This study aimed to assess the best combination of indicators of problematic hypersexuality (PH), in a survey (n = 58,158) targeting individuals wondering if they were sex addicted. The survey allowed for testing of criteria from three theoretical models used to conceptualize PH. Factor analyses for women and men yielded an interpretable grouping of indicators consisting of four factors. In subsequent logistic regressions, these factors were used as predictors for experiencing the need for help for PH. The factors Negative Effects and Extreme positively predicted experiencing the need for help, with Negative Effects as the most important predictor for both women and men. This factor included, among others, withdrawal symptoms and loss of pleasure. The Sexual Desire factor negatively predicted the need for help, suggesting that for the targeted population more sexual desire leads to less PH. The Coping factor did not predict experiencing the need for help. Outcomes show that a combination of indicators from different theoretical models best indicates the presence of PH. Therefore, a measurement instrument to assess existence and severity of PH should consist of such a combination. Theoretically, this study suggests that a more comprehensive model for PH is needed, surpassing existing conceptualizations of PH.

We investigated the effect of fluctuations in negative and positive affect on momentary sexual motivation in a sample of women and men in a steady relationship (n = 133). Sexual motivation was regarded as the aggregate of sexual desire, subjective sexual arousal and openness to sexual contact. Experience sampling methodology was used to collect up to 70 measurements per participant over a period of seven consecutive days of sexual motivation, and negative and positive affect. Using multilevel analysis, we investigated cross-level interactions between affect and trait measures as specified in the dual control model (DCM). This model postulates sexually excitatory and inhibitory mechanisms as relatively independent systems that together can explain individual differences in sexual motivation and behavior. Results implicated that any intensification of feelings, positive or negative, was associated with a momentary increase in sexual motivation for participants more prone to sexual excitation. In the lagged analysis, higher preceding negative affect, measured 1–2 h earlier, forecasted an increase in current sexual motivation for participants more prone to sexual excitation. The lagged analysis included the autoregressive effect or inertia of sexual motivation. Inertia reflects the extent to which sexual motivation lingers and persists at similar levels. Our findings showed that sexual motivation levels persisted less in individuals with higher sexual inhibition proneness due to threat of performance failure. This study demonstrated how experience sampling methodology can be used to extend research on associations between mood and sexual motivation and implicates that DCM factors moderate these associations.

Objective The first objective was to assess the psychometric properties of the 92-item Dutch Naming Test (DNT-92), developed to assess word finding difficulties in people with aphasia, using Item Response Theory (IRT). The second objective was to select suitable items for a short version with a discriminative purpose. Method This study has a retrospective, psychometric research design, in which 510 DNT-92-forms of people with aphasia and 192 DNT-forms of healthy participants were used for analyses. An IRT analysis was performed and information on the item- and person parameters was obtained. Item selection for the short version was based on a combination of the discriminative ability of the items and their estimated theta or difficulty. Items with the highest information load, and a difficulty parameter in the range of overlap between the sample of people with aphasia and healthy participants were selected. Results A 2-PL IRT analysis showed best fit to the data. Assumptions of unidimensionality, local independence, and monotonicity were met. Items were removed incrementally, whilst checking sensitivity and specificity of the remaining short form. A selection of six items proved optimal in terms of sensitivity and specificity, with an area under the curve value of 0.85. Differences were found between participants younger than 70 and older. Conclusions The IRT assumptions for the DNT-92 were met, indicating that the test has good psychometric properties. A reduction of items to just six items proved possible, leading to a reliable six item short form with a discriminatory purpose.

In the present study, we explore the proposed cyclic models for problematic hypersexuality (PH) that involve shame, self-esteem, and sexual desire. These cyclic models are characterized by temporal associations but have not been investigated previously with intensive longitudinal designs. In this study, we collected up to 70 measurements per participant within a period of seven consecutive days, which allowed us to investigate associations between fluctuations of shame, self-esteem, and sexual desire. Participants were divided in four subgroups: (1) women (n = 87); (2) men (n = 46) from a general population convenience sample; (3) men watching porn >2 times per week, showing non-problematic hypersexuality (NH; n = 10); and (4) men watching porn >2 times per week, experiencing PH (n = 11). Multilevel analyses, including cross-level interactions, were used to investigate between-group differences in intraindividual processes. Results showed that prior increases in shame forecasted higher current sexual desire for men with PH, but not for the other groups, suggesting that men with PH use sexual desire to downregulate dysphoric feelings of shame. Differences between groups in associations between self-esteem and sexual desire were also found. Based on our results, we propose the Split Pleasure/Shame model, which represents emotion dysregulation in PH, and juxtapose this with the pleasurable experience of sex by non-PH groups. Further intensive longitudinal research is necessary to test this model and, more generally, to investigate the fluctuating nature of sexual desire.

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