Sexual compulsivity among heterosexual college students.
Recent studies suggest that sexual compulsivity com·pul·sive
1. Having the capacity to compel: a frightening, compulsive novel.
2. Psychology Caused or conditioned by compulsion or obsession.
n. is related to participation in sexual behaviors sexual behavior A person's sexual practices–ie, whether he/she engages in heterosexual or homosexual activity. See Sex life, Sexual life. that are high risk for HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. infection (Benotsch, Kalichman, & Kelly, 1999; Kalichman, Greenberg, & Abel, 1997; Kalichman et al., 1994; Kalichman & Rompa, 1995; Kalichman & Rompa, 2001; Reece, Hate, & Daughtry, 2001). Sexual compulsivity has been defined as "an insistent in·sis·tent
1. Firm in asserting a demand or an opinion; unyielding.
2. Demanding attention or a response: insistent hunger.
3. , repetitive, intrusive, and unwanted urge to perform specific acts often in ritualized or routinized fashions" (Kalichman & Rompa, 1995, p. 587). Recently, some have conceptualized sexual compulsivity as a pattern of participation in sexually oriented o·ri·ent
1. Orient The countries of Asia, especially of eastern Asia.
a. The luster characteristic of a pearl of high quality.
b. A pearl having exceptional luster.
3. activities in a manner that is persistent and escalating and that has the potential to result in negative consequences for self and others, or the drive to participate in such activities (National Council on Sexual Addiction sexual addiction Sex compulsion Sexology Compulsive and ritualized sexuoerotic hyperactivity, generally under specific sexuoerotic conditions and stimuli. See Sexaholics Anonymous. and Compulsivity, 2004; Reece, 2003). Although substantial debate and skepticism surround the nature and existence of sexual compulsivity as a "pathological 1. pathological - [scientific computation] Used of a data set that is grossly atypical of normal expected input, especially one that exposes a weakness or bug in whatever algorithm one is using. condition" (Levine & Troiden, 1988), the concept has been widely studied and measured in recent sexological, psychological, and public health research (Carnes & Adams, 2002). As yet, sexual compulsivity and its associations with HIV risk behavior have only been assessed among those at high risk for infection or those who are HIV-positive.
Because the human immunodeficiency virus human immunodeficiency virus
Human immunodeficiency virus (HIV)
A transmissible retrovirus that causes AIDS in humans. (HIV) is principally transmitted through sexual and intravenous drug use intravenous drug use Intravenous drug abuse The habitual IV injection of drugs of abuse Epidemiology In the US ± 2.5 million–population ± 235 million have used IVDs Infections Pyogenic–eg, endocarditis, pneumonia, sepsis Common agents behaviors, public health researchers have examined factors related to sexual risk including substance use, sexual situations, and relationship features. Few early studies on HIV transmission considered the role of personality traits and their relation to sexual and risk behaviors. Researchers have begun to focus on individual characteristics, including the "propensity to prefer exciting, optimal, and novel stimulation or arousal arousal /arous·al/ (ah-rou´z'l)
1. a state of responsiveness to sensory stimulation or excitability.
2. the act or state of waking from or as if from sleep.
3. " known as sensation seeking (Kalichman, et al., 1994, p. 387), and their relation to sexual behaviors that may place individuals at high risk for HIV infection. Recent attention to sexual compulsivity arose from an interest in sensation seeking as the potential cause for the continuation of high risk sexual behaviors despite their potentially harmful and lethal consequences.
In earlier studies, before the dawn of the HIV epidemic, Zuckerman (1979, 1994) found that sensation seeking was associated with participation in a number of behaviors including "potentially risky experiments, sports, vocations, criminal activities, sexual behavior, smoking, heavy drinking
See also Profligacy.
constantly flits from one girl to another. [Aust. Drama: Schnitzler Anatol in Benét, 33]
promiscuous goddess of sensual love. [Gk. Myth. , in which an individual did not properly compare, for example, "the possibilities of contracting a sexually transmitted disease sexually transmitted disease (STD) or venereal disease, term for infections acquired mainly through sexual contact. Five diseases were traditionally known as venereal diseases: gonorrhea, syphilis, and the less common granuloma inguinale, against the possibility of a thrilling sexual encounter" (Zuckerman & Kuhlman, 2000, p. 1000). Kalichman et al. (1994) argued that traditional criteria for sensation seeking that were applied to sexual behaviors, including the Sensation Seeking Scale (Zuckerman, Kolin, Price, & Zoob, 1964), contained socioculturally outdated concepts and terminology that were not directly related to the sexual variables of interest.
New scales have subsequently been produced with the intention of measuring both sexual and nonsexual sensation seeking as well as sexual compulsivity as a separate and discrete phenomenon. Although the term sexual compulsivity to some extent overlaps with and has been used interchangeably INTERCHANGEABLY. Formerly when deeds of land were made, where there Were covenants to be performed on both sides, it was usual to make two deeds exactly similar to each other, and to exchange them; in the attesting clause, the words, In witness whereof the parties have hereunto with popular concepts such as sexual addiction (Carnes & Adams, 2002), sexual impulsivity (Barth & Kinder, 1987), and the established psychiatric psy·chi·at·ric
Of or relating to psychiatry.
psychiatric adjective Pertaining to psychiatry, mental disorders diagnosis of hypersexuality hypersexuality
see mounting behavior. (Montaldi, 2002), it has been most widely measured and studied as a distinct concept in relation to HIV risk behavior using the Sexual Compulsivity Scale (SCS: Kalichman & Rompa, 1995).
