Adolescents’ Compulsive Sexual Behavior: The Role of Parental Competence, Parents’ Psychopathology, and Quality of Parent–Child Communication About Sex

Background and aims: Compulsive sexual behavior (CSB) has implications for clinical and non-clinical adult populations. Disposition to CSB has been shown to influence adolescence sexual behaviors, but the development of adolescents’ disposition toward CSB has yet to be examined in the family context. In this study, we investigated whether parent–adolescent communication mediates the links between parental characteristics and adolescents’ CSB. Methods: The sample included 275 Israeli families [triad of mothers (age = 34–63 years, M = 45.48, SD = 5.46), fathers (age = 36–83 years, M = 48.33, SD = 6.63), and one adolescent (48.2% boys, 51.1% girls; age = 14–18 years, M = 16.23, SD = 1.18)]. Parents completed measures of psychopathology, parental self-esteem, and parental self-efficacy, and adolescents completed measures of quality of sex-related communication and CSB. Results: The results indicate that, for girls, higher maternal self-esteem and lower psychopathology were linked with better sex-related communication and so with lower CSB. For boys, only parental religiosity was linked with the quality of sex-related communication and CSB, with religious parents having better communication than secular ones. Discussion: The findings provide an opportunity for researchers to gain a better insight into the dynamics of familial factors in the development of CSB among adolescents

Promoting educational, classification, treatment, and policy initiatives : Commentary on: Compulsive sexual behaviour disorder in the ICD-11 (Kraus et al., 2018)

The letter by Kraus et al. (2018) published recently in World Psychiatry presents diagnostic criteria for compulsive sexual behaviors (CSBs). Here, we discuss the potential impact of including CSB disorder in ICD-11 for four areas: educational efforts related to CSB (for both clinicians and patients), investigation of underlying mechanisms and subtypes, development of personalized treatment frameworks, and answering socially important questions and advancing important prevention efforts and effective policies. Each of these four areas has their own challenges that should be addressed, and we briefly describe and discuss them. We hope that this information will help continue a dialog and provide a framework for moving forward in this area

Paroxetine Treatment of Problematic Pornography Use: A Case Series

Background How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive–compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU). Case presentation Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment. Discussion Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months. Conclusions Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use

Compulsive sexual behavior: A twelve-step therapeutic approach

Background and aims Sexuality is natural to human life and inseparable from it, yet some individuals develop compulsive sexual behavior (CSB). Many individuals with CSB seek treatment in free self-support groups based on the twelve-step program. This program was extensively studied in substance abuse disorders (e.g., Alcoholics Anonymous), but little is known about its efficiency in CSB. Methods We “assesed” questionnaire data on sociodemographical-, psychological-, and recovery-related factors from 97 male participants of Sexaholics Anonymous (SA) programs in Israel. Results Our results indicated that advancement in the SA program, measured as a current step of the program, is significantly related to lower levels of sexual-related overall sense of helplessness, avoidant help-seeking, self-control, overall CSB, and sexual suppression. It is also related to the higher well-being. Discussion This is the first study to examine psychological factors of CSB recovery process in twelve-step groups, and future research is needed to replicate our results within a longitudinal study

Anhedonia. Co o niej wiemy i jak ją badać?

Anhedonia (originally defined as „inability to experience pleasure”) occurs as a symptom in major depressive disorder, schizophrenia, addiction and also as a trait in the general population. However, recent studies on experiencing pleasure make classical definition of anhedonia out-of-date. The feeling of pleasure is tied to reward processing which consists of three phases - learning, wanting and liking. Each of these phase is related to neuronal activity within the reward system, and abnormalities in this system result in anhedonia. Recent studies use variety of methods to investigate and redefine anhedonia. Here we present the most frequently used questionnaires assessing anhedonia: PAS, SAS, SHAPS, TEPS and DARS. We discuss their psychometric properties and theoretical assumptions. We also describe experimental procedures used in studies on anhedonia allowing for measurement of neuronal activity during the phases of learning, wanting and liking. Use of multi-level measurements of subjective reports, behavioral and neuronal activity allow for complex analysis of anhedonia and comparisons of its characteristics between different clinical and non-clinical populations. Applying both: questionnarires and experimental procedures seems to be an effective way to assess anhedonia not only for research purpose, but also for clinical diagnosis.Anhedonia to zarówno objaw depresji, schizofrenii, uzależnień, jak i cecha występująca w populacji ogólnej. Pierwotnie definiowano ją jako „niemożność odczuwania przyjemności”. W świetle współczesnych badań dotyczących odczuwania przyjemności definicja ta przestaje być aktualna. Odczuwanie przyjemności wiąże się z procesami przetwarzania nagród podzielonymi na trzy etapy: uczenie się, pożądanie oraz satysfakcję. Za każdy z etapów przetwarzania nagród odpowiada neuronalna aktywność w obrębie mózgowego układu nagrody, której zaburzenia skutkują anhedonią. Autorzy współczesnych badań próbują precyzyjnie określić przyczyny anhedonii, wykorzystując zarówno kwestionariusze samoopisowe, zadania behawioralne oraz techniki neuroobrazowania. Wyniki tych badań stanowią podstawę do redefinicji anhedonii. W artykule zaprezentowano najczęściej używane kwestionariusze do pomiaru anhedonii: PAS, SAS, SHAPS, TEPS oraz DARS. Dyskutowane są ich własności psychometryczne oraz różnice w założeniach teoretycznych. Opisano także procedury eksperymentalne wykorzystywane w badaniach nad anhedonią, pozwalające mierzyć aktywność neuronalną na etapie uczenia się, pożądania oraz satysfakcji. Wykorzystanie pomiarów na wielu poziomach: opisu subiektywnych odczuć, behawioralnym, a także aktywności układu nerwowego pozwalają na kompleksową analizę anhedonii oraz porównanie jej właściwości pomiędzy różnymi grupami osób badanych. Zastosowanie zarówno kwestionariuszy samoopisowych, jak i procedur eksperymentalnych oraz opis ich wzajemnych zależności daje szansę na lepsze poznanie mechanizmów leżących u podłoża anhedonii oraz skuteczniejszej diagnozy pacjentów z zaburzeniami psychiatrycznymi

