Archives of Sexual Behavior

, Volume 39, Issue 4, pp 968–978 | Cite as

Perceived “Out of Control” Sexual Behavior in a Cohort of Young Adults from the Dunedin Multidisciplinary Health and Development Study

  • Keren SkeggEmail author
  • Shyamala Nada-Raja
  • Nigel Dickson
  • Charlotte Paul
Original Paper


Out of control sexual behavior, also known as compulsive sexual behavior or sexual addiction, has not been studied in a representative sample of the general population. At age 32 years, 940 (93%) of 1,015 members of the birth cohort of the Dunedin Multidisciplinary Health and Development Study responded to a series of questions about sexual behavior, administered by computer. We enquired about sexual fantasies, urges or behavior that participants regarded as out of control during the previous year, and defined such experiences as out of control sexual experiences (OCSE). Nearly 13% of men and 7% of women reported OCSE in the past year. Women who reported such experiences were more likely than other women to have reported (elsewhere in the interview) having had high numbers of opposite sex partners, concurrent sexual relationships, or sex with a partner met on the internet, as well as a higher likelihood of same-sex attraction or behavior. Among men reporting OCSE, there was an association with having paid for heterosexual sex and with same-sex attraction and behavior. Few believed that OCSE had interfered with their lives (3.8% of all men and 1.7% of all women in the cohort). Only 0.8% of men and 0.6% of women reported that their actual sexual behavior had interfered with their lives. OCSE were also analyzed in relation to certain personality traits and to childhood sexual abuse (CSA). Some evidence of a link with impulsivity (women only) and negative affectivity was found. CSA was associated with OCSE among men. In conclusion, this population-based study has provided the first empirical estimations of the occurrence of OCSE and its relationship to a range of sexual behaviors in a representative sample.


Compulsive sexual behavior Sexual addiction Hypersexuality Sexual behavior Childhood sexual abuse Sexual orientation 



We thank the study members and the Unit Director, Professor Richie Poulton, the study founder, Dr. Phil Silva, and all interview and administrative staff involved with the Dunedin Multidisciplinary Health and Development Study. We thank Thea van Roode for preparing the data set on sexual behaviors used in the study. Helpful comments on earlier drafts were provided by Professor Alex Blaszczinski, Professor John Langley, Associate Professor Oliver Davidson, and Peter Saxton. The research was funded by Grants 03/250 and 03/271E from the Health Research Council of New Zealand. Personality data were funded by U.S. Public Health Service Grants from the Personality and Social Processes Research Branch to Professor A. Caspi (MH-49414).


