “cultural and value factors.” In addition, barriers were “positive opportunities,” “appropriate education and positive role models.”
This qualitative study was conducted to explore the images of personal identity from the perspective of women with sexual addiction. The data required for the study were collected through 31 in-depth interviews. Sensing a threat to personal identity, dissatisfaction with gender identity, dissociation with the continuum of identity, and identity reconstruction in response to threat were four of the experiences that were common among women with sexual addiction. Painful emotional experiences appear to have created a sense of gender and sexual conflict or weakness in these women and thus threatened their personal identity and led to their sexual addiction.
Hypersexuality, or extreme normophilic sexual urges and behaviors, is a controversial construct that was recently considered as a candidate disorder for the DSM-5 and was rejected. It was also rejected for inclusion in Section III (Conditions for Further Study). Nonetheless, it has been found to be an important predictor of recidivism among sex offenders, and it continues to be discussed widely in the literature. In the present study, we investigated the developmental roots of this construct in a sample of 529 adult male sexual offenders, who were administered the Multidimensional Assessment of Sex and Aggression. Physical, psychological, and sexual abuse experiences were estimated using several scales of early development. Psychological abuse in childhood and adolescence, especially by a father, was found to be the most prominent predictor of subsequent hypersexual thoughts and behaviors. The accumulation of abuse types, however, was also associated with a monotonic increase in the latent trait of hypersexuality. The consequences of these results for conceptualizations of the construct are discussed.
Compulsive sexual behavior (CSB), a relatively common disorder, is characterized by having sexually related thoughts, urges, and behaviors that cause significant psychosocial distress and functional impairment. This chapter describes the phenomenology and etiology of CSB. Gender, age, and ethnic/cultural influences on CSB are discussed, as well as comorbidity issues and the relationship between CSB and Parkinson's disease. Addiction and obsessive-compulsive spectrum theoretical models of CSB are also summarized. Finally, the chapter provides future directions for clinicians and research to pursue.
Research shows that many adult sexual behaviors may be related to childhood sexual abuse (CSA), ranging from withdrawal and dysfunction on one end of the spectrum to hypersexuality and compulsion on the other, but it is unclear why some individuals respond to CSA by withdrawal, fear and anxiety, while others respond with impulsiveness and acting-out behavior. This literature review finds that there are two distinct factors which account for differences in sexual behavior among adult survivors of CSA: (a) the gender of the victim, and (b) the age at onset of victimization. Based on this data, an integrative framework is proposed, incorporating elements of social learning theory and psychoanalytic concepts, to explain the etiology of problematic adult sexual behaviors, as well as corresponding implications for clinical treatment.
Controversies exist about the diagnostic concept of “sexual addiction.” The aim of this study was to investigate if German specialized sex therapists are confronted with patients who possess sexual addiction symptoms and to obtain information about diagnoses, comorbidity and treatment. A 12-item questionnaire was sent to all members of the German Society of Sex Research asking them about diagnoses, comorbidity and treatment of patients who experienced sexual addiction problems. Forty-three out of 149 members (28.9%) responded to the survey and reported about 97 patients with sexual addiction symptoms. Most common were pornography dependence, compulsive masturbation, and protracted promiscuity. Using ICD-10 definition “excessive sexual drive” was diagnosed more often in women while “disorder of sexual preference” was mainly diagnosed in men. In women neurotic (e.g., anxiety disorders) and eating disorders were most commonly diagnosed as comorbid disorders, while in men substance disorders were most commonly diagnosed. Most patients were treated by individual psychotherapy. We discuss the difficulties of the “sexual addiction” concept critically and propose an algorithm to facilitate the diagnostic process. This algorithm differentiates between the paraphilic and non-paraphilic (we use the term paraphilia-related disorder) types of excessive sexual behavior first. As a second step it includes a dynamic perspective differentiating between a progressive and a non-progressive course.