Originally designed in the mid-1990s to explore high risk sexual behaviors (e.g., unprotected anal intercourse Noun 1. anal intercourse - intercourse via the anus, committed by a man with a man or woman
anal sex, buggery, sodomy
sexual perversion, perversion - an aberrant sexual practice; ) in samples of men who have sex with men Men who have sex with men (MSM) is a term used mostly in the United States to classify men who engage in sex with other men, regardless of whether they self-identify as gay, bisexual, or heterosexual. (MSM MSM - Micronetics Standard MUMPS ), the SCS seeks to tap into underlying compulsive personality compulsive personality
A personality pattern characterized by rigidity, perfectionistic standards, meticulous attention to order and detail, and excessive concern with conformity, duty, and adherence to standards of conscience. traits that could be linked to a resistance to sexual behavior change despite exposure to HIV prevention messages and interventions (Kalichman et al., 1994). The instrument asks respondents to indicate the extent of their agreement to 10 statements related to compulsive com·pul·sive
Caused or conditioned by compulsion or obsession.
A person with behavior patterns governed by a compulsion.
the state of being subject to compulsion. sexually intrusive thoughts Intrusive thoughts are unwelcome, involuntary thoughts, images or unpleasant ideas that may become obsessions, are upsetting or distressing, and can be difficult to be free of and manage. , preoccupations, and behaviors (see Table 1). The statements were largely derived from a contemporary 12-step self-help manual for persons seeking recovery from so-called sexual addiction in clinical settings; specifically, these individuals complained of sexual control issues, problems managing their sexual behaviors and thoughts, or a possible belief that they might be sex addicts (CompCare, 1987; Kalichman & Rompa, 2001). Responses are given on a 4-point scale that ranges from 1 (not at all like me) to 4 (very much like me). Reliability of the SCS was originally found to be high ([alpha] = .89) in a pilot convenience sample of self-identified homosexually active men (Kalichman et al., 1994). Higher levels of compulsivity were found to be positively related to psychological constructs such as loneliness, self-esteem, and sexual self-control. In this initial sample, however, the scale did not demonstrate significant associations with high risk sexual behaviors (in terms of frequency of engaging in these behaviors).
Kalichman & Rompa (1995) used the scale in two separate convenience samples of gay men and inner-city, low-income, primarily African American African American Multiculture A person having origins in any of the black racial groups of Africa. See Race. men and women. The scale was internally consistent for both gay men ([alpha] = .86) and inner-city men and women ([alpha] = .87). Among gay men, sexual compulsivity was found to be significantly correlated with HIV risk behaviors (i.e., insertive and receptive anal intercourse without a condom 1. condom - The protective plastic bag that accompanies 3.5-inch microfloppy diskettes. Rarely, also used of (paper) disk envelopes. Unlike the write protect tab, the condom (when left on) not only impedes the practice of SEX but has also been shown to have a high failure ). Among inner-city men and women, significant associations were also found between sexual compulsivity and HIV risk behaviors (i.e., vaginal vag·i·nal
1. Of or relating to the vagina.
2. Relating to or resembling a sheath.
pertaining to the vagina, the tunica vaginalis testis, or to any sheath. intercourse without a condom, anal intercourse without a condom, masturbating a partner, and giving oral sex to a partner). The authors also found relationships between sexual compulsivity and substance use, commenting that many participants were recruited from agencies that serve people with substance abuse disorders substance abuse disorder
Any of a category of disorders in which pathological behavioral changes are associated with the regular use of substances that affect the central nervous system. . Thus, further research was recommended "'to excavate varied expressions ... of sexual compulsivity in diverse populations" (Kalichman & Rompa, 1995, p. 599).
Several studies have measured sexual compulsivity in samples of HIV-positive individuals. Benotsch et al. (1999) recruited a sample of 112 HIV-positive self-identified gay and bisexual bisexual /bi·sex·u·al/ (-sek´shoo-al)
1. pertaining to or characterized by bisexuality.
2. an individual exhibiting bisexuality.
3. pertaining to or characterized by hermaphroditism.
4. men through convenience sampling methods. Men living with HIV who scored higher in sexual compulsivity reported more frequent receptive and total unprotected anal and oral sex acts with more partners than those who scored lower on the scale. In a convenience sample of 287 primarily African American HIV-positive men and women recruited from community organizations, Kalichman & Rompa (2001) found relationships of sexual compulsivity with higher frequencies of reported sexual behaviors and higher numbers of sexual partners. Sexual compulsivity was also related to several markers of psychopathology psychopathology /psy·cho·pa·thol·o·gy/ (-pah-thol´ah-je)
1. the branch of medicine dealing with the causes and processes of mental disorders.
2. abnormal, maladaptive behavior or mental activity. (including trait trait (trat)
1. any genetically determined characteristic; also, the condition prevailing in the heterozygous state of a recessive disorder, as the sickle cell trait.
2. a distinctive behavior pattern. anxiety, obsessive-compulsiveness, pessimism pessimism, philosophical opinion or doctrine that evil predominates over good; the opposite of optimism. Systematic forms of pessimism may be found in philosophy and religion. , depression, and borderline personality disorder bor·der·line personality disorder
A personality disorder marked by a long-standing pattern of instability in interpersonal relationships, behavior, mood, and self-image that can interfere with social or occupational functioning or cause extreme ) in men but not in women.
In summary, the SCS has demonstrated reliability and construct validity construct validity,
n the degree to which an experimentally-determined definition matches the theoretical definition. in several samples of individuals that can be classified as high risk for HIV, including MSM, substance abusers, and inner-city low-income men and women. The studies have also demonstrated that compulsivity was significantly related to sexual risk behaviors in these samples. However, the reliability, construct validity, and relevance of sexual compulsivity among more general populations, such as college students, have not yet been explored. There is also limited information on the relevance of sexual compulsivity to women since many previous studies have focused solely on samples of men. If sexual compulsivity is associated with high risk sexual behavior in more general populations, health professionals may need to integrate this into the ways in which HIV prevention, education, and care services are delivered.
The aim of this study was to determine the reliability and construct validity of the SCS in a previously neglected population, specifically heterosexual heterosexual /het·ero·sex·u·al/ (-sek´shoo-al)
1. pertaining to, characteristic of, or directed toward the opposite sex.
