Development and Validation of the Metacognitions about Sex Scale: Exploring its Role as a Mediator between Negative Affect, Emotion Dysregulation Strategies, and Compulsive Sexual Behavior Disorder.

Metacognitions about sex are theorized to shape cognitive appraisal, coping mechanisms, and regulation or dysregulation before, during, and/or after exposure to sexual stimuli. In our study, we examined the construct structure and validity of the Metacognitions about Sex Scale (MSS) among a sample of adolescents. We estimated the convergent validity of the MSS by factors: negative affect, dysregulated thoughts, and impulsivity, and compulsive sexual behavior (CSB). We also ran a structural equation model in which we examined the possibility that metacognitions about sex would mediate the association between negative affect, dysregulated thoughts, and impulsivity on the one hand, and CSB on the other. The study population included 662 adolescents (252 boys and 410 girls, M = 16.70, SD = 1.32) between 13-18 years of age. The analyses indicated that the factorial structure of the MSS comprised the two expected factors. We also found that positive and negative metacognitions about sex significantly mediated the effect of negative affect, dysregulated thoughts, and impulsivity on CSB. The findings provide evidence that MSS among Israeli adolescents are psychometrically appropriate for use by researchers and practitioners in the prevention and treatment of CSB.

Parental practices as predictors of adolescents' compulsive sexual behavior: a 6-month prospective study.

Compulsive sexual behavior (CSB) is a prevalent disorder among adolescents. To date, most studies focused on the self-report assessment of individuals without assessing possible parental practices that might alleviate or exacerbate adolescents' CSB. In the present research, I adopted the family systematic approach, which considers the effects of family context on children's and adolescents' development and examined whether and how parental (fathers' and mothers') support giving, communication, and restrictive mediation relate to children's current and future severity of CSB. The sample comprised 300 Israeli families [triad of mothers, fathers, and one adolescent (39% boys, 61% girls; age 14-18)]. Results indicate that maternal support and paternal quality of communication with children significantly predicted lower severity of current and future CSB, respectively. These findings highlight an important and understudied topic in the hope of motivating additional researchers and practitioners to adopt a familial, microsystem perspective on healthy sexual development-a perspective that holds great promise in promoting normal sexual development and in decreasing risky sexual behaviors.

Risk and protective factor profiles predict addictive behavior among adolescents.

BACKGROUND AND AIMS: Internet gaming disorder (IGD), compulsive sexual behavior (CSB), and problematic social network usage (PSNU) are prevalent disorders among adolescents. Research indicates an increase in the number of adolescents engaging in daily gaming, sex, and the use of social networks, as well as an increase in the number of adolescents diagnosed with these disorders. The current study aims to detect unique profiles of risk and protective factors and examine whether these profiles could explain the different severities of IGD, CSB, and PSNU among adolescents. METHOD: The sample comprised 544 Jewish Israeli adolescents from the general community (age 14-18), who were asked about risk (childhood adversity, childhood trauma, depression, anxiety, stress, post-traumatic stress, self-concealment, internalized stigma) and protective (parent-adolescent communication,) factors and addictive behaviors (IGD, CSB, and PSNU). RESULTS: Adolescents were classified into three different clusters based on their risk and protective factors: "at risk" (n = 48, 8.82%), "moderate" (n = 400, 73.53%), and "resilient" (n = 96, 17.65%). The "at risk" group had significantly greater severity of addictive behaviors (IGD, CSB, and PSNU) than did the "moderate" or "resilient" groups, and the "moderate" group had significantly greater severity of addictive behaviors than the "resilient" group. CONCLUSIONS: The findings highlight the fact that protective and risk factor profiles are highly indicative of various addictive behaviors among adolescents. The current research expands knowledge about addictive behaviors by providing a more individualized approach to understanding addictive behaviors among adolescents.

Parents' Psychopathology Promotes the Adoption of Ineffective Pornography-Related Parenting Mediation Strategies.

Approximately half of all adolescents aged 9-16 are exposed to pornography. Research has indicated that parents often try to employ various mediating strategies (negative active, restriction and co-use) in order to regulate their children's exposure to undesired content, and that most of these strategies are ineffective or have the opposite effect. In the present study, we investigated whether parental psychopathology (depression, anxiety, stress) promotes the adoption of less optimal parenting styles and an ineffective mediating strategy to regulate their child pornography exposure. The sample comprised 1,070 Jewish-Israeli parents to 10-14-year-old adolescents. Results indicated that for parents who characterized with mild anxiety and/or stress tend to adopte more authoritarian and less authoritative parenting style, which were linked with more ineffective mediating strategies with their child regarding pornography exposure - restrictive and negative active. These findings provide an opportunity for therapists as well as parents to gain a better insight into the link between psychopathology, parenting styles and the ability to regulate pornography exposure among children.

