AUTHOR=Golder Sarah , Markert Charlotte , Psarros Rhea , Discher Julian Peter , Walter Bertram , Stark Rudolf 

TITLE=Two subtypes of compulsive sexual behavior disorder

JOURNAL=Frontiers in Psychiatry

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1248900

DOI=10.3389/fpsyt.2023.1248900

ISSN=1664-0640

ABSTRACT=<p>Models explaining addictive behaviors such as the Interaction of Person-Affect-Cognition-Execution (I-PACE) model emphasize the importance of reinforcement mechanisms for developing and maintaining these behaviors, including compulsive sexual behavior disorder (CSBD) as well as personal characteristics as vulnerability factors. This study aimed to determine whether there are CSBD subtypes distinguished by reinforcement sensitivity. We hypothesize that one subtype is sensitive to positive reinforcement (C<sup>+</sup>subtype) and one is sensitive to negative reinforcement (Ȼ<sup>−</sup>subtype). We calculated a cluster analysis with data from 62 patients with CSBD and tested differences between the identified clusters by <italic>t</italic>-test. The sample consisted only of men. Cluster variables were: the sensitivity to the <italic>Behavioral Inhibition</italic> and <italic>Approach System</italic> (BIS/BAS), the severity of depressive symptoms (BDI-II), the severity of <italic>Trait Anxiety</italic> (STAI-T), <italic>Sexual Sensation Seeking</italic> (SSSS), <italic>Thrill- and Adventure-Seeking</italic> (SSS-V subscale), <italic>Disinhibition</italic> (SSS-V subscale), <italic>Experience Seeking</italic> (SSS-V subscale), and <italic>Boredom Susceptibility</italic> (SSS-V subscale). Between-cluster differences were analyzed for <italic>Trait Sexual Motivation</italic> (TSMQ) and <italic>Sexual Compulsivity</italic> (SCS). The results showed a two-cluster solution with cluster 1 representing patients sensitive to negative reinforcement (Ȼ<sup>−</sup>subtype) and cluster 2 representing patients sensitive to positive reinforcement (C<sup>+</sup>subtype). No significant difference in symptom severity of <italic>Sexual Compulsivity</italic> between clusters was found. Cluster 2 showed higher <italic>Importance of Sex</italic> and a higher motivation to seek sexual encounters than cluster 2. We found a two-cluster solution regarding reinforcement sensitivity in patients with CSBD. This may have clinical implications regarding individual therapy by focusing on the underlying maintenance mechanisms.</p>