Abstract
Criteria for hypersexual disorder (HD) were proposed for consideration in the DSM-5 but ultimately excluded for a variety of reasons. Regardless, research continues to investigate hypersexual behavior (HB). The Hypersexual Behavior Inventory (HBI) is one of the most robust scales assessing HB, but further examination is needed to explore its psychometric properties among different groups. Therefore, the aim of the present study was to examine the generalizability of the HBI in a large, diverse, non-clinical sample (N = 18,034 participants; females = 6132; 34.0%; Mage = 33.6 years, SDage = 11.1) across both gender and sexual orientation. Measurement invariance testing was carried out to ensure gender- and sexual orientation-based comparisons were meaningful. Results demonstrated when both gender and sexual orientation were considered (i.e., heterosexual males vs. LGBTQ males vs. heterosexual females vs. LGBTQ females), LGBTQ males had significantly higher latent means on the HBI factors. Results also demonstrated LGBTQ males had the highest scores on other possible indicators of hypersexuality (e.g., frequency of masturbation, number of sexual partners, or frequency of pornography viewing). These findings suggest LGBTQ males may be a group most at risk of engaging in hypersexual behavior, and LGBTQ females are at a higher risk of engaging in hypersexual activities due to coping problems. Given the large-scale nature of the study, the findings contribute to the currently growing body of the literature on hypersexuality.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Press.
Balon, R., Segraves, R. T., & Clayton, A. (2007). Issues for DSM-V: Sexual dysfunction, disorder, or variation along normal distribution: Toward rethinking DSM criteria of sexual dysfunctions. American Journal of Psychiatry, 164(2), 198–200. https://doi.org/10.1176/ajp.2007.164.2.198.
Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191.
Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107(2), 238–246. https://doi.org/10.1037/0033-2909.107.2.238.
Bogaert, A. F. (2004). Asexuality: Prevalence and associated factors in a national probability sample. Journal of Sex Research, 41(3), 279–287. https://doi.org/10.1080/00224490409552235.
Bőthe, B., Tóth-Király, I., Zsila, Á., Griffiths, M. D., Demetrovics, Z., & Orosz, G. (2018). The development of the Problematic Pornography Consumption Scale (PPCS). Journal of Sex Research, 55(3), 395–406. https://doi.org/10.1080/00224499.2017.1291798.
Brown, T. A. (2015). Confirmatory factor analysis for applied research (2nd ed.). New York, NY: Guilford Press.
Browne, M. V., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.
Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling, 14(3), 464–504. https://doi.org/10.1080/10705510701301834.
Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233–255. https://doi.org/10.1207/S15328007SEM0902_5.
Cooper, A. (1998). Sexuality and the Internet: Surfing into the new millennium. CyberPsychology & Behavior, 1(2), 187–193. https://doi.org/10.1089/cpb.1998.1.187.
Cooper, A., Delmonico, D. L., & Burg, R. (2000). Cybersex users, abusers, and compulsives: New findings and implications. Sexual Addiction & Compulsivity, 7(1–2), 5–29. https://doi.org/10.1080/10720160008400205.
Dhuffar, M., & Griffiths, M. D. (2014). Understanding the role of shame and its consequences in female hypersexual behaviours: A pilot study. Journal of Behavioral Addictions, 3, 231–237. https://doi.org/10.1556/JBA.3.2014.4.4.
Dhuffar, M. K., & Griffiths, M. D. (2016). Barriers to female sex addiction treatment in the UK. Journal of Behavioral Addictions, 5(4), 562–567. https://doi.org/10.1556/2006.5.2016.072.
Finney, S. J., & DiStefano, C. (2006). Non-normal and categorical data in structural equation modeling. In G. R. Hancock & R. D. Mueller (Eds.), Structural equation modeling: A second course (pp. 269–314). Charlotte, NC: Information Age Publishing.
Franqué, F., Klein, V., & Briken, P. (2015). Which techniques are used in psychotherapeutic interventions for nonparaphilic hypersexual behavior? Sexual Medicine Reviews, 3(1), 3–10. https://doi.org/10.1002/smrj.34.
Grubbs, J. B., Hook, J. P., Griffin, B. J., Cushman, M. S., Hook, J. N., & Penberthy, J. K. (2017). Treating hypersexuality. In Z. D. Peterson (Ed.), The Wiley handbook of sex therapy (pp. 115–128). Chichester: Wiley.
