Sexual Addiction Research Articles

Long-term changes on behavioral addictions symptoms among adults with attention deficithyperactivity disorder treated withmethylphenidate.

Attention deficit hyperactivity disorder (ADHD) and behavioral addictions (BAs) are highly comorbid but little is known about the effect of anti-ADHD medications on behavioral addiction symptoms. Thus, the aim of this naturalistic prospective study was to investigate the long-term changeson BAs symptoms among methylphenidate-treated adults with a primary diagnosis of ADHD. 37 consecutive adult ADHD outpatients completed a baseline and follow-up assessment of ADHD, mood and BAs symptoms (internet, shopping, food, sex addictions and gambling disorder) after one year of methylphenidate (flexible dose) treatment. Internet addiction test scores pre-treatment were significantly higher than post-treatment scores (p < 0.001). The same trend was seenfor the shopping addiction (p = 0.022), food addiction scores (p = 0.039) and sex addiction scores (p = 0.047). Gambling disorder scores did not differ pre and post treatment since none of the included patients reported significant gambling symptoms at baseline. The rate of ADHD patients with at least one comorbid BA was reduced after methylphenidate treatment (51.4% vs 35.1%). The correlation analyses showed a moderate positive correlation between the changes in sluggish cognitive tempo symptoms, cognitive impulsivity, mood and anxiety symptoms and changes in internet addiction symptoms. This is the first study showing that after one-year of treatment with methylphenidate,adult ADHD patients show a significant reduction on internet, food, shopping and sex addiction symptoms. Further controlled studies with larger samples should replicate these preliminaryresults and elucidate the role of methylphenidate and other moderator factors (such as concomitant psychological treatments or lifestyle habits changes) on BAs improvements.

The Lived Experiences and Well-Being of Female Partners Following Discovery or Disclosure of Their Male Partner’s Compulsive Sexual Behaviours: An Australian Phenomenological Study

Abstract Introduction There has been an upsurge of research articles in the last two decades about sexual addiction (SA) and compulsive sexual behaviour (CSB). In the literature, SA/CSB is mainly presented as comparable to other behavioural addictions and similarly involves a problematic consumption model: loss of control, psychosocial impairments, and risky sexual activities. Despite this recent rise in research interest in this area, only a small number of studies have focused on the partners’ lived experiences and well-being. Methods This qualitative descriptive phenomenological investigation aimed to examine female partners’ lived experiences and well-being following the discovery or disclosure of their male partners’ SA/CSB. Individual in-depth semi-structured interviews were conducted (2020–2022) with primary participants (female partners; n = 12) and supplementary participants (counsellors; n = 15). Results The analysis reveals that this group has encountered several detrimental consequences of CSB-associated betrayal trauma (BT), including but not limited to suicidal thoughts and self-harm, compulsive self-comparisons with other women, physical and behavioural difficulties, and diminished self-esteem. Conclusions This empirical research is the first study in Australia to examine the voices and experiences of female partners upon learning of their mates’ CSBs. The findings contribute to the field of SA/CSB and enhance understanding of the multifarious consequences for the emotional, physical, sexual, spiritual and/or relational well-being of intimate female partners and their general outlook on life. Policy Implications Based on the results, there are strong indications with implications for policy that this population requires validation and multifaceted support systems to better navigate the challenging, complex, and stressful processes of discovery/disclosure and subsequent recovery.

“One can’t Occur without the Other”: How Men Describe the Connection Between Healing from Childhood Sexual Abuse and Addiction Recovery

ABSTRACT The role that healing from childhood sexual abuse (CSA) plays in the context of substance use disorder (SUD) recovery is not well understood, particularly in male survivors. Building on interviews with 25 men and using grounded theory, this qualitative study explored the connection between healing from CSA and SUD recovery among male survivors. The findings reveal a cyclical nature in the connection between healing from CSA and addiction recovery, where sobriety enables healing and healing from CSA enables long-term recovery. This study highlights the importance of acknowledging and addressing sexual trauma in the treatment of SUD, particularly in male survivors.

