Hypersexuality Research Articles

The role of maladaptive cognitions in hypersexuality among highly sexually active gay and bisexual men.

Cognitive appraisals about sex may represent an important component of the maintenance and treatment of hypersexuality, but they are not currently represented in conceptual models of hypersexuality. Therefore, we validated a measure of maladaptive cognitions about sex and examined its unique ability to predict hypersexuality. Qualitative interviews with a pilot sample of 60 highly sexually active gay and bisexual men and expert review of items yielded a pool of 17 items regarding maladaptive cognitions about sex. A separate sample of 202 highly sexually active gay and bisexual men completed measures of sexual inhibition and excitation, impulsivity, emotional dysregulation, depression and anxiety, sexual compulsivity, and a measure of problematic hypersexuality. Factor analysis confirmed the presence of three subscales: perceived sexual needs, sexual costs, and sexual control efficacy. Structural equation modeling results were consistent with a cognitive model of hypersexuality whereby magnifying the necessity of sex and disqualifying the benefits of sex partially predicted minimized self-efficacy for controlling one's sexual behavior, all of which predicted problematic hypersexuality. In multivariate logistic regression, disqualifying the benefits of sex predicted unique variance in hypersexuality, even after adjusting for the role of core constructs of existing research on hypersexuality, AOR = 1.78, 95 % CI 1.02, 3.10. Results suggest the utility of a cognitive approach for better understanding hypersexuality and the importance of developing treatment approaches that encourage adaptive appraisals regarding the outcomes of sex and one's ability to control his sexual behavior.

Hypersexuality in Dementia

Hypersexuality in Dementia

Prevalence Rates of Sexual Difficulties and Associated Distress in Heterosexual Men and Women: Results From an Internet Survey in Flanders

As most epidemiological surveys on sexual problems have not included assessment of associated distress, the principal aim of this study was to provide prevalence estimates of both DSM-IV-TR-defined (American Psychiatric Association [APA], 2000) and less commonly assessed sexual difficulties and dysfunction (e.g., lack of responsive sexual desire, lack of subjective arousal). A secondary aim was to obtain information about comorbidity between sexual desire and sexual arousal difficulties/dysfunction. This study comprised an online survey completed by 35,132 heterosexual Flemish men and women (aged 16 to 74 years). Results indicated that sexual dysfunctions were far less common than sexual difficulties, and some uncommonly assessed sexual problems (e.g., “lack of responsive desire” in women; “hyperactive sexual desire” in men) were quite prevalent. In women, there was a high comorbidity between “lack of spontaneous sexual desire” and “lack of responsive sexual desire”; between “lack of genital arousal” and “lack of subjective sexual arousal”; and between sexual desire and sexual arousal difficulties/dysfunctions. The implications of these findings for epidemiological research on sexual dysfunction and for the newly defined DSM-5 Female Sexual Interest/Arousal Disorder (APA, 2013) are discussed.

Non-motor symptoms in Parkinson's disease: cognition and behavior

Although the diagnosis of Parkinson disease is based on motor symptoms, it is now well known that non-motor symptoms are an integral part of this pathology, involving in fact multiple systems. These non-motor symptoms affect large population of patients and can appear sometimes before the motor disorders. The non-motor symptoms include mainly neuropsychological difficulties, neuropsychiatric symptoms, and autonomic disorders, but involve also pain and sleep disturbances for example. Depression may occur at any stage of the disease, and consists in major depressive disorder, minor depressive disorder, and dysthymia. During the course of the disease, 50% of patients experience anxiety. Apathy is present in up to 30-40% of patients, due to loss of motivation, appearing in emotional, intellectual and behavioral domains. Dopamine dysregulation syndrome and impulse control disorders are not rare, and in relation with dopaminergic therapies. Impulse control disorders include pathological gambling, hyper sexuality, compulsive shopping, and eating disorder. Visual hallucinations can occur in 30% of patients, mostly induced by dopaminergic therapies. Often, they have deeper impact on the quality of life than the motor symptoms themselves, which stay the focus of attention during consulting. Identifying those can help in providing better care with a positive impact on the quality of life of the patients.

