Sexual Compulsivity Research Articles

Prospective predictors of technology-based sexual coercion by college males.

Technology-based coercive behavior (TBC) represents an emerging public health problem. This study contributes to the literature by identifying prospective individual-, social-, and community-level predictors of TBC. Data were collected from 800 males who participated in a prospective study on attitudes and behaviors regarding relationships with women. Variables across multiple ecological layers were used to predict TBC. Bivariate analyses indicated that 16 of the 17 risk variables significantly predicted TBC including anger, impulsivity, sexual compulsivity, hostility towards women, rape supportive beliefs, high-risk drinking, childhood sexual abuse, interparental conflict, peer pressure to engage in sex, peer approval of forced sex, number of sexual partners, perceived negative sanctions for sexual aggression, exposure to pornography, and participation in varsity sports, student government, and religious groups. Multivariate regression analyses indicated five variables uniquely accounted for TBC behaviors, including rape supportive beliefs, peer approval of forced sex, number of sexual partners, exposure to pornography, and participation in student government. Our findings that TBC can be prospectively predicted by these risk factors suggest that computer-based technology interventions focusing on these factors through social network ads that promote reflection on healthy social and romantic relationship behaviors and attitudes could help prevent and reduce TBC.

Evaluation and Treatment of Sex Addiction

There have been several diagnostic labels for persistent, excessive sexual behaviors, often referred in the popular media as sex addiction. Two related diagnoses, Internet addictive disorder and hypersexual disorder, were considered for, but not included in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. However, most clinicians, even those trained in sexual disorders or addiction medicine, have little to no training in treating sexual compulsivity and cybersex addiction. The authors present the historical context, proposed diagnostic criteria, evaluation protocols, comorbid disorders, speculations about the neuroscience, and treatment recommendations.

Syndemic and Other Risk Factors for Unprotected Anal Intercourse Among an Online Sample of Belgian HIV Negative Men Who have Sex with Men

Men who have sex with men (MSM) are confronted with different health problems. Next to a higher HIV prevalence and a higher reporting of depressive symptoms and other mental health problems, there is also evidence of substance dependence and sexual compulsivity occurring simultaneously. Using a sample of 591 HIV-negative Belgian MSM, we examine the relationships between depressive symptoms and other risk factors of unprotected anal intercourse (UAI) practice with casual partners. These risk factors include depressive symptoms, sexual behavioural indicators, individual risk perception of UAI, intrapersonal factors measured by the sexual sensation seeking scale, substance use, sources of social support and social norming regarding condom use and finally the location where or media through which men find sex partners. Our findings show that multifactorial, intertwined factors contribute to the explanation of UAI among MSM at risk for HIV infection. These findings underline the need for an integrated sexual health approach for MSM.

Depressive symptoms among immigrant Latino sexual minorities.

To estimate the prevalence and identify correlates of depressive symptoms among immigrant Latino sexual minorities. Respondent-driven sampling (RDS) was used to estimate the prevalence of depressive symptoms, and univariate and multivariable analyses were conducted to identify correlates of depressive symptoms. Unweighted and RDS-weighted prevalence estimates of depressive symptoms were 69.2% and 74.8%, respectively. In the multivariable analysis, low social support, sexual compulsivity, and high self-esteem were significantly associated with increased depressive symptoms. A need exists for culturally congruent mental health services for immigrant Latino sexual minorities in the southern United States.

Counselors’ Understanding of Process Addiction: A Blind Spot in the Counseling Field

