Much of the research on treatment of sexual offenders is focused on contact sexual offenses, which include physical contact with a victim. Conversely, there is a dearth of literature on effective psychological interventions for individuals who commit non-contact sexual offenses. This paper briefly reviews the research on the characteristics and risk of some of the main types of non-contact sexual offenders (i.e., online, voyeuristic, exhibitionistic) before critically examining the psychological treatment literature in this area. Suggestions for future research are provided.
Abstract A sample group of 19 recovering sex and porn addicts who had attended both one-to-one and group therapy at the Laurel Centre sex addiction clinic in the UK undertook an hour-long semi-structured interview relating to the usefulness of group work to their recovery. Interview data was analysed for themes and cross-referenced with Yalom’s 11 therapeutic factors of group therapy (Yalom and Leszcz, 2005). Some additional themes were also found that related specifically to the Hall Recovery Course psycho-educational programme that they each attended. Group work was found to be more important to participants’ recovery than one-to-one therapy but this was not consistent, and drawbacks to group work were also identified.
This study explored the stigma toward individuals with sexual addiction and how it compared to gambling addiction, alcohol addiction, and depression in both males and females. Undergraduate students (N = 241) were assigned to read one of eight vignettes (mental illness x gender) and completed quantitative stigma measures (e.g., social distance). Results showed that alcohol addiction was the most stigmatized, followed closely by gambling addiction. Sexual addiction and depression had similar levels of stigma. Participants were less stigmatizing toward females with sexual addiction, and no other gender differences emerged. Additional variables and measures (e.g., perceived causes) were also explored.
Helping someone consider what it might be like to desist from an ingrained, highly-prized, sexually-compulsive behavior is challenging. To help a client move toward such a goal, it may be helpful to break down the process of refraining into two parts or subsequences: first, the moment of choosing not to engage in the pleasure-seeking behavior(s); and second, the moments after one has chosen not to engage. This "second moment" is not often addressed granularly in intervention models because in a sense, it seems like a negative space, a void. It presumes the hard work and mental energy of desisting has already occurred. But we may conceptualize the "moment(s) after" as forming a temporal, affective, and psychological space in which the client needs specific help, support, and tools. This article uses theoretical and casework material to demonstrate how such a "two-step" model can help clients envision and prepare for the challenges of ceasing sexually addictive behaviors by also getting them in touch with what may follow an episode marked by inhibition.
Abstract In response to the problem of the social integration of masturbation groups, existing studies have simplified it into a one-way, passive correction process, which has mixed heterogeneous organizational groups and ignored the interactive meanings displayed by several in this process. Through the participatory observation and in-depth interviews with the masturbation abstainers in the network group organization, this article presents the abstinence process of the masturbation group in the internet platform. The qualitative study found that the use of symbols by Internet organizations with the experience of “evil sex” and “moral irrationality” has strengthened the stigma of the masturbation group, but at the same time provided a religious compensatory role for quit masturbation. Religious compensation within a certain period of time formed a moral order and strengthened self-identification. In essence, the order established by the network organization is supported by the “sex addiction-Buddhism” interpretation system proposed by the administrator. With the change of power within the network organization, the original firm interpretation system quickly formed a new discourse. This change of management has not triggered conflicts between masturbation guards and the maintenance of the old system but has been accepted because the moral constraints and health regulations in the new interpretation system are still orderly. This acceptance process clearly demonstrates the constant desire of the masturbator for security and certainty and the desire for the order to accommodate his own qualities.
Although paraphilias encompass a broad range of sexual interests, they often are regarded broadly as maladaptive. Doing so, however, may conceal relatively well-adjusted and satisfying forms of sexuality. Participants were recruited through Amazon Mechanical Turk and completed online questionnaires assessing paraphilic interests, sexual satisfaction, resilience, and attachment. Participants were 614 adults, aged 19 to 30 years (M = 26.08, SD = 3.18). Regression analyses demonstrated that atypical paraphilias, paraphilias related to nonconsensual sexual activities, and paraphilias related to BDSM explained a significant proportion of variance in sexual satisfaction. Findings suggest directions on the conceptualization and treatment of paraphilias.
To examine the effectiveness of a combination treatment for hypersexual disorder (HD), using regular involvement with a 12-step program related to sexual behavior and weekly individual psychotherapy, this qualitative study recruited volunteers with minimum three-year concurrent experience of the two interventions and minimum two-year abstinence from unwanted sexual behavior. Transcript analysis of interviews with four participants revealed the strength of 12-step meeting attendance and active involvement with a sponsor. The analysis further revealed the complementary benefit of individual psychotherapy, including inherent tension between the two interventions. The discussion section addresses, among other things, the clinical importance to treat clients' dysregulation.