The Effect of Early Life Trauma on Compulsive Sexual Behavior among Members of a 12-Step Group.

INTRODUCTION: Early life trauma is at the core of many psychopathologies, including compulsive sexual behavior (CSB). The intermediate processes linking early life trauma and CSB have been less well studied. AIMS: To investigate whether impulsiveness, internalizing symptoms, sensation-seeking, and self-criticism mediate the links between early life trauma and CSB. METHODS: The sample comprised 65 Sexaholics Anonymous members and 47 healthy volunteers who completed self-report measures assessing CSB, early life trauma, and the mediating variables. MAIN OUTCOMES MEASURES: The main outcome measures were severity of CSB symptoms, impulsiveness, internalizing symptoms, sensation-seeking, self-criticism, and early life trauma. RESULTS: The analysis indicated that the total effect of early life trauma on CSB was significant, with more prevalent and severe trauma relating to higher CSB. The analysis also revealed that this effect was significantly mediated by 3 mediation paths-greater sensation-seeking, internalizing symptoms, and self-criticism-and that these measures in turn were associated with higher CSB. CONCLUSION: Our findings provide an opportunity for researchers to gain a better insight into the effect of early life trauma on CSB. Efrati Y, Gola M. The Effect of Early Life Trauma on Compulsive Sexual Behavior among Members of a 12-Step Group. J Sex Med 2019;16:803-811.

The Relation of Intra-Psychic and Relational Aspects of the Self to Compulsive Sexual Behavior.

Background and Aims: Research has indicated that addictions include not only the consumption of psychoactive substances but also behavioral addictions such as compulsive sexual behavior (CSB). In the current study we examine differences in the "addictive personality" of people with CSB as well as drug addicts. Methods: The sample sized included 160 Israeli men, of whom 67 were members of Sexaholics Anonymous (SA) support groups, 48 were members of Narcotics Anonymous (NA) support groups, and 45 were from the general community. Self-report measures of intra-psychic (narcissism, self-compassion, self-efficacy) and relational-related (sense of entitlement, pathological concern) measures were administrated. Results: Results indicate that SA groups had higher narcissism, lacked self-compassion and efficacy, and had greater pathological senses of entitlement and concern than drug addicts and control individuals. Conclusion: A theoretical conceptualization of these results is presented as a basis for future research directions and clinical intervention.

Adolescent Compulsive Sexual Behavior: Is It a Unique Psychological Phenomenon?

Adolescent compulsive sexual behavior (CSB), and its associations with other personality predispositions (attachment orientations, temperament), gender, religiosity, and psychopathological tendencies, is the subject of this study. Five alternative empirical models were examined, all based on current theory and research on CSB. The sample included 310 high-school adolescents (183 boys, 127 girls), ranging in age from 16 to 18 years (M = 16.94, SD = .65) and enrolled in the 11th (43.4%) and 12th (56.6%) grades, who completed self-report measures tapping CSB and the above mentioned variables. One model was found to be compatible with the data, indicating that CSB is an independent disorder from other psychopathological tendencies and is associated with religiosity, gender, temperament, and attachment orientations. Findings have implications for understanding the meaning of adolescent CSB as a psychological disorder and treating it differently from other disorders.

Individual-Based Compulsive Sexual Behavior Scale: Its Development and Importance in Examining Compulsive Sexual Behavior.

Compulsive sexual behavior comprises individual-based (e.g., sexual fantasies, compulsive sexual thoughts, masturbation) and partnered (e.g., interpersonal sexual conquests, repeated infidelity) facets. Most instruments for assessing compulsive sexual behavior, however, focus less on the individual-based facet and specifically on fantasies and compulsive thoughts. In the current research, we developed and validated an individual-based compulsive sexual behavior scale (I-CSB). In Study 1 (N = 492), the factorial structure of the I-CSB was examined. In Study 2 (N = 406), we assessed I-CSB's convergent validity. In Study 3 (N = 112), we examined whether the I-CSB differentiates between individuals who suffer from compulsive sexual behavior and those who do not. Results revealed a four-factor structure for individual-based compulsive sexual behavior that is associated with an intense inner conflict regarding sexuality (high arousal contrasting with high sexual anxiety), and that accounts for approximately 75% of the differences between people with compulsive sexual behavior and controls. Results are discussed in light of the need for a broader understanding of compulsive sexual behavior.