The addictions field continues to grow and is expanding beyond the area of substance abuse and substance dependence. Process addictions are now an integral aspect of addictions treatment, diagnosis, and assessment. There is a gap in the literature related to process addictions which impacts counselors and clients due to lack of literature and knowledge on this new area. It also is hypothesized that there is a gap in continued education for incorporating treatment and assessment measure into clinical practice. This initial study was conducted to initiate an understanding of levels of knowledge counselors have in diagnosing, assessing and treating clients suffering with process addictions, indicators of where and how they learned about process addictions, and how they integrate their level of the treatment of process addictions in to clinical practice. The authors provide a brief overview of process addictions, a summary of original research, implications of this study, discussion, and recommendations for future research.Keywords: process addictions, counseling, addiction disorders, compulsive behaviors, behavioral addictionsIt is important for counselors and mental health professionals to stay current with information impacting their profession. Staying abreast of new ideas and new information can assist in providing successful and holistic treatment for clients (ACA, 2005). Specifically, the field of addictions has had many transformations of the last few decades. One of the most recent issues impacting the addictions area in counseling is process addictions (PAs) (Grant, Potenza, Weinstein, & Gorelick, 2010; Holden, 2001; Martin & Petry, 2005). For many years, mental health professionals have treated clients with systematic behaviors mimicking the disease of addiction, but many find they haven't received adequate training in this area to be competent. The terminology of PA sweeps a wide variety of behavioral addictions or compulsive behaviors. It is defined as any compulsive-like behavior that interferes with normal living and which causes significant negative consequences in their family, work and social life. Gambling, Internet addiction, sex addiction, exercise addiction and eating addictions are among those identified as PA(Sussman, Lisha, & Griffiths, 2011).The neurological changes in the brains of people who engage in gambling, binge eating, and compulsive sex were similar to those brains of persons who abused substances such as alcohol and marijuana. Treatment observations and prevalence data, coupled with a growing body of literature suggests the existence of PAs (Smith & Seymour, 2004), also called compulsive behaviors (Inaba & Cohen, 2011), and behavioral addictions (Grant et al., 2010). Process addictions may be new to some, however, PAs represent neither a new phenomenon nor do they represent new disorders. In actuality, PAs have been an area of concern in the addictions field for many years (Grant et al., 2010; Holden, 2001; Martin & Petry, 2005).There is little evidence that this evolving research on PA is being translated to those providing services to clients. Due to the gap in the literature related to process addictions and the knowledge of counselors, students, and counselor educators related to process addictions, the International Association for Addictions and Offender Counseling (IAAOC) Process Addictions Committee (a division and committee of the American Counseling Association) conducted a survey of students, post-graduate counselors, and counselor educators with the purpose of understanding the deficiencies clinicians are struggling with in understanding process addiction. The purpose of this article is to provide the results of a survey, which indicated the percentage of post-graduate counselors/clinicians in the study and their understanding of PAs. The information in this manuscript will specifically address the knowledge of counselors who are actively engaged in providing treatment services in community settings. …

Sexual Compulsivity Scale: Adaptation and Validation in the Spanish Population

Sexual compulsivity has been studied in relation to high-risk behavior for sexually transmitted infections. The aim of this study was the adaptation and validation of the Sexual Compulsivity Scale to a sample of Spanish young people. This scale was applied to 1,196 (891 female, 305 male) Spanish college students. The results of principal components factor analysis using a varimax rotation indicated a two-factor solution. The reliability of the Sexual Compulsivity Scale was found to be high. Moreover, the scale showed good temporal stability. External correlates were examined through Pearson correlations between the Sexual Compulsivity Scale and other constructs related with HIV prevention. The authors’ results suggest that the Sexual Compulsivity Scale is an appropriate measure for assessing sexual compulsivity, showing adequate psychometric properties in the Spanish population.

Compulsive sexual behavior and psychopathology among treatment-seeking men in São Paulo, Brazil

This study examined compulsive sexual behavior (CSB) and psychopathology in a treatment-seeking sample of men in São Paulo, Brazil. Eighty-six men (26% gay, 17% bisexual, 57% heterosexual) who met diagnostic criteria for excessive sexual drive and sexual addiction completed assessments consisting of the Mini International Neuropsychiatric Interview, a structured clinical interview for DSM-IV Axis I Disorders—Clinical Version (segment for Impulse Control Disorder), Sexual Compulsivity Scale (SCS), and questions about problematic CSB. The average SCS score for our sample was above the cut-off score reported in other studies, and 72% of the sample presented at least one Axis I psychiatric diagnosis. There were no differences among gay, bisexual, and heterosexual men on SCS scores and psychiatric conditions, but gay and bisexual men were more likely than heterosexual men to report casual sex and sex with multiple casual partners as problematic behaviors. SCS scores were associated with psychiatric co-morbidities, mood disorder, and suicide risk, but diagnosis of a mood disorder predicted higher SCS scores in a regression analysis. The study provides important data on the mental health needs of men with CSB in São Paulo, Brazil.

The depressive façade in a case of compulsive sex behavior with frottage

Compulsive sexual behavior consists of sexual obsessions and compulsions that are recurrent, distressing, and interfere with daily functioning. It has been called hypersexual disorder in the upcoming diagnostic and statistical manual 5th edition. Though hypersexuality is commonly seen in mania, it can also be seen in depression and anxiety disorders. This case report describes a case that presented with depression and had underlying compulsive sexual behavior in the form of frottage.

