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Archives of Sexual Behavior

, Volume 48, Issue 2, pp 443–447 | Cite as

Incongruence as a Variable Feature of Problematic Sexual Behaviors in an Online Sample of Self-Reported “Sex Addiction”

  • Michael T. WaltonEmail author
Commentary

Introduction

Grubbs, Perry, Wilt, and Reid (2018) completed a systematic and comprehensive review of the literature on problematic pornography use and also developed the “pornography problems due to moral incongruence” (PPMI) model arising from their meta-analysis of the research. Internet pornography (IP) use is prevalent globally (Ogas & Gaddam, 2011), with users exposed to ever increasing content (Fustich, 2017). Indeed, for some people their anonymous access to free and unrestricted IP may establish repetitive patterns of use, which are self-perceived as problematic to control (or addictive), and a source of significant psychological distress and/or impairment.

Grubbs et al. (2018) posited moral incongruence is broadly “the experience of engaging in activities that violate one’s deeply held moral values,” which the researchers found for some IP cases is related to self-perceived pornography-related problems. Rogers (1951/2003) originally suggested incongruence occurs when a person’s “ideal self” (i.e., who he/she would like to be) is incongruent with their actual behavior (i.e., perceived self) (Fig. 1). Rogers found that the greater the discrepancy between one’s ideal self and perceived self, the more that it is likely individuals will experience their behavior as incongruent. Therefore, some individuals perceive their IP use is inconsistent with their ideal self-concept or self-image and for which pornography-related problems arise (e.g., psychological distress).
Fig. 1

Nature of incongruence versus congruence

Walton, Cantor, Bhullar, and Lykins (2017a, b) proposed the sexhavior cycle of hypersexuality as a non-pathological model that potentially explained the neuropsychology and maintenance cycle of hypersexuality. The model suggested sexual incongruence may help to explain a repeated pattern of psychological distress when interpreting one’s sexual behavior. When I originally posited sexual incongruence for investigation during his Ph.D. candidature, research that related to moral incongruence was not identified from the search terms used to review the literature on hypersexuality. Notwithstanding at the time of the candidate’s literature search that moral incongruence existed as an emerging construct to explain some self-reported pornography problems. In this Commentary, I discuss sexual (rather than moral) incongruence to ensure consistency with previous Walton et al. publications on hypersexuality.

I continue my Commentary to broadly evaluating sexual incongruence as a moderate (yet variable) feature of hypersexuality. Data analysis involved a small-medium sample of self-reported “sex addicts” who identified the primary and secondary sexual behaviors they had difficulty regulating, including pornography use.

Method

Participants

In total, 277 participants, aged 18 years and older, were prescreened for hypersexuality as measured by the Hypersexual Behavior Inventory (HBI) (Reid, Garos, & Carpenter, 2011). Reid (2010) suggested a HBI cutoff score for men of ≥ 53 to indicate clinically significant hypersexuality. Given an absence of clinically relevant data for women, the same HBI cutoff score advised for men was applied to assess hypersexuality for women. Based on the reported HBI cutoff score of ≥ 53, 225 individuals met the criteria for hypersexuality, whereas 52 respondents did not. The overall sample comprised 186 cisgender men (Mage = 33.31, SD = 10.99), 82 cisgender women (Mage = 26.41, SD = 8.13), 2 transgender men (female-to-male) (Mage = 22.00, SD = 4.24), 3 transgender women (male-to-female) (Mage = 31.33, SD = 2.52), and 4 respondents who identified their gender as being other than one of the aforementioned groups (Mage = 22.75, SD = 5.50).

Measures

Problematic Sexual Behaviors

Participants reported the sexual behaviors they felt most unable and next most unable to control. For these two items, individuals were asked to rate how often they typically engaged in self-reported problematic sexual behaviors. Responses were rated on a nine-point Likert scale from 1 (not at all) to 9 (4 or more times a day). Additionally, participants were asked to estimate how many hours per week they engaged in the two sexual behaviors they perceived as problematic to control. Sexual activity frequency was rated on a seven-point Likert scale from 1 (1 h per week) to 7 (over 14 h per week).

Sexual Incongruence

Participants’ sexual incongruence was measured by adapting five items from the HBI, namely Items 4, 10, 11, 12, and 17 (see Appendix). The Sexual Incongruence Scale (SIS) was developed to measure the extent to which individuals perceived their sexual behavior was wrong, inappropriate, and behaviorally incongruent. Items were rated on a five-point Likert scale from 1 (never) to 5 (very often) and summed to provide a total scale score that ranged between 5 and 25. The SIS indicated high internal reliability based on the sample of 277 participants who completed the prescreening questionnaire (Cronbach’s alpha = .91) and also discriminated between hypersexual (n = 225) and non-hypersexual groups (n = 52) (see Results).