Examined the dimensionality of the Rosenberg Self-Esteem Scale (M. Rosenburg, 1965), a global self-esteem measure that is assumed to be unidimensional. A confirmatory factor analysis was conducted with 1,726 government employees (aged 18–50+ yrs) that supported the superiority of the 2-factor model suggested by H. B. Kaplan and A. D. Pokorny (see record
1970-08510-001) over a 1-factor model, but the analysis indicated that their model provided a poor fit to the data. An exploratory factor analysis was conducted using the same 1,726 Ss that revealed 2 dimensions, one mostly defined by negatively worded items (self-derogation) and the other by positively worded items (self-enhancement). Although correlations were generally quite small, relations with work-related attitudes shown for the negative factor were in the opposite direction and somewhat larger than those shown for the positive factor. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A monoamine pathophysiological hypothesis for paraphilias in males is based on the following data: (i) the monoamines norepinephrine, dopamine, and serotonin are involved in the appetitive dimension of male sexual behavior in laboratory animals; (ii) data gathered from studying the side effect profiles of antidepressant psychostimulant, and neuroleptic drugs in humans suggest that alteration of central monoamine neurotransmission can have substantial effects on human sexual functioning, including sexual appetite; (iii) monoamine neurotransmitters appear to modulate dimensions of human and animal psychopathology including impulsivity, anxiety, depression, compulsivity, and pro/antisocial behavior, dimensions disturbed in many paraphiliacs; (iv) pharmacological agents that ameliorate psychiatric disorders characterized by the aforementioned characteristics, especially central serotonin enhancing drugs, can ameliorate paraphilic sexual arousal and behavior.
The purposes of this article are to introduce a theory regarding why individuals develop compulsive relationships to sexuality and to present therapeutic recommendations based upon this theory that I have found effective in my own work with sexually compulsive persons.
The consistency of childhood sexual abuse (CSA) reporting was explored in this study. Two-hundred seventeen adolescents and young adults (ages 14-24) enrolled in urban health care clinics completed self-report questionnaires assessing CSA and other problem behaviors at enrollment and at 7 months. Results indicated that the stability of CSA self-report at two time points was poor (58% consistent nonreporters of CSA, 20% consistent reporters, 22% inconsistent reporters). Consistent and inconsistent reporters were differentiated on risk measures. Adolescents who endorsed more items from the CSA scale were five times more likely to be consistent reporters. In sum, adolescent CSA reporting was quite inconsistent over time. Using multi-item scales and assessing CSA at two time points enhances accuracy of reporting.
The present study investigated sexual at-risk behaviors of sexually abused adolescent girls. Variables of interest were presence of consensual sexual activity, age at first consensual intercourse, number of sexual partners, condom use, and pregnancies. Participants were 125 sexually abused adolescent girls aged 12 to 17 years. Results showed that severity of sexual abuse (e.g., penetration, multiple perpetrators, physical coercion, multiple incidents of abuse) was related to a greater number of sexual at-risk behaviors. For instance, adolescents with a history of sexual abuse involving penetration were 13 times as likely to have been pregnant. Although family characteristics were significantly associated with being sexually active, their effect proved non-significant in the final hierarchical regression. Regression analyses clearly showed that the likelihood of engaging in sexual at-risk behaviors increased as a function of the number of severity factors.
This study examined the associations between perceived risks and benefits of drug use, unsafe sexual behavior, alcohol consumption, and aggressive/illegal behavior and reports of expected involvement in those behaviors in a sample of 340 college women with and without histories of interpersonal victimization (i.e., child sexual abuse, child physical abuse, adult sexual assault, and aggravated assault). Trauma victims reported greater perceived benefits and lower perceived risks associated with risky sexual behavior, illicit drug use, and heavy drinking, but not aggressive/illegal behavior than nonvictims. Victims also reported greater expected involvement in risky sex behavior, drug use, and heavy drinking. Regression analyses revealed that the relationship between victim status and expected involvement in risky behaviors was mediated by cognitions about risks and benefits of risky behavior, controlling for trauma-related symptoms. Implications of the findings for the understanding of repeat victimization are discussed.
