Verena Klein

Self‐Reported Indicators of Hypersexuality and Its Correlates in a Female Online Sample

INTRODUCTION Hypersexual behavior has been a controversial and much disputed issue in the field of sexual medicine. However, only little attention has been paid to hypersexual behavior in women. Therefore, to date there is limited knowledge on the behavioral patterns of hypersexuality in women. AIMS The purpose of the present study was to examine which sexual behavioral patterns are associated with self-reported indicators of hypersexuality in a female online sample. The second aim was to evaluate the association between hypersexuality and sexual risk behavior in women. METHODS In total, 988 women participated in an online survey. Logistic regression analysis was conducted to examine the association between sexual behavioral patterns and hypersexuality. Furthermore, correlation analyses were calculated in order to identify the relationship between sexual risk behavior and hypersexuality. MAIN OUTCOME MEASURES Indicators of hypersexual behavior were measured by the Hypersexual Behavior Inventory (HBI). In addition, current and present impersonal sexual activities were investigated. Sexual risk behavior was assessed using the Sexual Sensation Seeking Scale (SSSS). RESULTS High masturbation frequency, number of sexual partners, and pornography use were associated with a higher degree of hypersexual behavior in women. Furthermore, the HBI total score was positively correlated to sexual risk behavior. CONCLUSION The results of the current study do not support the idea of previous research that hypersexual women are typically engaged in more passive forms of sexual behavior. Rather female hypersexuality seems to be more characterized by impersonal sexual activity. An association between hypersexual behavior and sexual risk behavior was identified. The implications of these findings for potential prevention strategies and therapeutic interventions are discussed.

Are Sex Drive and Hypersexuality Associated with Pedophilic Interest and Child Sexual Abuse in a Male Community Sample

Although much is currently known about hypersexuality (in the form of excessive sexual behavior) among sexual offenders, the degree to which hypersexual behavior is linked to paraphilic and especially pedophilic interests in non-forensic populations has not been established. The purpose of the present study was to elucidate the associations between total sexual outlets (TSO) and other sex drive indicators, antisocial behavior, pedophilic interests, and sexual offending behavior in a large population-based community sample of males. The sample included 8,718 German men who participated in an online study. Hypersexual behavior as measured by self-reported TSO, self-reported sex drive, criminal history, and pedophilic interests were assessed. In moderated hierarchical logistic regression analyses self-reported contact sexual offending against children was linked to sexual fantasizing about children and antisociality. There was no association between aggregated sex drive, and sexual abusive behaviour in the multivariate analyses. In contrast, self-reported child pornography consumption was associated with sex drive, sexual fantasies involving children, and antisociality. Nevertheless, in clinical practice an assessment of criminal history and pedophilic interests in hypersexual individuals and vice versa hypersexuality in antisocial or pedophilic men should be considered as particularly antisociality and pedophilic interest are important predictors of sexual offending against prepubescent children.

Which Techniques Are Used in Psychotherapeutic Interventions for Nonparaphilic Hypersexual Behavior

INTRODUCTION Attempts to draw a distinction between excessive and so-called normal sexual behavior are discussed controversially. Although no consensus has been reached so far on how to label the phenomenon of clinical relevant excessive sexual behavior, Kafka proposed the term hypersexual disorder. There are only a few empirical studies on the effectiveness of treatment. In the recent systematic review by Hook and colleagues, the total number of subject-related studies amounts to only 14 studies. However, it might be difficult for mental health professionals to fully comprehend the intervention techniques used in the different studies. AIM The present article aims at reviewing the psychotherapeutic interventions for nonparaphilic hypersexual behavior use. METHOD Each study mentioned in the recent review by Hook et al. was analyzed with regard to the psychotherapeutic interventions that had been applied. Only studies with positive treatment outcomes were considered. From among those studies, only the interventions which seemed to be sufficiently detailed and which are related to the obvious therapeutic results in the treatment of hypersexual symptoms were chosen. Furthermore, the interventions were assigned to the proposed diagnostic criteria of the hypersexual disorder. RESULTS The hypothesized mechanisms how certain treatment techniques could change and influence hypersexual symptoms were mostly described in an unsatisfactory way. Interventions were targeted on impairment in social, occupational, or other important areas of functioning, negative mood states, stressful life events, and lack of behavioral control. No specific interventions were included for the risk for physical or emotional harm to self or others. CONCLUSION Future treatment approaches should explicitly formulate the etiological mechanism and contain interventions for the neglected areas. In addition, a more flexible approach in the treatment of different subgroups with hypersexual behavior might be promising. von Franqué F, Klein V, and Briken P. Which techniques are used in psychotherapeutic interventions for nonparaphilic hypersexual behavior? Sex Med Rev 2015;3:3-10.

