Rory C. Reid

Reliability, Validity, and Psychometric Development of the Hypersexual Behavior Inventory in an Outpatient Sample of Men

Psychometric properties of the Hypersexual Behavior Inventory (HBI) are reported using treatment-seeking samples of hypersexual men. Study 1 details item reduction and exploratory factor analysis of the HBI. Study 2 provides results of a confirmatory factor analysis yielding a 3-factor model measuring Control, Consequences, and Coping associated with sexual thoughts, feelings, and behaviors. Concurrent and discriminant validity was established with measures of theoretically related and dissimilar constructs. The psychometric properties of the HBI suggest it reflects the proposed DSM-V classification criteria for hypersexual disorder and has both the clinical and research utility to advance a more comprehensive understanding of hypersexuality.

Report of Findings in a DSM‐5 Field Trial for Hypersexual Disorder

INTRODUCTION Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for hypersexual disorder (HD) have been proposed to capture symptoms reported by patients seeking help for out-of-control sexual behavior. The proposed criteria created by the DSM-5 Work Group on Sexual and Gender Identity Disorders require evaluation in a formal field trial. AIM This DSM-5 Field Trial was designed to assess the reliability and validity of the criteria for HD in a sample of patients seeking treatment for hypersexual behavior, a general psychiatric condition, or a substance-related disorder. METHOD Patients (N = 207) were assessed for psychopathology and HD by blinded raters to determine inter-rater reliability of the HD criteria and following a 2-week interval by a third rater to evaluate the stability of the HD criteria over time. Patients also completed a number of self-report measures to assess the validity of the HD criteria. MAIN OUTCOME MEASURES HD and psychopathology were measured by structured diagnostic interviews, the Hypersexual Behavior Inventory, Sexual Compulsivity Scale, and Hypersexual Behavior Consequences Scale. Emotional dysregulation and stress proneness were measured by facets on the NEO Personality Inventory-Revised. RESULTS Inter-rater reliability was high and the HD criteria showed good stability over time. Sensitivity and specificity indices showed that the criteria for HD accurately reflected the presenting problem among patients. The diagnostic criteria for HD showed good validity with theoretically related measures of hypersexuality, impulsivity, emotional dysregulation, and stress proneness, as well as good internal consistency. Patients assessed for HD also reported a vast array of consequences for hypersexual behavior that were significantly greater than those diagnosed with a general psychiatric condition or substance-related disorder. CONCLUSIONS The HD criteria proposed by the DSM-5 Work Group on Sexual and Gender Identity Disorders appear to demonstrate high reliability and validity when applied to patients in a clinical setting among a group of raters with modest training on assessing HD.

The Impact of Internet Pornography on Adolescents: A Review of the Research

The recent proliferation of Internet-enabled technology has significantly changed the way adolescents encounter and consume sexually explicit material. Once confined to a personal computer attached to a telephone line, the Internet is now available on laptops, mobile phones, video game consoles, and other electronic devices. With the growth of the Internet has come easier and more ubiquitous access to pornography. The purpose of this article was to review the recent (i.e., 2005 to present) literature regarding the impact of Internet pornography on adolescents. Specifically, this literature review examined the impact of Internet pornography on sexual attitudes, beliefs, behaviors, and sexual aggression. The authors also discuss the literature related to the influence of sexually explicit Internet material on self-concept, body image, social development, as well as the expanding body of research on adolescent brain function and physical development. Finally, recommendations for future research were discussed, based on this literature review.

Self-Reported Differences on Measures of Executive Function and Hypersexual Behavior in a Patient and Community Sample of Men

ABSTRACT 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 of differences between a group of hypersexual patients (n == 87) and a non-hypersexual community sample (n == 92) of men using the Behavior Rating Inventory of Executive Function—Adult Version (BRIEF-A) and the Hypersexual Behavior Inventory (HBI). Significant differences between the groups emerged on eight subscales and all of the general indices of executive functioning with the most dramatic differences on BRIEF-As Shift, Emotional Control, Initiate, and Plan/Organize subscales. Hypersexual behavior was positively correlated (r == .37, p < .01) with global indices of executive dysfunction and several subscales of the BRIEF-A. These findings provide preliminary evidence supporting the hypothesis that executive dysfunction may be implicated in hypersexual behavior.

Differentiating Emotions in a Sample of Men in Treatment for Hypersexual Behavior

This study investigated distinct emotions in a sample of men (n = 103) seeking help for hypersexual behavior compared to a control group of college students (n = 100) using the Hypersexual Behavior Inventory and the Differential Emotions Scale. Significant differences between groups emerged on several domains of emotion and hypersexual behavior. Self-hostility was the most significant predictor of hypersexual behavior. These findings suggest that self-critical affect, such as shame, might exert an influence in precipitating or perpetuating hypersexual behavior.