The purpose of this study was to both provide additional evidence of the psychometric properties of the Trauma Inventory for Partners of Sex Addicts (TIPSA), and add empirical evidence for the application of betrayal trauma theory outside the context of complex and/or historical trauma. It was hypothesized that reliability coefficients for TIPSA would exceed 0.70; TIPSA and PTSD Checklist for DSM 5 (PCL-5) scores would be significantly positively correlated; TIPSA and Composite Codependency Scale (CCS) scores would not be significantly correlated; and neither Adverse Childhood Experiences (ACE) nor Benevolent Childhood Experiences (BCE) scores would be significantly correlated with, or have a significant effect on, TIPSA or PCL-5 scores. All reliability estimates were above 0.70, and correlation between TIPSA and PCL-5 produced a Pearson's r of 0.851 (p = 5.541 E-55), which indicated a large effect size. Correlations with additional measures produced statistically significant, yet small to weak, effect sizes (CCS: r = 0.292; ACE: r = -0.173; BCE: r = 0.244). This evidence established convergent validity of TIPSA as a measure of trauma symptoms, divergent validity of TIPSA as a measure of codependency, and added empirical evidence for utilizing betrayal trauma theory in this context.
Dysregulated sexuality refers to sexual thoughts, feelings, and behaviors that are perceived as out of control and distressing. This study aimed to explore the relationships between desire thinking and metacognition about desire thinking in relation to dysregulated sexuality and craving. Approximately 1,042 participants completed a battery of self-report questionnaires. The results suggest that increased desire thinking and metacognition around desire thinking are significantly associated with dysregulated sexuality. Furthermore, the verbal perseveration aspect of desire thinking significantly predicted dysregulated sexuality after controlling for trait sexual desire. These findings support both the model of desire thinking and craving and the tri-phasic metacognitive model of addictive behavior. Despite study limitations, there is a need for further research in this area.
Sex is an integral part of human behavior but what constitutes healthy versus pathological sexual behavior can vastly differ between individuals and remains a topic of wide debate. What is not debatable is that for some individuals, sexual behavior becomes highly problematic leading to clinically significant impairment and distress, and follows a pattern similar to many well-established addictive disorders. Because sexual addiction is not classified as a mental disorder in the DSM-5, recognition and treatment of this condition is often overlooked by clinicians and can lead to poor outcomes. This case describes the progression of a patient with an undiagnosed sexual addiction and illustrates the transformative effect of recognizing and treating individuals who suffer from this condition. A brief discussion provides a practical review of the diagnostic dilemmas and treatment options for sexual addiction.
Internet Pornography (IP) is a phenomenon that has been the focus of much research and debate recently, yet there is still a lack of consensus regarding when the use of IP becomes problematic. There is also a lack of qualitative research on the effects of IP on those who self-identify as experiencing problematic use. This phenomenological, qualitative study surveyed 53 self-identified users of IP. Thematic analysis of the results found that users experienced a number of psychosocial impacts attributed to their use of IP, such as diminished positive mental health and wellbeing, detrimental effects on relationships and intimacy, and symptoms of dependency. Suggestions for further research are made.
Risk factors for men becoming sexual perpetrators against underage victims were identified using data provided by 1,556 respondents who had been guaranteed unbreakable anonymity. Early behaviors occurring while the respondents and their partners were both under the age of 18 increased the risk that the respondents would begin masturbating using images of the same sex as their early partners. Masturbating using images of underage children and early experiences with children and adolescents increased the likelihood that the respondents would become adults who preyed on partners who were of an age and sex similar to those early underage partners and images.
This paper evaluates the efficacy of treatment of 119 clients who sought help for CSBD (Compulsive Sexual Behavior Disorder). Using CORE OM and a tailor made supplement for CSBD, clients were evaluated at the beginning of a psycho-educational groupwork program and then again at three-month follow-up. 36 clients were evaluated a second time six-months later. The study identified, through CORE OM, that 85% of the sample were experiencing 'clinical distress' and 67% were at risk on intake. At three-month follow-up, there was 'significant' or 'reliable' improvement for 58% on clinical distress and 30% on risk. Compulsive sexual behaviors reduced for 97% of the sample group and 87% experienced a reduction in intrusive thoughts and feelings. However, for approximately 30% of clients, this reduction in problem symptoms was accompanied by negligible change in clinical distress and a worsening for some. A discussion is provided on why this may be and the implications of this research for treatment providers.