2. one who is sexually attracted to persons of the opposite sex. college students. To assess construct validity, we determined whether sexual compulsivity was related to higher frequencies of sexual behaviors and higher numbers of sexual partners. After establishing support for reliability and construct validity, we explored associations between sexual compulsivity and select demographic variables (gender, age, and ethnicity). Lastly, we ascertained whether sexual compulsivity was predictive of sexual behaviors considered risky in terms of HIV/STD infection.
In January 2002, a sample of 899 college students ages 18 years or older completed a questionnaire in introductory health science classes at a large, public university in the Midwestern United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. . All classes used for recruitment were general elective courses Noun 1. elective course - a course that the student can select from among alternatives
course, course of instruction, course of study, class - education imparted in a series of lessons or meetings; "he took a course in basket weaving"; "flirting is that attracted a diverse cross-section of male and female college students. Coinvestigators at a university independent of where the data collection took place later analyzed an·a·lyze
tr.v. an·a·lyzed, an·a·lyz·ing, an·a·lyz·es
1. To examine methodically by separating into parts and studying their interrelations.
2. Chemistry To make a chemical analysis of.
3. the data. The study protocol materials were approved by the institutional review boards of Indiana University-Bloomington and the Columbia University Columbia University, mainly in New York City; founded 1754 as King's College by grant of King George II; first college in New York City, fifth oldest in the United States; one of the eight Ivy League institutions. Department of Psychiatry psychiatry (səkī`ətrē, sī–), branch of medicine that concerns the diagnosis and treatment of mental, emotional, and behavioral disorders, including major depression, schizophrenia, and anxiety. .
During the data collection process, a research assistant briefly described the survey and asked students to participate. Participants were told the study would investigate sexual attitudes and behaviors among college students. Participants completed questionnaires anonymously and placed them in a box in the front of the classroom when finished. We provided no incentives. Of the students who were enrolled in and attended the classes during data collection, a total of 94% responded to the survey (n = 899).
We constructed a survey for the purposes of data collection to assess a wide variety of sexuality-related variables. No identifying information, with the exception of broad demographic characteristics, was collected. We organized the variables in the following domains.
Demographics The attributes of people in a particular geographic area. Used for marketing purposes, population, ethnic origins, religion, spoken language, income and age range are examples of demographic data. . Participants provided information related to their age, class standing, size of hometown home·town
The town or city of one's birth, rearing, or main residence.
Noun 1. hometown - the town (or city) where you grew up or where you have your principal residence; "he never went back to his hometown again" , and relationship status, as well as their gender, sexual orientation sexual orientation
The direction of one's sexual interest toward members of the same, opposite, or both sexes, especially a direction seen to be dictated by physiologic rather than sociologic forces. or identity, and ethnicity.
Sexual compulsivity. We measured sexual compulsivity using the Sexual Compulsivity Scale (Kalichman & Rompa, 1995: see Table 1). Mean scores are based on responses to the 10-item scale, with a possible range from 1 to 4.
Sexual behaviors. Survey items measured participants" frequencies of various sexual activities with men and women, as well as numbers of male and female sex partners, in the past 3 months. We asked participants to report how many times and with how many partners they had engaged in a wide variety of sexual activities. The following subscales were created from individual variables to represent the frequency and variety of sexual activities: partner sex activities (kissing, fingering, rimming, mutual masturbation masturbation
Erotic stimulation of one's own genital organs, usually to achieve orgasm. Masturbatory behavior is common in infants and adolescents, and is indulged in by many adults as well. Studies indicate that over 90% of U.S. males and 60–80% of U.S. , vaginal intercourse, anal intercourse, and oral interaction): solo sex activities (masturbation alone+ with toys, with sexually explicit videos, with sexually explicit computer images, with magazines, with an on-line computer partner, and with a phone partner): and public sex activities (sexual activity in a campus restroom, other public restroom, public park, car, locker-room, sauna sauna
Bath in steam from water thrown on heated stones. Known in ancient times in various places, saunas are most closely identified with the Finnish people, who made saunas a national tradition. , or other public or semipublic sem·i·pub·lic
1. Partially but not entirely open to the use of the public: prohibited smoking in public and semipublic places.
2. venue). We chose to examine public sex behaviors among heterosexual college students since previous studies have suggested that sexual compulsivity may be related to public sex but have only examined the phenomenon among MSM who engage in sex in public and commercial sex environments (Benotsch et al., 1999: Reece & Dodge, 2004a, 2004b: Reece & Dodge, 2003). Higher scores on each subscale represent a greater frequency of participation in the various sexual activities and, in the case of partner sex and public sex, with a greater number of sexual partners. We determined reliability of the sexual behavior subscales to be acceptable for partner sex ([alpha] = .76), solo sex ([alpha] = .73), and public sex ([alpha] = .68).
The survey also measured frequencies of protected and unprotected anal. vaginal, and oral sex. We created subscales to assess risky sex, in terms of possible HIV/STD infection, for men (number of partners and times for unprotected oral sex and unprotected insertive vaginal and anal intercourse) and for women (number of partners and times for unprotected oral sex and unprotected receptive vaginal and anal intercourse). Reliability of the risky sexual behavior subscales was determined to be acceptable for men ([alpha] = .75) and for women ([alpha] = .76).
Data analyses included descriptive and inferential in·fer·en·tial
1. Of, relating to, or involving inference.
2. Derived or capable of being derived by inference.
in statistical techniques and were conducted in several steps. First, we assessed reliability of the SCS. Next, where appropriate, we used Spearman's correlations, analyses of variance (ANOVAs), independent-samples t tests, and Pearson's correlations to determine the construct validity of the scale as well as to explore the potential bivariate bi·var·i·ate
Mathematics Having two variables: bivariate binomial distribution.