Hook, J. N., Farrell, J. E., Davis, D. E., Van Tongeren, D. R., Griffin, B. J., Grubbs, J., … Bedics, J. D. (2015). Self-forgiveness and hypersexual behavior. Sexual Addiction and Compulsivity, 22, 59–70. https://doi.org/10.1080/10720162.2014.1001542.
Hook, J. N., Hook, J. P., Davis, D. E., Worthington, E. L., & Penberthy, J. K. (2010). Measuring sexual addiction and compulsivity: A critical review of instruments. Journal of Sex and Marital Therapy, 36, 227–260.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118.
Kafka, M. P. (2010). Hypersexual disorder: A proposed diagnosis for DSM-V. Archives of Sexual Behavior, 39(2), 377–400. https://doi.org/10.1007/s10508-009-9574-7.
Kafka, M. P., & Hennen, J. (1999). The paraphilia-related disorders: An empirical investigation of nonparaphilic hypersexuality disorders in outpatient males. Journal of Sex and Marital Therapy, 25(4), 305–319. https://doi.org/10.1080/00926239908404008.
Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male. Philadelphia: W.B. Saunders Company.
Klein, V., Rettenberger, M., Boom, K. D., & Briken, P. (2014). Eine Validierungsstudie der deutschen Version des Hypersexual Behavior Inventory (HBI). Psychotherapie Psychosomatik Medizinische Psychologie, 64(03/04), 136–140. https://doi.org/10.1055/s-0033-1357133.
Kline, R. B. (2011). Principles and practice of structural equation modeling. Methodology in the social sciences (3rd ed.). New York: Guilford Press.
Kraus, S. W., Martino, S., & Potenza, M. N. (2016). Clinical characteristics of men interested in seeking treatment for use of pornography. Journal of Behavioral Addictions, 5(2), 169–178. https://doi.org/10.1556/2006.5.2016.036.
Langström, N., & Hanson, R. K. (2006). High rates of sexual behavior in the general population: Correlates and predictors. Archives of Sexual Behavior, 35(1), 37–52. https://doi.org/10.1007/s10508-006-8993-y.
Levaque, E., Sawatsky, M. L., & Lalumière, M. L. (2016). Hypersexualité chez les étudiants universitaires hétérosexuels. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 48(3), 182–192. https://doi.org/10.1037/cbs0000042.
Marsh, H. W., & Hau, K. T. (2007). Applications of latent-variable models in educational psychology: The need for methodological-substantive synergies. Contemporary Educational Psychology, 32(1), 151–170. https://doi.org/10.1016/j.cedpsych.2006.10.008.
Marsh, H. W., Muthén, B., Asparouhov, T., Lüdtke, O., Robitzsch, A., Morin, A. J. S., et al. (2009). Exploratory structural equation modeling, integrating CFA and EFA: Application to students’ evaluations of university teaching. Structural Equation Modeling: A Multidisciplinary Journal, 16(3), 439–476. https://doi.org/10.1080/10705510903008220.
Marshall, L. E., & Briken, P. (2010). Assessment, diagnosis, and management of hypersexual disorders. Current Opinion in Psychiatry, 23(6), 570–573. https://doi.org/10.1097/YCO.0b013e32833d15d1.
Meredith, W., & Teresi, J. A. (2006). An essay on measurement and factorial invariance. Medical Care, 44(11), S69–S77. https://doi.org/10.1097/01.mlr.0000245438.73837.89.
Missildine, W., Feldstein, G., Punzalan, J. C., & Parsons, J. T. (2005). S/he loves me, s/he loves me not: Questioning heterosexist assumptions of gender differences for romantic and sexually motivated behaviors. Sexual Addiction & Compulsivity, 12(1), 65–74. https://doi.org/10.1080/10720160590933662.
Montgomery-Graham, S. (2017). Conceptualization and assessment of hypersexual disorder: A systematic review of the literature. Sexual Medicine Reviews, 5(2), 146–162. https://doi.org/10.1016/j.sxmr.2016.11.001.
Muench, F., & Parsons, J. T. (2004). Sexual compulsivity and HIV: Identification and treatment. Focus, 19(6), 1–5.