Psychometric development of the hypersexual behavior consequences scale

Background and aims The past decade has seen an increased interest in understanding hypersexual behavior and its associated features. Beyond the obvious risks for sexually transmitted infections, there is a paucity of literature examining specific challenges encountered by hypersexual individuals. This study investigated and developed a new scale, the Hypersexual Behavior Consequences Scale (HBCS), to assess the various consequences reported among hypersexual patients. Methods Participants were drawn from a sample of patients recruited in a DSM-5 Field Trial for Hypersexual Disorder (HD). Participants completed the Hypersexual Behavior Inventory, a structured diagnostic interview to assess for psychopathology and HD, and self-report measures of personality, life satisfaction, and the initial item pool for the HBCS. Results Factor analysis reduced the HBCS items to a single factor solution which showed high internal consistency and stability over time. Higher HBCS scores were positively correlated with higher levels of emotional dysregulation, impulsivity, and stress proneness and lower levels of satisfaction with life and happiness. HBCS scores among the hypersexual patients were significantly higher than non-hypersexual patients. Conclusions The HBCS possesses good psychometric properties and appears to capture various consequences associated with the DSM-5 proposed criteria for HD. The HBCS can be used to aid clinicians and researchers in identifying consequences associated with hypersexual behavior. The HBCS may also prove a useful tool to guide treatment interventions aimed at reducing the negative impact of hypersexuality in patient populations.

Should Hypersexual Disorder be Classified as an Addiction

Hypersexual behavior has been documented within clinical and research settings over the past decade. Despite recent research on hypersexuality and its associated features, many questions remain around how best to define and classify hypersexual behavior. Diagnostic criteria for Hypersexual Disorder (HD) have been proposed for the DSM-5 and a preliminary field trial has lent some support to the reliability and validity of the HD diagnosis. However, debate exists with respect to the extent to which the disorder might be categorized as a non-substance or behavioral addiction. In this article, we will discuss this debate in the context of data citing similarities and differences among hypersexual disorder, drug addictions, and pathological gambling. The authors of this article conclude that despite many similarities between the features of hypersexual behavior and substance-related disorders, the research on HD at this time is in its infancy and much remains to be learned before definitively characterizing HD as an addiction.

Psychometric development of the Problematic Pornography Use Scale

Despite the increased social acceptance and widespread use of pornography over the past few decades, reliable and valid instruments assessing problematic use of pornography are lacking. This paper reports the findings of three studies aimed at developing and validating a new scale measuring problematic pornography use. The Problematic Pornography Use Scale (PPUS) items showed high internal consistency, convergent validity, and construct validity. Exploratory and confirmatory factor analyses revealed four core factors relating to proposed domains of problematic pornography use. High PPUS scores were positively correlated with measures of psychopathology, low self-esteem and poor attachment. Although PPUS scores were related to other behavioral addictions, problematic pornography use as operationalized in the current paper appears to be uniquely distinguished from features of behavioral addictions relating to gambling and Internet use. Findings highlight the potential use of the PPUS for future research and possible clinical applications by defining problematic pornography use as a behavioral addiction.

A Surprising Finding Related to Executive Control in a Patient Sample of Hypersexual Men

INTRODUCTION Patients seeking help for hypersexual behavior often exhibit features of impulsivity, cognitive rigidity, and poor judgment as well as 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. Exploring relationships between dysregulated sexual behavior and executive deficits will enhance our understanding of hypersexuality. AIM This study sought to assess whether patients seeking help for hypersexual behavior exhibit executive deficits as measured by standardized neuropsychological tests of executive functioning when compared with healthy controls. METHODS Executive deficits were assessed in a sample of male patients (N = 30) seeking help for hypersexual behavior compared with a nonhypersexual community sample of men (N = 30) using neuropsychological tests of executive functioning. Using multivariate statistics, differences between the groups were examined. MAIN OUTCOME MEASURES Sexual activity measured by the Hypersexual Behavior Inventory and the Compulsive Sexual Behavior Inventory. Executive functions measured through neuropsychological testing using several subtests of Delis-Kaplan Executive Function System: Color-Word Interference Test, the Tower Test, the Trail Making Test, the Verbal Fluency Test, as well as the Wisconsin Card Sorting Test. Psychopathology was assessed using the Mini International Neuropsychiatric Interview, and cognitive ability was assessed using the Wechsler Adult Intelligence Scale. RESULTS Significant differences on measures of hypersexuality were observed. However, the groups failed to exhibit significant differences across neuropsychological tests of executive functioning even after controlling for cognitive ability. CONCLUSIONS These results contradict a previous finding of executive deficits among hypersexual men measured by self-report. The lack of executive deficits suggests that this population may exhibit domain-specific aspects of impulsivity, poor judgment, and risky behavior that are not generalizable to other domains of life. Furthermore, our findings fail to support a conceptualization of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, proposed hypersexual disorder based on models of executive dysfunction. .

Mindfulness, emotional dysregulation, impulsivity, and stress proneness among hypersexual patients

OBJECTIVE The current study explores relationships between mindfulness, emotional regulation, impulsivity, and stress proneness in a sample of participants recruited in a Diagnostic and Statistical Manual of Mental Disorder Fifth Edition Field Trial for Hypersexual Disorder and healthy controls to assess whether mindfulness attenuates symptoms of hypersexuality. METHOD Hierarchal regression analysis was used to assess whether significant relationships between mindfulness and hypersexuality exist beyond associations commonly found with emotional dysregulation, impulsivity, and stress proneness in a sample of male hypersexual patients (n = 40) and control subjects (n = 30). RESULTS Our results show a robust inverse relationship of mindfulness to hypersexuality over and above associations with emotional regulation, impulsivity, and stress proneness. CONCLUSIONS These results suggest that mindfulness may be a meaningful component of successful therapy among patients seeking help for hypersexual behavior in attenuating hypersexuality, improving affect regulation, stress coping, and increasing tolerance for desires to act on maladaptive sexual urges and impulses.