Adverse Childhood Experiences (ACEs) in 252 Board-Certified Plastic Surgeons: Prevalences, ACE Clustering, and Effects on Adult Health and Behaviors, Including Self-Defined Depression, Work Addiction, and Burnout.

The CDC/Kaiser Adverse Childhood Experiences (ACE) study documented that ACEs predict adult health and self-harming behaviors. ACEs have been documented in physicians and are higher in physicians treated for problematic behavior. Plastic surgeons have never been assayed. Might ACE prevalences in plastic surgeons predict their adult health and/or behavior? 252 ABPS-certified plastic surgeons (72% men, 28% women, ) completed the 10-question CDC/Kaiser ACE survey by de-identified email. Data was collected on adult health and behaviors previously associated with ACEs in the literature. 42% of plastic surgeons had 1 or more ACEs; 9.9% had 4 or more. Emotional abuse was 2 times higher than the control CDC/Kaiser population, though other ACEs were lower. Gender differences existed: women suffered more sexual abuse (17% vs. 8%), physical neglect (7% vs. 1%), violence against their mothers (7% vs. 2%), and self-defined burnout (32% vs. 17%). ACEs occurred in clusters. Total ACEs predicted autoimmune disorders, chronic pain/fatigue, self-defined depression, irritable bowel, antidepressant/anxiolytic use, alcohol abuse, >3 marriages, >10 sexual partners, sex and work addiction, eating disorders, and self-defined burnout (all p< 0.020). Emotional abuse predicted alcohol abuse. Sexual abuse predicted sex addiction. Emotional neglect predicted autoimmune disease, antidepressant/anxiolytic use, eating disorder, and work addiction. Physical neglect predicted chronic fatigue/chronic pain, depression, and burnout (all p< 0.001 or less). Adverse childhood experiences occurred in 42% of our 252-member plastic surgeon cohort and predicted 13 adult illnesses and self-harming behaviors that can impair surgeons' lives and performances. Recognition may facilitate their recognition and treatment.

Pastoral Care Regarding Sexual Addictions within the Context of the Pentecostal-Charismatic Churches in South Africa

Pastoral Care Regarding Sexual Addictions within the Context of the Pentecostal-Charismatic Churches in South Africa

The Bergen-Yale Sexual Addiction Scale (BYSAS): Longitudinal Measurement Invariance Across a Two-Year Interval.

The Bergen-Yale Sexual Addiction Scale (BYSAS; [1]) is arguably the most popular questionnaire at present for assessing sex addiction. Employing Confirmatory Factor Analysis (CFA) and treating item scores as ordered categorical, we applied Weighted Least Square Mean and Variance Adjusted Chi-Square (WLSMV) extraction to investigate the longitudinal measurement and structural invariance of ratings on the BYSAS among 276 adults (mean = 31.86 years; SD = 9.94 years; 71% male) over a two-year period, with ratings at three yearly intervals. Overall, there was support for configural invariance, full loading, full threshold, the full unique factor invariance; and all structural (latent variances and covariances) components. Additionally, there was no difference in latent mean scores across the three-time points. The psychometric and practical implications of the findings are discussed.

Sexuality in the digital world: Treatment of a case of dating app addiction

This article explores internet addiction, with a focus on digital devices and dating apps. Using the psychoanalytical conceptualization, we present a clinical case study of a young man struggling with both his sexuality and his addiction to online interactions. The addictive nature of internet use, particularly in relation to sexuality and pornography, is explored, highlighting its pervasive characteristics in contemporary society. Drawing on psychoanalytic theories, we explore the concept of “symptom” as the expression of discontents in civilization, from a Freudian approach, and therefore the impact of symbolic and cultural factors on psychopathological phenomena. The study offers insights into the psychodynamics of various forms of addiction, particularly sexual addiction. The treatment of a case of addiction to dating apps will show how this relationship to sexuality is shaped by social practices disseminated through the internet and social networks. Finally, the psychodynamic underpinnings of internet addiction and its impact, particularly on vulnerable young people, underline the importance of recognising the addictive nature of digital devices in contemporary society. In fact, the patient’s addictive style of enjoyment could be considered as typical of a generalised style of enjoyment in contemporary society. Addiction thus becomes a typical symptomatic trait that excludes the existential lack of the subject.

