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Is Hypersexuality Dimensional? Evidence for the DSM-5 from General Population and Clinical Samples

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Abstract

Hypersexual Disorder is currently being considered for inclusion in the DSM-5. To inform this process, we investigated the latent structure of the hypersexuality construct using Meehl’s (1995) taxometric method. Data on sexual interests and behaviors were obtained from 2,101 general population males and females in Sweden and 716 male sex offenders from the United States. Taxometric analyses of self-report indicators of hypersexuality supported a dimensional interpretation of latent structure in both samples. These findings suggest that individual differences in hypersexuality are quantitative (matter of degree) rather than qualitative (difference in kind) in nature, at least when self-report data were used. This is another way of saying that hypersexuality is organized along a continuum of increasing sexual frequency and preoccupation, with clinical cases of hypersexuality falling at the upper end of the continuum or dimension. We conclude that the proposed inclusion of Hypersexual Disorder in the DSM-5 should acknowledge the lack of non-arbitrary breaks in the latent symptoms continuum which runs from very low to very high engagement in sexual behavior and preoccupation. The diagnostic threshold should therefore be decided from an analysis of external data on severity, comorbidity, and prognosis for individuals with sub-threshold and full diagnoses, respectively. Additionally, dimensional assessment of Hypersexual Disorder should be part of clinical diagnostic practice.

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References

  • Arntz, A., Bernstein, D., Gielen, D., van Nieuwenhuyzen, M., Penders, K., Haslam, N., et al. (2009). Taxometric evidence for the dimensional structure of cluster C, paranoid, and borderline personality disorders. Journal of Personality Disorders, 23, 606–628.

    Article  PubMed  Google Scholar 

  • Bancroft, J. (1999). Central inhibition of sexual response in the male: A theoretical perspective. Neuroscience and Biobehavioral Reviews, 23, 763–784.

    Article  PubMed  Google Scholar 

  • Bartlett, M. S. (1937). The statistical conception of mental factors. British Journal of Psychology, 28, 97–104.

    Google Scholar 

  • Black, D. W. (2000). The epidemiology and phenomenology of compulsive sexual behavior. CNS Spectrums, 5, 26–72.

    PubMed  Google Scholar 

  • Blanchard, J. J., Horan, W. P., & Collins, C. M. (2005). Examining the latent structure of negative symptoms: Is there a distinct subtype of negative symptom schizophrenia? Schizophrenia Research, 77, 151–165.

    Article  PubMed  Google Scholar 

  • Carnes, P. (1983). Out of the shadows: Understanding sexual addiction. Minneapolis, MN: CompCare.

    Google Scholar 

  • Coleman, E. (1990). The obsessive-compulsive model for describing compulsive sexual behavior. American Journal of Preventive Psychiatry and Neurology, 2, 9–14.

    Google Scholar 

  • Daversa, M., & Knight, R. A. (2007). A structural examination of the predictors of sexual coercion against children in adolescent sexual offenders. Criminal Justice and Behavior, 34, 1313–1333.

    Article  Google Scholar 

  • Edens, J. F., Marcus, D. K., & Ruiz, M. A. (2008). Taxometric analyses of borderline personality features in a large-scale male and female offender sample. Journal of Abnormal Psychology, 117, 705–711.

    Article  PubMed  Google Scholar 

  • Frazier, T. W., Youngstrom, E. A., Sinclair, L., Kubu, C. S., Law, P., Rezai, A., … et al. (2010). Autism spectrum disorders as a qualitatively distinct category for typical behavior in a large, clinically ascertained sample. Assessment, 17, 308–322.

    Article  PubMed  Google Scholar 

  • Green, B. A., Ahmed, A. O., Marcus, D. K., & Walters, G. D. (2011). The latent structure of alcohol use pathology in an epidemiological sample. Journal of Psychiatric Research, 45, 225–233.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Kafka, M. P. (2001). The paraphilia-related disorders: A proposal for a unified classification of nonparaphilic hypersexuality disorders. Sexual Addiction and Compulsivity, 8, 227–239.

    Article  Google Scholar 

  • Kafka, M. P. (2003). Sex offending and sexual appetite: The clinical and theoretical relevance of hypersexual desire. International Journal of Offender Therapy and Comparative Criminology, 47, 439–451.

    Article  PubMed  Google Scholar 

  • Kafka, M. P. (2007). Paraphilia-related disorders: The evaluation and treatment of nonparaphilic hypersexuality. In S. Leiblum (Ed.), Principles and practice of sex therapy (4th ed., pp. 442–476). New York: Guilford.

    Google Scholar 

  • Kafka, M. P. (2010). Hypersexual disorder: A proposed diagnosis for DSM-V. Archives of Sexual Behavior, 39, 377–400.

    Article  PubMed  Google Scholar 

  • 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, 305–319.

    PubMed  Google Scholar 

  • King, M. W. (2010). Neurodevelopmental vulnerability for pedophilia: A taxometric investigation of its latent structure. Dissertation Abstracts International: Section B. Sciences and Engineering, 71(8).