Hypersexuality

Hypersexuality was measured by analyzing the total score on the HBI (Reid et al., 2011). The HBI is a 19-item self-report questionnaire that measures participants’ hypersexuality over three subscales: Coping (7 items), Consequences (4 items), and Control (8 items). Items were rated on five-point Likert scales from 1 (never) to 5 (very often) and summed to provide a total scale score that ranged between 0 and 95. Sample items include: “I use sex as a way to try to help myself deal with my problems” (Coping); “I sacrifice things I really want in life in order to be sexual” (Consequences); and “My attempts to change my sexual behavior fail” (Control).

The HBI exhibits high internal reliability (Cronbach’s alpha = .96) and strong test–retest reliability (r = .91) based on patients who sought treatment for hypersexuality (Reid et al., 2011). The inventory has demonstrated strong concurrent validity with other measures of hypersexuality, such as the Compulsive Sexual Behavior Inventory (r = .92) (Coleman, Miner, Ohlerking, & Raymond, 2001). The HBI also indicated high internal reliability based on the sample of 277 participants who had completed the prescreening questionnaire (Cronbach’s alpha = .94).

Procedure

Participants were mostly recruited via forums such as Reddit and Facebook which discussed diverse topics about sex, hypersexuality, pornography addiction, compulsive masturbation, etc. Reddit is a website that provides social news, web content rating, and discussion forums to its registered community of international members. Individuals were asked to participate in the study because (1) they identified with having a sex addiction, (2) they experienced ongoing difficulty controlling their sexual fantasies, urges, and behaviors, for at least the past 6 months, and (3) their problematic sexual behaviors were the source of significant personal distress and impairment. Persons who completed the prescreening questionnaire had their responses analyzed by the researchers to determine their eligibility to participate in a daily diary study. A nucleus of participants who had answered the prescreening questionnaire (n = 31), completed the daily diary study over a 1-month period (Walton, Bhullar, & Lykins, 2018).

Results

Table 1 details the sexual behaviors that participants perceived they were most and next most unable to control. Notably, participants frequently self-reported that masturbation, pornography use, and sexual behavior with consenting adults were challenging to control. Each participant typically identified different problematic sexual behaviors for the categories of most often and next most often. For example, masturbation (n = 201, 72.6%), pornography use (n = 126, 45.5%), and sexual behavior with consenting adults (n = 107, 38.6%) were strongly endorsed by participants as either a primary or secondary sexual behavior they found problematic. Results further indicated problematic masturbation and pornography use were often comorbid sexual behaviors. Additionally, the hypersexual group recorded a mean total score for the HBI of M = 73.14 (SD = 11.97) compared to the non-hypersexual group of M = 40.65 (SD = 9.61).
Table 1

Sexual behaviors that participants reported they were most and next most unable to control

Sexual behavior

Most often

Next most often

(n)

%

(n)

%

Masturbation

107

38.6

98

35.4

Pornography

60

21.7

69

24.9

Sexual behavior with consenting adults

55

19.9

53

19.1

Telephone sex

1

0.4

2

0.7

Cybersex, online chatrooms

5

1.8

13

4.7

Hook-up apps

17

6.1

14

5.1

Escorts

10

3.6

9

3.2

Swingers clubs

1

0.4

1

0.4

Saunas, bathhouses

3

1.1

5

1.8

Beats, parks, public toilets

1

0.4

1

0.4

Other

14

5.1

10

3.6

Not applicable

3

1.1

2

0.7

N = 277. The category of “Other” described a composite expression of the aforementioned sexual behaviors, sexual fantasies, intrusive thoughts, casual and group sex, exhibitionism, etc.

Participants self-reported they engaged in problematic sexual behaviors, on average, between 4 and 6 times per week (i.e., most often: M = 6.21, SD = 2.31 and next most often: M = 6.19, SD = 2.16). The number of hours that participants engaged in problematic sexual behavior, on average, was 6–7 h per week (i.e., most often: M = 3.77, SD = 1.89) and 4–5 h per week (next most often: M = 3.48, SD = 1.89). However, independent sample t test comparisons between hypersexual and non-hypersexual participants found they self-reported similar rates of problematic sexual behavior (i.e., 4–6 times per week), although hypersexual participants generally spent more time per week engaged in problematic sexual behaviors (i.e., 6–7 h vs. 4–5 h).

An independent sample t test was conducted to examine differences between hypersexual and non-hypersexual participants on their reported SIS total scores. Levene’s test for equality of variances was significant (p = .003), and equal variances were not assumed when analyzing the t test results. Hypersexual participants reported, on average, higher sexual incongruence (M = 16.04, SD = 5.40, range 5–25) than non-hypersexual participants (M = 8.77, SD = 3.83, range 5–20), t(103.57) = 11.33, p < .001. The mean difference in sexual incongruence scores between the two groups was 7.27 (95% CI 6.0, 8.54), and Cohen’s d = 1.55, which indicated a large effect size (Cohen, 1988). Hypersexual participants indicated, on average, they sometimes experienced their sexual behavior as incongruent, whereas non-hypersexual participants indicated, on average, they rarely (if ever) experienced their sexual behavior as incongruent.