  1. Balsam, K. F., Rothblum, E. D., & Beauchaine, T. P. (2005). Victimization over the life span: A comparison of lesbian, gay, bisexual, and heterosexual siblings. Journal of Consulting and Clinical Psychology, 73, 477–487.CrossRefPubMedGoogle Scholar
  2. Bancroft, J., & Vukadinovic, Z. (2004). Sexual addiction, sexual compulsivity, sexual impulsivity or what? Towards a theoretical model. Journal of Sex Research, 41, 225–234.CrossRefPubMedGoogle Scholar
  3. Black, D. W. (1998). Compulsive sexual behavior: A review. Journal of Practical Psychiatry and Behavioral Health, 4, 219–229.Google Scholar
  4. Black, D. W., Kehrberg, L. D., Flumerfelt, D. L., & Schlosser, S. S. (1997). Characteristics of 36 subjects reporting compulsive sexual behavior. American Journal of Psychiatry, 154, 243–249.PubMedGoogle Scholar
  5. Carnes, P. J. (1991). Don’t call it love: Recovery from sexual addiction. New York: Bantam Books.Google Scholar
  6. Carnes, P. J., & Delmonico, D. L. (1996). Childhood sexual abuse and multiple addictions: Research findings in a sample of self-identified sexual addicts. Sexual Addiction & Compulsivity, 3, 258–268.CrossRefGoogle Scholar
  7. Chivers, M. L. (2005). Clinical management of sex addiction [Review of the book Clinical management of sex addiction]. Archives of Sexual Behavior, 34, 476–478.CrossRefGoogle Scholar
  8. Coleman, E. (1992). Is your patient suffering from compulsive sexual behavior? Psychiatric Annals, 22, 320–325.Google Scholar
  9. Coleman, E. (2003). Compulsive sexual behavior: What to call it, how to treat it? SIECUS Report, 31, 12–16.Google Scholar
  10. Cooper, A., Delmonico, D. L., & Burg, R. (2000). Cybersex users, abusers, and compulsives: New findings and implications. Sexual Addiction & Compulsivity, 7, 5–29.CrossRefGoogle Scholar
  11. Cooper, A., Griffin-Shelley, E., Delmonico, D. L., & Mathy, R. M. (2001). Online sexual problems: Assessment and predictive variables. Sexual Addiction & Compulsivity, 8, 267–285.CrossRefGoogle Scholar
  12. Daneback, K., Ross, M. W., & Månsson, S. (2006). Characteristics and behaviors of sexual compulsives who use the internet for sexual purposes. Sexual Addiction & Compulsivity, 13, 53–67.CrossRefGoogle Scholar
  13. Davis, P., McLeod, K., Ransom, M., Ongley, P., Pearce, N., & Howden-Chapman, P. (1999). The New Zealand Socioeconomic Index: Developing and validating an occupationally-derived indicator of socio-economic status. Australian and New Zealand Journal of Public Health, 23, 27–33.CrossRefPubMedGoogle Scholar
  14. Dickson, N., Paul, C., & Herbison, P. (2003). Same-sex attraction in a birth cohort: Prevalence and persistence in early adulthood. Social Science and Medicine, 56, 1607–1615.CrossRefPubMedGoogle Scholar
  15. Dickson, N., Paul, C., Herbison, P., & Silva, P. (1998). First sexual intercourse: Age, coercion, and later regrets reported by a birth cohort. British Medical Journal, 316, 29–33.PubMedGoogle Scholar
  16. Dinwiddie, S., Heath, A. C., Dunne, M. P., Bucholz, K. K., Madden, P. A. F., Slutske, W. S., et al. (2000). Early sexual abuse and lifetime psychopathology: A co-twin-control study. Psychological Medicine, 30, 41–52.CrossRefPubMedGoogle Scholar
  17. Dodge, B., Reece, M., Cole, S. L., & Sandfort, T. G. M. (2004). Sexual compulsivity among heterosexual college students. Journal of Sex Research, 41, 343–350.CrossRefPubMedGoogle Scholar
  18. Doll, L. S., Joy, D., Bartholow, B. N., Harrison, J. S., Bolan, G., Douglas, J. M., et al. (1992). Self-reported childhood and adolescent sexual abuse among adult homosexual and bisexual men. Child Abuse and Neglect, 16, 855–864.CrossRefPubMedGoogle Scholar
  19. Eskin, M., Kaynak-Demir, H., & Demir, S. (2005). Same-sex sexual orientation, childhood sexual abuse, and suicidal behavior in university students in Turkey. Archives of Sexual Behavior, 34, 185–189.CrossRefPubMedGoogle Scholar