Adj. 1. relationships between sexual compulsivity and select demographic variables (gender, age, ethnicity, and sexual relationship status). Using Pearson's correlations, we examined the association between sexual compulsivity and risky sexual behaviors and we employed univariate ANOVAs to investigate the relationships between the SCS and specific sexual activities (solo sex, partner sex, public sex, and risky sex) while controlling for select demographic variables.
A total of 899 participants responded to the survey. We analyzed data from 876 self-identified heterosexual participants (Table 2). We excluded 15 bisexual, 6 gay, and 1 questioning participant since low response rates of nonheterosexual individuals prohibited further analyses and comparisons based on sexual orientation or identity. The sample consisted of 37% men (N = 325) and 63% women (n = 551). The mean age was 20.2 years (SD = .87). Eighty-nine percent identified as White (n = 777), 5% as Black (n = 45), and the remaining 6% as other ethnicities (n = 54). These demographics closely approximated the overall composition of the student body of the university from which the sample was drawn (mean age = 20.3.89% White, 5% Black).
In terms of sexual relationship status, 46% (n = 397) of the total participants reported currently being in an exclusive sexual relationship (that is, a relationship in which the two individuals engage in sexual activity exclusively with each other). An additional 21% (n = 183) reported current involvement in nonexclusive sexual situations (either currently maintaining multiple intimate relationships An intimate relationship is a particularly close interpersonal relationship. It is a relationship in which the participants know or trust one another very well or are confidants of one another, or a relationship in which there is physical or emotional intimacy. with several different sexual partners or currently engaging in sexual activity with multiple partners but not maintaining any sort of intimate relationship). The remainder of the participants (33%, n = 288) reported not being currently sexually active.
We found a significant relationship between gender and sexual relationship status, [chi square chi square (kī),
n a nonparametric statistic used with discrete data in the form of frequency count (nominal data) or percentages or proportions that can be reduced to frequencies. ] (2, n = 876) = 45.02, p < 0.001. Women were significantly more likely to report being in exclusive sexual relationships (52%, n = 281) than men (36%, n = 116). Men were also significantly more likely to report current involvement in nonexclusive sexual situations (33%, n = 106) than were women (14%, n = 77). We did not find significant differences between men and women in terms of age and ethnicity.
We determined that the reliability of the Sexual Compulsivity Scale was high in the total study sample ([alpha] = .82). In addition, we found high reliability for the subgroups of male participants ([alpha] = .77) and female participants ([alpha] = .81) within the sample. All item-total correlations were .40 or higher (see Table 1).
We found a significant relationship between sexual compulsivity and partner sex activities, r(876) = 0.14, p < 0.001 (see Table 2). Individuals who reported a broader range of partner sex activities with higher frequencies had higher sexual compulsivity scores.
A significant relationship between solo sex activities and sexual compulsivity also emerged, r(876) = 0.38, p < 0.001. Participants who reported a broader range of masturbatory mas·tur·ba·to·ry
1. Of or relating to masturbation.
2. Excessively self-indulgent or self-involved: "[The play's] star . . . activities with higher frequencies were more likely to have higher sexual compulsivity scores.
The data also revealed a significant relationship between public sex activities and sexual compulsivity, r(876) = 0.24, p < 0.001. Participants who reported a broader range of public sex activities with higher frequencies were more likely to have higher sexual compulsivity scores.
Lastly, we found a significant association between sexual compulsivity and self-reported sexual relationship status, F(2, 865) = 31.37, p < 0.001. Tukey HSD HSD Human Services Department
HSD High Speed Data
HSD Hillsboro School District (Hillsboro, OR)
HSD Hybrid Synergy Drive (Toyota/Lexus)
HSD High School Diploma
HSD Historical Society of Delaware post-hoc analyses revealed that participants who reported current involvement in nonexclusive sexual situations (M = 1.64, SD = .39) were significantly more likely to have higher sexual compulsivity scores than those who reported exclusive sexual relationships (M = 1.40, SD = .35) and those who reported not being currently sexually active (M = 1.39, SD = .37).
The relationships between solo, partner, and public sex activities and sexual compulsivity all remained significant when we controlled for demographic variables (Table 3).
We found a significant difference between men and women in terms of sexual compulsivity scores, t(876) = 12.63, p < 0.001, d = .81 (Table 2). Mean scores of sexual compulsivity were higher for men (M = 1.64, SD = .40) than for women (M = 1.33, SD = .32).
A significant relationship was also present between sexual compulsivity scores and age. As age decreased, participants were more likely to have higher mean scores of sexual compulsivity, r(876) = 0.13, p < 0.001. Results did not reveal significant differences in levels of sexual compulsivity when groups were compared by ethnicity.
Risky Sexual Behaviors
Sexual compulsivity was positively related to sexual behaviors considered to be risky in terms of HIV/STD infection for both male and female participants (Table 2). Men and women who had higher sexual compulsivity scores were more likely to have engaged in unprotected oral, vaginal, and anal sex Noun 1. anal sex - intercourse via the anus, committed by a man with a man or woman
anal intercourse, buggery, sodomy
sexual perversion, perversion - an aberrant sexual practice; in the preceding 3 months, respectively r(325) = 0.24, p < 0.001 and r(551) = 0.16, p < 0.001. The relationship between risky sexual behaviors and sexual compulsivity remained significant when we controlled for demographic variables (Table 3).
As in studies of high risk individuals and those living with HIV, sexual compulsivity appears to be a relevant construct for describing elevated levels of sexual practices with multiple partners in our sample of heterosexual college students (Kalichman & Rompa, 1995. 2001). The SCS was determined to have high reliability. We found support for construct validity in the results showing that individuals who reported higher frequencies of partner sex, solo sex, and public sex activities were more likely to have higher sexual compulsivity scores. Additionally, participants who reported involvement in nonexclusive sexual situations (i.e., multiple sexual partners) were more likely to have higher sexual compulsivity scores than those who reported involvement in exclusive sexual relationships and those who were not currently sexually, active. Given reliability and construct validity, we found significant relationships between sexual compulsivity and gender and age. Lastly, in relation to HIV/STD risk, men and women who had higher sexual compulsivity scores were more likely to report higher frequencies of unprotected oral. vaginal, and anal sex in the preceding 3 months.