  • Kingston, D. A., & Firestone, P. (2008). Problematic hypersexuality: A review of conceptualization and diagnosis. Sexual Addiction and Compulsivity, 15, 284–310.

    Article  Google Scholar 

  • Knight, R. A., & Cerce, D. D. (1999). Validation and revision of the Multidimensional Assessment of Sex and Aggression. Psychologica Belgica, 39, 187–213.

    Google Scholar 

  • Knight, R. A., & King, M. W. (in press). Typologies for child molesters: The generation of a new structural model. In B. K. Schwartz (Ed.), The sexual offender (Vol. 7). Kingston, NJ: Civic Research Institute, Inc.

  • Knight, R. A., Prentky, R. A., & Cerce, D. D. (1994). The development, reliability, and validity of an inventory for the Multidimensional Assessment of Sex and Aggression. Criminal Justice and Behavior, 21, 72–94.

    Article  Google Scholar 

  • Knight, R. A., Ronis, S. T., Prentky, R. A., & Kafka, M. (2010). The role of sexual motivation in sexually coercive behavior. Manuscript submitted for publication.

  • Knight, R. A., & Sims-Knight, J. E. (2003). The developmental antecedents of sexual coercion against women: Testing alternative hypotheses with structural equation modeling. Annals of the New York Academy of Sciences, 989, 72–85.

    Article  PubMed  Google Scholar 

  • Knight, R. A., & Sims-Knight, J. E. (2004). Testing an etiological model for juvenile sexual offending against women. Journal of Child Sexual Abuse, 13, 33–55.

    Article  PubMed  Google Scholar 

  • Kraemer, H. C. (2008). DSM categories and dimensions in clinical and research contexts. In J. E. Helzer, H. C. Kraemer, R. F. Krueger, H. Wittchen, P. J. Sirovotka, & D. A. Regier (Eds.), Dimensional approaches in diagnostic classification: Refining the research agenda for DSM-V (pp. 5–17). Washington, DC: American Psychiatric Publishing.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Långström, N., & Seto, M. C. (2006). Exhibitionistic and voyeuristic behavior in a Swedish national population survey. Archives of Sexual Behavior, 35, 427–435.

    Article  PubMed  Google Scholar 

  • Långström, N., & Zucker, K. J. (2005). Transvestic fetishism in the general population: Prevalence and correlates. Journal of Marital Therapy, 31, 87–95.

    Article  Google Scholar 

  • Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press.

    Google Scholar 

  • Longley, S. L., Broman-Fulks, J. J., Calamari, J. E., Noyes, R., Wade, M., & Orlando, C. M. (2010). A taxometric analysis of hypochondriasis symptoms. Behavior Therapy, 41, 505–514.

    Article  PubMed  Google Scholar 

  • Marcus, D. K., & Barry, T. D. (in press). Does Attention-Deficit/Hyperactivity Disorder have a dimensional latent structure? A taxometric analysis. Journal of Abnormal Psychology.

  • Maser, J. D., & Patterson, T. (2002). Spectrum and nosology: Implications for DSM-V. Psychiatric Clinics of North America, 25, 855–885.

    Article  PubMed  Google Scholar 

  • Meehl, P. E. (1992). Factors and taxa, traits and types, differences of degree and differences in kind. Journal of Personality, 60, 117–174.

    Article  Google Scholar 

  • Meehl, P. E. (1995). Bootstraps taxometrics: Solving the classification problem in psychopathology. American Psychologist, 50, 266–275.

    Article  PubMed  Google Scholar 

  • Meehl, P. E. (2004). What’s in a taxon? Journal of Abnormal Psychology, 113, 39–43.

    Article  PubMed  Google Scholar 

  • Meehl, P. E., & Yonce, L. J. (1994). Taxometric analysis: I. Detecting taxonicity with two quantitative indicators using means above and below a sliding cut (MAMBAC procedure). Psychological Reports, 74, 1059–1274.

    Google Scholar 

  • Meehl, P. E., & Yonce, L. J. (1996). Taxometric analysis: II. Detecting taxonicity using covariance of two quantitative indicators in successive intervals of a third indicator (MAXCOV procedure). Psychological Reports, 78, 1091–1227.

    Google Scholar 

  • MIDSA Clinical Manual. (2008). Bend, OR: Augur Enterprises. Retrieved March 15, 2010, from www.midsa.us.

  • Rawlings, D., Williams, B., Haslam, N., & Claridge, G. (2008). Taxometric analysis supports a dimensional latent structure for schizotypy. Personality and Individual Differences, 44, 1640–1651.

    Article  Google Scholar 

  • Ruscio, J. (2007). Taxometric analysis: An empirically-grounded approach to implementing the method. Criminal Justice and Behavior, 34, 1588–1622.

    Article  Google Scholar 

  • Ruscio, J. (2008) Taxometric programs for the R computing environment: User’s manual. (http://www.taxometricmethod.com). Accessed June 12, 2008.

