Impulsivity and sexual compulsivity - a comparison of untreated individuals with CSBD, individuals undergoing long-term treatment for CSBD, and a healthy control group

Background – Compulsive Sexual Behavior Disorder (CSBD) has been classified in the eleventh revision of the International Classification of Diseases (ICD-11) as an impulse control disorder. Impulsivity, risk-taking, and compulsivity play an important role in CSBD. Aims – The present study aims to examine impulsivity and sexual compulsivity by comparing three groups: untreated individuals with CSBD, individuals undergoing long-term treatment for CSBD, and a healthy control group. The study aims to use questionnaires and computerized tasks measuring risk-taking and delay discounting in order to investigate impulsivity in untreated and treated individuals for CSBD and control participants. Methods – Seventy-seven men participated in the study: 26 untreated individuals with CSBD (M = 29.92, SD = 7.05), 26 individuals with CSBD in treatment (M = 32.12, SD = 10.09), and 25 controls (M = 29.32, SD = 4.88). Participants completed five questionnaires: a demographic questionnaire, the Bergen–Yale Sex Addiction Scale (BYSAS), the Sexual Risk Survey (SRS), the Cyber Pornography Use Inventory (CPUI), and the Yale-Brown Obsessive-Compulsive (Y-BOCS) questionnaire. In addition, they completed two computerized tasks: the Balloon Analogue Risk Task and the Experiential Delay Discounting Task. Results – CSBD Individuals, both treated and untreated, scored higher on measures of sex addiction, pornography use, and obsessive-compulsive, but not on the sexual risk survey compared with the control group. Untreated individuals with CSBD showed greater risk-taking and difficulty in delaying gratification, indicating impulsivity, compared with treated individuals. A linear regression analysis showed that sexual compulsivity and delay discounting explained 71.2% of the variance of sex addiction scores. Follow-up analyses indicated that the untreated CSBD group demonstrated a higher rate of severe and extreme symptom levels compared to the untreated group. Finally, impulsivity and compulsivity were correlated across groups. Discussion and conclusions – The findings of this study provide evidence of risk-taking and difficulty delaying gratification, indicating greater impulsivity in untreated individuals than in treated individuals. Furthermore, there were no group differences in ratings of sexual risk-taking measures (SRS), but this finding may be limited by low statistical power and social desirability. The data also highlight the role of sexual compulsivity in CSBD and the need for longitudinal studies with larger samples.