Does Clitoral Knowledge Translate into Orgasm? The Interplay Between Clitoral Knowledge, Gendered Sexual Scripts, and Orgasm Experience.

Despite some efforts to enhance clitoral knowledge to increase women's sexual pleasure, a gendered orgasm gap persists. We aimed to provide contemporary data on people's knowledge about the clitoris and investigate its association with the experience of sexual pleasure. Heterosexual participants (n = 573; 64.2% women) took a quiz on clitoral knowledge and answered sexuality-related questions. Participants answered only 50% of the nine quiz items correctly. Clitoral knowledge predicted sexual pleasure and orgasm in women, mediated via reduced endorsement of gendered sexual scripts. Our results highlight the importance of clitoral knowledge and its interplay with societal barriers for the experience of pleasure.

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS).

INTRODUCTION: Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. AIMS: The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. METHODS: Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; Mage: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. RESULTS: A two-factor model with factors describing 'alcohol use' (items 1-3) and 'alcohol problems' (items 4-10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. CONCLUSIONS: In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations.

Alcohol use disorder as a risk factor for violent offending and reoffending in delinquent women with substance use disorders.

Female gender is generally less associated with aggressive behavior and violent offending than male gender. Therefore, most studies on violence and (re-)offending include only men. However, it is crucial to better understand pathways to female offending in order to enable efficient psychological interventions and risk assessment in women. Well-established risk factors for aggressive behavior include alcohol use disorder (AUD) and other substance use disorders (SUDs). We retrospectively analyzed the association of AUD and other SUDs with violent offending and reoffending in a sample of female offenders (N = 334) in a forensic treatment facility. In total, 72% of the patients with an AUD had committed a violent crime leading to admission, whereas only 19% of those with other SUDs had. Over 70% of the participants with AUD had a family history of AUD, and over 83% had experienced physical violence in adulthood. Rates of AUD and other SUDs did not differ regarding aggressive behavior during inpatient treatment, while the risk of reoffending with a violent crime after discharge was nine times higher in patients with an AUD than in those with other SUDs. Our results indicate that AUD is a significant risk factor for violent offending and reoffending in women. A familial background of AUD and a history of physical abuse increase the probability for both AUD and offending, suggesting a possible interaction between (epi-)genetic and environmental factors. The comparable rates of aggression during inpatient treatment in patients with AUD and other SUDs indicate that abstinence is a protective factor for violence.

Sexual Motivations Underlying Compulsive Sexual Behavior in Women and Men From Germany and Hungary.

BACKGROUND: There are ongoing debates about conflicting models on how to conceptualize compulsive sexual behavior. At the heart of these discussions is the question about the sexual motivations underlying compulsive sexual behavior, as different models assume different motivations. AIM: The aim of the present study was to understand sexual motivations underlying compulsive sexual behavior and their relation to the most prominent conceptualizations of compulsive sexual behavior (eg, compulsive sexual behavior disorder [CSBD], sex addiction). METHODS: We used self-reported data from 2 large samples of Hungarian and German populations (N = 9814). The Sexual Motivation Scale (SexMS), a 24-item self-report measure based on self-determination theory, was used to assess a diverse set of sexual motivations. Compulsive sexual behavior was assessed with the 19-item Compulsive Sexual Behavior Disorder Scale (CSBD-19), that is based on the ICD-11 diagnostic guidelines of CSBD. We used structural equation modeling to examine the hypothesized associations between sexual motivations and compulsive sexual behavior and examined potential gender differences in these associations. OUTCOMES: Compulsive sexual behavior was assessed in relation to a set of sexual motivations. RESULTS: Amotivation had the strongest positive association with compulsive sexual behavior, but integrated, introjected, and intrinsic motivations were also positively related to it. Importantly, these associations did not differ for women and men, and between the 2 samples. CLINICAL IMPLICATIONS: Future research and treatment should also consider sexual motivations that are not listed among the ICD-11 guidelines for CSBD, including high levels of sexual interest, continuing the behavior despite having little satisfaction from it and coping with sex. STRENGTHS & LIMITATIONS: Although we used large samples of general populations in 2 Western countries, this motivational background of compulsive sexual behavior awaits replication in a clinical sample of individuals experiencing CSBD. CONCLUSION: The identified sexual motivations underlying compulsive sexual behavior are relevant for assessing and treating patients as motivations may be integrated into psychotherapeutic interventions. Koós M, Fuss J, Klein V, et al. Sexual Motivations Underlying Compulsive Sexual Behavior in Women and Men From Germany and Hungary. J Sex Med 2022;19:170-181.