We critically review the concepts of sexual addiction, sexual compulsivity, and sexual impulsivity and discuss their theoretical bases. A sample of 31 self-defined sex addicts were assessed by means of interview and questionnaires and compared with a large age-matched control group. A tendency to experience increased sexual interest in states of depression or anxiety was strongly characteristic of the sex addict group. Dissociative experiences were described by 45% of sex addicts and may have some explanatory relevance. Obsessive-compulsive mechanisms may be relevant in some cases, and the addiction concept may prove to be relevant with further research. Overall, results suggested that out of control sexual behavior results from a variety of mechanisms. We propose an alternative theoretical approach to investigating these mechanisms based on the dual control model and recent research on the relation between mood and sexuality.
The purpose of this descriptive and correlational study was to understand the role of sexual compulsivity, sensation seeking, and alcohol use as mediators of HIV risk behaviors among college students. College students (n = 256) completed an online survey in 2003. Instruments included the Sexual Compulsivity Scale (SCS), Sexual Sensation Seeking Scale (SSS), and the College Alcohol Problem Scale (CAPS). Men scored higher on the SSS and SCS than women. Women who belong to Greek organizations reported significantly more personal problems, including depression and low self-esteem, after consuming alcohol than women who were not members of Greek organizations. Four predictor variables associated with HIV risk behaviors were age, high score on SSS and CAPS, but a low score on SCS. The personality dispositions of sexual sensation seeking and compulsivity among college students may need to be explored in other college settings, to determine if these traits are related to HIV risk taking behaviors. Interventions to help women better cope with the effects of alcohol and self-esteem issues may be beneficial.
A growing body of literature suggests that an association exists between sexual compulsivity and participation in sexual behaviors that are high risk in terms of HIV/STD infection. In most of these studies, sexual compulsivity has been measured using the Sexual Compulsivity Scale. As yet, sexual compulsivity has only been assessed with this scale among individuals who are members of high risk groups for HIV infection or who are HIV-positive. In this study, we found support for reliability and construct validity of the SCS in a sample of 876 heterosexual college students, a group not yet examined in the sexual addiction and compulsivity literature. Construct validity was substantiated by the presence of significant relationships of sexual compulsivity with frequencies of sexual behaviors and numbers of sexual partners. The scale was also related to gender and age. Sexual compulsivity scores were associated with frequency of risky sexual behaviors. The relationships between sexual compulsivity and solo, partner, public, and risky sexual behaviors remained significant when we controlled for demographic variables. Although we found support for construct validity of the SCS in our sample, it is not clear whether the scale distinctly measures sexual compulsivity or taps into other constructs, such as sexual desire and sexual exploration.
Individual health risk behaviors among Caribbean youth account for the majority of adolescent morbidity and mortality in that area. This study explores the associations between individual factors, socioenvironmental factors, and sexual health-related behaviors in Caribbean youth. Data from the 1995 Caribbean Youth Health Survey, a nine-country, cross-sectional study completed by 15,695 in-school youth 10-18 years of age were analyzed. One-third of the sample (n = 5,060) reporting sexual activity was analyzed. This study examined age at first sexual intercourse, number of sexual partners, history of pregnancy, and condom use. The predictor variables were rage, depressed mood, expectation of early death, self-reported school performance, parental mental health or substance abuse problems, and family connectedness. Bi- and multivariate analyses were done separately for males and females, controlling for age, to examine associations between individual and socioenvironmental factors and sexual health behaviors. In the multivariate model, there were associations between rage, abuse, family mental health and substance use, anticipation of early death, and many of the outcome variables in males and females. Family connectedness and positive self-reported school status were correlated with greater condom use at last intercourse in males. Family connectedness was correlated with older age at first sexual intercourse. Depressed mood was not correlated with any of the outcome variables. The findings of the study demonstrate an association between individual and socioenvironmental factors and sexual health behaviors in the lives of Caribbean youth. Strong associations between rage and physical/sexual abuse and risky sexual behaviors are of notable concern.