Adversity and Syndemic Production Among Men Participating in the Multicenter AIDS Cohort Study: A Life-Course Approach

We tested a theory of syndemic production among men who have sex with men (MSM) using data from a large cohort study. Participants were 1551 men from the Multicenter AIDS Cohort Study enrolled at 4 study sites: Baltimore, Maryland-Washington, DC; Chicago, Illinois; Los Angeles, California; and Pittsburgh, Pennsylvania. Participants who attended semiannual visits from April 1, 2008, to March 31, 2009, completed an additional survey that captured data about events throughout their life course thought to be related to syndemic production. Using multivariate analysis, we found that the majority of life-course predictor variables (e.g., victimization, internalized homophobia) were significantly associated with both the syndemic condition and the component psychosocial health outcomes (depressive symptoms, stress, stimulant use, sexual compulsivity, intimate partner violence). A nested negative binomial analysis showed that the overall life course significantly explained variability in the syndemic outcomes (χ(2) = 247.94; P < .001; df = 22). We identified life-course events and conditions related to syndemic production that may help to inform innovative interventions that will effectively disentangle interconnecting health problems and promote health among MSM.

Sexual Cognition Guides Viewing Strategies to Human Figures

Gaze patterns to figure images have been proposed to reflect the observer's sexual interest, particularly for men. This eye-tracking study investigated how individual differences in sexual motivation tendencies are manifested in naturalistic gaze patterns. Heterosexual men and women (M = 21.0 years, SD = 2.1) free-viewed plain-clothed male and female figures, aged 10, 20, and 40 years old, while their eye movements were recorded. Questionnaires were used to measure sexual cognitions, including sensation seeking and sexual compulsivity, sexual inhibition and excitation, and approach and avoidance responses to sexual stimuli. Our analysis showed a clear role of sexual cognitions in influencing gaze strategies for men. Specifically, men who scored higher on sexual compulsivity dedicated more gaze to the waist–hip region when viewing figures of their preferred sexual partners than men who scored lower on sexual compulsivity. Women's sexual cognitions showed no clear effect on the gaze pattern in viewing figures of their preferred age and gender of sexual partners, suggesting women's gaze is unlikely to be a straightforward reflection of their sexual preferences. The findings further suggest that men's gaze allocation is driven by sexual preferences and supports the utility of eye tracking in the assessment of male sexual interest.

Report of Findings in a DSM‐5 Field Trial for Hypersexual Disorder

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for hypersexual disorder (HD) have been proposed to capture symptoms reported by patients seeking help for out-of-control sexual behavior. The proposed criteria created by the DSM-5 Work Group on Sexual and Gender Identity Disorders require evaluation in a formal field trial. This DSM-5 Field Trial was designed to assess the reliability and validity of the criteria for HD in a sample of patients seeking treatment for hypersexual behavior, a general psychiatric condition, or a substance-related disorder. Patients (N = 207) were assessed for psychopathology and HD by blinded raters to determine inter-rater reliability of the HD criteria and following a 2-week interval by a third rater to evaluate the stability of the HD criteria over time. Patients also completed a number of self-report measures to assess the validity of the HD criteria. HD and psychopathology were measured by structured diagnostic interviews, the Hypersexual Behavior Inventory, Sexual Compulsivity Scale, and Hypersexual Behavior Consequences Scale. Emotional dysregulation and stress proneness were measured by facets on the NEO Personality Inventory-Revised. Inter-rater reliability was high and the HD criteria showed good stability over time. Sensitivity and specificity indices showed that the criteria for HD accurately reflected the presenting problem among patients. The diagnostic criteria for HD showed good validity with theoretically related measures of hypersexuality, impulsivity, emotional dysregulation, and stress proneness, as well as good internal consistency. Patients assessed for HD also reported a vast array of consequences for hypersexual behavior that were significantly greater than those diagnosed with a general psychiatric condition or substance-related disorder. The HD criteria proposed by the DSM-5 Work Group on Sexual and Gender Identity Disorders appear to demonstrate high reliability and validity when applied to patients in a clinical setting among a group of raters with modest training on assessing HD.