  20. Gold, S. N., & Heffner, C. L. (1998). Sexual addiction: Many conceptions, minimal data. Clinical Psychology Review, 18, 367–381.CrossRefPubMedGoogle Scholar
  21. Goodman, A. (1997). Sexual addiction. In J. H. Lowinson, P. Ruiz, R. B. Millman, & J. G. Langrod (Eds.), Substance abuse: A comprehensive textbook (pp. 340–354). Baltimore: Williams & Wilkins.Google Scholar
  22. Goodman, A. (2001). What’s in a name? Terminology for designating a syndrome of driven sexual behavior. Sexual Addiction & Compulsivity, 8, 191–213.CrossRefGoogle Scholar
  23. Grant, J. E., Levine, L., Kim, D., & Potenza, M. N. (2005). Impulse disorders in adult psychiatric inpatients. American Journal of Psychiatry, 162, 2184–2188.CrossRefPubMedGoogle Scholar
  24. Horwitz, A. V., Widom, C. S., McLaughlin, J., & White, H. R. (2001). The impact of childhood abuse and neglect on adult mental health: A prospective study. Journal of Health and Social Behavior, 42, 184–201.CrossRefPubMedGoogle Scholar
  25. Isay, R. A. (1999). Gender in homosexual boys: Some developmental and clinical considerations. Psychiatry, 62, 187–194.PubMedGoogle Scholar
  26. Jinich, S., Paul, J. P., Stall, R., Acree, M., Kegeles, S., Hoff, C., et al. (1998). Childhood sexual abuse and HIV risk-taking behavior among gay and bisexual men. AIDS and Behavior, 2, 41–51.CrossRefGoogle Scholar
  27. Johnson, A. M., Wadsworth, J., Wellings, K., & Field, J. (1994). Sexual attitudes and lifestyles. Oxford: Blackwell.Google Scholar
  28. Kafka, M. P. (1997). Hypersexual desire in males: An operational definition and clinical implications for males with paraphilias and paraphilia-related disorders. Archives of Sexual Behavior, 26, 505–526.CrossRefPubMedGoogle Scholar
  29. Kafka, M. P., & Prentky, R. (1992). A comparative study of nonparaphilic sexual addictions and paraphilias in men. Journal of Clinical Psychiatry, 53, 345–350.PubMedGoogle Scholar
  30. Kalichman, S. C., Johnson, J. R., Adair, V., Rompa, D., Multhauf, K., & Kelly, J. A. (1994). Sexual sensation seeking: Scale development and predicting AIDS-risk behavior among homosexually active men. Journal of Personality Assessment, 62, 385–397.CrossRefPubMedGoogle Scholar
  31. Kalichman, S. C., & Rompa, D. (1995). Sexual sensation seeking and sexual compulsivity scales: Reliability, validity, and predicting HIV risk behavior. Journal of Personality Assessment, 65, 586–601.CrossRefPubMedGoogle Scholar
  32. Kendler, K. S., Bulik, C. M., Silberg, J., Hettema, J. M., Myers, J., & Prescott, C. A. (2000). Childhood sexual abuse and adult psychiatric and substance use disorders in women. Archives of General Psychiatry, 57, 953–959.CrossRefPubMedGoogle Scholar
  33. Krueger, R. F., Caspi, A., & Moffitt, T. E. (2000). Epidemiological personology: The unifying role of personality in population-based research on problem behaviors. Journal of Personality, 68, 967–998.CrossRefPubMedGoogle Scholar
  34. Krueger, R. F., Schmutte, P. S., Caspi, A., Moffitt, T. E., Campbell, K., & Silva, P. A. (1994). Personality traits are liked to crime among men and women: Evidence from a birth cohort. Journal of Abnormal Psychology, 103, 328–338.CrossRefPubMedGoogle Scholar
  35. Långström, N., & Hanson, R. K. (2006). High rates of sexual behavior in the general population: Correlates and predictors. Archives of Sexual Behavior, 35, 37–52.CrossRefPubMedGoogle Scholar
  36. Levine, M. P., & Troiden, R. R. (1988). The myth of sexual compulsivity. Journal of Sex Research, 25, 347–363.CrossRefGoogle Scholar
  37. McConaghy, N., Armstrong, M. S., & Blaszczynski, A. (1985). Expectancy, covert sensitization and imaginal desensitization in compulsive sexuality. Acta Psychiatrica Scandinavica, 72, 176–187.CrossRefPubMedGoogle Scholar