Can Clinicians Use Dimensional Information to Make a Categorical Diagnosis of Paraphilic Disorders? An ICD-11 Field Study.

BACKGROUND: The diagnosis of paraphilic disorder is a complicated clinical judgment based on the integration of information from multiple dimensions to arrive at a categorical (present/absent) conclusion. The recent update of the guidelines for paraphilic disorders in ICD-11 presents an opportunity to investigate how mental health professionals use the diagnostic guidelines to arrive at a diagnosis which thereby can optimize the guidelines for clinical use. AIM: This study examined clinicians' ability to use the ICD-11 diagnostic guidelines for paraphilic disorders which contain multiple dimensions that must be simultaneously assessed to arrive at a diagnosis. METHODS: The study investigated the ability of 1,263 international clinicians to identify the dimensions of paraphilic disorder in the context of written case vignettes that varied on a single dimension only. OUTCOMES: Participants provided diagnoses for the case vignettes along with dimensional ratings of the degree of presence of five dimensions of paraphilic disorder (arousal, consent, action, distress, and risk). RESULTS: Across a series of analyses, clinicians demonstrated a clear ability to recognize and appropriately integrate the dimensions of paraphilic disorders; however, there was some evidence that clinicians may over-diagnose non-pathological cases. CLINICAL TRANSLATION: Clinicians would likely benefit from targeted training on the ICD-11 definition of paraphilic disorder and should be cautious of over-diagnosing. STRENGTHS AND LIMITATIONS: This study represents a large international sample of health professionals and is the first to examine clinicians' ability to apply the ICD-11 diagnostic guidelines for paraphilic disorders. Important limitations include not generalizing to all clinicians and acknowledging that results may be different in direct clinical interactions vs written case vignettes. CONCLUSION: These results indicate that clinicians appear capable of interpreting and implementing the diagnostic guidelines for paraphilic disorders in ICD-11. Keeley JW, Briken P, Evans SC, et al. Can Clinicians Use Dimensional Information to Make a Categorical Diagnosis of Paraphilic Disorders? An ICD-11 Field Study. J Sex Med 2021;18:1592-1606.

[Lifetime prevalences of nonconsensual sexual intercourse and touch and associations with health-related factors : Results from the German Health and Sexuality Survey (GeSiD)]. / Lebenszeitprävalenz des Erlebens von Sex und sexueller Berührung gegen den eigenen Willen sowie Zusammenhänge mit gesundheitsbezogenen Faktoren : Ergebnisse aus der Studie Gesundheit und Sexualität in Deutschland (GeSiD).

BACKGROUND: In the last decade, the negative effects of sexual violence on health have again become a focus of health policies worldwide. So far, representative population data on lifetime prevalence for different age groups and specific links to health-related factors for Germany are lacking. OBJECTIVES: The study aimed to assess 1) the lifetime prevalence of self-reported nonconsensual sexual intercourse and sexual touch in childhood and across the lifespan and 2) associations with health-related factors. MATERIALS AND METHODS: Using a two-step stratified, randomized sample of residents' registration offices, 4955 persons aged 18 to 75 years were interviewed within the scope of the nationwide scientific survey on health and sexuality in Germany (GeSiD). The associations between experiences of sexual violence and socio-demographic and health-related factors were age-adjusted and stratified for gender using logistic regression. RESULTS: For women, the lifetime prevalence of (attempted/completed) nonconsensual intercourse was 14.9% and in the form of (attempted/completed) nonconsensual sexual touching was 40.8%; for men the prevalences were 3.1% and 13.2%, respectively. Regarding forced experiences in childhood, the prevalence of sex was 2.1% and of sexual touching was 7.5%. For both genders, the prevalence of nonconsensual intercourse was significantly higher in the case of low quality of life, poor health condition, a chronic illness or disability, or treatment for depression or for another mental disorder. CONCLUSIONS: The results illustrate the strong links between sexual violence and mental and somatic health. This points to the urgency to routinely explore experiences of sexual aggression.