  • Ruscio, J., Haslam, N., & Ruscio, A. M. (2006). Introduction to the taxometric method: A practical guide. Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Ruscio, J., & Marcus, D. K. (2007). Detecting small taxa using simulated comparison data: A reanalysis of Beach, Amir, and Bau’s (2005) data. Psychological Assessment, 19, 241–246.

    Article  PubMed  Google Scholar 

  • Ruscio, J., Ruscio, A. M., & Meron, M. (2007). Applying the bootstrap to taxometric analysis: Generating empirical sampling distributions to help interpret results. Multivariate Behavioral Research, 42, 349–386.

    Article  Google Scholar 

  • Ruscio, J., & Walters, G. D. (2009). Using comparison data to differentiate categorical and dimensional data by examining factor score distributions: Resolving the mode problem. Psychological Assessment, 21, 578–594.

    Article  PubMed  Google Scholar 

  • Ruscio, J., Walters, G. D., Marcus, D. K., & Kaczetow, W. (2010). Comparing the relative fit of categorical and dimensional latent variable models using consistency tests. Psychological Assessment, 22, 5–21.

    Article  PubMed  Google Scholar 

  • Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Boston: Mifflin.

    Google Scholar 

  • Slade, T., & Grisham, J. R. (2009). A taxometric investigation of agoraphobia in a clinical and a community sample. Journal of Anxiety Disorders, 23, 799–805.

    Article  PubMed  Google Scholar 

  • Solomon, A., Ruscio, J., Seeley, J. R., & Lewinsohn, P. M. (2006). A taxometric investigation of unipolar depression in a large community sample. Psychological Medicine, 36, 973–985.

    Article  PubMed  Google Scholar 

  • Træen, B., Spitznogle, K., & Beverfjord, A. (2004). Attitudes and use of pornography in the Norwegian population 2002. Journal of Sex Research, 41, 193–200.

    Article  PubMed  Google Scholar 

  • Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47, 373–388.

    Article  PubMed  Google Scholar 

  • Waller, N. G., & Meehl, P. E. (1998). Multivariate taxometric procedures: Distinguishing types from continua. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Walters, G. D. (2008). The latent structure of alcohol use disorders: A taxometric analysis of structured interview data obtained from male federal prison inmates. Alcohol and Alcoholism, 43, 326–333.

    Article  PubMed  Google Scholar 

  • Walters, G. D. (2009). Latent structure of a two-dimensional model of antisocial personality disorder: Construct validation and taxometric analysis. Journal of Personality Disorders, 23, 647–660.

    Article  PubMed  Google Scholar 

  • Walters, G. D. (2010). Dementia: Continuum or distinct entity? Psychology and Aging, 25, 534–544.

    Article  PubMed  Google Scholar 

  • Walters, G. D., McGrath, R. E., & Knight, R. A. (2010). Taxometrics, polytomous constructs, and the comparison curve fit index: A Monte Carlo analysis. Psychological Assessment, 22, 149–156.

    Article  PubMed  Google Scholar 

  • Walters, G. D., & Ruscio, J. (2009). To sum or not to sum: Taxometric analysis with ordered categorical assessment items. Psychological Assessment, 21, 99–111.

    Article  PubMed  Google Scholar 

  • Walters, G. D., & Ruscio, J. (2010). Where do we draw the line? Assigning cases to subsamples for MAMBAC, MAXCOV, and MAXEIG taxometric analyses. Assessment, 17, 321–333.

    Article  PubMed  Google Scholar 

  • Winters, J. (2010). Hypersexual disorder: A more cautious approach [Letter to the editor]. Archives of Sexual Behavior, 39, 594–596.

    Article  PubMed  Google Scholar 

  • Zakireh, B., Ronis, S. T., & Knight, R. A. (2008). Individual beliefs, attitudes, and victimization histories of male juvenile sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 20, 323–351.

    Article  Google Scholar 

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Acknowledgments

Niklas Långström is a member of the Paraphilias Sub-workgroup of the DSM-5 Sexual and Gender Identity Disorders Work Group and Raymond Knight is an advisor to that group. The assertions and opinions contained herein are the private views of the authors and should not be construed as official or as reflecting the views of the Federal Bureau of Prisons or the United States Department of Justice.

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Authors and Affiliations

  1. Psychology Services, Federal Correctional Institution-Schuylkill, P.O. Box 700, Minersville, PA, 17954, USA

    Glenn D. Walters

  2. Department of Psychology, Brandeis University, Waltham, MA, USA

    Raymond A. Knight

  3. Centre for Violence Prevention, Karolinska Institutet, National Prison and Probation Administration R&D, Stockholm, Sweden

    Niklas Långström

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  1. Glenn D. Walters
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Correspondence to Glenn D. Walters.

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Walters, G.D., Knight, R.A. & Långström, N. Is Hypersexuality Dimensional? Evidence for the DSM-5 from General Population and Clinical Samples. Arch Sex Behav 40, 1309–1321 (2011). https://doi.org/10.1007/s10508-010-9719-8

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