  38. Miner, M. H., Coleman, E., Center, B. A., Ross, M., & Rosser, B. R. S. (2007). The Compulsive Sexual Behavior Inventory: Psychometric properties. Archives of Sexual Behavior, 36, 579–587.CrossRefPubMedGoogle Scholar
  39. Montaldi, D. F. (2002). Understanding hypersexuality with an Axis II model. Journal of Psychology & Human Sexuality, 14, 1–23.CrossRefGoogle Scholar
  40. Nelson, E. C., Heath, A. C., Madden, P. A. F., Cooper, L., Dinwiddie, S. H., Bucholz, K. K., et al. (2002). Association between self-reported childhood sexual abuse and adverse psychosocial outcomes. Archives of General Psychiatry, 59, 139–145.CrossRefPubMedGoogle Scholar
  41. Noll, J. G., Trickett, P. K., & Putnam, F. W. (2003). A prospective investigation of the impact of childhood sexual abuse on the development of sexuality. Journal of Consulting and Clinical Psychology, 71, 575–586.CrossRefPubMedGoogle Scholar
  42. Paul, J. P., Catania, J., Pollack, L., & Stall, R. (2001). Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: The Urban Men’s Health Study. Child Abuse and Neglect, 25, 557–584.CrossRefPubMedGoogle Scholar
  43. Putnam, F. W. (2003). Ten-year research update review: Child sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 269–278.CrossRefPubMedGoogle Scholar
  44. Raymond, N. C., Coleman, E., & Miner, M. H. (2003). Psychiatric comorbidity and compulsive/impulsive traits in compulsive sexual behavior. Comprehensive Psychiatry, 44, 370–380.CrossRefPubMedGoogle Scholar
  45. Ross, M. W., Mänsson, S., Daneback, K., Cooper, A., & Tikkanen, R. (2005). Biases in sexual health samples: Comparison of an internet sexuality survey and a national sexual health survey in Sweden. Social Science and Medicine, 61, 245–252.CrossRefPubMedGoogle Scholar
  46. Schneider, J. P. (2004). Understanding and diagnosing sex addiction. In R. H. Coombs (Ed.), Handbook of addictive disorders (pp. 197–232). Hoboken, NJ: Wiley.Google Scholar
  47. Silva, P. A., & Stanton, W. R. (1996). From child to adult: The Dunedin multidisciplinary health and development study. Auckland: Oxford University Press.Google Scholar
  48. Stein, D. J., Black, D. W., & Pienaar, W. (2000). Sexual disorders not otherwise specified: Compulsive, addictive, or impulsive? CNS Spectrums, 5, 60–64.PubMedGoogle Scholar
  49. Tellegen, A., Lykken, D. T., Bouchard, T. J., Wilcox, K. J., Segal, N. L., & Rich, S. (1988). Personality similarity in twins reared apart and together. Journal of Personality and Social Psychology, 54, 1031–1039.CrossRefPubMedGoogle Scholar
  50. Tomeo, M. E., Templer, D. I., Anderson, S., & Kotler, D. (2001). Comparative data of childhood and adolescence molestation in heterosexual and homosexual persons. Archives of Sexual Behavior, 30, 535–541.CrossRefPubMedGoogle Scholar
  51. Van Roode, T., Dickson, N., Herbison, P., & Paul, C. (2009). Child sexual abuse and persistence of risky sexual behaviors and negative sexual outcomes over adulthood: Findings from a birth cohort. Child Abuse and Neglect, 33, 161–172.CrossRefPubMedGoogle Scholar
  52. Widom, C. S., & Ames, M. A. (1994). Criminal consequences of childhood sexual victimization. Child Abuse and Neglect, 18, 303–318.CrossRefPubMedGoogle Scholar
  53. Zucker, K. J. (2007). Sexology and epidemiology [Editorial]. Archives of Sexual Behavior, 36, 1–3.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Keren Skegg
    • 1
    Email author
  • Shyamala Nada-Raja
    • 2
  • Nigel Dickson
    • 3
  • Charlotte Paul
    • 3
  1. 1.Department of Psychological MedicineUniversity of Otago Medical SchoolDunedinNew Zealand
  2. 2.Injury Prevention Research Unit, Department of Preventive and Social MedicineUniversity of Otago Medical SchoolDunedinNew Zealand
  3. 3.Department of Preventive and Social MedicineUniversity of Otago Medical SchoolDunedinNew Zealand

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