Understanding and predicting profiles of compulsive sexual behavior among adolescents

Background and aims: This two-study research was designed to define and predict profiles of compulsive sexual behavior (CSB) among non-clinical population of adolescents, and aimed to fill gaps in the current research. Methods: In Study 1 (N = 1,182), we examined the profiles of CSB among adolescents using latent profile analysis. Results revealed the following three clusters: abstainers, sexual fantasizers, and individuals with CSB. In Study 2 (N = 618), we replicated this classification and examined differences between the clusters in Big Five personality traits, locus of control, attachment orientations, loneliness, age, gender, socioeconomic status (SES), residence quality, use of pornography, and sex-related online activities. Results: Adolescents classified into different clusters significantly differed in personality traits, loneliness, age, SES, use of pornography, and sex-related online activities. Specifically, individuals with CSB had external locus of control, anxious attachment, greater loneliness, higher frequency of pornography use, and more sex-related online activities than the other groups. Discussion: The current research expands the knowledge about CSB by providing a more individualized approach to understanding CSB among adolescence

Evaluating Pornography Problems Due to Moral Incongruence Model

INTRODUCTION: To date, multiple models of problematic pornography use have been proposed, but attempts to validate them have been scarce. AIM: In our study, we aimed to evaluate the Pornography Problems due to Moral Incongruence model proposing that self-appraisals of pornography addiction stem from (i) general dysregulation, (ii) habits of use, and (iii) moral incongruence between internalized norms and behavior. We investigated whether the model can be used to adequately explain the self-perceptions of addiction to pornography (model 1) and a broader phenomenon of problematic pornography use (model 2). METHODS: An online, nationally representative study was conducted on a sample of 1036 Polish adult participants, of whom, 880 declared a lifetime history of viewing pornography. MAIN OUTCOME MEASURE: The outcomes were self-perceived pornography addiction, problematic pornography use, avoidant coping, frequency of pornography use, religiosity, moral disapproval of pornography, and related variables. RESULTS: Our results indicated that avoidant coping (an indicator of general dysregulation), frequency of pornography use (indicator of habits of use), and the distress connected with incongruence between own sexual behavior and internalized norms, attitudes and beliefs positively contributed to self-perceived addiction (model 1) as well as problematic pornography use (model 2). This broadly confirms the basic shape of the PPMI model. There were, however, notable differences between the models. Moral incongruence related distress was only weakly related to self-perceived addiction (β = 0.15, P \u3c .001), with a stronger relation for problematic pornography use (β = 0.31, P \u3c .001). When controlling for other factors, religiosity weakly predicted problematic pornography use (β = 0.13, P \u3c .001), but not self-perceived addiction to pornography (β = 0.03, P = .368). Frequency of pornography use was the strongest predictor of both self-perceived addiction (β = 0.52, P \u3c .001) and problematic pornography use (β = 0.43, P \u3c .001). CLINICAL IMPLICATIONS: Factors proposed within the PPMI model are distinctly relevant intervention targets, and they should be considered in the process of diagnosis and treatment. STRENGTHS & LIMITATIONS: The presented study is the first to evaluate PPMI model. Its main limitation is that it has a cross-sectional design. CONCLUSION: The PPMI model is a promising framework for investigating the factors related to self-perceived addiction and problematic pornography use. Despite the differences between the models and in the strength of specific predictors, (i) dysregulation, (ii) habits of use, and (iii) moral incongruence all uniquely contribute to self-perceived addiction and problematic pornography use. Lewczuk, K., Glica, A., Nowakowska, I., et al. Evaluating Pornography Problems Due to Moral Incongruence Model. J Sex Med 2020;17:300-311