Effective Disengagement: Insecure People Are More Likely to Disengage From an Ongoing Task and Take Effective Action When Facing Danger.

OBJECTIVE: People believe that they can respond effectively to threats, but actually they experience difficulties in disengaging from ongoing tasks and shifting their attention to life-threatening events. We contend that this tendency is especially true for secure people with respect to their worldview and perception of others and not for insecure individuals. METHOD: In Study 1 (N = 290), we examined individuals' reactions to various threat scenarios. In Study 2 (N = 65), we examined these reactions using a behavioral design high in ecological validity. In Study 3 (N = 78), we examined group-level benefits for the actions of insecure individuals by manipulating asocial behavior in response to an emergency. RESULTS: Study 1 indicated that anxiously attached individuals stayed away from threats and sought help; avoidant people tended to take action by either assessing the risk of the event and/or enacting an asocial action such as fight or flight. Study 2 added ecological validity to these findings, and Study 3 showed that priming asocial behavior responses promoted actions that increased group members' chances of survival. CONCLUSION: Results validate the central tenets of social defense theory and indicate that actions that are deemed asocial may paradoxically promote the survival of individuals and groups.

Normative and Clinical Self-Perceptions of Sexuality and Their Links to Psychopathology among Adolescents.

BACKGROUND: Compulsive sexual behavior (CSB) has been linked to psychopathology among adults. Only preliminary research has been conducted on adolescents. In our study, we examined whether CSB is linked to psychopathology among adolescents or whether it is a part of normal sexual development. We also, examined potential risk and resiliency factors that might influence this link. METHODS: The study population included 311 high school students (184 males and 127 females) aged 16-18 years who completed self-report measures regarding CSB, psychopathology, temperament, and attachment orientations. RESULTS: Adolescents with clinical CSB had more severe psychopathologies than nonclinical ones (with moderate and low levels of CSB) and were unable to utilize resilience factors (i.e., low negative affectivity, high effortful control, and/or attachment security). CONCLUSIONS: Low and moderate levels of CSB seem to be part of the normal development of sexuality among adolescents. Clinical CSB seems to be a deviation from this normal development.

The sense of relational entitlement among adolescents toward their parents (SREap) - Testing an adaptation of the SRE.

The quality of the adolescent-parent relationship is closely related to the adolescent's sense of entitlement. Study 1 (458 central-Israel adolescents, 69% girls, ages: 11-16) developed the sense of relational entitlement among adolescents toward their parents (SREap, adapted from the original SRE on adults' romantic relationships) and provided initial validity evidence of its three-factor structure: exaggerated, restricted and assertive - replicating the SRE's factor structure. Studies 2-5 (1237 adolescents, 56% girls) examined the link between the SREap factors and relevant psychological measures. Exaggerated and restricted SREap factors were associated with attachment insecurities. Restricted and exaggerated entitlement factors were related to higher levels of emotional problems, and lower levels of: wellbeing, positive mood and life satisfaction. Conversely, assertive entitlement was related to higher life satisfaction and self-efficacy and lower levels of emotional problems. The findings also indicate that SREap is not merely a form of narcissism. The implications of SREap are discussed.

Effective parental strategies against problematic smartphone use among adolescents: A 6-month prospective study.

Problematic Smartphone Use (PSU) among adolescents is growing problem worldwide and multiple studies investigated its associated parental risk and protective factors. The available studies, however, typically do not address the multidimensional nature of PSU. They also rely heavily on cross-sectional designs with a small number of potentially contributing variables. This 6-month prospective study examines the relationships between a large range of parental factors with the three known dimensions of PSU: social environment pressure, emotional gain, and addiction-like behaviors. Specifically the study examines whether, and to what extent, the various dimensions of current and future PSU are related to parental support giving, general quality of communication, specific communication about smartphone use, and the four common mediation strategies. The sample comprised 1187 triads of mothers, fathers, and adolescents. The data-analysis pipeline consisted of three consecutive phases: (1) analyses of parental factors at baseline, (2) analyses of parental factors change over 6-months, and (3) interaction analyses between parental factors and the time-period of the study. The pipeline elicited three factors that moderated the change in PSU over time: Communication about smartphones with mothers, parental support giving, and parental co-use. The implications of these findings are discussed in the context of the existing literature and the familial, microsystem theoretical framework. Altogether, this prospective study scrutinized key parental factors and strategies that could be utilized by parents for coping with one of the most difficult parenting challenges of the digital era. Further research may build upon these findings to develop designated interventions to reduce PSU.