Investigation of the psychometric properties of the Toronto Alexithymia Scale in men with and without compulsive sexual behavior.

Previous studies have provided initial evidence supporting the association between compulsive sexual behavior (CSB) and alexithymia, but these studies did not investigate the psychometric property of a measure of alexithymia in individuals with CSB, which is necessary. This study investigated the factor analysis, reliability, and construct validity of the Toronto Alexithymia Scale (TAS) in men with CSB and control individuals. This cross-sectional study included 418 participants (304 individuals with CSB and 114 control individuals) who underwent a semi-structured psychiatric interview and completed the following instruments: the Sexual Compulsivity Scale, Hypersexual Disorder Screening Inventory, Beck Anxiety Inventory, Beck Depression Inventory, TAS, and Barratt Impulsiveness Scale. The eligible participants were men 18 years of age or older who were literate and residing in Brazil. Individuals who met the diagnostic criteria for Goodman's criteria for sex addiction were subsequently assessed for the excessive sexual drive (International Classification of Diseases-Tenth Revision F52.7) criteria. Those who met this second criteria were considered individuals with CSB. Participants who did not reach this point were considered control individuals. We conducted factor analysis, reliability analysis (internal consistency and temporal stability), and discriminant and construct validity analyses. The outcomes included the TAS total score and scores on TAS factors 1, 2, 3, and 4. The extracted factors explained 44% of the variance in the TAS. Factor 1 explained 21%, but 3 items (items 2, 9, and 21) did not load onto this factor. The Cronbach's alpha was 0.83, and the reproducibility (intraclass correlation coefficient) was 0.70. The TAS can differentiate between individuals with CSB and control individuals. The different forms of validity were demonstrated through correlations between factors 1 to 4 and the total score, as well as with impulsivity, hypersexuality, sexual compulsivity, and depression. Surprisingly, anxiety was only weakly correlated with factors 1 and 2. Moreover, the TAS-4 score was not correlated with impulsivity. The TAS can be used in clinical practice to identify men with difficulties in recognizing subjective experiences, and proper interventions can subsequently be provided to these patients to increase their treatment efficacy. Various dimensions of alexithymia covary with other key psychopathological symptoms of CSB. This study examined a convenience sample. The results cannot be generalized to the broader population. Factors 3 and 4 presented low internal consistency (0.50). In general, TAS presented good psychometric properties in a sample mainly composed of individuals with CSB.

What is the “Sex” in Sex Addiction? Problem Behaviors Reported Among Those Endorsing Compulsive Sexual Behavior

What is the “Sex” in Sex Addiction? Problem Behaviors Reported Among Those Endorsing Compulsive Sexual Behavior

Prevalence and clinical phenotypes of adult patients with attention deficit hyperactivity disorder and comorbid behavioral addictions.

Although the correlation between substance use disorder and attention deficit hyperactivity disorder (ADHD) has been largely studied, less is known about the correlation between behavioral addictions and ADHD. Thus, the aim of the present study was to investigate the prevalence of behavioral addictions in a large sample of adult patients with a primary diagnosis of ADHD and to compare the clinical profile of ADHD patients with and without behavioral addictions comorbidity. 248 consecutive adults newly diagnosed as ADHD patients were assessed through a series of validated scales for gambling disorder, internet, sex, shopping and food addictions. ADHD patients with at least one comorbid behavioral addiction were compared to non-comorbid patients on ADHD symptoms, impulsivity, mood and anxiety symptoms and functional impairment. 58.9% of patients had at least one behavioral addiction comorbidity. Of the whole sample, 31.9% of the patients had a comorbidity with one behavioral addiction while the 27% showed a comorbidity with two or more behavioral addictions. Internet addiction was the most common comorbidity (33.9%) followed by food addiction (28.6%), shopping addiction (19%), sex addiction (12.9%) and gambling disorder (3.6%). ADHD patients with comorbid behavioral addictions showed higher ADHD current and childhood symptoms, higher cognitive and motor impulsivity, higher mood and anxiety symptoms and higher functional impairment. Behavioral addictions are highly frequent in adult ADHD patients. Comorbid patients seem to have a more complex phenotype characterized by more severe ADHD, mood and anxiety symptoms, higher impulsivity levels and greater functional impairment.

