Maladaptive personality traits linked to hypersexual disorder in men, study finds

A new study indicates that men with hypersexual disorder may have higher levels of maladaptive personality traits, such as negative affect, detachment, psychoticism, antagonism, and disinhibition, compared to healthy men. The paper was published in the Journal of Behavioral Addictions.

Mental health professionals have long been noting the existence of people preoccupied with sexual behavior to the extent that created serious problems in their daily functioning. Such individuals show an excessive preoccupation with sexual fantasies, urges, or behaviors that cause significant distress and impairment. The term hypersexual disorder was proposed to describe this condition. It differs from just having a strong sex drive by the presence of distress and compulsivity in one’s sexual actions.

Individuals with hypersexual disorder tend to engage in compulsive sexual activities such as frequent masturbation, pornography use, promiscuity, or pursuing sexual encounters to the detriment of their relationships, work, or personal responsibilities. It is often associated with a loss of control, where attempts to reduce or stop these behaviors are unsuccessful. That is why it is generally considered an impulse control disorder.

Study author Jannis Engel and her colleagues wanted to better understand the relationship between personality factors and hypersexual disorder. They conducted a study in which they compared a group of men with hypersexual disorder with men not suffering from this disorder on personality domains described by an assessment of maladaptive personality traits, the PID-5-BF.

This assessment assesses five broad domains of personality dysfunction – Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. Negative Affectivity is characterized by intense emotional distress, anxiety, or fear. Detachment involves social withdrawal, emotional coldness, and avoidance of close relationships. Antagonism is marked by hostility, manipulativeness, and a disregard for others’ needs or feelings. Disinhibition reflects impulsivity, recklessness, and difficulty maintaining self-control. Finally, Psychoticism describes a tendency to have eccentric thoughts, perceptions, or behaviors that deviate significantly from reality.

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Study participants were 47 men who self-identified as having hypersexual disorder, and 41 men without this disorder matched for age with the hypersexual disorder group. Participants’ average age was 37-38 years.

The hypersexual disorder group was identified through a combination of self-report measures and clinical interviews, ensuring they met the diagnostic criteria for the condition. Participants with significant mental health issues, such as psychotic disorders or severe head injuries, were excluded to maintain the study’s focus on hypersexuality. The comparison group of men without hypersexual disorder was recruited through advertisements and underwent similar screening to confirm they did not exhibit hypersexual behaviors.

Study participants completed assessments of maladaptive personality traits (the Personality Inventory for DSM-5), hypersexual disorder symptoms (the Hypersexual Behavior Inventory-19), and sexual addiction symptoms (the Sexual Addiction Screening Test – revised).

The results showed that men with hypersexual disorder scored higher across all five domains of personality maladjustment compared to their counterparts. These differences were particularly pronounced in the domains of disinhibition and detachment.

• Disinhibition: Men with hypersexual disorder demonstrated higher levels of impulsivity, distractibility, and irresponsibility. These traits align with previous research suggesting that impulsivity plays a central role in behavioral addictions.
• Detachment: This group also showed increased levels of social withdrawal, anhedonia (reduced ability to experience pleasure), and suspiciousness. These traits could reflect a tendency to avoid emotional intimacy, potentially leading to reliance on sexual behavior as a coping mechanism.
• Negative affect: Men with hypersexual disorder exhibited heightened emotional instability, including hostility, separation insecurity, and perseveration (rigidity in behavior). This aligns with findings that individuals with hypersexual disorder often struggle with stress and emotional dysregulation.
• Antagonism: Traits such as attention-seeking, deceitfulness, and grandiosity were also more prevalent in the hypersexual disorder group, suggesting interpersonal challenges that may exacerbate feelings of isolation.
• Psychoticism: Elevated scores in this domain pointed to unusual thought processes and behaviors, which may contribute to maladaptive coping strategies.

Despite these differences, a logistic regression analysis indicated that no single personality domain could reliably predict whether an individual would fall into the hypersexual disorder group.

“In sum, the findings of the study underline the extent of personality maladjustment in men with HD. Interpersonal difficulties which men with HD [hypersexual disorder] frequently experience can contribute to clinically relevant levels of distress and adverse consequences reported by affected individuals,” the study authors concluded.

The study sheds light on the personality correlates of hypersexual disorder symptoms. However, it should be noted that the study’s design does not allow for causal inferences. Additionally, the study included a very small sample of men. Results from larger or more representative groups might differ.

Future research should aim to include more diverse samples, encompassing individuals from different cultural backgrounds, genders, and sexual orientations. Longitudinal studies would also help clarify whether personality maladjustments are a cause or consequence of hypersexual disorder.

The paper, “Personality dimensions of compulsive sexual behavior in the Sex@Brain study,” was authored by Jannis Engel, Marie Carstensen, Maria Veit, Christopher Sinke, Jonas Kneer, Uwe Hartmann, and Tillmann H.C. Kruge.