Eine Validierungsstudie der deutschen Version des Hypersexual Behavior Inventory (HBI)

Hypersexuality is characterized by recurrent and intense sexual fantasies, sexual urges, or sexual behaviors resulting in clinically significant personal distress or impairment in social, occupa-tional, or other important areas of functioning. The Hypersexual Behavior Inventory (HBI, Reid et al., 2011) is a 3-factor measure (coping, control and consequences) developed to assess hypersexual behaviour. The aim of the present study was to investigate the psychometric properties of the German version of the HBI. In a sample consisting of 1 749 men and women the questionnaire was used as part of an online survey. The questionnaire showed good reliability and validity. A confirmatory factor analysis supported the 3-factor structure of the original English version. The results and potential benefit of the HBI in research and clinical practice are discussed.

Risk Assessment in Child Sexual Abusers Working With Children

Child sexual abuse occurring in a child- or youth-serving institution or organization has attracted great public and scientific attention. In light of the particular personal and offense-related characteristics of men who have abused children within such an institution or organization, it is of special importance to evaluate the predictive performance of currently applied risk assessment instruments in this offender population. Therefore, the present study assessed the risk ratings and predictive performance of four risk assessment instruments and one instrument assessing protective factors concerning any, violent and sexual recidivism in child sexual abusers working with children (CSA-W) in comparison with extra-familial child sexual abusers (CSA-E) and intra-familial child sexual abusers (CSA-I). The results indicate that CSA-W mostly recidivate with a sexual offense. Although all included risk measures seem to function with CSA-W, the Static-99 seems to be the instrument that performs best in predicting sexual recidivism in CSA-W. CSA-W had the most protective factors measured with the Structured Assessment of PROtective Factors (SAPROF). While the SAPROF could not predict desistance from recidivism in CSA-W, it predicted desistance from any recidivism in all CSA. As CSA-W frequently hold many indicators for pedophilic sexual interests but only a few for antisocial tendencies, it can be suggested that CSA-W are at an increased risk for sexual recidivism and thus risk measures especially designed for sexual recidivism work best in CSA-W. Nevertheless, CSA-W also hold many protective factors; however, their impact on CSA-W is not clear yet and needs further study.

Protective Factors and Recidivism in Accused Juveniles Who Sexually Offended

To date, research on juvenile sexual offender recidivism has tended to focus on risk factors rather than protective factors. Therefore, very little is known about protective factors in the population of juveniles who sexually offended. The aim of the present study was to examine the impact of protective factors on non-recidivism in a sample of accused juveniles who sexually offended (N = 71) in a mean follow-up period of 47.84 months. Protective factors were measured with the Protective Factor Scale of the Structured Assessment of Violence Risk in Youth (SAVRY), and the Structured Assessment of PROtective Factors for violence risk (SAPROF). Criminal charges served as recidivism data. The internal scale of the SAPROF, in particular, yielded moderate predictive accuracy for the absence of violent and general recidivism, though not for the absence of sexual recidivism. No protective factor of the SAVRY did reveal predictive accuracy regarding various types of the absence of recidivism. Furthermore, protective factors failed to achieve any significant incremental predictive accuracy beyond that captured by the SAVRY risk factors alone. The potential therapeutic benefit of protective factors in juvenile sexual offender treatment is discussed.

Erectile Dysfunction, Boredom, and Hypersexuality among Coupled Men from Two European Countries

INTRODUCTION Much of the research on the association between erectile dysfunction (ED) and possible clinical relevant hypersexuality up to now has been only descriptive in nature. AIM The present study aimed to explore the relationships among hypersexuality, ED, and sexual boredom in a sample of coupled community men. METHODS An Internet-based survey was conducted in two European countries. The sample included 911 Croatian and 210 German coupled men. The survey comprised the Hypersexual Disorder Screening Inventory, the International Index of Erectile Function and the Sexual Boredom Scale. Poisson regression analysis was used to examine how ED, solitary sexual activities and sexual boredom were associated with hypersexuality. RESULTS Among Croatian and German men, hypersexuality was significantly correlated with proneness to sexual boredom and more problems with erectile function. CONCLUSIONS In some men, hypersexual behavior may serve as a coping mechanism for sexual fantasy poverty-associated boredom. In addition, ED within an intimate relationship can accompany this simultaneously.