Current neurological hypotheses of paraphilia posit that sexual deviance is associated with frontal and/or temporal lobe damage. This broad conception is based on few investigations, however, and the first goal of this study was to review the existing data derived from neuropsychiatry, neuroimaging and neuropsychology. It is concluded that although fronto-temporal dysfunctions are sporadically reported among sexual offenders, the evidence is scarce and it might not be specific to this type of offending. The second objective of this investigation was to gather preliminary neuropsychological data with more homogeneous subgroups of sexual offenders. A profile of lower-order executive dysfunctions (e.g. sustained attention and inhibition) and verbal deficits with intact or good capacities for higher-order executive functioning (e.g. reasoning and cognitive flexibility) and visuo-spatial processing was preferentially found among sexual offenders, suggesting basal fronto-temporal anomalies. Importantly, pedophiles were more consistently and severely impaired than rapists of adults. However, this basal fronto-temporal profile is not characteristic of sexual deviance, as it is also found in association with delinquency and criminality in general. Future neuropsychological and brain imaging studies should consider subgroups of sexual offenders and recruit non-sexual violent persons and non-violent individuals in order to disentangle the complex relations between brain anomalies and sexual deviance.
The authors examined whether the relationship between alcohol expectancies and sexual experiences while drinking differed between Latino and white college students.
The authors considered students if they were white or Latino, unmarried, aged 18-25 years, reported any drinking, and had at least 1 sexual partner in the present school year.
The investigators collected surveys from a random sample of 13,868 undergraduate students from the 14 California public university campuses. They used tests of group differences and hierarchical multiple regressions.
Social-facilitation alcohol expectancies were associated with the total number of different alcohol-related sexual experiences among Latino students. Neither social facilitation nor sexual-enhancement alcohol expectancies were differentially predictive of white or Latino students' frequency of sexual experiences.
Additional research is necessary to determine whether concepts targeted by alcohol prevention programs operate in a differential manner for Latino students.
New developments in understanding the nature, etiology and treatment of compulsive sexual behavior offer new hope for people suffering from these sexual disorders. There is considerable debate about terminology and these newer approaches to treatment. This paper reviews these new developments and the controversy which surround them. Compulsive sexual behavior can be divided into two types: paraphilic and nonparaphilic. While John Money (1986) has described the paraphilias at length, a specific attempt is made here to describe and classify nonparaphilic compulsive sexual behaviors. An obsessive-compulsive model for understanding paraphilic and nonparaphilic compulsive sexual behaviors is preferred by the author.
Most HIV-positive individuals do not engage in sexual behavior that places their partners at risk for contracting HIV. However, a small minority continues to engage in unprotected sexual activity with HIV-negative partners or partners of unknown HIV status. One factor that may play a role in high-risk sexual activity is sexual compulsivity or sexual addiction. The present study investigated the role of sexual compulsivity as a contributing factor to high-risk sexual behavior in a sample of HIV-positive men and women (N = 294). Participants completed measur es assessing sexual compulsivity, sexual behavior, substance use, and mental health variables. Men and women scoring high in sexual compulsivity (n = 49) reported engaging in unprotected anal and vaginal intercourse with HIV-negative partners or partners of unknown HIV status more frequently than participants scoring low in sexual compulsivity (n = 243). Mathematical modeling of sexual risk behavior indicated that four times as many new HIV infections could be expected among the HIV-negative sex partners of sexually compulsive participants as among the partners of noncompulsives. Individuals scoring high in sexual compulsivity were more likely to report cocaine use, and scored higher on measures of psychopathology than individuals low in sexual compulsivity. The results suggest a need to integrate HIV risk reduction services, mental health treatment, and substance use treatment for sexually compulsive persons living with HIV.
