Psychometric Properties of the Spanish Version of the Online Sexual Addiction Questionnaire: An Exploratory Study Using a Sample of Convicted Sex Offenders

This study explored the psychometric properties of the Online Sexual Addiction Questionnaire (OSA-Q). In total, 100 sexual offenders completed the OSA-Q Spanish version, along with the Millon Clinical Multiaxial Inventory-III (MCMI-III) for the assessment of related impairment. 34 individuals with social-desirability bias were extracted from the sample. A four-factor structure accounted for 77% of the variance and internal consistency was strong (α = .97). Additionally, correlations with related clinical scales were statistically significant. Overall, online sexual offenders showed higher scores on the OSA-Q than contact-exclusive offenders. According to our results, the OSA-Q shows promise as a screening in forensic samples

Disfunção erétil induzida por pornografia : revisão de literatura

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019Este artigo de revisão aborda a sexualidade humana no contexto de comportamentos aditivos e compulsivos, suscetíveis de causar disfunção sexual. As disfunções sexuais, em particular a disfunção erétil (DE), são doenças angustiantes e constrangedoras, especialmente em jovens adultos do sexo masculino. Na última década, testemunhámos uma subida exponencial da prevalência de DE em homens com menos de 40 anos. Tradicionalmente, a DE em homens jovens era atribuída a causas psicossomáticas, como ansiedade ou stress. Embora a ansiedade e o stress possam ser uma explicação plausível em algumas situações, aparentam ser insuficientes para justificar o aumento de DE. O surgimento de novas linhas de investigação revelou que a prevalência de DE associada a alterações do sistema límbico, nomeadamente o consumo compulsivo de pornografia da internet (PI), é muito maior do que se pensava anteriormente. Nesta revisão, serão abordados conhecimentos clínicos, biológicos, psicológicos e sociológicos. Será apresentada uma história clínica de um doente que ultrapassou as suas disfunções sexuais, após cessar o consumo de PI. Mencionam-se ainda inúmeras evidências de como as propriedades únicas da PI podem ser suficientemente adversas para condicionar a excitação sexual com elementos que não transitam necessariamente para relações sexuais reais, comprometendo as expectativas e promovendo a disfunção sexual. Por ser essencial diagnosticar e tratar tais disfunções, mediante uma adequada comunicação médico-doente, apresenta-se uma proposta de protocolo de diagnóstico e de tratamento, para avaliar doentes com disfunção sexual induzida por PI, no sentido de melhorar a sua qualidade de vida.This review article addresses human sexuality in the context of addictive and compulsive behaviors that are likely to cause sexual dysfunction. Sexual dysfunctions, particularly erectile dysfunction (ED), are distressing and embarrassing diseases, especially in young adult males. In the last decade, we have witnessed an exponential rise in the prevalence of ED among men under 40 years. Traditionally, ED in young men was attributed to psychosomatic causes, such as anxiety or stress. Although anxiety and stress may be a plausible explanation in some situations, they appear to be insufficient to justify the increase in ED. The emergence of new lines of research has revealed that the prevalence of ED associated with changes in the limbic system, namely compulsive use of Internet pornography (IP), is much higher than previously thought. In this review, clinical, biological, psychological and sociological knowledge will be addressed. A clinical history of a patient who has overcome his sexual dysfunctions will be presented after cessation of IP consumption. It also mentions numerous evidences as to how the unique properties of PI may be adverse enough to condition sexual arousal with elements that do not necessarily transition to actual sexual intercourse, compromising expectations and promoting sexual dysfunction. Because it is essential to diagnose and treat such dysfunctions through an adequate doctor-patient communication, a proposal for a diagnostic and treatment protocol is presented, to evaluate patients with IP-induced sexual dysfunction and to improve their quality of life

Cibersexo, saúde mental e intimidade : um estudo exploratório junto de uma população com perturbação de uso de substâncias psicoactivas