Factors Predicting Desistance From Reoffending: A Validation Study of the SAPROF in Sexual Offenders:

The present study aims at validating the German version of the Structured Assessment of PROtective Factors (SAPROF) for violence risk in a representative sample of incarcerated adult male sexual offenders. Sexual offenders (n = 450) were rated retrospectively with the SAPROF using the database of the Federal Evaluation Centre for Violent and Sexual Offenders (FECVSO) in the Austrian Prison System. Interrater reliability and predictive validity of the SAPROF scores concerning desistance from recidivism were calculated. Concurrent and incremental validity were tested using the combination of the SAPROF and the Sexual Violence Risk–20 (SVR-20). Interrater reliability was moderate to excellent, and predictive accuracy for various types of recidivism was rather small to moderate. There was a clear negative relationship between the SAPROF and the SVR-20 risk factors. Whereas the SAPROF revealed itself as a significant predictor for various recidivism categories, it did not add any predictive value beyond the SVR-20. Although the SAPROF itself can predict desistance from recidivism, it seems to contribute to the risk assessment in convicted sexual offenders only to a limited extent, once customary risk assessment tools have been applied. Implications for clinical use and further studies are discussed.

Sexual history of male partners of women with the diagnosis vaginismus

Research on vaginismus has thus far not focused on the biography and sexual history of partners of women suffering from the condition. The aim of this study was to examine the sexual history of men who are in a relationship with women suffering from vaginismus and who are seeking help in couples sex therapy. It was hypothesized that the majority of male partners of women with vaginismus suffer from sexual dysfunctions themselves, which predisposes them to avoid sexual behavior. The sample of the present study consisted of 17 couples that participated in couples therapy for sexual dysfunctions. The sexual history of each couple was evaluated using clinical files and additional written summaries of case supervision. The majority of men in the study had little or no sexual experience with women prior the current relationship. Erectile dysfunction was the most frequently reported diagnosis in this sample. The results of the present study can contribute to a better understanding of the partnership dynamics of couples with vaginismus. The implications of the results for therapeutic practice are discussed.

Klinische und forensische Aspekte hypersexuellen Verhaltens

ZusammenfassungDer vorliegende Beitrag befasst sich mit Ausdrucksformen sexuellen Verhaltens und Erlebens, die durch ihren exzessiven Charakter und Leidensdruck und/oder Fremdgefährdung charakterisiert sind. Zunächst wird die historische Entwicklung des gegenwärtig im klinisch-diagnostischen Bereich überwiegend als Hypersexualität bezeichneten Konstrukts dargestellt – von der fallgeschichtlichen Darstellung bei Krafft-Ebing bis hin zur aktuellen Diskussion um die Aufnahme der hypersexuellen Störung in das Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). Anschließend werden unterschiedliche Diagnoseformen und -ansätze für hypersexuelles Verhalten vorgestellt sowie ein kurzer Überblick über Epidemiologie, ätiologische Modelle und Hypothesen gegeben. Es wird die forensische Relevanz des Konstrukts für die gutachterliche Tätigkeit diskutiert; hierbei steht der mögliche Einfluss hypersexuellen Verhaltens auf die Schuldfähigkeit bzw. die Kriminalprognose im Mittelpunkt.AbstractThe present article deals with hypersexual behavior and experience which is characterized by excessive sexual activity and a high degree of psychological strain and/or endangerment for others. Initially, the historical developments of different conceptualizations of the construct which is currently predominantly denominated hypersexuality are illustrated from the beginning in terms of the famous case studies presented by Krafft-Ebing up to the current discussion about the inclusion of hypersexual disorder in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). Different diagnostical methods and approaches for hypersexual behavior are presented as well as a brief overview about the epidemiology and different etiological models and hypotheses. Finally, the forensic relevance of the construct for expert witness activity is discussed by focusing on the potential impact of hypersexual behavior on criminal responsibility and recidivism risk assessment.