[The impact of religiousness on the attitude towards aggression and on aggressive behavior in a forensic-psychiatric inpatient sample]. / Der Einfluss von Religiosität auf die Einstellung gegenüber Aggression und auf aggressives Verhalten von forensisch-psychiatrischen Patienten.

AIM OF STUDY: According to previous research, religiousness might have a positive effect on the risk of delinquent behavior. This study aims to examine this correlation in a forensic-psychiatric inpatient sample. Furthermore, it compares self-reported aggression with the individuals' criminal history of violent offending. METHOD: The study sample consisted of 84 forensic patients in mandatory drug treatment according to section 64 of the German Penal Code. Religiousness and attitude towards aggressive behavior were assessed by self-report. The participants' criminal history was screened for violent offences. RESULTS: In the male forensic-psychiatric inpatient sample, higher levels of religiousness correlated negatively with the attitude towards appetitive aggression, but not with aggressive behavior. In the female sample, no significant correlation was found. CONCLUSION: We found a gender difference regarding the correlation of religiousness with the attitude towards aggression. Additionally, our results indicated a discrepancy between self-report of aggression and actual behavior in the sample of forensic-psychiatric inpatients. This might be explained by cognitive distortions, poor self-perception, or planning deficits.

Violent aggression predicted by multiple pre-adult environmental hits.

Early exposure to negative environmental impact shapes individual behavior and potentially contributes to any mental disease. We reported previously that accumulated environmental risk markedly decreases age at schizophrenia onset. Follow-up of matched extreme group individuals (≤1 vs. ≥3 risks) unexpectedly revealed that high-risk subjects had >5 times greater probability of forensic hospitalization. In line with longstanding sociological theories, we hypothesized that risk accumulation before adulthood induces violent aggression and criminal conduct, independent of mental illness. We determined in 6 independent cohorts (4 schizophrenia and 2 general population samples) pre-adult risk exposure, comprising urbanicity, migration, physical and sexual abuse as primary, and cannabis or alcohol as secondary hits. All single hits by themselves were marginally associated with higher violent aggression. Most strikingly, however, their accumulation strongly predicted violent aggression (odds ratio 10.5). An epigenome-wide association scan to detect differential methylation of blood-derived DNA of selected extreme group individuals yielded overall negative results. Conversely, determination in peripheral blood mononuclear cells of histone-deacetylase1 mRNA as 'umbrella mediator' of epigenetic processes revealed an increase in the high-risk group, suggesting lasting epigenetic alterations. Together, we provide sound evidence of a disease-independent unfortunate relationship between well-defined pre-adult environmental hits and violent aggression, calling for more efficient prevention.

Accuracy of diagnostic classification and clinical utility assessment of ICD-11 compared to ICD-10 in 10 mental disorders: findings from a web-based field study.