Tese de mestrado, Psicologia (Secção de Psicologia Clínica e da Saúde, Núcleo de Psicologia Sistémica), Universidade de Lisboa, Faculdade de Psicologia, 2018O cibersexo refere-se ao uso da Internet para aceder a diversas actividades sexuais online. Vários autores mencionam que o cibersexo problemático tem a dependência de substâncias psicoactivas como comorbilidade, porém não se encontram estudos que o demonstrem. Assim, investigou-se a prevalência do uso de cibersexo numa amostra de 100 pessoas em tratamento por perturbação de uso de substâncias psicoactivas e estudou-se as relações que o uso de cibersexo tem com a saúde mental, com as queixas subjectivas no quotidiano devido a actividades de cibersexo e os sintomas potenciais de dependência de cibersexo, bem como com a intimidade do casal (segundo a percepção do participante). Também foi analisada a associação entre a saúde mental e as queixas subjectivas no quotidiano devido a actividades de cibersexo e os sintomas potenciais de dependência de cibersexo. Para além disso, estudou-se a relação de quatro características da amostra (idade, sexo, substância psicoactiva de eleição e estado civil) com o uso de cibersexo. Não existindo estudos prévios que relacionem ocibersexo com a dependência de substâncias psicoactivas, esta investigação consiste numestudo exploratório e descritivo, onde se aplicou um questionário composto por um Questionário de Caracterização do Participante, um Questionário de Utilização de Cibersexo, oShort Internet Addiction Test Adapted to Cybersex (versão portuguesa), as Escalas deAnsiedade, Depressão e Stress, e as Escalas de Bem-Estar Psicológico (versão experimental reduzida). Do presente estudo pode concluir-se que existe uma prevalência elevada de uso de cibersexo ao longo da vida, na população com perturbação de uso de substâncias psicoactivas; que os indivíduos que têm a cocaína como droga de eleição apresentam significativamente maior tempo de uso de pornografia e médias de frequência de uso da generalidade das actividades de cibersexo superiores às dos participantes que têm o álcool como substância de eleição; que os indivíduos do sexo masculino e os mais jovens são os que apresentam maior prevalência de uso de cibersexo nos últimos 6 meses; que a frequência de uso não varia entre sexos em qualquer uma das actividades sexuais online estudadas; que a frequência de uso de pornografia e de procura de informação sobre sexo ou práticas sexuais se relaciona com sintomas de dependência de cibersexo e com queixas subjectivas no quotidiano; enquanto a frequência de troca de mensagens e/ou imagens de conteúdo sexual se relaciona com o bem-estar psicológico. Os resultados mostram ainda que os participantes que se encontram envolvidos em relações amorosas estáveis têm a percepção que o cibersexo influencia positivamente a relação de intimidade com o(a) companheiro(a) e que os que não estão numa relação amorosa estável apresentam uma tendência para utilizarem cibersexo com maior frequência, para apresentarem pior saúde mental, mais queixas subjectivas do quotidiano devido às actividades sexuais online e mais sintomas potenciais de dependência ao cibersexo. São ainda abordadas possíveis implicações deste trabalho e sugeridas novas abordagens de investigação, tendo em conta as limitações indicadas.Cybersex refers to using the Internet to access various online sexual activities. Several authors mention that problematic cybersex has substance addiction as a comorbidity, but there are no studies that demonstrate this. Thus, we investigated the prevalence of cybersex use in a sample of 100 people under treatment for substance use disorders and studied the relationships that the use of cybersex has with mental health, with subjective complaints in daily life due to cybersex activities and the potential symptoms of cybersex addiction, as well as the intimacy of the couple (according to the participant's perception). We also analyzed the association between mental health and subjective complaints in everyday life due to cybersex activities and potential symptoms of cybersex addiction. In addition, we studied the relation between four characteristics of the sample (age, sex, psychoactive substance of choice and marital status) and the use of cybersex. In the absence of previous studies that relate cybersex to psychoactive substance addiction, this investigation consists of an exploratory and descriptive study, where a questionnaire was applied, composed of a Participant Characterization Questionnaire, a Cybersex Use Questionnaire, the Short Internet Addiction Test Adapted to Cybersex (Portuguese version), the Anxiety, Depression and Stress Scales, and the Psychological Well-Being Scales (reduced trial version). From the present study, it can be concluded that there is a high prevalence of cybersex use throughout life in the population with psychoactive substance use disorders; that individuals who have cocaine as drug of choice have significantly longer time of use of pornography and means of frequency of use of most of the cybersex activities than those who have alcohol as substance of choice; that the male and younger individuals are the ones with the highest prevalence of cybersex use in the last 6 months; that the frequency of use does not vary between sexes in any of the online sexual activities studied; that the frequency of use of pornography and the search for information on sex or sexual practices is related to symptoms of cybersex dependence and to subjective complaints in the daily life; while the frequency of exchange of messages and / or images of sexual content is related to psychological well-being. The results also show that participants who are involved in stable relationships have the perception that cybersex positively influences the relationship of intimacy with the partner and that those who are not in a stable relationship have a tendency to use cybersex more often, to present worse mental health, more subjective everyday complaints due to online sexual activities and more potential symptoms of cybersex addiction. The possible implications of this work are also discussed and new research approaches are suggested, taking into account the limitations indicated