Dissociative and sexual behaviors were assessed in a sample of 350 children ages 7-18. Four groups were evaluated: a nonpsychiatric comparison sample, a psychiatric sample with no history of sexual abuse, a psychiatric sample with clear evidence of sexual abuse, and another group for whom sexual abuse was likely but not substantiated. All children completed the Trauma Symptom Checklist-Children (TSC-C), and varying numbers completed the Rorschach and MMPI. Parents completed the Child Behavior Checklist (CBC), Child Sexual Behavior Inventory (CSBI), and Child Dissociation Checklist (CDC). Mean differences on the Dissociation and Sexual Concerns subscales of the TSC-C existed between the nonpsychiatric and psychiatric groups. The Dissociation subscale was significantly correlated with MMPI Scale 8 and CDC. Sexual Concerns were significantly related to sexual content on the Rorschach, CBC sex problems, and the CSBI. Duration and nature of abuse significantly contributed over and above age and gender in predicting total score on the Dissociation subscale.
The purpose of the study was to assess the psychometric properties of the Sexual Compulsivity Scale (SCS) and its relations with sexual behaviors and their associated outcomes. Data were collected from 390 young adults. Results indicated acceptable levels of internal consistency for the SCS (α = .79) and acceptable levels of construct and criterion-related validity. Forward stepwise logistic regression analyses suggest that the SCS was capable of predicting negative outcomes and unprotected sexual intercourse. The SCS appears to hold great potential for use in sexual health programs focusing on young adults.
A developmental focus in treatment adolescents with sexual issues is often lacking. These issues include an understanding of normative sexual development, identity development, gender identity, sexual orientation, and relationship formation. Sexually vulnerable youth have special problems related to their sexual development that requires a developmental perspective in order to offer effective treatment. Sexually vulnerable youth, a term used by the author, describes youth that are sexually abusive, have been sexually abused and sexual minority youth. The characteristics of these three groups of youth are described and compared and many similarities are noted. A model of healthy sexuality that integrates several theories is presented as a way to conceptualize and understand the special needs of this population.
This paper discusses sexual addiction in both men and women. The definition, etiology, categories, and prevalence are explored. The purpose of this study was to evaluate the presence of sexual addiction behaviors among men and women on the college campus. Students from a private college in the southeast completed the Sexual Addiction Screening Test or Women's Sexual Addiction Screening Test to determine the prevalence of sexual addiction behaviors among this group. It was hypothesized that there would be an equal representation of males and females with scores suggesting sexual addiction.
To explore associations among sexual compulsivity, HIV serostatus disclosure, and sexual risk behaviors, data were collected from 180 gay and bisexual men living with HIV upon their self-enrollment into mental health care at an inner-city clinic. Results indicated associations among level of sexual compulsivity and a participant s likelihood of participation in high-risk sexual behavior, their perceived level of responsibility to disclose HIV serostatus to sexual partners, and whether they had disclosed their HIV status to a sexual partner in their most recent act of unprotected intercourse. These findings suggest the need to include, across the continuum of HIV care, activities related to the assessment of, and response to, sexual compulsivity and its association with behaviors likely to sustain the HIV epidemic.
Awareness of multiple addictions has increased in recent years. However, studies designed to investigate key factors in the multiply addicted individual are scarce in the literature. This study uses a national sample of sexual addicts (n = 290) to examine the relationship between the frequency of childhood abuse and the number of reported addictions in adulthood. The study employed correlations and a multiple regression to examine this relationship and its application to predictability. Low to moderate correlations were found to exist between the frequency of the three basic forms of abuse (sexual, physical, emotional) and the number of reported addictions in adulthood. In addition, the regression was also found to be statistically significant; however, the multicollinearity of the three types of abuse was a confounding factor in this study. Implications for all results and future studies are discussed.
Current (descriptive) accounts of hypersexuality are Axis I models in that they explain “out of control” excessive sexual behavior by comparing it to one or more Axis I disorders, e.g., substance addiction, obsessive compulsive disorder. This article presents an Axis II model for a subset of hypersexual patterns that seem more similar in structure to personality disorders. Persons can exhibit an “Axis II” hypersexual pattern without necessarily meeting sufficient criteria for a wider Axis II personality diagnosis. Case vignettes that illustrate Axis II subtypes (e.g., narcissistic, borderline) are discussed, along with treatment implications.