Discussion

Hypersexual participants’ SIS total scores indicated their problematic sexual behaviors, on average, were not always interpreted as behaviorally incongruent, although often existed as a moderate feature. Present results were consistent with Rogers’ (1951/2003) conceptualization of incongruence as a differential relationship between one’s self-concept and ideal self. Indeed, the extent to which participants reported their sexual behavior was wrong, irresponsible, and inconsistent with personal beliefs and values varied from low to high rates of concern. Participants’ level of sexual incongruence was also likely to vary among the sexual interests/behaviors undertaken, with some activities perceived as more or less problematic. It is further likely that at times a participant’s perception may vary on whether their problematic sexual behaviors are incongruent. For example, pornography use may be considered less incongruent when undertaken at home alone rather than when the family is about. In addition, problematic sexual behaviors may be episodic rather than continuous (Walton et al., 2018), and therefore perceived as variously incongruent.

Walton and Bhullar (2018a, b) have previously found the extent to which some individuals perceived their sexual behavior as problematic was dependent upon the sexual interest/behavior undertaken, the situational context in which it occurs, and one’s mental state. Indeed, 31 self-reported “sex addicts” completed online a 1-month daily diary of their sexual arousal/behaviors (Walton et al., 2018). It was found participants reported variable rates of sexual satisfaction for sexual interests/behaviors that they often interpreted were problematic and at times experienced as out of control. Taken together, this may explain why self-reported problematic sexual behaviors are difficult to regulate because sexual satisfaction or dissatisfaction is variably experienced.

Limitations and Future Research

The results should not be overstated because the SIS comprised five items adapted from the HBI, which in turn was used to discriminate hypersexuality versus non-hypersexuality in the sample. Therefore, hypersexual participants were likely to score higher on the SIS than non-hypersexual participants. Further research of the SIS is required, using comparative measures other than the HBI to assess hypersexuality, in order to establish the SIS scale’s reliability and validity as a measure of sexual incongruence in at risk and general populations. Assessment also involved a small-medium sample of hypersexual (n = 225) and non-hypersexual (n = 52) participants.

Test instructions advised participants to select the response that best described their sexual behavior rather than the measure specifically assessing their problematic sexual behavior. Therefore, results potentially underscored hypersexual participants’ level of sexual incongruence that was purely attributable to problematic sexual behavior/s. However, hypersexual participants did seem to experience variable rates of sexual incongruence, given the diverse range of SIS total scores they reported. Indeed, it is useful to understand the intrinsic features, defining characteristics, and circumstances under which individuals perceive their sexual behavior as more or less problematic and/or incongruent.

Concluding Comment

Present results supported Grubbs et al.’s (2018) PPMI model that sexual incongruence is a feature of problematic IP use. It is also likely that sexual incongruence is a feature of problematic sexual activity in general, irrespective of whether individuals’ sexual interests/behaviors are variably expressed as IP, compulsive masturbation, casual sex, etc. In addition, present results build upon a growing body of research which suggests that some hypersexuality presentations relate to individuals who perceive their sexual behavior is out of control when rates of sexual activity are comparable with the general population (Grubbs, Exline, Pargament, Hook, & Carlisle, 2015; Grubbs, Stauner, Exline, Pargament, & Lindberg, 2015; Kwee, Dominguez, & Ferrell, 2007; Walton, Lykins, & Bhullar, 2016; Walton et al., 2018). Notwithstanding that such presentations may be experienced as psychologically distressing, impair areas of daily functioning, and sometimes require treatment (Grubbs et al., 2018; Walton et al., 2017a, b).

Most people do not openly discuss with colleagues at work that “I did porn last night and masturbated,” for example. These behaviors are typically private rather than public, can be either complementary or compensatory activities (Regnerus, Price, & Gordon, 2017), and occur within a sociocultural-normative context the behavioral myschology (mī kol əd jē) of which is individually experienced and understood (Walton & Bhullar, 2018b). Present results supported Grubbs et al.’s (2018) findings that for some people their perceived hypersexuality, sex addiction, or problematic sexual interests/behaviors are likely to indicate (1) activities that are incongruent with one’s beliefs and values, life circumstances, and societal norms, and (2) individuals who had difficulty with accepting rather than needing to control aspects of their sexual behavior. However, present results also suggested that sexual incongruence may at times variably relate to problematic sexual interests/behaviors, which is relevant information for empirical research, assessment, and treatment.

Notes

Compliance and Ethical Standards

Informed Consent

Informed consent was obtained from all participants in the study, who provided online consent prior to commencing the prescreening questionnaire. The study was approved by the Human Research Ethics Committee of the University of New England, Armidale, Australia, and conducted in accordance with its ethical standards and the National Statement on Ethical Conduct in Research in Australia.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Psychology and Behavioural ScienceUniversity of New EnglandArmidaleAustralia

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