Development and validation of a measure of cybersexual addiction

Sexual addiction has long been a controversial topic, and it has become no less tendentious with its latest incarnation as Internet cybersexual addiction, i.e., the addiction to sexual materials on the Internet. As cybersexual addiction is a relatively recent phenomenon, it is important to have adequate measures to assess the behavior and provide empirical support for diagnostic criteria. While a number of measures are used in the research, none of the measures are based on the currently proposed diagnostic criteria. This study aimed to develop a new measure of cybersexual addiction based on the proposed hypersexual disorder diagnostic criteria and to better understand the relationship between cybersexual addiction, shame, loneliness, anxiety, depression, offline sexual addiction behavior, and Internet addiction. This study provides support for the use of two already established measures. Further, shame, loneliness, sexual compulsivity, and compulsive Internet use were all found to predict cybersexual behavior, whereas substance abuse was inversely related to the behavior. Finally, a model of the predictive correlates found that sexual compulsivity, compulsive Internet use, and depression provided the strongest predictive value. The results imply that additional validation is needed for the Problematic Cybersexual Behavior Scale and the Internet Sex Screening Test for use across general samples. Further, the model of prediction provides support for the role of offline sexual addiction in the development of cybersexual addiction

Cybersex addiction: Conditioning processes and implicit cognition

Research on cybersex addiction, as one form of specific Internet addiction, has been receiving growing attention in the past years. However, there is no consensus regarding the phenomenology, classification, and diagnostic criteria of cybersex addiction and respectively Internet addiction, so far. Some approaches suggest similarities to substance dependencies for which conditioning processes, approach/avoidance tendencies, and implicit associations are seen to be crucial mechanisms regarding development and maintenance. In the course of this dissertation, three studies that aim at investigating these mechanisms in the context of cybersex addiction were conducted. Each study adapted an experimental paradigm used in substance dependence research while it was expected to obtain comparable results. First, to investigate conditioning processes, a Standard Pavlovian to Instrumental Transfer Task (Hogarth, Dickinson, Wright, Kouvaraki, & Duka, 2007) was modified. Second, an adapted version of the Approach Avoidance Task (Rinck & Becker, 2007) was used for investigating a potential role of approach/avoidance tendencies. Third, to assess effects of implicit associations on cybersex addiction, an Implicit Association Test was adapted (Greenwald, McGhee, & Schwartz, 1998). All experimental paradigms were modified with pornographic pictures. Results revealed that conditioning processes, approach/avoidance tendencies as well as implicit associations had an effect on tendencies towards cybersex addiction. Moreover, all three studies could show that self-reported symptoms of cybersex addiction were particularly high if the investigated mechanisms interacted either with specific predispositions towards sex (i.e. sexual excitation or problematic sexual behaviors) or subjective craving due to watching pornographic pictures. Overall, the findings of this dissertation provide further empirical evidence for similarities between cybersex addiction and substance dependencies. Therefore, similarities between dual-process models of addiction (Bechara, 2005; Wiers & Stacy, 2006) and the theoretical framework of cybersex addiction by Laier and Brand (2014) are discussed. Furthermore, extensions of the cybersex addiction framework by Laier and Brand (2014) are proposed. At last, practical implications are discussed, while limitations and future directives are pointed out

Novel Research in Sexuality and Mental Health

Sexuality is considered as a great human value related to happiness and satisfaction, but unfortunately, when affecting mental disorders, they tend to be associated with second level human functions. Nevertheless, sexual dysfunction often accompanies psychiatric disorder, intensely influencing compliance, quality of life and human relationships. Sexuality could be influenced either by a mental disorder itself, difficulties to get and maintain couple relationships or by the use of psychotropic treatments. Treatment-related adverse events are unfortunately under-recognized by clinicians, scarcely spontaneously communicated by patients, and rarely investigated in clinical trials. The most frequent psychotropic compounds that could deteriorate sexuality and quality of life include antidepressants, antipsychotics and mood regulators. There are important differences between them related to some variations in mechanisms of action including serotonin, dopamine and prolactin levels. Little is known about the relevance of sexuality and its dysfunctions in chronic and frequent mental and neurological disorders, such as psychosis, mood disorders, anxiety, phobias, eating disorders, alcohol or drug dependencies, epilepsy and childhood pathology. Poor sexual life, low satisfaction and more frequent risky sex behavior than in the general population are associated with severe mental diseases. There is a need for increasing research in this field, including epidemiological, psychological, neurophysiological, neuroanatomical and genetic variables related to sexual life to get a better understanding of the implicated mechanisms. To increase the sensibility of clinicians, the identification and management of sexual disturbances after the onset of any mental disorder should be highlighted. This would avoid unnecessary suffering and deterioration of quality of life