Hypersexual behavior in an online sample of males: associations with personal distress and functional impairment.

INTRODUCTION The population of individuals reporting hypersexual behavior is heterogeneous. Prior research has implicated the importance of personal distress and functional impairment, as both may serve as indicators of problem severity and relevance. Still, little is known about associations with distress and impairment following hypersexuality. AIM The purpose of this study was to investigate personal distress and functional impairment in a community sample of male self-identified "sex addicts" and to explore the associations with related variables. METHODS Three hundred forty-nine men completed an online survey that included questions about personal distress, functional impairment, motivation for behavior change, type of hypersexual behaviors, time spent on sexual behavior, and progression of sexual urges. The survey included the Sexual Addiction Screening Test-Revised (SAST-R) core. MAIN OUTCOME MEASURE Specific survey questions about personal distress and functional impairment in six life areas were used to assess these variables. Chi-square and P-values were calculated to explore the interrelations among them. RESULTS There were 75.3% (N = 253) who reported feeling distressed due to hypersexual behavior. Functional impairment in at least one life area was specified by 77.4% (N = 270), and most participants (56.2%) reported impairment regarding partner relationships. Personal distress and functional impairment in three areas were associated with a strong motivation for behavior change. Distress was associated with online pornography use, masturbation, and/or sexual contact with changing partners. The progression of sexual urges was related to distress, while time spent on sexual behavior was not. There were 92.9% of the distressed participants who scored above the SAST-R core scale cut-off, but also 59.0% of the participants with little or no distress scored in this range. CONCLUSIONS Results underline the particular role of problems in social or intimate relationships in association with hypersexuality. Clustering individuals with regard to their specific sexual behavior and impairment pattern seems to be promising for further research.

[1]  M. Kaplan,et al.  Diagnosis, Assessment, and Treatment of Hypersexuality , 2010, Journal of sex research.

[2]  M. South,et al.  The Roles of Shame and Guilt in Hypersexual Behavior , 2011 .

[3]  B. Kinder,et al.  The mislabeling of sexual impulsivity. , 1987, Journal of sex & marital therapy.

[4]  J. Harper,et al.  Coping strategies used by hypersexual patients to defend against the painful effects of shame. , 2009, Clinical psychology & psychotherapy.

[5]  R. K. Hanson,et al.  High Rates of Sexual Behavior in the General Population: Correlates and Predictors , 2006, Archives of sexual behavior.

[6]  J. Giugliano.  Out of Control Sexual Behavior: A Qualitative Investigation , 2006 .

[7]  Are nonparaphilic sexual addictions a variant of obsessive-compulsive disorder? A pilot study , 2003 .

[8]  E. Coleman.  Sexual Compulsivity:: Definition, Etiology, and Treatment Considerations , 1987 .

[9]  Sylvain C. Boies,et al.  Sexuality on the Internet: From sexual exploration to pathological expression. , 1999 .

[10]  Barbara Steffens,et al.  The Traumatic Nature of Disclosure for Wives of Sexual Addicts , 2006 .

[11]  John Bancroft,et al.  Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model , 2004, Journal of sex research.

[12]  R. Reid,et al.  Assessing psychological symptom patterns of patients seeking help for hypersexual behavior , 2009 .

[13]  Timothy Fong,et al.  Report of findings in a DSM-5 field trial for hypersexual disorder. , 2012, The journal of sexual medicine.

[14]  James L. Zapf,et al.  Attachment Styles and Male Sex Addiction , 2008 .

[15]  A. Goodman.  What's in a Name? Terminology for Designating a Syndrome of Driven Sexual Behavior , 2001 .

[16]  J. Parsons,et al.  Sexual Compulsivity and Sexual Risk in Gay and Bisexual Men , 2010, Archives of sexual behavior.

[17]  Sylvain C. Boies,et al.  Online sexual compulsivity: Getting tangled in the net , 1999 .

[18]  E. Hollander,et al.  The Consequences of Compulsive Sexual Behavior: The Preliminary Reliability and Validity of the Compulsive Sexual Behavior Consequences Scale , 2007 .

[19]  D. Black,et al.  Characteristics of 36 subjects reporting compulsive sexual behavior. , 1997, The American journal of psychiatry.

[20]  M. Kafka.  Paraphilia‐Related Disorders—Common, Neglected, and Misunderstood , 1994, Harvard review of psychiatry.

[21]  D. Weiss.  The Prevalence of Depression in Male Sex Addicts Residing in the United States , 2004 .

[22]  E. Coleman,et al.  Psychiatric comorbidity and compulsive/impulsive traits in compulsive sexual behavior. , 2003, Comprehensive psychiatry.

[23]  M. Kafka.  Hypersexual Desire in Males: An Operational Definition and Clinical Implications for Males with Paraphilias and Paraphilia-Related Disorders , 1997, Archives of sexual behavior.

[24]  R. Reid.  Assessing Readiness to Change among Clients Seeking Help for Hypersexual Behavior , 2007 .

[25]  Patrick J. Carnes,et al.  Don't Call It Love: Recovery From Sexual Addiction , 1991 .

[26]  Kiran Amin,et al.  Internet Pornography and Loneliness: An Association? , 2005 .

[27]  S. Carnes,et al.  The Same Yet Different: Refocusing the Sexual Addiction Screening Test (SAST) to Reflect Orientation and Gender , 2010 .

[28]  A. Štulhofer,et al.  Revisiting the Association between Pornography Use and Risky Sexual Behaviors: The Role of Early Exposure to Pornography and Sexual Sensation Seeking , 2013, Journal of sex research.

[29]  David L. Delmonico,et al.  The Internet Sex Screening Test: A comparison of sexual compulsives versus non-sexual compulsives , 2003 .

[30]  Elissa Draper,et al.  Disputing the Notion of Psychopathology Among Women Married to Hypersexual Men Using the MMPI-2-RF , 2010, Journal of sex & marital therapy.

[31]  M. Kafka,et al.  Hypersexual Disorder: A Proposed Diagnosis for DSM-V , 2010, Archives of sexual behavior.

[32]  Matthew P. Spackman,et al.  Alexithymia, Emotional Instability, and Vulnerability to Stress Proneness in Patients Seeking Help for Hypersexual Behavior , 2008, Journal of sex & marital therapy.

[33]  J. Stein,et al.  Understanding the Roles of Shame and Neuroticism in a Patient Sample of Hypersexual Men , 2011, The Journal of nervous and mental disease.

[34]  S. Kalichman,et al.  Sexual sensation seeking and Sexual Compulsivity Scales: reliability, validity, and predicting HIV risk behavior. , 1995, Journal of personality assessment.

[35]  P. Hall.  A biopsychosocial view of sex addiction , 2011 .

[36]  A. Hill,et al.  Syndrome sexueller Sucht , 2009 .

[37]  W. Edwards.  Applying a Sexual Health Model to the Assessment and Treatment of Internet Sexual Compulsivity , 2012 .

[38]  L. Marshall,et al.  Assessment, diagnosis, and management of hypersexual disorders , 2010, Current opinion in psychiatry.