Predictors of drug use in prison among women convicted of violent crimes

Worldwide, some prisoners consume illicit drugs while in prison. There is now some recognition of risk factors for this among male but not female prisoners. The aim was to identify variables associated with drug use by women in prison after conviction for violent crimes. Data were obtained from 315 women serving a sentence for robbery or homicide in the Penitentiary of Sant'Ana, São Paulo State, Brazil. Mainly self-report assessments of alcohol and drug misuse, sexual and general impulsiveness, depression, and psychosocial and criminological features were completed. Data were analysed using descriptive statistics and multivariate logistic regression. Thirty-five (11%) women reported illicit drug use in prison. Younger age, history of childhood sexual abuse, having committed robbery (rather than homicide), earlier onset of criminal activities, higher scores on sexual impulsiveness, drug-related problems prior to incarceration and having same-sex relationships inside prison were associated with a higher risk of using drugs in prison. In a multiple logistic regression, only prior drug history and having same-sex relationships in prison were independently associated with in-prison drug use. Illicit drug use in prison impairs rehabilitative goals. Identification of risk factors for this can help to recognise people with high treatment needs. We found that in-prison drug users seemed to be an exceptionally needy group, likely to have more wide ranging historical problems than their similar offending peers. It is essential to check for history of drug use outside prison. The strong association with active sexual behaviour in the prison highlighted another area of vulnerability, requiring sensitive in-prison attention to safeguard these women. Further research to understand the reasons for this relationship is recommended.

ARSH 5: Reproductive Health Needs Assessment of Adolescents and Young People (15–24 y): A Qualitative Study on ‘Perceptions of Community Stakeholders’

To explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among adolescents in order to improve reproductive health services for adolescents. The study was conducted in three districts of Kerala and need assessment was done qualitatively using focus group discussions (FGDs), five each from all the three districts among junior public health nurses (JPHNs), anganwadi workers (AWWs), non-government organizations (NGOs), community leaders and adolescents. Majority of community stakeholders expressed that adolescents get knowledge regarding personal hygiene from their family itself and that they have poor knowledge about genital hygiene. Pain and associated problems are the most important difficulties faced by adolescent girls during menstrual periods. Most of the adolescents believed that excessive masturbation is a very dangerous practice. Most of the community stakeholders pointed out that though our adolescents know about HIV, they have very poor knowledge about other STIs and that parental ignorance increases vulnerability for sexual abuse among adolescents. They also suggested family life education sessions at schools and colleges for younger ones and premarital counseling for older ones, apart from counseling services and adolescent clinics. The important barriers in the utilization of services for adolescents are lack of awareness of parents, stigma to utilize services, economic factors, facility available at faraway places, and non-availability of services. The need for adolescent friendly health services and premarital counseling services in the community attached to health facilities, has been highlighted.

The Relationship Between the FFM Personality Traits, State Psychopathology, and Sexual Compulsivity in a Sample of Male College Students

Several studies have advocated a relationship between psychopathological features and sexual compulsivity. Such relationship is often found among individuals seeking help for out of control sexual behavior, suggesting that the association between psychological adjustment and sexual compulsivity may have a significant clinical value. However, a more complete approach to the topic of sexual compulsivity would also include the analysis of nonclinical samples as healthy individuals may be at risk of developing some features of hypersexuality in the future. The aim of this study was to explore the relationship between stable traits of personality, state psychopathology, and sexual compulsivity in a sample of male college students. Furthermore, the potential mediating role of state psychopathology in the relationship between personality traits and sexual compulsivity was tested. Participants completed the following measures: the NEO Five-Factor Inventory, the Brief Symptom Inventory, and the Compulsive Sexual Behavior Inventory-22. The sample included 152 male college students recruited in a Portuguese university using nonrandom methods. The measures were completed individually and anonymously. Findings on state psychopathology suggested that psychoticism may be one of the key dimensions associated with sexual compulsivity in male students. The personality traits of Neuroticism and Agreeableness were also significant predictors of sexual compulsivity. Findings on the mediating effects suggested that state psychopathology mediated the relationship between Neuroticism and sexual compulsivity but not between Agreeableness and sexual compulsivity. A psychopathological path (encompassing Neuroticism and state psychopathology) and a behavioral path (encompassing Agreeableness features) may be involved in sexual compulsivity as reported by a nonclinical sample of male students.

Rivastigmine in the Treatment of Hypersexuality in Alzheimer Disease

Inappropriate sexual behaviors (ISB) represent uncommon and often misdiagnosed clinical disorders among patients with Alzheimer disease. So far, no randomized clinical trials regarding the treatment of ISB in demented people have been conducted, but available data from case series and isolated case reports suggest the efficacy of selective serotonin reuptake inhibitors (SSRIs), antipsychotics, antiandrogens, and H2-receptor antagonists. Controversial data exist on the therapeutic influence of cholinesterase inhibitors on sexual disorders. In the present article, we describe the case of an Alzheimer disease patient presenting hypersexuality, successfully treated with rivastigmine. Thus, we perform a revision of the existing literature regarding the therapeutical effect of cholinesterase inhibitors in the treatment of ISB.

