A network approach to hypersexuality: insights and clinical implications
Werner, M1; Stulhofer, A2; Waldorp, L3; Jurin, T2
1: University of Amsterdam and Academic Medical Center, Netherlands; 2: University of Zagreb, Croatia; 3: University of Amsterdam, the Netherlands
Objectives. In spite of a growing interest in research on hypersexuality, consensus about its etiology and best treatment strategy has not been achieved. This study furthers the empirical and clinical understanding of hypersexuality by exploring the structure of its symptoms using a novel network analytic approach.
Material and Methods. In 2014, an online survey advertised as focusing on Internet pornography, sexual health and relationships was carried out among Croatian men and women aged 18-60 years (Mage = 31.1, SD = 9.67). In a sample of 3,028 participants, we estimated and plotted regularized partial correlation networks by gender to explore the structure of hypersexuality. Network nodes represented hypersexuality symptoms and associated sexual behaviors (i.e., items from the Hypersexual Disorder Screening Inventory, the Hypersexual Behavioral Consequences Scale, as well as indicators of sexual desire, pornography use, sexual intercourse and masturbation frequency). Four research questions were addressed: (1) Does the hypersexuality network differ between genders; (2) which symptoms are centrally positioned; (3) what is the topological location of pornography use; and (4) are there distinct clusters (“communities”) of symptoms in the network?
Results. The structure of the hypersexuality network was surprisingly similar in female and male participants, both in terms of symptom centrality and the “clustering” of symptoms. Psychological distress and negative emotions triggered by sexual fantasies and/or behaviors, together with a loss of control over sexual feelings, occupied central positions in the networks. Pornography use was located peripherally in both the male and female hypersexuality networks.
Conclusions. This is the first network analytic approach to hypersexuality. The authors employed several methods to assure robustness of the findings. Psychological distress and negative emotions triggered by sexual fantasies and/or behaviors constituted the core of the hypersexuality network, which makes them potential prime targets for clinical intervention. These observations call for normalization of sexual expression through affirmative therapy that enhances self-care, -compassion and adaptive coping mechanisms. We encourage future clinical and longitudinal studies of hypersexuality using the network analytic approach.
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