Sexual obsessions and suicidal behaviors in patients with mood disorders, panic disorder and schizophrenia

BackgroundThe topic of sexual obsessions as a psychiatric symptom has not been well investigated. The aim of this study was twofold: 1) to explore the presence of sexual obsessions in patients with mood disorders (n=156), panic disorder (n=54) and schizophrenia (n=79), with respect to non-psychiatric subjects (n=100); 2) to investigate the relationship between sexual obsessions and suicidal behaviors, taking into account socio-demographic variables ad mental disorders.Methods289 psychiatric patients with mood disorders, panic disorder or schizophrenia, were recruited at the Italian University departments of psychiatry along with 100 non-psychiatric subjects, who presented for a routine eye exam at the ophthalmology department of the same Universities. The assessments included: the Structured Clinical Interview for DSM-IV-TR, the Brief Psychiatric Rating Scale (BPRS), the Obsessive-Compulsive Spectrum Self-Report (OBS-SR), for sexual obsession, and the Mood Spectrum-Self Report lifetime version (MOODS-SR). Suicidality was assessed by means of 6 items of the MOODS-SR.ResultsSexual obsessions were more frequent in schizophrenia (54.4%), followed by mood disorders (35.9%). Among schizophrenia patients, males reported more sexual obsessions than females (P<0.01). Subjects who were more likely to report suicidal behaviors (suicidal ideation, plans and attempts) were female (adjusted OR=1.99), patients with mental disorders, specifically mood disorders (adjusted OR=11.5), schizophrenia (adjusted OR=3.7) or panic disorder (adjusted OR=2.9), and subjects who reported lifetime sexual obsessions (adjusted OR= 3.6). Sexual obsessions remained independently associated with all aspects of suicidal behaviors. Age, education, marital and employment status were not related to suicidal behaviors.ConclusionsSpecial attention should be given to investigate and establish effective strategies of treatment for sexual obsessions, especially those with comorbid mood disorders or schizophrenia.

Use of Lithium for Sexual Obsessions in Asperger’s Disorder

Back to table of contents Previous article Next article LettersFull AccessUse of Lithium for Sexual Obsessions in Asperger’s DisorderLokesh Shahani, M.D.Lokesh ShahaniDept. of Internal MedicineSIU School of MedicineSpringfield, ILSearch for more papers by this author, M.D.Published Online:1 Oct 2012https://doi.org/10.1176/appi.neuropsych.11090232AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Obsessional/repetitive behaviors are a core feature of autistic-spectrum disorders. Symptoms suggesting a DSM-IV diagnosis of obsessive compulsive disorder have been reported in 37% of the children with autism.1 Sexual obsessions have been commonly reported in these patients.2We report on a 17-year-old young man with a diagnosis of Asperger’s disorder who complained of having intrusive sexual thoughts and urges. He was masturbating 25–30 times per day, resulting in penile ulcers. These symptoms were associated with severe anxiety and frustration, leading to suicidal thoughts and self-injurious behavior, including stabbing his penis with tweezers. The patient denied any concomitant mood or psychotic symptoms. He denied any substance use, and his urine toxicology screen was negative. The patient was currently on sertraline 200 mg, clomipramine 225 mg, and aripiprazole 10 mg daily. He has had previous failed trials on citalopram, fluvoxamine, fluoxetine, clonazepam, quetiapine, and risperidone.Low serotonin levels have been associated with impulsive and aggressive behaviors,3 and enhancement of central serotonin neurotransmission could ameliorate heightened sexual desire and compulsivity associated with such sexual behaviors.4 Lithium has been shown to have some efficacy in similar behaviors associated with obsessive-compulsive features, such as pathological gambling.5 Hence, a trial of lithium was considered in this patient, and the dose was titrated up to 600 mg twice daily, with a lithium level of 0.56 mEq/L. The patient showed significant improvement in his sexual obsessions. He has not had a relapse in his obsessive symptoms and participates in cognitive-behavioral therapy to help with sustained remission.Lithium is known to increase serotonin levels in the cerebrospinal fluid by inducing serotonin synthesis.6 The particular pro-serotonergic action of lithium could be helpful in reducing the heightened sexual obsession and compulsive behavior. Further double-blind, placebo-controlled studies are needed to confirm the role of lithium as an augmentation agent for treatment of obsessive sexual behaviors.Dept. of Internal MedicineSIU School of MedicineSpringfield, ILCorrespondence: e-mail: [email protected]comReferences1 Leyfer OT, Folstein SE, Bacalman S, et al.: Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord 2006; 36:849–861Crossref, Medline, Google Scholar2 Zandt F, Prior M, Kyrios M: Repetitive behaviour in children with high-functioning autism and obsessive-compulsive disorder. J Autism Dev Disord 2007; 37:251–259Crossref, Medline, Google Scholar3 Cocarro EF, Kavoussi RJ: Fluoxetine and impulsive aggressive behavior in personality-disordered subjects. Arch Gen Psychiatry 1998; 54:1081–1088Crossref, Google Scholar4 Stein DJ, Hollander E, Anthony DT, et al.: Serotonergic medications for sexual obsessions, sexual addictions, and paraphilias. J Clin Psychiatry 1992; 53:267–271Medline, Google Scholar5 Pallanti S, Quercioli L, Sood E, et al.: Lithium and valproate treatment of pathological gambling: a randomized, single-blind study. J Clin Psychiatry 2002; 63:559–564Crossref, Medline, Google Scholar6 Lenox RH, Hahn CG: Overview of the mechanism of action of lithium in the brain: fifty-year update. J Clin Psychiatry 2000; 61(Suppl 9):5–15Medline, Google Scholar FiguresReferencesCited byDetailsCited byThe World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder17 November 2022 | Dialogues in Clinical Neuroscience, Vol. 24, No. 1Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder1 April 2022 | Dialogues in Clinical Neuroscience, Vol. 19, No. 4 Volume 24Issue 4 Fall 2012Pages E17-E17 Metrics PDF download History Published online 1 October 2012 Published in print 1 October 2012