“Pornographic binges” as a key characteristic of males seeking treatment for compulsive sexual behaviors: Qualitative and quantitative 10-week-long diary assessment

Background and aims Compulsive sexual behaviors (CSBs) are an important clinical and social issue. Despite the increasing number of studies, some of CSB’s aspects remain under-investigated. Here, we explore the nature of CSB, such as binge pornography use and masturbation (PuM), and verify the correspondence between self-perceived factors leading to such behavior with its measures obtained in a diary assessment. Methods Semi-structuralized interviews with nine treatment-seeking males aged 22–37 years (M = 31.7, SD = 4.85) were followed by a questionnaire and a 10-week-long diary assessment, allowing us to acquire real-life daily patterns of CSB. Results Six out of nine subjects experienced binge (multiple hours or times a day) PuM. All subjects presented a high level of anxiety and perceived PuM as a way to regulate mood and stress. Data collected in the diary assessment uncovered a high diversity in the patterns of sexual behaviors (such as frequency of regular and binge PuM) and its correlates. Binge PuM was related to decreased mood and/or increased stress or anxiety. The causal relation between these correlates remains undetermined. Discussion and conclusions Binge PuM seems to be one of the most characteristic behavior among males who are seeking treatment for CSB and is related to the feeling of losing control over one’s sexual activity. CSB individuals indicate a variety of binge triggers. Also, diary assessment data indicate that specific correlates of binge PuM (decreased mood, increased stress, and anxiety) differ between subjects. It suggests the existence of significant individual differences in binge PuM behaviors, and a need to study these differences, as it may help guide personalized treatment

Treatment seeking for problematic pornography use among women

Background and aims Previous studies examined psychological factors related to treatment seeking for problematic pornography use (PU) among males. In this study, we focused on females who seek treatment for problematic PU and compared them with non-problematic pornography users with regard to variables related to problematic PU. Second, we investigated the relationships between critical constructs related to problematic PU with the path analysis method, emphasizing the predictors for treatment seeking among women. We also compared our results with previous studies on males. Methods A survey study was conducted on 719 Polish-speaking Caucasian females, 14–63 years old, including 39 treatment seekers for problematic PU. Results The positive relationship between the mere amount of PU and treatment seeking loses its significance after introducing two other predictors of treatment-seeking: religiosity and negative symptoms associated with PU. This pattern is different from the results obtained in previous studies on males. Discussion Different from previous studies on male samples, our analysis showed that in the case of women, mere amount of PU may be related to treatment-seeking behavior even after accounting for negative symptoms associated with PU. Moreover, religiousness is a significant predictor of treatment seeking among women, which may indicate that in the case of women, treatment seeking for problematic PU is motivated not only by experienced negative symptoms of PU but also by personal beliefs about PU and social norms. Conclusion For females, negative symptoms associated with PU, the amount of PU and religiosity is associated with treatment seeking. Those factors should be considered in treatment

Spotlight on Compulsive Sexual Behavior Disorder: A Systematic Review of Research on Women

Purpose of Review: World Health Organization recently included compulsive sexual behavior disorder (CSBD) to the upcoming 11th edition of International Classification of Diseases (6C72). Despite the potential benefits of this decision (eg, the acceleration of research in the field will allow the development of effective treatments), previous research focused mainly on men, and as a result, we do not have an accurate clinical picture of compulsive sexual behavior (CSB) among women. Therefore, in this systematic review, we aim to present available knowledge on this topical subject. Literature search was conducted in the guideline of PRISMA methodology. Studies were identified from multiple databases including Academic Search Ultimate, SocINDEX, PsycARTICLES, PsycINFO, PubMed, and MEDLINE. Out of a total of 10,531 articles identified and screened, 58 were included in this review. Included studies covered the following topics: prevalence and etiology of CSB, behavioral and cognitive processes involved, comorbidities, personality traits, psychosocial and interpersonal difficulties, traumatic experiences, and treatments. Recent Findings: Available studies indicate that CSB symptom severity is lower in women than in men. Overall, women reported consuming pornography less often than men and exhibit lower rates of feeling urges to these materials. CSB symptoms (including problematic pornography use) have been found to be positively related to trait psychopathy, impulsivity, sensation seeking, attention-deficit/hyperactivity disorder symptoms, obsessive-compulsive disorder, pathological buying, sexual dysfunctions, general psychopathology, child sexual abuse, while negatively related to dispositional mindfulness. Summary: Conclusions that can be drawn from prior studies are considerably limited. There are no accurate estimates of the CSB prevalence or severity among women, and studies have been mostly conducted on non-clinical populations, which has limited application for women diagnosed with CSBD