This investigation was designed to determine what variables significantly predicted sexual compulsivity and risk-taking behaviors regarding use of the Internet for sexual purposes and if there were differences within those variables. Participants (N = 307) from colleges and universities in the New England area voluntarily completed the Sexual Compulsivity Scale (SCS), Sexual Sensation Seeking Scale (SSSS), and the Non-Sexual Sensation Seeking Scale (NSSS), which comprised the dependent variables. Independent variables of gender, age exposed to pornographic material, year in college, and using the Internet to seek adult entertainment were significant predictors. The age when students were exposed to pornographic material was a significant predictor of SSSS score. Upper class students had an increase on their SSSS scores compared to Under class students. Gender significantly predicted SSSS, SCS, and NSSS scores, where females scored lower on all scales in comparison to males. Students who reported using the Internet to access online entertainment had higher SSSS, NSSS, and SCS scores compared to those who did not access adult entertainment. Implications of the study are discussed.
The purpose of the study was to assess the psychometric properties of the Compulsive Sexual Behavior Inventory (CSBI) and its relations with sexual behaviors and their outcomes. Data were collected from 390 young adults. Results indicated high levels of internal consistency for the CSBI (á = .87) and acceptable levels of construct and criterion-related validity. Forward stepwise logistic regression analyses suggest that the CSBI was capable of predicting negative outcomes and unprotected. The CSBI appears to hold great potential for use in sexual health programs focusing on young adults. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Presents longitudinal evidence from 3 age cohorts (Grades 7–8, 9–10, and 11–12) in 13 private and parochial schools that demonstrates systematic increases in self-esteem as Ss grow older. Three potential artifactual reasons for these results are assessed: (a) S attrition, (b) the effects of testing, and (c) carelessness of Ss. None of these are found to be responsible for the pattern of results. Several possible explanations for rising self-esteem during adolescence are discussed. (24 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Presents an empirical description and evaluation of the validity, reliability, and accuracy of 127 social psychological measures in 9 areas (e.g., self-esteem, locus of control, alienation and anomie, authoritarianism and dogmatism, values, and religious and social attitudes). A review of factors involved in the measurement of life satisfaction and happiness is included. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The Rosenberg Self-Esteem Scale (RSE) is a widely used measure of global self-esteem. Although its psychometric properties have found considerable support, its relationship to a multidimensional scale of self-concept has yet to be investigated. The sample for this study consisted of 150 adolescents randomly drawn in equal numbers and equated by gender from grades 8 to 12. Along with the RSE, Harter's Self-Perception Profile for Adolescents was administered to assess the adolescents' self-concept in nine separate domains. Correlational and cross-validation multiple regression analyses found that the RSE total score and both its factor scores were strongly related to Global Self-Worth, supporting Rosenberg's conclusions that his scale is a measure of global self-esteem and that its two identified factors are essentially measuring one rather than two different constructs. Other findings include a gender difference, with females reporting significantly lower RSE scores, and modest correlational support for a grade level rise found in the literature.
The concept of mechanisms that protect people against the psychological risks associated with adversity is discussed in relation to four main processes: 1) reduction of risk impact, 2) reduction of negative chain reactions, 3) establishment and maintenance of self-esteem and self-efficacy, and 4) opening up of opportunities. The mechanisms operating at key turning points in people's lives must be given special attention.
There are few topics so fascinating both to the research investigator and the research subject as the self-image. It is distinctively characteristic of the human animal that he is able to stand outside himself and to describe, judge, and evaluate the person he is. He is at once the observer and the observed, the judge and the judged, the evaluator and the evaluated. Since the self is probably the most important thing in the world to him, the question of what he is like and how he feels about himself engrosses him deeply. This is especially true during the adolescent stage of development.