Muthén, L. K., & Muthén, B. O. (1998–2015). Mplus user’s guide (7th ed.). Los Angeles, CA: Muthén & Muthén.
Parsons, J. T. (2005). HIV-positive gay and bisexual men. In S. C. Kalichman (Ed.), Positive prevention: Reducing HIV transmission among people living with HIV/AIDS (pp. 99–133). New York: Springer.
Parsons, T., Kelly, B. C., Bimbi, D. S., DiMaria, L., Wainberg, M. L., & Morgenstern, J. (2008). Explanations for the origins of sexual compulsivity among gay and bisexual men. Archives of Sexual Behavior, 37, 817–826. https://doi.org/10.1007/s10508-007-9218-8.
Parsons, J. T., Rendina, H. J., Ventuneac, A., Cook, K. F., Grov, C., & Mustanski, B. (2013). A psychometric investigation of the Hypersexual Disorder Screening Inventory among highly sexually active gay and bisexual men: An item response theory analysis. Journal of Sexual Medicine, 10(12), 3088–3101. https://doi.org/10.1111/jsm.12117.
Parsons, J. T., Starks, T. J., Gamarel, K. E., & Grov, C. (2012). Non-monogamy and sexual relationship quality among same-sex male couples. Journal of Family Psychology, 26(5), 669.
Reid, R. C. (2015). How should severity be determined for the DSM-5 proposed classification of Hypersexual Disorder? Journal of Behavioral Addictions, 4(4), 221–225. https://doi.org/10.1556/2006.4.2015.041.
Reid, R. C., Bramen, J. E., Anderson, A., & Cohen, M. S. (2014a). Mindfulness, emotional dysregulation, impulsivity, and stress proneness among hypersexual patients. Journal of Clinical Psychology, 70, 313–321. https://doi.org/10.1002/jclp.22027.
Reid, R. C., Carpenter, B. N., Hook, J. N., Garos, S., Manning, J. C., Gilliland, R., … Fong, T. (2012a). Report of findings in a DSM-5 field trial for hypersexual disorder. Journal of Sexual Medicine, 9, 2868–2877. https://doi.org/10.1111/j.1743-6109.2012.02936.x.
Reid, R. C., Carpenter, B. N., & Lloyd, T. Q. (2009). Assessing psychological symptom patterns of patients seeking help for hypersexual behavior. Sexual and Relationship Therapy, 24(1), 47–63. https://doi.org/10.1080/14681990802702141.
Reid, R. C., Dhuffar, M. K., Parhami, I., & Fong, T. W. (2012b). Exploring facets of personality in a patient sample of hypersexual women compared with hypersexual men. Journal of Psychiatric Practice, 18(4), 262–268. https://doi.org/10.1097/01.pra.0000416016.37968.eb.
Reid, R. C., Garos, S., & Carpenter, B. N. (2011). Reliability, validity, and psychometric development of the Hypersexual Behavior Inventory in an outpatient sample of men. Sexual Addiction & Compulsivity, 18(1), 30–51. https://doi.org/10.1080/10720162.2011.555709.
Reid, R. C., & Kafka, M. P. (2014). Controversies about Hypersexual Disorder and the DSM-5. Current Sexual Health Reports, 6, 259–264.
Reid, R. C., Temko, J., Moghaddam, J. F., & Fong, T. W. (2014b). Shame, rumination, and self-compassion in men assessed for hypersexual disorder. Journal of Psychiatric Practice, 20, 260–268. https://doi.org/10.1097/01.pra.0000452562.98286.c5.
Rubel, A. N., & Bogaert, A. F. (2015). Consensual nonmonogamy: Psychological well-being and relationship quality correlates. Journal of Sex Research, 52(9), 961–982. https://doi.org/10.1080/00224499.2014.942722.
Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8(2), 23–74.
Seegers, J. A. (2003). The prevalence of sexual addiction symptoms on the college campus. Sexual Addiction & Compulsivity, 10(4), 247–258. https://doi.org/10.1080/713775413.
Séguin, L. J., Blais, M., Goyer, M. F., Adam, B. D., Lavoie, F., Rodrigue, C., & Magontier, C. (2017). Examining relationship quality across three types of relationship agreements. Sexualities, 20(1–2), 86–104. https://doi.org/10.1177/1363460716649337.