The limitations of our study must be considered while interpreting the results. As with all previous research using the SCS, our findings are based on a convenience sample that cannot be considered representative. The focus of our study was heterosexual college students, and it is possible that college students may respond differently to a questionnaire on human sexuality This article is about human sexual perceptions. For information about sexual activities and practices, see Human sexual behavior.
Generally speaking, human sexuality is how people experience and express themselves as sexual beings. than their peers who do not attend college. Thus, generalization gen·er·al·i·za·tion
1. The act or an instance of generalizing.
2. A principle, a statement, or an idea having general application. of the findings beyond tiffs sample must be done with caution.
As with the majority of research on human sexual behavior
The frequency of sexual intercourse might range from zero (sexual abstinence) for some to 15 or 20 times a week. , underreport un·der·re·port
tr.v. un·der·re·port·ed, un·der·re·port·ing, un·der·re·ports
To report (income or crime statistics, for example) as being less than actually is the case. the frequency of sexual activities, misunderstand mis·un·der·stand
tr.v. mis·un·der·stood , mis·un·der·stand·ing, mis·un·der·stands
To understand incorrectly; misinterpret. a question due to lack of knowledge and respond inaccurately, or answer questions in ways that they feel are socially desirable. However, previous work also suggests that survey measures of self-report can be valid and reliable in sexuality research (Turner, Miller, & Rogers, 1997).
Table 4 situates our study within the previous literature exploring the SCS in other samples; it shows that in our study, sexual compulsivity scores for heterosexual male college students were within the lower range of scores and scores for heterosexual female college students were relatively lower in comparison to other studies. It is notable that in all of these san]pies, as in ours, mean scores on the SCS were significantly higher among men than women. Additionally, SCS scores were especially elevated in a sample of primarily ethnic minority gay and bisexual men (2.06. SD = .61, Reece, 2003) and men living with HIV (2.05, SD = .64, Reece et al., 2001). While gender may be a potential explanatory factor for higher compulsivity scores in these samples, the higher scores may also be due to the fact that individuals in these two samples had identified a level of psychological distress psychological distress The end result of factors–eg, psychogenic pain, internal conflicts, and external stress that prevent a person from self-actualization and connecting with 'significant others'. See Humanistic psychology. that resulted in their enrollment in mental health care programs.
As with high risk samples, sexual compulsivity was a predictor of unprotected sexual activity in our study, although correlations between sexual compulsivity scores and several sexual behavior variables were relatively low. It is still not understood how sexual compulsivity functions in relation to sexual risk after the concept has been identified and measured. Zuckerman and Kuhlman (2000) presented a "'biosocial model" to better explain risk taking (including sexual), in which they hypothesized that risk taking is related to impulsive im·pul·sive
1. Inclined or tending to act on impulse rather than thought.
2. Motivated by or resulting from impulse.
im·pul sensation seeking, aggression, and sociability as well as several biological traits associated with general risk taking and sensation-seeking personality. This work has implications for sexual compulsivity in that it could lead to a deeper understanding of its causes and potential treatments: however, such a theoretical model has not yet emerged for sexual compulsivity and related sexual risk-taking behavior.
Several of the substantive findings in our study are interesting and deserve deeper exploration. For example, the SCS was more highly correlated with solo sex activities than with partner sex or public sex activities. In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke"
put differently , it appears that sexual compulsivity is more successful in predicting masturbatory behaviors than partner or public sex behaviors. The reason for this may be that masturbatory behaviors are, by nature, intrapersonal in·tra·per·son·al
Existing or occurring within the individual self or mind.
intra·per and usually not dependent on other individuals, while partner and public sex behaviors are. Although the solo sex activities we assessed may involve other individuals, such as those with an on-line partner or telephone partner, these require less personal interaction and commitment than sexual activities involving "real time" sexual partners.
The relationships of sexual compulsivity with gender and age in our sample also warrant further discussion. We found that mean scores for sexual compulsivity were significantly higher for male participants than female participants. Kalichman and Rompa (1995, 2001) found similar results in samples of primarily African American HIV-positive men and women and inner-city participants. In addition, younger participants in our sample had higher sexual compulsivity scores than older participants. These findings raise the question of whether the SCS, despite its construct validity and the face validity face validity (fāsˑ v·liˑ·di·tē),
n of the scale items, actually measures sexual compulsivity or if it taps into other constructs, such as sexual desire and sexual exploration, as well.
Differences in sexual compulsivity scores between men and women resemble broader gender differences found in sexuality research that suggest a stronger sexual desire in men. Women have reported less frequent masturbation, less accepting attitudes toward casual sexual encounters, and less consistency in orgasms than men in select samples (Hyde & DeLamater, 2000). These gender differences have been interpreted in the context of not only the wide array of biological differences between men and women but also the numerous and complex gender-related socio-cultural factors that shape human sexuality, including restrictive sex roles and double standards traditionally ascribed to female sexuality.
Differences in compulsivity scores by age resemble differences in human sexual desire across the life course, which we believe may be developmental in nature. Hyde and DeLamater (2000) suggest that roughly between the ages of 13 and 19, "[a] surge of sexual interest occurs around puberty puberty (py`bərtē), period during which the onset of sexual maturity occurs. and continues through adolescence ... [H]eightened sexual arousal sexual arousal Horny/horniness, randy/randiness Physiology A state of sexual 'yellow alert' which has a mental component–↑ cortical responsiveness to sensory stimulation, and physical component–↑ penile sensitivity, neural response to stimuli, may be caused by a number of factors, including bodily changes and an awareness of them, rises in levels of sex hormones sex hormone
Any of various steroid hormones, such as estrogen and androgen, affecting the growth or function of the reproductive organs and the development of secondary sex characteristics. , and increased cultural emphasis on sex and rehearsal for adult gender roles" (p. 293). The interaction of biological and especially social factors during the early college years (including dormitory living, mass media, and new opportunities in the vast sexual landscape of the university setting) reinforce that age is related to sexual desire.