In this study, 1968 high-school students were selected randomly through clustering, who responded to the Persian version of four measures: the Internet Addiction Test (IAT), UCLA Loneliness Scale, Rosenberg Self-Esteem Scale, and Matson Evaluation of Social Skills. Of the sample, 977 students were Internet users, who were classified into 37 Internet addicts, 304 possible Internet addicts, and 636 moderate users. Since possible addicts, moderate users, and nonusers can all be considered nonaddicts, to make a comprehensive and controlled comparison between addicts and nonaddicts, 37 possible addicts, 37 moderate users and 37 nonusers were matched with the Internet addicts. Results suggest that Internet addicts are lonelier and have lower self-esteem and poorer social skills than moderate users, but not necessarily than possible addicts or nonusers.
This important volume presents a definitive review of the origins and implications of developmental psychopathology and what has been learned about the phenomenon of psychosocial resilience in diverse populations at risk. Chapters by distinguished investigators in clinical psychology, psychiatry, and child development, many of whose work led to the new developmental model of psychopathology, provide a unique review of research on vulnerability and resistance to disorder spanning from infancy to adulthood. The volume is a tribute to Professor Norman Garmezy, a pioneer in developmental psychopathology and a renowned researcher of resilience in children at risk. Highlighted throughout the volume is Professor Garmezy's theme that it is as important to understand successful outcomes as it is to study pathology in the search for better treatments and the prevention of developmental behavioural problems.
Sensation seeking, the propensity to prefer exciting, optimal, and novel stimulation or arousal, is a potential mediating factor in sexual risk for human immunodeficiency virus infection (HIV), the cause of acquired immunodeficiency syndrome (AIDS). However, the most widely used measure of sensation seeking, the Sensation Seeking Scale (Zuckerman, Kolin, Price, & Zoob, 1964), contains numerous culturally outdated items and items that do not pertain to sexual behavior. In this study, 106 homosexually active men completed newly developed measures of sensation seeking related to sexual and nonsexual experiences, as well as a measure of sexual compulsivity. Results show that the new scales were internally consistent and time-stable. Additional analyses demonstrated convergent, divergent, and discriminant validity for these scales, showing them to be of use as mediating variables in models of high-risk sexual behavior. Implications for HIV prevention and behavior change are discussed.
Two studies are presented that evaluate newly developed scales of sensation seeking and sexual compulsivity. Results showed that the scales were reliable and correlated with convergent and divergent measures in expected directions in samples of both gay men (N = 296) and inner city low-income men and women (N = 158). Consistent with theories of sensation seeking, the scales corresponded to an attraction toward a range of sexual practices, including increased frequencies of unprotected intercourse and a greater number of sexual partners. As expected, sexual compulsivity was not related to variety and novelty in sexual practices, but was associated with lower levels of self-esteem and resistance to adopting sexual risk-reducing strategies. However important differences were observed between the gay men and heterosexual samples; scales correlated with substance use only among gay men, and sexual compulsivity was related to a range of sexual practices only among heterosexuals. The sensation seeking and Sexual Compulsivity Scales were therefore reliable, appeared valid, and useful in predicting sexual risk behaviors.
Case material is presented from two patients suffering from addictive sexual behavior. The term addiction is used because of the intense, driven quality of the behavior and because of its mood-elevating effects. Psychodynamically, the patients' sexual acts helped to undo feelings of rejection at the hands of their mothers and to enhance feelings of lovability and of self-esteem. The behavior also helped to neutralize powerful feelings of rage toward the mother. In one patient, the acts also helped to ease inner turmoil related to an underlying attention deficit disorder. I speculate that some adults with addictive sexual behavior may have underlying attention deficit disorders. In both my patients, the sexual behaviors served the self-regulatory function of alleviating inner feelings of anhedonia and depression. When they decreased their sexual activities during the course of the treatment, they required adjunctive antidepressant medication. The underlying meaning of the medication and countertransference attitudes toward such patients are explored.