A case report of Partial Kluver - Bucy Syndrome with Anterior Opercular syndrome in childhood: A sequel of limbic encephalitis

Kluver Bucy Syndrome is a rare neuropsychiatric disorder and a sequel of limbic encephalitis. Its presentation may vary in different ages. The patients may have all the features of Kluver Bucy Syndrome like – Hyper orality, Hyper sexuality, hyper metamorphosis, affective blunting, memory difficulties, eating disturbances etc; or may have only few of the symptoms which are commonly known as partial Kluver Bucy syndrome. Partial Kluver Bucy Syndrome is relatively more common than classic Kluver Bucy Syndrome. Anterior opercular syndrome is characterized by diminished voluntary control of facial, pharyngeal, lingual, and masticatory muscles. It usually follows bilateral lesions of the anterior opercular area surrounding the insula. In this case report, we highlight the clinical phenomenology and management issues of Kluver Bucy Syndrome with Anterior opercular syndrome in a young girl with limbic encephalitis.

Choline Associated Hypersexuality in a 79-Year-Old Man

Hypersexuality, also referred to as sexually inappropriate behavior and sexual disinhibition, involves persistent, uninhibited sexual behaviors directed at oneself or at others, sometimes associated with neurodegenerative disorders. Choline is a water-soluble essential nutrient, used as a dietary supplement in different diseases. This report was aimed at considering choline intake as a possible cause of iatrogenic hypersexuality. After an evaluation, a 79-year-old man affected by memory loss was diagnosed with mild cognitive impairment and treated with oral choline. After 6weeks of regular choline assumption, the patient showed a pathological increase in libido with sexual urges. As choline was withdrawn, the hypersexuality disappeared within 5days. Since hypersexuality may be an underreported and overlooked adverse effect of drugs and dietary supplements acting on the cholinergic pathway, this should be considered when treating and counselling patients with inappropriate sexual behavior.

Young Men's Condom Use Resistance Tactics: A Latent Profile Analysis

Research suggests that many men have used a variety of tactics to avoid using condoms when having sex with women. Guided by previous work demonstrating that men's use of coercive condom resistance tactics was predicted by negative attitudes toward women, inconsistent condom use, multiple partners, and sexual sensation seeking, the current study used latent profile analysis (LPA) to determine whether similar constructs were associated with a variety of resistance tactics. A community sample of 313 moderate-drinking men participated, of whom 80% reported employing at least one condom use resistance tactic since adolescence. The LPA revealed three classes of men. In general, men with the least negative beliefs about women, low levels of sexual sensation seeking and impulsivity, and positive beliefs about condoms (Condom Positive/Low Hostility) reported less use of resistance tactics than men with moderate sexual sensation seeking and impulsivity, negative beliefs about condoms, and moderate (Condom Negative/Moderate Hostility) or high (Condom Negative/High Hostility) negative attitudes about women. The classes also differed in terms of their sexual behaviors. This study demonstrated that sexual risk behavior interventions should not only address the tactics through which men resist using condoms but also tailor these efforts to men's individual characteristics.

Indicadores de Deseo, Autoerotismo e Impulsividad Sexual en Mujeres de la Ciudad de México

The purpose of this study was to describe indicators of sexual desire, sexual impulsivity and auto-eroticism in 402 women aged between 17 and 35 years living in Mexico City. Positive relationships were found between the factors sexual self-efficacy and four of the six factors of sexual desire (‘attraction’, ‘excitement’, ‘romance’ and ‘sexual surrender’) and only one negative relationship between ‘self-efficacy’ and ‘sexual guilt’. ‘Sexual impulsivity’ correlated positively with sexual guilt. ‘Autoerotic desire’ correlated negatively with the factors ‘self-efficacy’ and ‘sexual guilt’. Some significant differences were found between age groups and between those classified as being or not sexually active. The group of elder women and of those who had already started their sexual life obtained the highest averages in the factors ‘sexual surrender’ and ‘excitement’.