Thus, the extent to which the SCS captures constructs other than sexual compulsivity, including sexual desire and sexual exploration, is not clear. Heterosexual college students in particular are a population with easy access to multiple sexual partners and a wide array of sexual opportunities. The university atmosphere itself often encourages and promotes a sense of social and sexual exploration among students (Strong, DeVault, Sayad, & Yarber, 2005, p. 191). What may appear to be pathological compulsive sexual behavior to researchers and health professionals may actually be experienced as normal sexual exploration by college students. Recent studies on sexual behaviors of college students, including the college ritual of "hooking up," suggest that researchers must be keenly aware that meanings of various forms of sexual expression may be unique to college students themselves (Sanders & Reinisch, 1999).
Considering this, future studies are needed to determine the practical significance of sexual compulsivity among heterosexual college students and various other populations. These studies should evaluate the presence of actual negative health outcomes in individuals who score higher on measures of sexual compulsivity and who engage in more frequent sexual risk behaviors so that health professionals may develop and tailor HIV/STD education and intervention efforts as needed as needed prn. See prn order. . Researchers should also design, test, and refine potential therapeutic treatments and interventions for sexual compulsivity, if it is determined to exist as a clinical condition through further sociomedical inquiry. Last, although one of the aims of our study was to focus solely on self-identified heterosexual college students, we acknowledge that further research is needed to explore the significance of sexual compulsivity for diverse samples of bisexual men and women, gay men, lesbians, transgenders, and other individuals to determine if they have different issues and needs than do high risk gay men and men who have sex with men or heterosexual individuals.
Table 1: The Sexual Compulsivity Scale (a): Reliability in Our Sample ([alpha] = .82) Item-total Item correlation My sexual appetite has gotten in the way of my relationships. .46 My sexual thoughts and behaviors are causing problems in my life. .52 My desires to have sex have disrupted my daily life. .60 I sometimes fail to meet my commitments and responsibilities because of my sexual behaviors. .44 I sometimes get so horny I could lose control. .50 I find myself thinking about sex while at work. .53 I feel that sexual thoughts and feelings are stronger than 1 am. .57 I have to struggle to control my sexual thoughts and behavior. .62 I think about sex more than 1 would like to. .45 It has been difficult for me to find sex partners who desire having sex as much as I want to. .41 (a) Kalichman & Rompa, 1995. Table 2. Description of the Sample, Sexual Compulsivity, and its Relation to Demographic and Behavioral Variables Variable N (%) Mean (SD) Gender Male 325 (37.1) Female 551 (62.9) Age 20.20 (0.87) Ethnicity White 777 (88.7) Black 45 (5.1) Other 54 (6.2) Sexual relationship status Exclusive 397 (45.7) Nonexclusive 183 (21.1) Not sexually active 288 (33.2) Sexual behaviors Solo sex (1.0-7.0) 1.55 (0.66) Partner sex (1.0-7.0) 2.40 (0.84) Public sex (1.0-6.0) 1.18 (0.31) Risky sexual behaviors Unprotected oral, vaginal, anal sex (male, 1.00-6.00) 1.57 (0.56) 1.00-5.00 Unprotected oral, vaginal, anal sex (female, 1.00-6.00) 1.68 (0.64) 1.00-4.50 Sexual compulsivity Variable Range mean (SD) Gender Male 1.64 (0.40) Female 1.33 (0.32) Age 18.00-25.00 Ethnicity White 1.45 (0.38) Black 1.39 (0.39) Other 1.53 (0.44) Sexual relationship status Exclusive 1.40 (0.35) Nonexclusive 1.64 (0.39) Not sexually active 1.39 (0.37) Sexual behaviors Solo sex (1.0-7.0) 1.00-5.00 Partner sex (1.0-7.0) 1.00-4.86 Public sex (1.0-6.0) 1.00-3.33 Risky sexual behaviors Unprotected oral, vaginal, anal sex (male, 1.00-6.00) r = 0.24 *** Unprotected oral, vaginal, anal sex (female, 1.00-6.00) r = 0.16 *** Variable F/t/r Gender Male Female t = 12.63 *** Age r = 0.13 *** Ethnicity White Black Other F = 1.74 Sexual relationship status Exclusive Nonexclusive Not sexually active F = 31.37 *** Sexual behaviors Solo sex (1.0-7.0) r = 0.38 *** Partner sex (1.0-7.0) r = 0.14 *** Public sex (1.0-6.0) r = 0.24 Risky sexual behaviors Unprotected oral, vaginal, anal sex (male, 1.00-6.00) Unprotected oral, vaginal, anal sex (female, 1.00-6.00) * p < 0.05. ** p < 0.01. *** p < 0.001. Table 3. Analyses of Variance for Sexual Activities and Sexual Compulsivity Scores, Controlling for Demographic Variables Adjusted Independent variables df MS F [R.sup.2] Solo sex activities 21 0.65 6.13 *** Gender 1 1.71 16.13 *** Age 1 0.36 3.35 Ethnicity 1 0.04 0.34 Not sexually active vs. others 1 0.04 0.40 Nonexclusive vs. others 1 2.14 20.19 *** 0.28 Partner sex activities 33 0.26 2.29 *** Gender 1 12.25 107.56 *** Age 1 0.37 3.26 Ethnicity 1 0.06 0.56 Not sexually active vs. others 1 0.48 4.29 * Nonexclusive vs. others 1 4.34 38.13 *** 0.22 Public sex activities 18 0.67 6.13 *** Gender 1 11.36 104.27 *** Age 1 0.99 9.11 ** Ethnicity 1 0.07 0.67 Not sexually active vs. others 1 0.06 0.55 Nonexclusive vs. others 1 2.48 22.67 *** 0.24 Risky sexual activities (male) 18 0.35 11.66 *** Gender 1 7.42 66.24 *** Age 1 0.41 3.62 ** Ethnicity 1 0.01 0.04 Not sexually active vs. others 1 4.16 37.06 ** Nonexclusive vs. others 1 0.35 3.13 ** 0.22 Risky sexual activities (female) 18 0.45 12.35 *** Gender 1 12.83 117.28 *** Age 1 0.23 2.12 Ethnicity 1 0.05 0.42 Not sexually active vs. others 1 4.20 38.39 *** Nonexclusive vs. others 1 0.66 6.03 ** 0.24 * p < 0.05. ** p < 0.01. *** p < 0.001. Table 4. Reported Mean Scores on the SCS Across Recent Studies Previous studies Description of sample This study Heterosexual college students Reece, 2003 MSM living with HIV Benotsch, Kalichman, & Kelly, 1999 MSM living with HIV Reece, Plate, & Daughtry, 2001 Individuals living with HIV Kalichman & Rompa, 2001 Individuals living with HIV Benotsch, Kalichman, & Pinkerton. 2001 Individuals living with HIV Kalichman & Rompa, 1995 Low-income individuals Parsons, Bimbi, & Halkitis, 2001 Gaylbisexual male sex workers Reece & Dodge, 2004a MSM/MSMW campus cruisers Cooper, Delmonico, & Burg, 2000 Internet users Reported mean scores (SD) on sexual compulsivity scale (a) Previous studies Men Women This study 1.64 (.40) 1.33 (.32) Reece, 2003 2.06 (61) n/a Benotsch, Kalichman, & Kelly, 1999 1.87 (.66) n/a Reece, Plate, & Daughtry, 2001 2.05 (.64) 1.61 (.39) Kalichman & Rompa, 2001 1.60 (.63) 1.40 (.64) Benotsch, Kalichman, & Pinkerton. 2001 1.64 (.72) 1.42 (.64) Kalichman & Rompa, 1995 1.87 (.72) 1.51 (.55) Parsons, Bimbi, & Halkitis, 2001 1.92 (.69) n/a Reece & Dodge, 2004a 1.80 (.43) n/a Men and women combined Cooper, Delmonico, & Burg, 2000 1.76 (.62) Note. If a summed score was presented, it was divided by 10 for consistency. MSM = men who have sex with men. MSMW = men who have sex with both men and women. (a) Kalichman & Rompa, 1995.
Barth, R. J., & Kinder, B. N. (1987). The mislabeling mislabeling,
n 1. the inaccurate identification of a product in which the label lists ingredients or components that are not actually included within the product.
2. of sexual impulsivity. Journal of Sex & Marital Therapy, 13, 15-23.
Benotsch, E. G., Kalichman, S. C., & Kelly, J. A. (1999). Sexual compulsivity and substance use in HIV-seropositive men who have sex with men: Prevalence and predictors of high-risk behaviors high-risk behavior Public health A lifestyle activity that places a person at ↑ risk of suffering a particular condition. See Safe sex practices. . Addictive Behaviors Addictive behavior is any activity, substance, object, or behavior that has become the major focus of a person's life to the exclusion of other activities, or that has begun to harm the individual or others physically, mentally, or socially. , 24, 857-868.
Benotsch, E. G., Kalichman, S. C., & Pinkerton, S. D. (2001). Sexual compulsivity in HIV-positive men and women: Prevalence, predictors, and consequences of high-risk behaviors. Sexual Addiction and Compulsivity, 8, 83-99.
Carnes, P. J., & Adams, K. M. (Eds.). (2002). Clinical management of sex addiction. New York New York, state, United States
New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of : Brunner-Routledge.
CompCare. (1987). Hope and recovery: A twelve-step guide for healing from compulsive sexual behavior. Minneapolis, MN: Author.
Cooper, A., Delmonico, D. L., & Burg, R. (2000). Cybersex The online equivalent of a telephone sex line, with two differences. First, it typically takes place in a chat room or IRC channel. Second, it is almost always a non-paid conversation between consenting adults. users, abusers, and compulsives: New findings and implications. Sexual Addiction and Compulsivity, 7, 5-29.
Hyde, J. S., & DeLamater, J. D. (2000). Understanding human sexuality. Boston: McGraw-Hill Higher Education higher education
Study beyond the level of secondary education. Institutions of higher education include not only colleges and universities but also professional schools in such fields as law, theology, medicine, business, music, and art. .
Kalichman, S. C., Greenberg, J., & Abel, G. G. (1997). HIV-seropositive men who engage in high-risk sexual behavior: Psychological characteristics and implications for prevention. AIDS Care, 9, 441-450.
Kalichman, S. C., Johnson, J. R., Adair, V., Rompa, D., Multhauf, K., & Kelly, J. A. (1994). Sexual sensation seeking: Scale development and predicting AIDS-risk behavior among homosexually active men. Journal of Personality Assessment, 62, 385-397.
Kalichman, S. C., & Rompa, D. (1995). Sexual sensation seeking and compulsivity scales: Reliability, validity, and predicting HIV risk behavior. Journal of Personality Assessment, 65, 586-601.
Kalichman, S. C., & Rompa, D. (2001). The sexual compulsivity scale: Further development and use with HIV-positive persons. Journal of Personality Assessment, 76, 379-395.
Levine, M. P., & Troiden, R. R. (1988). The myth of sexual compulsivity. The Journal of Sex Research, 25, 347-363.