Persistent Genital Arousal Disorder Misdiagnosed Because of Islamic Religious Bathing Rituals: A Report of Three Cases

Persistent genital arousal disorder is not well known or adequately understood by physicians. The disorder is characterized by a persistent and highly unwanted state of genital arousal and orgasm-like feelings. Ghusl is an ablution in Islamic culture, which is an obligatory ritual wherein the body is washed thoroughly after exposure to religious contaminants such as sexual intercourse, menstruation, and childbirth. Muslim women suffering from the disorder may bathe frequently because of their religious beliefs. The authors summarize the case histories of 3 patients with persistent genital arousal disorder who were initially misdiagnosed with obsessive-compulsive disorder. All 3 patients presented with complaints of unwanted, persistent orgasms or orgasm-like arousals, and as a result, they performed ghusl several times a day. At previous interviews, the genital arousal was diagnosed as a sexual and somatic obsession, and repeatedly performing ghusl was considered a cleansing compulsion. Physicians’ lack of awareness or knowledge of persistent genital arousal disorder, combined with the unwillingness of patients to discuss sexual problems, can lead to a focus on the repetitive bathing, and thus, a misdiagnosis of the problem as obsessive-compulsive disorder. These cases are presented to highlight the possible pitfalls in the diagnosis of persistent genital arousal disorder cases in Islamic countries where ghusl is common.

Sexual Addiction and Substance Addiction: Comparing Sexual Addiction Treatment Outcomes Among Clients With and Without Comorbid Substance Use Disorders

The current study sought to compare treatment outcomes for individuals with a single diagnosis of sexual addiction (SA) to those with comorbid sexual and substance addiction (SA-SUD), and to explore whether these two disorders can be successfully treated concurrently. Baseline and 6 month follow-up data were collected from adults receiving inpatient residential treatment for SA (n = 21) or for SA-SUD (n = 36) examining sexual impulse control, alcohol and drug use, and quality of life. Both SA and SA-SUD clients experienced significant improvements in self-reported sexual compulsivity and quality of life; however, on average, SA clients had significantly higher levels of compulsive sexual behavior than SA-SUD clients. The findings suggest that the two disorders can be successfully treated concurrently. Implications of these findings are discussed.

Direct and mediating effects of accessing sexually explicit online materials on Hong Kong adolescents' attitude, knowledge, and behavior relating to sex

This study investigated the impact of accessing sexually explicit online materials (SEOM) on Hong Kong adolescents' attitude, knowledge, and behavior relating to sex. Challenging the assumption of a direct relationship between the frequency of accessing SEOM and its influence on adolescent sexuality, the basic premise of the study is that exposure to SEOM elicits adolescents' intrapersonal reactions with mediating effects on their sexual development. To test this, the study employed a survey design with data based on a sample of 503 adolescents in Hong Kong. Analyses of covariance and mediation were conducted to test the hypotheses derived from the conceptual framework. The results indicated that adolescents' frequency of accessing and reactions to SEOM were positively linked to their acceptance of stereotyped gender roles and power imbalance in sexual relationships, permissiveness of premarital sex, sexual compulsion, and sexual daydreaming. Furthermore, the results supported the premise of the study that adolescents' reactions to SEOM mediate and amplify the effects of the frequency of accessing SEOM. The study provides a frame of reference for youth workers generating an in-depth analysis of adolescents' experience of SEOM exposure, thus broadening the conceptualization of the needs and problems faced by adolescents while expanding potential areas of intervention, prevention, and education.