Clustering care pathways of people with alcohol dependence using a data linkage of routine data in Bremen, Germany

BackgroundAlthough many individuals with alcohol dependence (AD) are recognized in the German healthcare system, only a few utilize addiction-specific treatment services. Those who enter treatment are not well characterized regarding their prospective pathways through the highly fragmented German healthcare system. This paper aims to (1) identify typical care pathways of patients with AD and their adherence to treatment guidelines and (2) explore the characteristics of these patients using routine data from different healthcare sectors.MethodsWe linked routinely collected register data of individuals with a documented alcohol-related diagnosis in the federal state of Bremen, Germany, in 2016/2017 and their addiction-specific health care: two statutory health insurance funds (outpatient pharmacotherapy for relapse prevention and inpatient episodes due to AD with and without qualified withdrawal treatment (QWT)), the German Pension Insurance (rehabilitation treatment) and a group of communal hospitals (outpatient addiction care). Individual care pathways of five different daily states of utilized addiction-specific treatment following an index inpatient admission due to AD were analyzed using state sequence analysis and cluster analysis. The follow-up time was 307 days (10 months). Individuals of the clustered pathways were compared concerning current treatment recommendations (1: QWT followed by postacute treatment; 2: time between QWT and rehabilitation). Patients’ characteristics not considered during the cluster analysis (sex, age, nationality, comorbidity, and outpatient addiction care) were then compared using a multinomial logistic regression.ResultsThe analysis of 518 individual sequences resulted in the identification of four pathway clusters differing in their utilization of acute and postacute treatment. Most did not utilize subsequent addiction-specific treatment after their index inpatient episode (n = 276) or had several inpatient episodes or QWT without postacute treatment (n = 205). Two small clusters contained pathways either starting rehabilitation (n = 26) or pharmacotherapy after the index episode (n = 11). Overall, only 9.3% utilized postacute treatment as recommended.ConclusionsA concern besides the generally low utilization of addiction-specific treatment is the implementation of postacute treatments for individuals after QWT.

"It's probably an addiction-It can't be anything else": The role of addiction discourse in the self-identity of men who pay for sex.

This study is about the role of the addiction discourse in the self-identity of Israeli men who pay women for sex (MPWS). Using the theoretical framework of symbolic interaction, we identified two main contradictory themes regarding the role of the addict identity in the self-narratives of the participants: one presenting the addict identity as contributing to the participants' positive self-perception and the second as challenging it. Within a social context that often portrays MPWS as perpetrators and abusers, the addiction discourse was a useful source in helping the participants negotiate the dilemma of how to engage in "deviant" acts and still appear to be decent men. While not dismissing the reality of addiction or the distress experienced by some of the participants, we suggest that being "sick" and "having no control over one's actions" might be considered by some MPWS as preferable explanations to being an outlaw, or villain. However, the inconclusive nature of the sex addiction discourse intimidated some of the participants' self-identity, thus stressing the need for a clear definition and further theorization of sex addiction, particularly in the context of sex for pay. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Hypersexualisation and racialised erotic capital in sex work