Montaldi, D. F (2002). Understanding hypersexuality with an Axis II Axis II Psychiatry A dimension used with DSM-IV, which includes personality disorders: paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, dependent, obsessive-compulsive, personality “NOS” and mental retardation. model. Journal of Psychology & Human Sexuality, 14(4), 1-23.
National Council on Sexual Addiction and Compulsivity. (2004). Sexual addiction. Retrieved March 16, 2004, from http://www.ncsac.org/ addicts/papers_sexual_addiction.aspx
Parsons Parsons, city (1990 pop. 11,924), Labette co., SE Kans.; inc. 1871. It is a shipping point for dairy products, grain, and livestock. Manufactures include ammunition, wire and paper products, plastics, and appliances. , J. T., Bimbi, D., & Halkitis, P. N. (2001). Sexual compulsivity among gay/bisexual male escorts who advertise on the internet. Sexual Addiction and Compulsivity, 8, 101-112.
Reece, M. (2003). Sexual compulsivity and HIV serostatus disclosure among men who have sex with men. Sexual Addiction & Compulsivity, 10, 1-11.
Reece, M., & Dodge, B. (2003). Exploring the physical, mental, and social well-being among gay and bisexual men who cruise for sex on a college campus. Journal of Homosexuality The Journal of Homosexuality (ISSN 0091-8369) is a long-standing peer-reviewed academic journal (founding editor Charles Silverstein) published by The Haworth Press, Inc., in New York. , 46(1/2), 111-136.
Reece, M., & Dodge, B. (2004a). Exploring indicators of sexual compulsivity among men who cruise for sex on campus. Sexual Addiction & Compulsivity, 11, 1-27.
Reece, M., & Dodge, B. (2004b). A study in sexual health applying the principles of community-based participatory research Community-based participatory research (CBPR) is research that is conducted as an equal partnership between traditionally trained "experts" and members of a community. In CBPR projects, the community participates fully in all aspects of the research process. . Archives of Sexual Behavior Archives of Sexual Behavior is an academic sexology journal and the official publication of the International Academy of Sex Research.
Contributions consist of empirical research (both quantitative and qualitative), theoretical reviews and essays, clinical case , 33, 235-247.
Reece, M., Plate, P. L., & Daughtry, M. (2001). HIV prevention and sexual compulsivity: The need for an integrated strategy of public health and mental health. Sexual Addiction & Compulsivity, 8, 157-167.
Sanders, S., & Reinisch, J. (1999). "Would you say you had sex if ...?" Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. , 281,275-277.
Strong, B., DeVault, C., Sayad, B. W., & Yarber, W. L. (2005). Human sexuality: Diversity in contemporary America (5th ed.). New York: McGraw Hill Higher Education.
Turner, C. F., Miller, H. G., & Rogers, S. M. (1997). Survey measurement of sexual behavior: Problems and progress. In J. Bancroft (Ed.), Researching sexual behavior (pp. 37-60). Bloomington: Indiana University Press Indiana University Press, also known as IU Press, is a publishing house at Indiana University that engages in academic publishing, specializing in the humanities and social sciences. It was founded in 1950. Its headquarters are located in Bloomington, Indiana. .
Zuckerman, M. (1979). Sensation seeking: Beyond the optimal level of arousal. Hillsdale, NJ: Erlbaum.
Zuckerman, M. (1994). Behavioral expressions and biosocial bi·o·so·cial
Of or having to do with the interaction of biological and social forces: the biosocial aspects of disease.
bi bases of sensation seeking. New York: Cambridge University Press Cambridge University Press (known colloquially as CUP) is a publisher given a Royal Charter by Henry VIII in 1534, and one of the two privileged presses (the other being Oxford University Press). .
Zuckerman, M., Kolin, E. A., Price, L., & Zoob, M. (1964). Development of a sensation seeking scale. Journal of Consulting and Clinical Psychology The Journal of Consulting and Clinical Psychology (JCCP) is a bimonthly psychology journal of the American Psychological Association. Its focus is on treatment and prevention in all areas of clinical and clinical-health psychology and especially on topics that appeal to a broad , 28, 477-482.
Zuckerman, M., & Kuhlman, D. M. (2000). Personality and risk-taking: Common biosocial factors. Journal of Personality Psychology, 68, 999-1029.
Manuscript accepted April 13, 2004
Columbia University/New York State Psychiatric Institute
Indiana University Indiana University, main campus at Bloomington; state supported; coeducational; chartered 1820 as a seminary, opened 1824. It became a college in 1828 and a university in 1838. The medical center (run jointly with Purdue Univ.
Sara L. Cole
Illinois State University ISU is recognized in the prestigious US News rankings as a "National University", that is, a university which grants a variety of doctoral degrees and strongly emphasizes research.
Theo G. M. Sandfort
Columbia University/New York State Psychiatric Institute
Support for this project was provided by funds from the William L. Yarber Professorship in Sexual Health, awarded to the second author. During the production of this manuscript, the first author acknowledges support in the form of Center Grant P30 MH43520 from the National Institute of Mental Health The National Institute of Mental Health (NIMH) is part of the federal government of the United States and the largest research organization in the world specializing in mental illness. to the HIV Center for Clinical and Behavioral Studies, Anke A. Ehrhardt, Ph.D., Principal Investigator Noun 1. principal investigator - the scientist in charge of an experiment or research project
scientist - a person with advanced knowledge of one or more sciences , and NRSA NRSA National Research Service Award (US National Institutes of Health)
NRSA National Remote Sensing Agency (India)
NRSA Non-Revenue Space Available (airline travel) T32 MH19139, Behavioral Sciences behavioral sciences,
n.pl those sciences devoted to the study of human and animal behavior. Research in HIV Infection, Anke A. Ehrhardt, Ph.D., Program Director.
Address correspondence to Brian Dodge, Ph.D., HIV Center for Clinical and Behavioral Studies, Columbia University/New York State Psychiatric Institute, 1051 Riverside Drive A number of cities around the world have a Riverside Drive.
In the United States: