Patients seeking help for hypersexual behavior often exhibit features of impulsivity, cognitive rigidity, poor judgment, deficits in emotion regulation, and excessive preoccupation with sex. Some of these characteristics are also common among patients presenting with neurological pathology associated with executive dysfunction. These observations led to the current investigation in which differences across scores on objective neuropsychological tests of executive functioning were explored in a group of hypersexual male patients (n = 30) compared with a non-hypersexual community sample (n = 30) of men. Using multivariate statistics, differences between the groups were examined yielding significant differences on measures of hypersexuality. However, the groups failed to exhibit significant differences across neuropsychological tests of executive functioning. These results contradict a previous finding of executive deficits among hypersexual men measured by self-report. These findings are discussed as they pertain to conceptualizations of hypersexual populations and possible implications for future research.

The proposed diagnostic criteria for Hypersexual Disorder included "[r]epetitively engaging in sexual fantasies, urges, or behaviors in response to stressful life events" (Kafka, 2010, p.279) as a symptom, although no data demonstrates a causal relationship between stress and hypersexual behavior. We sought to confirm previous findings while furthering the field's understanding of this relationship by being the first study to assess stress and hypersexual behavior across multiple time points. Specifically, we sought to test three hypotheses within a sample of men seeking treatment for hypersexual behavior: 1) hypersexual individuals report higher stress levels than published norm samples; 2) stress predicts sexual thoughts, urges, and behavior at the same time point and across multiple time points; and 3) among various domains of stress, social and personal forms of stress best predict hypersexual behavior. Thirty men seeking treatment for hypersexual behaviors at residential and intensive outpatient treatment centers participated in the study. Various indices of stress (perceived stress, daily hassles, stressful life domains, and salivary cortisol), affect (boredom, psychological distress, depression, anxiety, alexithymia, and loneliness), and process (psychological inflexibility) were assessed, some across two time points. Across multiple analyses, the study did not find sufficient evidence to support a causal relationship between stress and hypersexual behavior. Supporting previous research, the hypersexual sample demonstrated significant elevations on stress, affect, and process measures compared to published norms, strengthening the assertion that hypersexual individuals experience high levels of stress and psychological distress. The implications of these findings, limitations of the methods used, and future directions for research and treatment are discussed.

Studies among people struggling with hypersexual behavior commonly report that shame needs to be addressed when treating this population. These studies theoretically distinguish that it is shame and not guilt that exacerbates hypersexual behavior, yet no study to date has demonstrated this difference empirically. This observation led to the current investigation in which a sample (N = 177) of people seeking treatment for pornography use anonymously filledout measures of hypersexuality, shame-proneness, guilt-proneness, and motivation to change unwanted behavior. A hypothetical path model of the constructs was analyzed yielding significant positive relationships between shame-proneness and hypersexuality as well as guiltproneness and motivation to change. The data support previous findings that shame is active among people seeking treatment for hypersexual behavior. This study adds an additional element to the story by empirically demonstrating that shame and guilt have opposing relationships with hypersexuality and motivation for change.

This study qualitatively investigated the processes and outcomes associated with the The Church of Jesus Christ of Latter-day Saints’ (LDS) Addiction Recovery Program (ARP), with a specific focus on their Pornography Addiction Support Group (PASG) meetings. Researchers interviewed 24 (21 males, 3 females) individuals with varying experiences in PASG meetings. Their interview content was broken down into themes. Primary findings suggest that PASG participants experience a significant amount of shame due to their pornography use behaviors. Member-to-member sharing in meetings facilitates self-compassion and lessens shame. Participants reported strong spiritual process in PASG meetings and some spiritual outcomes. Attendance in PASG meetings impacts the way participants viewed their treatment conceptualization, problematic pornography use (PPU) behaviors, self, and God. Further, negative aspects of PASG meetings include the use of an addiction model, a focus on PPU behaviors, and some shaming experiences.

Inledning: Överdrivna sexuella handlingar och de risker de kan medföra har beskrivits sedan antiken. Hur man sett på problemen har varierat beroende på vilket religiöst eller politiskt perspektiv man utgått ifrån. Man har ännu inte kunnat enas om vilken term som bäst beskriver problemen, vilket försvårar forskningen och skapar osäkerhet om hur problemen ska behandlas. Den term som allt oftare används bland allmänheten och i media är sexmissbruk. Allt fler söker hjälp för problem som de själva kallar sexmissbruk. De flesta som söker hjälp är män. Syfte och frågeställningar: Denna studie syftar till att öka kunskapen om hur hjälpsökande män ser på och förstår sitt sexmissbruk med följande frågeställningar: Hur beskriver männen sitt sexmissbruk? Hur upplever de sexmissbruket? Hur förklarar männen sitt sexmissbruk? Metod: En kvalitativ metod med fenomenologisk och deskriptiv ansats har använts. Fem vuxna män, som själva uppgett att de har ett sexmissbruk, har intervjuats. Männen går i psykodynamisk psykoterapi på en mottagning där man kan söka hjälp för sexuella problem. De transkriberade intervjuerna har analyserats med hjälp av kvalitativ innehållsanalys. Resultat: Studiens resultat presenteras under fyra kategorier och ett flertal underkategorier. De fyra kategorierna omfattar männens faktiska beskrivning av sexmissbruket, olika typer av insikt i problemen, sexmissbrukets konsekvenser – individuella och sociala, samt männens egna förklaringar till sitt sexmissbruk. Ett övergripande tema, som löper som en röd tråd genom samtliga kategorier, tolkas som att leva med skam. Diskussion: Männens beskrivning av sitt sexmissbruk stämmer väl överens med hur man tidigare definierat problemen. Missbruket omfattar olika handlingar och har konsekvenser för männen själva, deras nära relationer och sociala liv. Studien visar att män med sexmissbruk för en kamp med sin skam. De har olika grader av skam och olika försvar mot skam. Skammen beskrivs som en form av "motor" i missbruksprocessen, vilket överensstämmer med tidigare forskningsresultat. Männen uppger att förklaringar till problem med sexmissbruk finns i deras uppväxtförhållanden och tidigare erfarenheter. De uttrycker behov av hjälp för att kunna ta sig ur missbruket. För att kunna hjälpa män med sexmissbruk behöver man som psykoterapeut ha mod att möta skammen, både den hjälpsökandes och den egna.

The purpose of this thesis was to investigate the feasibility of a treatment for hypersexual disorder (HD) by calculating and reporting the results with pre-collected data from a research project at ANOVA/Karolinska Universitetssjukhuset. The treatment was a cognitive behavioral group therapy (CBGT) developed for HD administered in a 7-session group setting with a sample of HD-diagnosed women (n = 16). Feasibility was explored through symptom change of hypersexuality, sexual compulsivity, psychological distress, and depression. Symptom change in relationship to treatment attendance was also explored. In this thesis, the results are considered in a broader context, discussing theoretical issues concerning women’s sexuality in relation to hypersexual problems and medicalization of hypersexual behaviors.   The treatment was shown to be feasible. Significant decrease was found on all measures. Attendance rate significantly correlated with a decrease in depressive symptoms, but not on other measures. Women’s sexuality might differ from men’s, but the treatment, which was first evaluated for men, is still feasible for women. Treatment for hypersexual problems in women and hypersexual problems in women in general have been understudied, which makes this study an important contribution to the research field. Further treatment studies could potentially investigate whether specific alterations based on gender and sexual orientation could be needed for further development of the treatment. There are issues concerning medicalization of hypersexual behaviors which should be considered when addressing the phenomenon, such as the influence of moral and cultural factors on the understanding of hypersexuality. Still, there is need for treatment for hypersexual behaviors experienced as problematic, and having these problems addressed within the medical and scientific field has potential for being beneficial and is preferred to having them left to alternative, unregulated health care providers.

The aim of this study was to test whether criminogenic needs change over the course of a cognitive-behavioural sexual offender-specific treatment programme (ROS) within a group of adult, incarcerated or on probation, male sexual offenders in Sweden. To measure criminogenic needs 25 offenders completed Locus of Control of Behaviour Scale (LCB), 26 Hypersexuality Behavior Inventory-19 (HBI-19) and 25 respectively 27 completed Relationship Scale Questionnare (RSQ), 2-factor. Therapists rated 46 sexual offenders using The Therapist Rating Scale-2 (TRS-2). The results demonstrated that participants showed non-significant increased internal locus of control, significant decreased hypersexual thoughts and behaviours (small to medium effect size), but no change regarding attachment styles, post-treatment. Results from The Therapist Rating Scale-2 showed that therapists rated significant decrease in all criminogenic needs post-treatment with medium to large effect size. Conclusions are that ROS appears to be effective, inducing change in criminogenic needs. ROS’s specific elements targeting sexual self-regulation seems to be successful resulting in significant reduction of hypersexual thoughts and behaviours, especially for participants with severe problems. Implications of results are discussed and theoretically analyzed from a perspective of cognitive theory, learning theory, attachment theory and affect theory. / Studiens syfte var att undersöka förändring i kriminogena behovsområden hos en grupp sexualbrottsdömda män som under sin verkställighet på anstalt eller inom frivård medverkat i Kriminalvårdens KBT-baserade behandlingsprogram ROS. För att mäta förändringen fyllde 25 deltagare i Locus of Control of Behaviour Scale (LCB), 26 stycken Hypersexuality Behavior Inventory-19 (HBI-19) och 25 respektive 27 stycken Relationship Scale Questionnaire (RSQ), 2-faktormodellen, före och efter behandling. Behandlarna bedömde förändring hos 46 deltagare enligt The Therapist Rating Scale-2 (TRS-2). Resultaten från deltagarnas självskattningsformulär visade att deltagarna efter behandling fick en icke-signifikant ökning av intern kontrollokus. Tankar och beteenden kopplade till hypersexualitet minskade signifikant med liten till medelstor effekt. Det gick inte påvisa förändring vad gäller relationsstilar. Resultaten av TRS-2 visade att behandlarna bedömde att det hade skett en signifikant förändring i positiv riktning med medel till stor effekt vad gäller samtliga kriminogena behovsområden. Slutsatsen är att ROS verkar vara effektivt genom att åstadkomma förändring inom kriminogena behovsområden. De specifika element i ROS som adresserar sexuell självreglering tycks vara lyckosamma då tankar och beteenden kopplade till hypersexualitet reducerats signifikant, särskilt för deltagare med svårast problem. Implikationer av resultaten diskuteras och analyseras teoretiskt utifrån kognitiv teori, inlärningsteori, anknytningsteori och affektteori.