Eight people, including six women of East Asian descent, at three massage spas were killed on 16 March 2021 in Atlanta, USA by a 21-year-old White man who sought to eliminate ‘temptation’ for a sex addiction he claimed to experience. This mass killing compelled public discussion about the hypersexualisation of Asian women in White, Western contexts and the risks faced by Asian women in ‘intimate labour’. This occurred alongside a dialogical shift towards sex worker rights in public and media discourses, yet these public dialogues appeared to occur alongside each other, rather than in interaction with each other. In between these dialogues remained questions about the legacies of hypersexualisation and what this means for Asian women in sex work, an industry that resists convenient understandings of desire and power and where hypersexuality may be simultaneously contested and deployed. This article bridges these dialogues to explore how a sex worker rights framework can engage with questions of race, hypersexualisation and erotic capital for Asian women in sex work. This is followed by an analysis of responses to hypersexualisation within Asian diasporic communities, and the implications for a more inclusive sex worker rights movement.

Investigating the Relationship of Childhood Traumas and Sexual Guilt with Sexual Addiction in Iranian Prostitutes.

Prostitution is a social phenomenon, and its underlying factors require more scholarly attention. This study aimed to investigate the relationship of childhood traumas and sexual guilt with sexual addiction in Iranian prostitutes. This was a cross-sectional study conducted on prostitutes who visited a health promotion center in Khorasan Razavi province, Iran in 2020. A total of 100 women agreed to participate in the study. Data collection tools included the Sexual Addiction Screening Test (SAST), Mosher Sex-Guilt Scale, and Childhood Trauma Questionnaire (CTQ). Data were analyzed using Pearson's correlation coefficient and multiple regression analysis. The age of the participants ranged from 23 to 42, with a mean age of 33.54±8.9 years. About 40% of the participants were divorced, 13% were married, 27% were single, and 10% were widows. The findings indicated that 84% of the prostitutes met the criteria for sexual addiction according to SAST. Emotional abuse (r=0.41, P<0.001), physical abuse (r=0.32, P<0.001), sexual abuse (r=0.33, P<0.001), emotional neglect (r=0.52, P<0.001), and physical neglect (r=0.37, P<0.001) had a positive and significant relationship with sexual addiction in prostitutes. There was no correlation between sexual guilt and sexual addiction (r=0.13, P=0.09). Furthermore, the linear regression results showed that emotional neglect was the only variable positively associated with sexual addiction (β=0.5, P<0.001). The findings of this study suggested that childhood traumas can predict sexual addiction in female prostitutes.

Problematic sexual behaviours, dissociation, and adult attachment: A path analysis model

BackgroundProblematic sexual behaviours are controversial phenomena, lacking diagnostic consensus, yet they are significant and warrant in-depth scientific research due to their clinically significant consequences. Therefore, this study aimed to explore the association between potential risk factors of sex addiction and problematic online pornography use, with a specific focus on the role of attachment and dissociation. MethodA sample of 375 participants (Mage = 30 years; SD = 12.441) was involved in the research. The collected data were analysed by implementing a path analysis model. ResultsSignificant and positive total effects in the relationships between fearful/preoccupied attachment patterns and both sex addiction and problematic online pornography use were shown. Furthermore, these associations were significantly mediated by dissociation. Finally, sex addiction and problematic online pornography use were significantly associated with daily thoughts about sex and weekly online pornography use, respectively. LimitationsThe cross-sectional design and the use of only self-report measures in an online survey should be kept in mind while interpreting the results. ConclusionsSuch data provide useful insight into the complex interplay of attachment, dissociation, and problematic sexual behaviours, providing information that may inform and guide targeted clinical interventions.

Why did God let this Happen? Assessing the Spiritual Impacts of Sexual Addiction on Intimate Female Partners: A Qualitative Investigation

