Characteristics of self-identified sexual addicts in a behavioral addiction outpatient clinic

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Abstract

Background and aims

Research on sexual addiction flourished during the last decade, promoted by the development of an increased number of online sexual activities. Despite the accumulation of studies, however, evidence collected in clinical samples of treatment-seeking people remains scarce. The aim of this study was to describe the characteristics (socio-demographics, sexual habits, and comorbidities) of self-identified “sexual addicts.”

Methods

The sample was composed of 72 patients who consulted an outpatient treatment center regarding their sexual behaviors. Data were collected through a combination of structured interviewing and self-report measures.

Results

Most patients were males (94.4%) aged 20–76 years (mean 40.3 ± 10.9). Endorsement of sexual addiction diagnosis varied from 56.9% to 95.8% depending on the criteria used. The sexual behaviors reported to have the highest degree of functional impairment were having multiple sexual partners (56%), having unprotected sexual intercourse (51.9%), and using cybersex (43.6%). Ninety percent of patients endorsed a comorbid psychiatric diagnosis, and 60.6% presented at least one paraphilia.

Conclusions

Results showed highly different profiles in terms of sexual preferences and behaviors, as well as comorbidities involved. These findings highlight the need to develop tailored psychotherapeutic interventions by taking into account the complexity and heterogeneity of the disorder.

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Most cited references 67

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The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population.

Ronald C Kessler, Lenard Adler, Minnie Ames … (2005)

A self-report screening scale of adult attention-deficit/hyperactivity disorder (ADHD), the World Health Organization (WHO) Adult ADHD Self-Report Scale (ASRS) was developed in conjunction with revision of the WHO Composite International Diagnostic Interview (CIDI). The current report presents data on concordance of the ASRS and of a short-form ASRS screener with blind clinical diagnoses in a community sample. The ASRS includes 18 questions about frequency of recent DSM-IV Criterion A symptoms of adult ADHD. The ASRS screener consists of six out of these 18 questions that were selected based on stepwise logistic regression to optimize concordance with the clinical classification. ASRS responses were compared to blind clinical ratings of DSM-IV adult ADHD in a sample of 154 respondents who previously participated in the US National Comorbidity Survey Replication (NCS-R), oversampling those who reported childhood ADHD and adult persistence. Each ASRS symptom measure was significantly related to the comparable clinical symptom rating, but varied substantially in concordance (Cohen's kappa in the range 0.16-0.81). Optimal scoring to predict clinical syndrome classifications was to sum unweighted dichotomous responses across all 18 ASRS questions. However, because of the wide variation in symptom-level concordance, the unweighted six-question ASRS screener outperformed the unweighted 18-question ASRS in sensitivity (68.7% v. 56.3%), specificity (99.5% v. 98.3%), total classification accuracy (97.9% v. 96.2%), and kappa (0.76 v. 0.58). Clinical calibration in larger samples might show that a weighted version of the 18-question ASRS outperforms the six-question ASRS screener. Until that time, however, the unweighted screener should be preferred to the full ASRS, both in community surveys and in clinical outreach and case-finding initiatives.

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Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research

Joël Billieux, Adriano Schimmenti, Yasser Khazaal … (2015)

Background Behavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a genuine addiction. Methods and aim In this article, we discuss how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of “new” behavioral addictions. Results Both methodological and theoretical shortcomings of these studies were discussed. Conclusions We suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research. Consequently, we proposed several roadmaps for future research in the field, centrally highlighting the need for longer tenable behavioral addiction research that shifts from a mere criteria-based approach toward an approach focusing on the psychological processes involved.

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Hypersexual disorder: a proposed diagnosis for DSM-V.

Martin P. Kafka (2010)

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

Journal ID (publisher-id): 2006

Journal ID (pmc): jba

Title: Journal of Behavioral Addictions

Abbreviated Title: J Behav Addict

Publisher: Akadémiai Kiadó (Budapest )

ISSN (Print): 2062-5871

ISSN (Electronic): 2063-5303

Publication date (Electronic, epub): 20 October 2016

Volume: 5

Issue: 4

Pages: 623-630

Affiliations

[ ¹ ]Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain , Louvain-la-Neuve, Belgium

[ ² ]Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc , Brussels, Belgium

[ ³ ]CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France

[ ⁴ ]Université de Nantes, EA 4275 SPHERE “MethodS for Patients-centered outcomes and HEalth Research,” Nantes, France

Author notes

[* ]Corresponding authors: Aline Wéry; Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Place du Cardinal Mercier, 10, B-1348 Louvain-la-Neuve, Belgium; Phone: +32 (0)10 47 45 46; Fax: +32 (0)10 47 37 74; E-mail: aline.wery@uclouvain.be; Marie Grall-Bronnec; CHU de Nantes, Department of Addictology and Psychiatry, Hôpital Saint-Jacques, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France; Phone: +33 (0)2 40 84 61 16; Fax: +33 (0)2 40 84 61 18; E-mail: marie.bronnec@ 123456chu-nantes.fr

Article

DOI: 10.1556/2006.5.2016.071

PMC ID: 5370367

PubMed ID: 27774812

SO-VID: 309c1f2a-9c70-4a47-b271-06049028a569

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited.

History

Date received : 27 June 2016

Date revision received : 14 September 2016

Date accepted : 18 September 2016

Page count

Figures: 0, Tables: 5, Equations: 0, References: 53, Pages: 8

Funding

Funding sources: Joël Billieux is funded by the European Commission for research on the problematic sage of information and communication technology (“Tech Use Disorders”; Grant no. FP7-PEOPLE-2013-IEF-627999). These funding agencies did not exert any editorial direction or censorship on any part of this study. This research was conducted at the initiative of and coordinated by the Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders” of the University Hospital of Nantes, who is the sponsor of this study.

Characteristics of self-identified sexual addicts in a behavioral addiction outpatient clinic

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Abstract

Background and aims

Methods

Results

Conclusions

Related collections

Journal of Behavioral Addictions

Most cited references 67

The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population.

Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research

Hypersexual disorder: a proposed diagnosis for DSM-V.

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