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      Compulsive sexual behavior and sexual offending: Differences in cognitive schemas, sensation seeking, and impulsivity

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          Abstract

          Background and aims

          People from the community seeking treatment in frameworks such as Sexaholics Anonymous (SA) and sex offenders are preoccupied with sex, sexual fantasies, and behaviors. The rates of compulsive sexual behavior disorder (CSBD), however, are reported to be substantially lower among sex offenders than SAs. In this study, we examined differences between SAs and sex offenders in CSBD and in processes that might be at the core of CSBD – maladaptive schemas about the self and others, impulsivity, and sensation seeking.

          Methods

          The study comprised 103 sex offenders, 68 SAs, and 81 violence offenders who served as controls aged 18–74 years, who completed self-report measures regarding CSBD, maladaptive schemas, impulsivity, and sensation seeking.

          Results

          SAs were higher on CSBD, maladaptive schemas, impulsivity, and sensation seeking than sex offenders. Sex offenders were higher on CSBD and impulsivity than violence offenders. Among all groups, maladaptive schemas were linked with higher CSBD.

          Conclusions

          High rates of CSBD among SAs might partially be accounted by differences in maladaptive schemas. We discuss the implication of the study to the understanding of CSBD, sexual offences, and therapy for CSBD and sexual offending.

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          Most cited references65

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          Psychiatric Aspects of Impulsivity

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            The characteristics of persistent sexual offenders: a meta-analysis of recidivism studies.

            A meta-analysis of 82 recidivism studies (1,620 findings from 29,450 sexual offenders) identified deviant sexual preferences and antisocial orientation as the major predictors of sexual recidivism for both adult and adolescent sexual offenders. Antisocial orientation was the major predictor of violent recidivism and general (any) recidivism. The review also identified some dynamic risk factors that have the potential of being useful treatment targets (e.g., sexual preoccupations, general self-regulation problems). Many of the variables commonly addressed in sex offender treatment programs (e.g., psychological distress, denial of sex crime, victim empathy, stated motivation for treatment) had little or no relationship with sexual or violent recidivism.
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              Hypersexual disorder: a proposed diagnosis for DSM-V.

              Hypersexual Disorder is proposed as a new psychiatric disorder for consideration in the Sexual Disorders section for DSM-V. Historical precedents describing hypersexual behaviors as well as the antecedent representations and proposals for inclusion of such a condition in the previous DSM manuals are reviewed. Epidemiological as well as clinical evidence is presented suggesting that non-paraphilic "excesses" of sexual behavior (i.e., hypersexual behaviors and disorders) can be accompanied by both clinically significant personal distress and social and medical morbidity. The research literature describing comorbid Axis I and Axis II psychiatric disorders and a purported relationship between Axis I disorders and Hypersexual Disorder is discussed. Based on an extensive review of the literature, Hypersexual Disorder is conceptualized as primarily a nonparaphilic sexual desire disorder with an impulsivity component. Specific polythetic diagnostic criteria, as well as behavioral specifiers, are proposed, intended to integrate empirically based contributions from various putative pathophysiological perspectives, including dysregulation of sexual arousal and desire, sexual impulsivity, sexual addiction, and sexual compulsivity.
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                Author and article information

                Journal
                J Behav Addict
                J Behav Addict
                jba
                JBA
                Journal of Behavioral Addictions
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                9 August 2019
                September 2019
                : 8
                : 3
                : 432-441
                Affiliations
                [1 ]Faculty of Education and Society and Culture, Beit-Berl College , Kefar Sava, Israel
                [2 ]Faculty of Education, Orot-Israel College , Elkana, Israel
                [3 ]Israel Prison Service , Ramla, Israel
                Author notes
                [* ]Corresponding author: Dr. Yaniv Efrati; Faculty of Education and Society and Culture, Beit-Berl College, Kefar Sava 4490500, Israel; Phone: +972 545 800 094; E-mail: ypefrati@ 123456gmail.com
                Article
                10.1556/2006.8.2019.36
                7044633
                31394911
                01c06a0b-4e99-468f-ab10-604d3fb12fd0
                © 2019 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 22 April 2019
                : 09 June 2019
                : 02 July 2019
                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 69, Pages: 10
                Funding
                Funding sources: None.
                Categories
                Full-Length Report

                compulsive sexual behavior disorder,sex offenders,maladaptive schemas

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