In this web-based field study, we compared the diagnostic accuracy and clinical utility of 10 selected mental disorders between the ICD-11 Clinical Descriptions and Diagnostic Guidelines (CDDG) and the ICD-10 CDDG using vignettes in a sample of 928 health professionals from all WHO regions. On average, the ICD-11 CDDG displayed significantly higher diagnostic accuracy (71.9% for ICD-11, 53.2% for ICD-10), higher ease of use, better goodness of fit, higher clarity, and lower time required for diagnosis compared to the ICD-10 CDDG. The advantages of the ICD-11 CDDG were largely limited to new diagnoses in ICD-11. After limiting analyses to diagnoses existing in ICD-11 and ICD-10, the ICD-11 CDDG were only superior in ease of use. The ICD-11 CDDG were not inferior in diagnostic accuracy or clinical utility compared to the ICD-10 CDDG for any of the vignettes. Diagnostic accuracy was consistent across WHO regions and independent of participants' clinical experience. There were no differences between medical doctors and psychologists in diagnostic accuracy, but members of other health professions had greater difficulties in determining correct diagnoses based on the ICD-11 CDDG. In sum, there were no differences in diagnostic accuracy for diagnoses existing in ICD-10 and ICD-11, but the introduction of new diagnoses in ICD-11 has improved the diagnostic classification of some clinical presentations. The favourable clinical utility ratings of the ICD-11 CDDG give reason to expect a positive evaluation by health professionals in the implementation phase of ICD-11. Yet, training in ICD-11 is needed to further enhance the diagnostic accuracy.

Comparison of outcome in men and women after treatment in psychiatric security hospitals in Germany.

Previous research has shown that forensic psychiatric treatment reduces reoffending, rehospitalization and premature mortality. Treatment outcome varies with diagnosis, but little is known about the influence of sex, psychosocial adjustment and aftercare. To assess these variables, we interviewed male and female patients discharged from three psychiatric security hospitals in Germany in the years 2010-2017. Participants were interviewed at discharge (n = 609) and 1 year later (n = 366) about reoffending, readmissions, substance use and psychosocial adjustment. Among patients with substance use disorder (SUD), 14% reoffended, 20% were re-hospitalized and 60% maintained abstinence. Among patients with severe mental disorder, 5% reoffended and 13% were re-hospitalized. Significant sex differences were found in offenders with SUD. The results suggest that sociodemographic and disorder-related risk factors are associated with treatment success and that female patients with SUD might need a specific treatment approach. Sex-specific aspects, diagnosis and psychosocial adjustment should be considered in forensic psychiatric treatment and risk assessment.

Perceptions of Sexual Script Deviation in Women and Men.

Traditional sexual scripts are characterized by a gendered power inequality (male dominance vs. female submission) (Sanchez, Fetterolf, & Rudman, 2012). Although gender differences in a variety of sexual behaviors have been decreasing, research into sexual scripts provides some support for the existence of traditional sexual scripts adherence. Study 1a and 1b focused on men's evaluations of sexual script deviation in women (i.e., sexually assertive behavior) and the possible disapproval of these behaviors (backlash effects). Participants (381 and 382 self-identified heterosexual men) were presented with a randomly assigned vignette describing a hypothetical sexual scenario in which a woman behaved either sexually assertive or sexually timid. Both studies indicated that men to some extent expressed disapproval of sexually assertive women. With the aim to assess if backlash effects were due to women's sexual script deviation or if there was an overall negative evaluation of sexually assertive behavior irrespective of the target's gender, in Study 2 we focused on the perception of sexually assertive behavior in both women and men (N = 268). Although we found that gender role conformity was held for women, but not for men, the results suggest that the negative evaluation of sexual assertiveness was not due to script deviation, but that there is an overall conservative attitude toward sexually assertive behavior. Our study provides some insight into the motives of traditional sexual script adherence particularly for women.

A Validation Study of the German Version of the Sexual Inhibition/Sexual Excitation Scales-Short Form.

The dual control model of human sexual behavior proposes that sexual responses involve an interaction between sexual excitatory and sexual inhibitory systems. The Sexual Inhibition/Sexual Excitation Scales (SIS/SES; Janssen, Vorst, Finn, & Bancroft, 2002) as well as its short form (SIS/SES-SF; Carpenter, Janssen, Graham, Vorst, & Wicherts, 2011) assess individual propensities to become sexually excited and sexually inhibited. The present study utilized a dataset of 2221 German-speaking adults (n = 1214 women and n = 987 men) to examine the psychometric properties of the German version of the SIS/SES-SF. The results of the confirmatory factor analysis indicated that the three factors suggested in the original version can be generally replicated within the current study. Analyses of measurement invariance for gender revealed that the general three-factor structure as well as factor loadings can be regarded as equal for men and women. However, scalar invariance could not be fully obtained, indicating that the intercepts of some items were different for men and women. Taken together, the results of the presents study provide further evidence for the psychometric properties of the German version of the SIS/SES-SF.