Recent years have seen a rise in research on sexual addiction (SA) and compulsive sexual behaviour (CSB). In the literature, these concepts describe an emerging field of study that may encompass a range of interpersonal and communal consequences for concerned individuals, their intimate partners, families, and society. Taboos surrounding SA/CSB often shroud the subject in shame and ignorance. Despite growing scholarly interest in SA/CSB, few studies have analysed intimate partners’ lived experiences in depth, and no other research has investigated the spiritual impacts of SA/CSB on intimate partners. This descriptive phenomenological study addresses this knowledge gap. In-depth semi-structured interviews were conducted with female partners (primary participants; n = 12) and professional counsellors (supplementary participants; n = 15). The analysis reveals that following discovery/disclosure, SA/CSB may affect women via complex and multifaceted spiritual consequences. Significantly, most women did not receive validation or safety from their faith communities. Instead, many reported experiencing a range of spiritual impacts, including changes in their faith, fear of stigmatization, the perception of pastoral pressure to ‘forgive and forget’, ostracism from their faith communities, and/or a sense of anger directed towards God as the perceived silent co-conspirator who permitted the deception to continue undiscovered, sometimes over years or even decades. The study’s findings point to salient opportunities for faith communities to provide more targeted support and assistance during healing and recovery.

Different facets of addiction from a systemic perspective: a case report

IntroductionMany individuals who suffer from one or multiple substance use disorders often also struggle with another co-morbid psychiatric condition, primarily anxiety disorders. As substance dependency develops, the loss of self-control becomes a pivotal issue, leading to challenges in self-esteem and self-respect. These challenges subsequently give rise to problems in interpersonal communication and close relationships. In addition to the biological model of substance use problems and highly manualized approaches, it is crucial to have a systemic understanding of the patient’s situation and appropriate treatment settings. This understanding allows for the proper consideration of individual differences and requirements, ultimately enabling better treatment and prevention strategies.ObjectivesOur aim is to present a comprehensive case that shows various facets of addiction and introduce a systemic therapy concept of an integrative/systemic day clinic from Germany.MethodsThrough a detailed case presentation, we will introduce a systemic-psychotherapeutic day-clinic concept from a psychiatric training hospital in Wunstorf, Germany.ResultsCase: In the case of a 48-year-old female patient initially diagnosed with recurrent depressive disorder, it was later revealed that she also deals with alcohol addiction and its interconnectedness with sex addiction. Shame and a lack of self-esteem in relationships played a central role in her journey. She does not perceive herself to be loved but to be harmed, which led to many violent sexual acts that increased her feelings of shame. Systemic therapeutic approaches like family constellations were applied, helping her to experience her child-ego states. This profound insight propelled her willingness to change. She began prioritizing self-care, learning to like, accept, and eventually love herself. Aromatherapy aided in calming and maintaining focus. The patient learned to redefine her emotions, aligning them with reality, thereby enabling the adaptive fulfillment of her needs.Conclusions Our interdisciplinary team at the day clinic employs therapeutic approaches like dynamic, cognitive-behavioral, and systemic therapy to thoroughly understand the patients and their conditions. This case underscores the significance of an individually tailored treatment drawing from diverse therapeutic concepts, especially in patients with addiction. The combination of different therapeutic approaches facilitates a profound engagement with the patient, potentially resulting in more intensive therapeutic work and a higher rate of success which should be evaluated in future studies.Disclosure of InterestNone Declared

Evaluating Covert Sensitization in the Treatment of Male Sex Addicts: Three Single Subject Studies

Evaluating Covert Sensitization in the Treatment of Male Sex Addicts: Three Single Subject Studies

Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective.

The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed "hypersexual disorder," "sexual addiction," "porn addiction," "sexual compulsivity," and "out-of-control sexual behavior." To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them. A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues. CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent "unhealthy" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed. Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related "out-of-control sexual behaviors" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.

Childhood trauma and sex addiction among adult men

AbstractThis study explored the relationship between childhood trauma and sex addiction among a sample of adult men (N = 149). Thirty‐eight (25.5%) men screened positive for sex addiction, whereas 111 (74.5%) did not. Using descriptive discriminant analysis, we found that four subscales of early trauma predicted risk of sex addiction group membership to varying degrees, accounting for 22.3% of the variance explained. Sexual and emotional abuse accounted for the most variance explained in the group differences, whereas physical abuse and, to a lesser extent, general trauma also contributed to the group differences. Implications of the study findings are discussed.