Stark, R., Kruse, O., Klucken, T., Strahler, J., & Wehrum-Osinsky, S. (2017). OP-107: Distractibility by sexual stimuli–a biological marker of hypersexuality? Journal of Behavioral Addictions, 6(S1), 50–51. https://doi.org/10.1556/JBA.6.2017.Suppl.1.
Starks, T. J., Grov, C., & Parsons, J. T. (2013). Sexual compulsivity and interpersonal functioning: Sexual relationship quality and sexual health in gay relationships. Health Psychology, 32(10), 1047–1056.
Stewart, H., & Fedoroff, J. P. (2014). Assessment and treatment of sexual people with complaints of hypersexuality. Current Sexual Health Reports, 6(2), 136–144. https://doi.org/10.1007/s11930-014-0017-7.
Štulhofer, A., Jurin, T., & Briken, P. (2016). Is high sexual desire a facet of male hypersexuality? Results from an online study. Journal of Sex and Marital Therapy, 42(8), 665–680. https://doi.org/10.1080/0092623X.2015.1113585.
Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). Boston, MA: Allyn and Bacon.
Tóth-Király, I., Bőthe, B., Rigó, A., & Orosz, G. (2017). An illustration of the exploratory structural equation modeling (ESEM) framework on the Passion scale. Frontiers in Psychology, 8, 1968. https://doi.org/10.3389/fpsyg.2017.01968.
Van Gordon, W., Shonin, E., & Griffiths, M. D. (2016). Meditation awareness training for the treatment of sex addiction: A case study. Journal of Behavioral Addictions, 5, 363–372. https://doi.org/10.1556/2006.5.2016.034.
Vandenberg, R. J., & Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3(1), 4–70. https://doi.org/10.1177/10944281003100.
Volberg, R. A. (1994). The prevalence and demographics of pathological gamblers: Implications for public health. American Journal of Public Health, 84(2), 237–241. https://doi.org/10.2105/AJPH.84.2.237.
Wéry, A., Vogelaere, K., Challet-Bouju, G., Poudat, F. X., Caillon, J., Lever, D., … Grall-Bronnec, M. (2016). Characteristics of self-identified sexual addicts in a behavioral addiction outpatient clinic. Journal of Behavioral Addictions, 5(4), 623–630. https://doi.org/10.1556/2006.5.2016.071.
Whitton, S. W., Weitbrecht, E. M., & Kuryluk, A. D. (2015). Monogamy agreements in male same-sex couples: Associations with relationship quality and individual well-being. Journal of Couple & Relationship Therapy, 14(1), 39–63. https://doi.org/10.1080/15332691.2014.953649.
Winters, J. (2010). Hypersexual disorder: A more cautious approach [Letter to the Editor]. Archives of Sexual Behavior, 39(3), 594–596. https://doi.org/10.1007/s10508-010-9607-2.
Winters, J., Christoff, K., & Gorzalka, B. B. (2010). Dysregulated sexuality and high sexual desire: Distinct constructs? Archives of Sexual Behavior, 39(5), 1029–1043. https://doi.org/10.1007/s10508-009-9591-6.
Womack, S. D., Hook, J. N., Ramos, M., Davis, D. E., & Penberthy, J. K. (2013). Measuring hypersexual behavior. Sexual Addiction & Compulsivity, 20(1–2), 65–78.
Yeagley, E., Hickok, A., & Bauermeister, J. A. (2014). Hypersexual behavior and HIV sex risk among young gay and bisexual men. Journal of Sex Research, 51(8), 882–892. https://doi.org/10.1080/00224499.2013.818615.
Acknowledgements
The research was supported by the Hungarian National Research, Development and Innovation Office (Grant Nos.: PD116686, FK124225, K111938) and the Hungarian Academy of Sciences (Lendület Project LP2012-36). The third author (ITK) was supported by the ÚNKP-17-3 New National Excellence Program of the Ministry of Human Capacities.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Bőthe, B., Bartók, R., Tóth-Király, I. et al. Hypersexuality, Gender, and Sexual Orientation: A Large-Scale Psychometric Survey Study. Arch Sex Behav 47, 2265–2276 (2018). https://doi.org/10.1007/s10508-018-1201-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-018-1201-z