Parenting, Communication about Sexuality, and the Development of Adolescent Womens' Sexual Agency: A Longitudinal Assessment.

Sexual agency (i.e., the ability to make decisions and assertions related to one's own sexuality) is associated with sexual health enhancing outcomes. Given that young women are expected to act passively, rather than with agency when it comes to sexual encounters, the present study aimed to explore whether parental support, knowledge, and communication about sexuality during late adolescence contribute to an enhancement of sexual agency in a sample of young women in the long-term. Using a longitudinal design (panel study), 320 female participants who participated in three data collection waves (T1, T2, and T5) were included in the analyses (Mage = 16.2 years, SD = 0.50 at baseline). Mediated by the frequency of parents' communication about sexuality with their daughters, both dimensions of parental support (emotional engagement and support of autonomy) positively predicted adolescent women's sexual agency two years later. In contrast, parental knowledge of their children's whereabouts was unrelated to communication and female sexual agency. Specific dimensions of parenting seem to play a crucial role in empowering adolescent girls to act agentic through communicating, emotional support, and encouraging autonomy, which in turn may contribute to healthy sexual behavior in young adulthood.

[Web-based field studies on diagnostic classification and code assignment of mental disorders: comparison of ICD-11 and ICD-10]. / Internetbasierte Untersuchungen zur diagnostischen Klassifikation und Kodierung psychischer Störungen im Vergleich von ICD-11 und ICD-10.

The German Society for Psychiatry, Psychosomatics and Psychotherapy (DGPPN,) conducted a comprehensive field study (principal investigator WG) funded by the German Federal Ministry of Health in cooperation with 4 other German medical societies in the field of mental health (DGPM, DGPPR, DeGFS, DGfS) * to support WHO's development of the ICD-11 (Chapters 6 and 17). The objective of the web-based field study was to compare ICD-10 and ICD-11 (beta draft) for selected mental disorders, regarding consistency, accuracy and assessment of utility. The first study (TP1) focused on the diagnostic classification and the second (TP2) on assignment of diagnostic codes.In TP1, clinicians used either the ICD-10 Clinical Descriptions and Diagnostic Guidelines (CDDG) version or a draft version of the ICD-11 CDDG to evaluate 10 case vignettes in a randomized study implemented through the WHO GCPN **. As hypothesized, consistency was in favor of the ICD-11 (p = .02; n = 319 expert participants) though there was some variability across the different diagnostic categories. In addition, time for diagnosis was shorter (p = .01) and clinicians' judgment of utility (ease of use; goodness of fit) was better for ICD-11 (p = .047 and p < .001 respectively).TP2 focused on consistency of diagnostic code assignment for 25 short case descriptions (including explicit diagnosis and additional clinical information) using both ICD-10 and ICD-11 in a randomized web-based field study which was run on the WHO ICD-FiT *** platform. Based on 531 code assignments by120 expert clinicians, consistency for ICD-11 was significantly lower compared to ICD-10 (71 % vs. 82 %, p < .001) contrary to study hypothesis, and time required was significantly higher for ICD-11 (p < .001). Nevertheless, utility assessments were in favor of ICD-11 (p < .005).In summary, in TP1, given vignettes with more complex clinical descriptions more similar to clinical cases, ICD-11 showed advantages in the consistency of correct diagnoses among clinicians, time required to reach a diagnosis, and clinicians' ratings of clinical utility. These results provide evidence for quality improvement of the diagnostic process due to the revision of the more complete diagnostic guidelines for ICD-11. In the coding task of TP2, coding by clinicians using the ICD-10 was more consistent and faster than coding using the ICD-11. This may be a result of the greater complexity for coding use of the ICD-11 (e. g., due to 'post-coordination'), as well as greater familiarity with the ICD-10 system (which German clinicians currently use) and lack of practice with the new ICD-11 codes and tools. In spite of this, users assessed the ICD-11 system as more useful than the ICD-10, in part also because of ICD-11's more systematic and comprehensive coding tools. In addition, time needed for coding improved with practice, indicating need for intense education and training initiatives when ICD-11 is adopted and implemented into clinical practice.