Problematic pornography viewing is a considerable issue for religious men. We tested a conceptual model positing scrupulosity and self-compassion as simultaneous mediators of the relationship between religiosity and problematic pornography viewing. We additionally examined the combined contributions of traditional masculinity ideology, pornography viewing frequency, spiritualty, and religious behaviors within the model. Results from 244 heterosexual men indicated scrupulosity as the only significant predictor and mediator of problematic pornography in the full model. Further, pornography viewing frequency was inversely related to scrupulosity. Our results compliment recent findings highlighting the importance of addressing religious scrupulosity in the treatment of problematic pornography viewing.
Compulsive sexual behaviors (CSB; i.e., a pattern of excessive and difficult to control sexual behaviors and fantasies) and risky sexual behaviors (e.g., unprotected sex, increased number of sexual partners, exchange of sex for drugs or money) are prevalent among those in treatment for substance misuse. CSB positively associated with risky sexual behaviors among high-risk populations such as men who have sex with men and persons living with sexually transmitted infections; however, this relationship has yet to be examined among men in treatment for substance misuse. Given the high prevalence of risky sexual behaviors among substance misusing populations, we examined if CSB were positively related to risky sexual behaviors among adult men in residential substance misuse treatment (N = 266), while statistically controlling for research supported correlates of risky sexual behavior including impulsivity, sensation seeking, affective instability, substance use, and age. CSB was positively associated with risky sexual behavior and accounted for a significant amount of the variance in the model predicting risky sexual behaviors. Our findings suggest that, among substance misuse patients, CSB may be a risk factor for risky sexual behaviors.
The Trauma Inventory for Partners of Sex Addicts (TIPSA) represents a pioneering attempt to measure trauma in the partners of sex addicts. In this study, we utilized a large sample of TIPSA responses to examine the impact of rescoring empirically disordered response options on error variance and scale reliability. Results suggested that rescoring by collapsing categories in response to empirical response option disordering has a mixed and marginal impact on error variance and scale reliability, and may not be beneficial from a practical standpoint in terms of reducing nuisance variation. Importantly, results also support the conclusion that measurement and diagnosis are distinct endeavors that serve two separate purposes.
Spouses, partners, parents, and other loved ones of sex addicts are generally treated with variations of the codependency model, which, in a general way, fails to acknowledge that these individuals are in the midst of a relational crisis. Prodependence is a new paradigm for addressing this clientele. Grounded in attachment rather than trauma theory, prodependence views what has previously been seen as dysfunctional (trying to help and stay connected with a sex addict) as how any rational person would act when presented with the extraordinary life crisis of a struggling family member. As an initial evaluation of this new paradigm, clinicians who treat this population were surveyed before and after an informal educational presentation explaining the prodependence model and how it differs from codependency. Findings showed that clinicians currently tend to use variations of codependency in their practices, although many expressed dissatisfaction with this approach. After exposure to the prodependence paradigm, the majority of clinicians expressed a desire to move away from codependency in favor of the prodependence model. This suggests that the attachment and crisis-centric model of prodependence could be more effective than codependency when working with loved ones of sex addicts (and perhaps loved ones of other addicts).
A comparative case-study method grounded in phenomenology with the use of interpretive phenomenological analysis (IPA) demonstrated similarities and differences between two men’s experiences with engaging in extramarital affairs who were married to women in either a monogamous or a non-monogamous union. Despite the difference in their marital arrangements, both men were unfaithful to their wives and demonstrated similar themes in their lives, which included religious obligations, communication conflicts, loss of connection in marriage, deception, sexual restriction, absent fathers, compartmentalization of sexual behavior, guilt, and addiction. Differences included how men created boundaries, emotional connections with affair partners, power differentials, and sexual experiences.
This is the first study in Russia to explore Compulsive Sexual Behavior in HIV-infected men. The aims of the present study were to estimate the frequency of Compulsive Sexual Behavior in HIV-infected men in community-based sample in Saint-Petersburg, Russia. The study sample consisted of 119 HIV-infected men. Compulsive Sexual Behavior was found in 18 men who have sex with men and 7 men who have sex with women (29.5% and 12.1%). Our results suggest that Compulsive Sexual Behavior could be a significant risk factor for HIV-infection.