Impulse control disorders and cognitive dysfunctions in patients with Parkinson’s disease

Keywords Pathological gambling Impulse controldisorders Parkinson’s disease Cognitive dysfunctions Frontal lobe dysfunctionsDear Sir,We have read with interest the study in which Bentivoglioet al. [1] investigated the cognitive correlates of ImpulseControlDisorders (ICDs)inpatientswith Parkinson’sdisease(PD). The authors evaluated spatial and verbal short-termmemory, episodic verbal memory, non-verbal abstract rea-soning, visuospatial functions, and several frontal cognitivefunctionssuchascognitiveflexibilityandresponseinhibition;moreover, the authors used specific rating scales and ques-tionnaires to assess depression, anxiety and impulsivity.Although no significant difference between PD patients withor without ICDs on cognitive tasks was detected, the authorsunderlined a trend toward a worse performance in patientswithICDsonsomeneuropsychologicaltasksconsideredtobepartially sensitive to frontal lobe dysfunction [1].Previous neuropsychological studies have reportedinconsistent results on this issue. In one study pathologicalgambling (PG) was found to be associated with preservedexecutive functions [2], whereas we have observed moresevere derangements of some frontal lobe functions such asset-shifting and cognitive flexibility (assessed by means ofpart B of the Trail Making Test and by a phonologicalfluency task, respectively) in PD patients with PG withrespect to PD patients without PG [3]. The findings byBentivoglio et al. [1] partially confirmed the latter pattern,although the authors enrolled patients with more than onetype of ICDs in their study.It is relevant for this issue that we have also performed aneuropsychological study comparing the cognitive profilesof PD patients affected by PG, hypersexuality (HS), orcompulsive eating (CE) alone or in combination [4]. Again,we found a specific association between PG and dysfunc-tion of both set-shifting and cognitive flexibility. Withrespect to patients with PG, patients affected by HS showedmore severe impairments of inhibitory control and verballearning, while patients with CE evidenced a somewhatintermediate pattern. On this basis, we suggested that PGand other ICDs are behavioral symptoms that might arisefrom difficulty in monitoring one’s own behavior and inshifting from negative to positive conduct; differencesamong subtypes of ICDs may reflect differential involve-ment of the neural substrates devoted to process intrinsic(e.g., sex and feeding) or learned rewards (e.g., money) [4].Bentivoglio et al.’s results [1] concur in supporting ourfindings that onset of PG and other ICDs in PD might bedue to a selective impairment in top-down regulation ofbehavior, likely related to dysfunction of an anatomical andfunctional loop including several prefrontal areas and sub-cortical structures in combination with dopamine replace-ment therapy [5–7].

Arousability as a predictor of sexual risk behaviours in African-American adolescent women

This study examined the impact of sexual excitation (arousability) on sexual risk-taking behaviours in a community sample of African-American adolescent women. A sample of 701 African-American adolescent women completed measures examining their propensity for sexual arousal, impulsivity and sexual behaviour. Compared with women with a lower propensity for sexual arousability, women with a higher propensity reported a greater number of sexual partners, more inconsistent condom use, a greater likelihood of having engaged in sexual intercourse with 'risky' partners, and sex while high on alcohol or drugs. These results indicate that women who have a greater propensity to become sexually aroused in a variety of situations may be at a greater risk for contracting HIV or sexually transmissible infections relative to women with a lower propensity for arousal. This suggests that individual differences in the propensity to become sexually aroused should be considered when developing intervention approaches targeting young African-American women.

An Investigation of Factors Increasing the Risk of Aggressive Behavior among Schizophrenic Inpatients

Aim of the study: This study tried to identify risk factors of aggressive behavior in a population of schizophrenic inpatients. We tested the association between aggressive behavior and socio-demographic characteristics, addictive disorders, history of suicide attempt, and sexual violence, impulsivity, and sensation seeking.Methods: All consecutive schizophrenic inpatients (100) were assessed during 6 months. Aggressive behavior was quantified with a standardized scale, the Overt Aggression Scale (OAS). We studied socio-demographic characteristics and the history of suicide attempt and sexual violence with a specific standardized questionnaire. Addictive disorders were identified with the Fagerström and CAGE questionnaires and with the DSM-IV-R diagnostic criteria for nicotine, alcohol, cannabis opiates, and cocaine abuse and dependence disorders. Lastly, we studied sensation seeking with the Zuckerman scale and impulsivity with the Barratt scale.Results: Linear regression identified four factors associated with aggressive behavior: male gender (odd ratio = 12.8), history of sexual violence (odd ratio = 3.6), Fagerström score (odd ratio = 1.3), number of cigarettes smoked each day (odd ratio = 1.16). Patients with nicotine use or dependence had significantly higher levels of OAS scores. This difference was not observed between patients with or without alcohol dependence. OAS scores were correlated to the number of cigarettes smoked each day and to Fagerström scores. Patients with a higher level of sensation seeking and impulsivity also had higher OAS scores.Conclusion: A typical schizophrenic patient at risk of showing aggressive behavior is a man, who smokes and presents a history of sexual violence.

Sex addiction as a mental health diagnosis: Coming together or coming apart?

