Original Paper

Archives of Sexual Behavior

, Volume 43, Issue 4, pp 669-683

The Role of Maladaptive Cognitions in Hypersexuality Among Highly Sexually Active Gay and Bisexual Men

  • John E. PachankisAffiliated withDepartment of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, Yale School of Public Health, Yale UniversityThe Center for HIV/AIDS Educational Studies and Training (CHEST)
  • , H. Jonathon RendinaAffiliated withThe Center for HIV/AIDS Educational Studies and Training (CHEST)Basic and Applied Social Psychology Doctoral Program, The Graduate Center of the City University of New York (CUNY)
  • , Ana VentuneacAffiliated withThe Center for HIV/AIDS Educational Studies and Training (CHEST)
  • , Christian GrovAffiliated withThe Center for HIV/AIDS Educational Studies and Training (CHEST)Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York (CUNY)School of Public Health at Hunter College, City University of New York (CUNY)
  • , Jeffrey T. ParsonsAffiliated withThe Center for HIV/AIDS Educational Studies and Training (CHEST)Basic and Applied Social Psychology Doctoral Program, The Graduate Center of the City University of New York (CUNY)School of Public Health at Hunter College, City University of New York (CUNY)Department of Psychology, Hunter College of the City University of New York (CUNY)Health Psychology Doctoral Program, The Graduate Center of the City University of New York (CUNY) Email author 

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Abstract

Cognitive appraisals about sex may represent an important component of the maintenance and treatment of hypersexuality, but they are not currently represented in conceptual models of hypersexuality. Therefore, we validated a measure of maladaptive cognitions about sex and examined its unique ability to predict hypersexuality. Qualitative interviews with a pilot sample of 60 highly sexually active gay and bisexual men and expert review of items yielded a pool of 17 items regarding maladaptive cognitions about sex. A separate sample of 202 highly sexually active gay and bisexual men completed measures of sexual inhibition and excitation, impulsivity, emotional dysregulation, depression and anxiety, sexual compulsivity, and a measure of problematic hypersexuality. Factor analysis confirmed the presence of three subscales: perceived sexual needs, sexual costs, and sexual control efficacy. Structural equation modeling results were consistent with a cognitive model of hypersexuality whereby magnifying the necessity of sex and disqualifying the benefits of sex partially predicted minimized self-efficacy for controlling one’s sexual behavior, all of which predicted problematic hypersexuality. In multivariate logistic regression, disqualifying the benefits of sex predicted unique variance in hypersexuality, even after adjusting for the role of core constructs of existing research on hypersexuality, AOR = 1.78, 95 % CI 1.02, 3.10. Results suggest the utility of a cognitive approach for better understanding hypersexuality and the importance of developing treatment approaches that encourage adaptive appraisals regarding the outcomes of sex and one’s ability to control his sexual behavior.

Keywords

Hypersexuality Maladaptive cognitions Gay and bisexual men Mental health