Student-teacher relational entitlement and its association with students' and teachers' characteristics.

INTRODUCTION: One's sense of entitlement-the subjective perception of what one deserves from another person-can contribute to social attitudes and behaviour in positive or negative ways, depending on the way in which one construes this subjective sense. Previous work has examined how adolescents' sense of entitlement towards their parents contributes positively or negatively to their well-being. In this study, we extend this line of research and focus on adolescents' sense of entitlement towards another important authority figure-teachers, while examining its associations with both students' and teachers' characteristics and implications for students' functioning at school. METHOD: We adapted the Adolescents' Sense of Relational Entitlement towards Parents scale to tap students' relational entitlement towards their teachers. We then examined the factor structure of the adapted scale and its associations with students' and teachers' relevant psychological measures in three samples (N = 1588). RESULTS: Findings confirmed the three-factor structure of student-teacher entitlement. Studies 2-3 also revealed that students' sense of entitlement was associated with both students' variables (e.g., psychological well-being, self-esteem, perceptions of teachers' acceptance of them and students' school engagement) and teachers' emotional difficulties. Study 3's findings indicated that students' sense of entitlement was associated with their school engagement. CONCLUSION: Students' sense of entitlement towards teachers seems to be associated with teachers' emotional makeup and attitudes towards students. In addition, this subjective sense is associated with students' school engagement. These findings suggest that there is theoretical value and practical implications for further unpacking both teachers' and students' factors associated with students' sense of entitlement and examining its association with academic functioning at school.

"I have no control over how much time I play" the metacognitions about online gaming scale: Evidence from a cross-cultural validation among Israeli adolescents.

In the current study we evaluated the psychometric properties of the Metacognitions about Online Gaming Scale (MOGS), including its factor structure, reliability, and predictive validity among Israeli adolescents in a six-month prospective study. We also examined the usefulness of the MOGS as a mediator of the effect of attachment patterns on Internet Gaming Disorder (IGD), the preference for online social interactions, and the motives for online gaming. The study population included 1,056 Israeli adolescents (610 males and 446 females, M = 15.77, standard deviation (SD) = 1.43) with an age range of 13-18 years. The participants completed the translated Hebrew version of the MOGS and measures on attachment style, IGD, preference for online social interactions, emotion regulation, and motives for online gaming. The analyses indicated that the factorial structure of the Hebrew MOGS comprised the expected two factors at T1 and T2 (a six-month follow-up). We also found that positive and negative metacognitions significantly mediated the effect of attachment styles on IGD, the preference for online social interactions, and the motives for online gaming. The findings provide evidence that the Hebrew MOGS among Israeli adolescents appears psychometrically appropriate for use by researchers and practitioners dealing with the prevention and treatment of IGD.

Mothers' Perceptions of Children's Screen Use During the COVID-19 Lockdown in Israel.

The contemporary parenting challenge of regulating children's screen time became even more difficult during the coronavirus pandemic (COVID-19). The current research addresses the characteristics of this challenge and explores mothers' perceptions regarding their children's screen use, through two consecutive studies. Study 1 included 299 mothers of elementary school children, who were asked to complete questionnaires regarding their children's screen habits. Mothers were also asked about their own attitudes towards screens, as parents, and about their personal feelings of frustration and guilt. Study 2 replicated this procedure among a new sample of 283 mothers who also completed validated scales assessing their sense of parental competence and authority style. Retrospective reports of mothers indicated that, during the lockdown, entertainment use of screens increased by 73% among 4th-6th graders and by 108% among 1st-3rd graders. Educational use increased by 86% in both age groups. Mothers' guilt increased as well and was predicted by children's entertainment use (but not educational use), after accounting for demographic variables and mothers' attitudes. Other factors, such as parenting style and having at-least one child with a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD), were associated with entertainment use (regardless of the COVID-19 lockdown). Factors that were found to moderate the lockdown effect were mothers' attitudes towards screens and parental confidence. The findings are discussed in the context of parents' efforts to regulate their children's screen use.

Self-perceived substance and behavioral addictions among Jewish Israeli adolescents during the COVID-19 pandemic.

This study examined self-perceived substance and behavioral addictions among Israeli adolescents during the COVID-19 pandemic across different sociodemographic categories. The sample comprised 2,074 adolescents (40% males, 60% females) aged 12-19 years who completed the survey anonymously and with parental consent. We examined what is the prevalence of self-perceived substance and behavioral addictions in this population in the COVID-19 pandemic context. Participants reported self-perceived addictions to social networks (70%), shopping (46%), binge eating (34%), gaming (30%), sex-related behavior (15%), psychoactive substance (31%, including alcohol, tobacco, cannabis, and/or cocaine), and gambling (3%). Moreover, differences were found to be directly related to age, biological sex, religiosity, socioeconomic status, and immigration status. From a lay epidemiological perspective, the current research expands our knowledge about self-perceived addiction among adolescents during the COVID-19 pandemic, offering better understanding of the likelihood probability factors for self-perceived addiction among adolescents and its related negative outcomes, including increased risk factors for later adult life.

Early-life trauma, negative and positive life events, compulsive sexual behavior disorder and risky sexual action tendencies among young women with substance use disorder.

Although significant advances have been made in the field to date, gender-based issues for women remain a neglected area in much of substance abuse research. In the current study we examined two gaps in the literature: the co-occurrence of compulsive sexual behavior disorder (CSBD) and risky sexual action tendencies among women with substance use disorders (SUDs), and their shared antecedents in the form of early life adversity and negative life events. The sample comprised 132 women of whom 62 had substance use disorder (drug and alcohol) and 70 were healthy controls. Each participant completed self-report measures of drug abuse and alcoholism, compulsive sexual behavior disorder and risky sexual action tendencies as well as early-life trauma and negative and positive life events. Results indicate that young women with substance use disorder have higher compulsive sexual behavior disorder symptoms and more prevalent risky sexual action tendencies than controls. Compulsive sexual behavior was also found to mediate the association between substance use and risky sexual action tendencies. In addition, all addictive behaviors were linked with emotional abuse at childhood but not with other types of abuse. Conversely, negative life events in adulthood were only linked with CSBD and not with substance use. The findings provide deeper insights into the comorbidity of addictive behaviors and an opportunity for developing more effective treatments for women who suffer from these addictions.

Adolescents who solely engage in online sexual experiences are at higher risk for compulsive sexual behavior.

In addition to its expression offline, sexual behavior is frequently expressed online. Some adolescents solely engage in online sexual activities, whereas others in offline and online activities, or have no sexual experience at all. In the current research, we examined whether those who solely engage in online sexual activities are at greater risk for compulsive sexual behavior. In Study 1 (n = 164), we examined differences in compulsive sexual behavior (CSB) and risky sexual action tendencies between study groups. In Study 2 (n = 713), we statistically replicated the classification into different sexual behaviors and examined differences between the clusters in CSB, social tendencies and socio-demographic measures. Results indicated that adolescents who only engaged in online sexual activities had significantly higher percentage of clinical CSB, were less likely boys and more likely to be religious. There were not more prone to risky sexual behavior, however. The current research expands the knowledge about offline or online sexually related activities among adolescence.

Early Maladaptive Schemas Are Highly Indicative of Compulsive Sexual Behavior.

Unlike the consequences of compulsive sexual behavior (CSB) and the profile of people with CSB that were extensively studied, the cognitive distortions that might be responsible to the development and maintenance of CSB are less understood. In Study 1 (n = 68), we examined intercorrelations between CSB and early maladaptive schemas among a sample with clinical CSB (Sexaholic Anonymous; SAs). In Study 2 (sex offenders; n = 103, and violence offenders; n = 81), we examined the intercorrelations between CSB and early maladaptive schemas among a sample with a sexual deviance but non-clinical levels of CSB. Results revealed that early maladaptive schemas are highly indicative of CSB severity. We discuss the implication of the study for the study and therapy of CSB.

Common Features in Compulsive Sexual Behavior, Substance Use Disorders, Personality, Temperament, and Attachment-A Narrative Review.

Do addictions share common traits of an "addictive personality" or do different addictions have distinct personality profiles? This narrative review examines the differences in the associations between substance use disorder (SUD) and compulsive sexual behavior disorder (CSBD), on the one hand, and personality traits, attachment dispositions, and temperament, on the other hand. We found that both people with a SUD and people with CSBD tended to be more spontaneous, careless, and less reliable, to place self-interest above getting along with others, to show emotional instability and experience negative emotions such as anger, anxiety, and/or depression, to be less able to control their attention and/or behavior, and to be engulfed with a constant sensation of "wanting". Only people with CSBD, but not SUD, noted concerns with their social ties, fear of losing close others, and/or trusting others around them. Results also suggested that people with a SUD and people with CSBD share high commonalities in personality traits and temperament, yet there are noted differences in their social tendencies, especially with close others. People with CSBD reported more concerns with possible relationship losses compared to people with SUD issues, who may be more worried about losing their source of escapism.