Summary The clinical literature on the phenomenon of out of control sexual behavior has been described in various ways including: a compulsion, impulsive disorder, or an addiction. Although sexual addiction is the terminology that has been most accepted by the general public, researchers and clinicians still debate about the nature of out-of-control sexual behaviors and what to name it. There was an unsuccessful effort to add “Hypersexual Disorder” to the appendix (not the main list of official diagnoses) of the DSM-5. This article addresses the controversy within the mental health community and among researchers that has stifled progress. Thousands of clients seek treatment because of the insufferable consequences of their uncontrollable sexual behaviors. Mental health providers are desperate for clear symptom descriptors and diagnostic guidelines to establish treatment modalities that are empirically based. Until such time, clinicians will do their best to treat clients who suffer from a disorder that has neither a name nor an established diagnosis.

Oral contraceptives and libido in women.

Oral contraceptives (OCs) provide safe, effective, and reversible contraception and are widely used by women for fertility control. Little is known about the effects of OCs on sexual functioning. This paper critically examines the published literature addressing the impact of OCs on sexual desire or libido. We reviewed 30 original research studies. In the retrospective, uncontrolled studies (n = 17), it was found that most women reported an increase in libido during OC use. In the uncontrolled, prospective studies (n = 4), it was found that most women reported little change in libido during OC use. In the prospective and cross-sectional controlled studies (n = 4), women using OCs reported both increased and decreased libido compared to non-OC users. The findings from randomized, placebo-controlled studies (n = 5) were mixed: In the most recent and well-conducted trial, a decrease in libido in OC users compared to placebo users was found. Overall, women experience positive effects, negative effects, as well as no effect on libido during OC use. Better-designed studies are needed to establish the independent, causal effects of OCs on libido.

Hyperactive sexual desire in Klinefelter Syndrome: Treatment with sertraline

Hyperactive sexual desire in Klinefelter Syndrome: Treatment with sertraline

Recurrent encephalopathy?—no, i'm a sleeping beauty!!

<h3>Aim</h3> To describe the clinical presentation of ‘Kleine-Levin (sleeping beauty) syndrome’ in a child, who presented with recurrent episodes consistent with encephalopathy, associated with excessive sleepiness, cognitive and behavioural disturbance and hyper sexuality. <h3>Method</h3> We report a previously well 14 years old boy who following a viral throat infection presented acutely with excessive tiredness, sleeping excessively, abnormal behaviour and hypersexuality. On examination he was sleepy but easily arousable. His GCS (15/15) and rest of the neurological examination including fundoscopy and other systemic examination was completely unremarkable. All his initial investigation including electrolytes, LFTs, CSF, virology screen and MRI brain scan were normal. Detailed autoimmune screening including anti-NMDAR, potassium channel and anti-GAD antibodies were also negative. EEG showed non-specific diffuse slowing consistent with encephalopathy. His excessive sleepiness gradually improved together with his altered behaviour in about two weeks after presentation. Hyper sexuality became more overt during this phase manifesting as fiddling with his genitalia, putting his pant down in front of parents and even inappropriate behaviour towards female staff. All these symptoms completely disappeared three weeks after his presentation and he attended school as before. He was readmitted six weeks later with exactly similar presentation and again only positive result being diffuse non-specific slowing of EEG. His recovery was also similar and he was completely back to his normal self in three weeks time. <h3>Result</h3> His recurrent symptoms are consistent with ‘Kleine-Levin syndrome (KLS)’ or ‘sleeping beauty syndrome’. KLS is a rare disorder which mainly affects adolescent men. Common symptoms include hypersomnia (100%), cognitive changes (96%), eating disturbances (80%), hypersexuality, compulsions, and depressed mood. The syndrome usually lasts for 8 years, with on an average seven episode of 10 days each recurring every 3.5 months. It is most frequently precipitated by infections and somnolence decreases using stimulants in nearly 40% of cases. <h3>Conclusion</h3> We believe neurologist and paediatricians should be aware of this (KLS) rare but distinct syndrome as early diagnosis will help us in reassuring patients and their families and will prevent unnecessary investigations.

The treatment of hypersexuality by cognitive behavioral therapy and virtual therapy

The hypersexuality recently entered the field of addiction. The sexual addiction is dependency relationship between a person and an abnormal or deviant sexual behavior. We are considering a treatment for this addiction, using two groups of 25 persons each; the first one being treated with he cognitive behavioral therapy and the second one .treated with the cognitive behavioral therapy and virtual reality. Better results should be registered for group 2. The Treatment of Hypersexuality by Cognitive Behavioral Therapy and Virtual Reality