The Relationship Between Hypersexual Behavior, Sexual Excitation, Sexual Inhibition, and Personality Traits.

The term hypersexuality was introduced to describe excessive sexual behavior associated with a person's inability to control his or her sexual behavior. The main aim of the present study was to investigate the impact of different personality traits on the degree of hypersexual behavior as measured by the Hypersexual Behavior Inventory (HBI). A further aim was to evaluate the association between sexual inhibition and excitation [as described in the Dual Control Model (DCM)] and hypersexual behavior. A sample of 1,749 participants completed an internet-based survey comprised the HBI, the short form of the Sexual Inhibition/Sexual Excitation Scales (SIS/SES-SF) as well as more general personality measures: the Behavioral Inhibition System/Behavioral Activation System-scales (BIS/BAS-scales) and a short version of the Big Five Inventory (BFI-10). Using the recommended HBI cut-off, 6.0 % (n = 105) of the present sample could be categorized as hypersexual, which is comparable to the results of previous studies about the prevalence of hypersexual behavior in the general population. The results provided strong support for the components of the DCM-sexual excitation and inhibition-to explain hypersexual behavior, irrespective of gender and sexual orientation. Some of the general personality traits also showed significant relationships with hypersexual behavior. Taken together, the results of the present study provide further support for the relevance of research about the relationships between sexual problems and disorders, the DCM, and personality variables.

Risk Factors for Sexual Offending in Men Working With Children: A Community-Based Survey.

Identifying risk factors for sexual abuse in men who work with children and who have already abused a child could lead to more appropriate screening and prevention strategies and is thus of major scientific and societal relevance. A total of 8649 German men from the community were assessed in an extensive anonymous and confidential online survey. Of those, 37 (0.4 %) could be classified as child sexual abusers working with children, 90 (1.0 %) as child sexual abusers not working with children, and 816 (9.4 %) as men who work with children and who have not abused a child. We assessed the impact of working with children as an individual risk factor for self-reported child sexual abuse and compared personal factors, pedophilic sexual fantasies, deviant sexual behaviors, antisocial behaviors, and hypersexuality among the three groups. Most interestingly, working with children was significantly associated with a self-reported sexual offense against children; however, it explained only three percent of its variance. Child sexual abusers working with children admitted more antisocial and more sexually deviant behaviors than child sexual abusers not working with children and than men working with children who have not abused a child. Our findings support some of the suggestions made by other researchers concerning factors that could be considered in applicants for child- or youth-serving institutions. However, it has to be pointed out that the scientific basis still seems premature.

Risk Assessment in Child Sexual Abusers Working With Children.

Child sexual abuse occurring in a child- or youth-serving institution or organization has attracted great public and scientific attention. In light of the particular personal and offense-related characteristics of men who have abused children within such an institution or organization, it is of special importance to evaluate the predictive performance of currently applied risk assessment instruments in this offender population. Therefore, the present study assessed the risk ratings and predictive performance of four risk assessment instruments and one instrument assessing protective factors concerning any, violent and sexual recidivism in child sexual abusers working with children (CSA-W) in comparison with extra-familial child sexual abusers (CSA-E) and intra-familial child sexual abusers (CSA-I). The results indicate that CSA-W mostly recidivate with a sexual offense. Although all included risk measures seem to function with CSA-W, the Static-99 seems to be the instrument that performs best in predicting sexual recidivism in CSA-W. CSA-W had the most protective factors measured with the Structured Assessment of PROtective Factors (SAPROF). While the SAPROF could not predict desistance from recidivism in CSA-W, it predicted desistance from any recidivism in all CSA. As CSA-W frequently hold many indicators for pedophilic sexual interests but only a few for antisocial tendencies, it can be suggested that CSA-W are at an increased risk for sexual recidivism and thus risk measures especially designed for sexual recidivism work best in CSA-W. Nevertheless, CSA-W also hold many protective factors; however, their impact on CSA-W is not clear yet and needs further study.