Hypersexuality in college students: The role of psychopathy

Psychopathy is a maladaptive personality style that is marked by hypersexual activity that may put the individual or others at risk for unintended consequences such as pregnancy, STDs, pain, and emotional distress. The current study examined associations between psychopathic personality traits and normative sexual risk taking behaviors. In a sample of undergraduate students (n=393), we examined psychopathy, with an emphasis on the two facets of Fearless-Dominance and Impulsive-Antisociality, and various aspects of hypersexuality (e.g., sexual sensation seeking, compulsivity, excitation, and disinhibition), including risky sexual behavior. Both psychopathy facets, particularly Impulsive-Antisociality, were distinctly associated with all forms of hypersexuality. An interaction effect for the two psychopathy facets was found for predicting risky sexual behavior, indicating that scoring high on both facets was a stronger predictor of hypersexuality than scoring high on either facet in isolation. The psychopathy effects were present even when controlling for general sensation seeking, impulsivity, and antisociality.

Shame and Sexual Compulsivity: Enactments That Fuel Addiction

Shame and Sexual Compulsivity: Enactments That Fuel Addiction

Predicting the Condom Assertiveness of Collegiate Females in the United States From the Expanded Health Belief Model

ABSTRACT. Collegiate females in the United States are susceptible to sexually transmitted infections (STIs) due to their propensity for sexual exploration, multiple sexual partnerships, and inconsistent safe-sex practices. Despite the potential for safe-sex communication to contribute to safer sex, little is known about the predictors of this form of sexual communication. Research on condom assertiveness—the unambiguous messaging that sex without a condom is unacceptable—is especially rare. This study employed the Expanded Health Belief Model (EHBM) in an attempt to understand why some collegiate females are more condom assertive than others. Compared with less condom-assertive females, more condom-assertive females have more faith in the effectiveness of condoms, believe more in their own condom communication skills, perceive that they are more susceptible to STIs, believe there are more relational benefits to being condom assertive, believe their peers are more condom assertive, and intend to be more condom assertive. Overall, EHBM variables accounted for nearly 70% of the variability in condom assertiveness. Several of these associations, however, were moderated by sexual compulsivity and general assertiveness. Implications of these findings for sexual health practitioners are discussed, and directions for future research are suggested.

Application of Syndemic Theory to Black Men Who Have Sex with Men in the Multicenter AIDS Cohort Study

This study analyzed data from a large prospective epidemiologic cohort study among men who have sex with men (MSM), the Multicenter AIDS Cohort Study, to assess syndemic relationships among black MSM in the cohort (N = 301). We hypothesized that multiple interconnections among psychosocial health conditions would be found among these men, defining syndemic conditions. Constituents of syndemic conditions measured included reported depression symptoms, sexual compulsiveness, substance use, intimate partner violence (IPV), and stress. We found significant evidence of syndemics among these black men: depression symptoms were independently associated with sexual compulsiveness (odds ratios [OR]: 1.88, 95% CI = 1.1, 3.3) and stress (OR: 2.67, 95% CI = 1.5, 4.7); sexual compulsiveness was independently associated with stress (OR: 2.04, 95% CI = 1.2, 3.5); substance misuse was independently associated with IPV (OR: 2.57, 95% CI = 1.4, 4.8); stress independently was associated with depression symptoms (OR: 2.67, 95% CI = 1.5, 4.7), sexual compulsiveness (OR: 2.04, 95% CI = 1.2, 3.5) and IPV (OR: 2.84, 95% CI = 1.6, 4.9). Moreover, men who reported higher numbers of syndemic constituents (three or more conditions) reportedly engaged in more unprotected anal intercourse compared to men who had two or fewer health conditions (OR: 3.46, 95% CI = 1.4-8.3). Findings support the concept of syndemics in black MSM and suggest that syndemic theory may help explain complexities that sustain HIV-related sexual transmission behaviors in this group.