Erectile Dysfunction, Boredom, and Hypersexuality among Coupled Men from Two European Countries.

INTRODUCTION: Much of the research on the association between erectile dysfunction (ED) and possible clinical relevant hypersexuality up to now has been only descriptive in nature. AIM: The present study aimed to explore the relationships among hypersexuality, ED, and sexual boredom in a sample of coupled community men. METHODS: An Internet-based survey was conducted in two European countries. The sample included 911 Croatian and 210 German coupled men. The survey comprised the Hypersexual Disorder Screening Inventory, the International Index of Erectile Function and the Sexual Boredom Scale. Poisson regression analysis was used to examine how ED, solitary sexual activities and sexual boredom were associated with hypersexuality. RESULTS: Among Croatian and German men, hypersexuality was significantly correlated with proneness to sexual boredom and more problems with erectile function. CONCLUSIONS: In some men, hypersexual behavior may serve as a coping mechanism for sexual fantasy poverty-associated boredom. In addition, ED within an intimate relationship can accompany this simultaneously.

Protective factors and recidivism in accused juveniles who sexually offended.

To date, research on juvenile sexual offender recidivism has tended to focus on risk factors rather than protective factors. Therefore, very little is known about protective factors in the population of juveniles who sexually offended. The aim of the present study was to examine the impact of protective factors on non-recidivism in a sample of accused juveniles who sexually offended (N = 71) in a mean follow-up period of 47.84 months. Protective factors were measured with the Protective Factor Scale of the Structured Assessment of Violence Risk in Youth (SAVRY), and the Structured Assessment of PROtective Factors for violence risk (SAPROF). Criminal charges served as recidivism data. The internal scale of the SAPROF, in particular, yielded moderate predictive accuracy for the absence of violent and general recidivism, though not for the absence of sexual recidivism. No protective factor of the SAVRY did reveal predictive accuracy regarding various types of the absence of recidivism. Furthermore, protective factors failed to achieve any significant incremental predictive accuracy beyond that captured by the SAVRY risk factors alone. The potential therapeutic benefit of protective factors in juvenile sexual offender treatment is discussed.

Self-reported indicators of hypersexuality and its correlates in a female online sample.

INTRODUCTION: Hypersexual behavior has been a controversial and much disputed issue in the field of sexual medicine. However, only little attention has been paid to hypersexual behavior in women. Therefore, to date there is limited knowledge on the behavioral patterns of hypersexuality in women. AIMS: The purpose of the present study was to examine which sexual behavioral patterns are associated with self-reported indicators of hypersexuality in a female online sample. The second aim was to evaluate the association between hypersexuality and sexual risk behavior in women. METHODS: In total, 988 women participated in an online survey. Logistic regression analysis was conducted to examine the association between sexual behavioral patterns and hypersexuality. Furthermore, correlation analyses were calculated in order to identify the relationship between sexual risk behavior and hypersexuality. MAIN OUTCOME MEASURES: Indicators of hypersexual behavior were measured by the Hypersexual Behavior Inventory (HBI). In addition, current and present impersonal sexual activities were investigated. Sexual risk behavior was assessed using the Sexual Sensation Seeking Scale (SSSS). RESULTS: High masturbation frequency, number of sexual partners, and pornography use were associated with a higher degree of hypersexual behavior in women. Furthermore, the HBI total score was positively correlated to sexual risk behavior. CONCLUSION: The results of the current study do not support the idea of previous research that hypersexual women are typically engaged in more passive forms of sexual behavior. Rather female hypersexuality seems to be more characterized by impersonal sexual activity. An association between hypersexual behavior and sexual risk behavior was identified. The implications of these findings for potential prevention strategies and therapeutic interventions are discussed.