It has been suggested that sex differences in the processing of erotic material (e.g., memory, genital arousal, brain activation patterns) may also be reflected by differential attention to visual cues in erotic material. To test this hypothesis, we presented 20 heterosexual men and 20 heterosexual women with erotic and non-erotic images of heterosexual couples and tracked their eye movements during scene presentation. Results supported previous findings that erotic and non-erotic information was visually processed in a different manner by both men and women. Men looked at opposite sex figures significantly longer than did women, and women looked at same sex figures significantly longer than did men. Within-sex analyses suggested that men had a strong visual attention preference for opposite sex figures as compared to same sex figures, whereas women appeared to disperse their attention evenly between opposite and same sex figures. These differences, however, were not limited to erotic images but evidenced in non-erotic images as well. No significant sex differences were found for attention to the contextual region of the scenes. Results were interpreted as potentially supportive of recent studies showing a greater non-specificity of sexual arousal in women. This interpretation assumes there is an erotic valence to images of the sex to which one orients, even when the image is not explicitly erotic. It also assumes a relationship between visual attention and erotic valence.

The term pedophilia denotes the erotic preference for prepubescent children. The term hebephilia has been proposed to denote the erotic preference for pubescent children (roughly, ages 11 or 12-14), but it has not become widely used. The present study sought to validate the concept of hebephilia by examining the agreement between self-reported sexual interests and objectively recorded penile responses in the laboratory. The participants were 881 men who were referred for clinical assessment because of paraphilic, criminal, or otherwise problematic sexual behavior. Within-group comparisons showed that men who verbally reported maximum sexual attraction to pubescent children had greater penile responses to depictions of pubescent children than to depictions of younger or older persons. Between-groups comparisons showed that penile responding distinguished such men from those who reported maximum attraction to prepubescent children and from those who reported maximum attraction to fully grown persons. These results indicated that hebephilia exists as a discriminable erotic age-preference. The authors recommend various ways in which the DSM might be altered to accommodate the present findings. One possibility would be to replace the diagnosis of Pedophilia with Pedohebephilia and allow the clinician to specify one of three subtypes: Sexually Attracted to Children Younger than 11 (Pedophilic Type), Sexually Attracted to Children Age 11-14 (Hebephilic Type), or Sexually Attracted to Both (Pedohebephilic Type). We further recommend that the DSM-V encourage users to record the typical age of children who most attract the patient sexually as well as the gender of children who most attract the patient sexually.

An empirical review of hypersexuality is timely as "compulsive sexual behavior" is being considered as an impulse control disorder for inclusion in the forthcoming International Classification of Diseases, 11th ed. Specifically, hypersexuality has been conceptualized in the literature as the inability to regulate one's sexual behavior that is a source of significant personal distress. Various theoretical models have been posited in an attempt to understand the occurrence of hypersexuality, although disagreement about these divergent conceptualizations of the condition has made assessment and treatment of hypersexual clients more challenging. Theories of sexual compulsivity, sexual impulsivity, dual control (sexual inhibition/excitation), and sex addiction are critically examined, as are the diagnostic criteria for clinically assessing hypersexuality as a sexual disorder. Our discussion of hypersexuality covers a diversity of research and clinical perspectives. We also address various challenges associated with reliably defining, psychometrically measuring, and diagnosing hypersexuality. Furthermore, literature is reviewed that expresses concerns regarding whether hypersexuality (conceptualized as a disorder) exists, whether it is simply normophilic behavior at the extreme end of sexual functioning, or alternatively is a presenting problem that requires treatment rather than a clinical diagnosis. Following our literature review, we developed the "sexhavior cycle of hypersexuality" to potentially explain the neuropsychology and maintenance cycle of hypersexuality. The sexhavior cycle suggests that, for some hypersexual persons, high sexual arousal may temporarily and adversely impact cognitive processing (cognitive abeyance) and explain a repeated pattern of psychological distress when interpreting one's sexual behavior (sexual incongruence). We also suggest that further research is required to validate whether hypersexuality is a behavioral disorder (such as gambling), although some presentations of the condition appear to be symptomatic of a heterogeneous psychological problem that requires treatment.

Negative mood states, such as depression and anxiety, are typically associated with decreased sexual interest and arousal. However, there is also some evidence that depressed or anxious mood may increase sexual interest or arousal in some individuals. In this study, 663 female college students (mean age = 18.9 years, SD = 1.21) answered questions regarding the effects of anxious and depressed mood on sexual interest and arousal and completed trait measures of sexual excitation and inhibition, anxiety, and depression. The majority of women reported decreased sexual interest and response when feeling depressed or anxious; a minority (about 10%) of women, however, reported increased sexual interest/response during anxious and depressed mood. This sample of women was compared to a sample of 399 college-aged men. In general, men were more likely than women to report increased sexual interest during negative mood states. Of the variables explored, propensity for sexual excitation was the strongest predictor of the relationship between negative mood and sexuality in women. Individual differences in the effects of negative mood may prove relevant to our understanding of a variety of topics, including risky and compulsive sexual behavior and sexual dysfunction.

As a first step in the investigation of the role of visual attention in the processing of erotic stimuli, eye-tracking methodology was employed to measure eye movements during erotic scene presentation. Because eye-tracking is a novel methodology in sexuality research, we attempted to determine whether the eye-tracker could detect differences (should they exist) in visual attention to erotic and non-erotic scenes. A total of 20 men and 20 women were presented with a series of erotic and non-erotic images and tracked their eye movements during image presentation. Comparisons between erotic and non-erotic image groups showed significant differences on two of three dependent measures of visual attention (number of fixations and total time) in both men and women. As hypothesized, there was a significant Stimulus x Scene Region interaction, indicating that participants visually attended to the body more in the erotic stimuli than in the non-erotic stimuli, as evidenced by a greater number of fixations and longer total time devoted to that region. These findings provide support for the application of eye-tracking methodology as a measure of visual attentional capture in sexuality research. Future applications of this methodology to expand our knowledge of the role of cognition in sexuality are suggested.

"Hypersexual" behavior represents a perceived inability to control one's sexual behavior. To investigate hypersexual behavior, an international sample of 510 self-identified heterosexual, bisexual, and homosexual men and women completed an anonymous online self-report questionnaire battery. In addition to age and sex (male), hypersexual behavior was related to higher scores on measures of sexual excitation, sexual inhibition due to the threat of performance failure, trait impulsivity, and both depressed mood and anxiety. In contrast, hypersexual behavior was related to lower scores on sexual inhibition due to the threat of performance consequences. Higher neuroticism and extraversion, as well as lower agreeableness and conscientiousness, also predicted hypersexual behavior. Interestingly, interactions among the variables assessed did not significantly predict hypersexual behavior, suggesting the possible existence of multiple and predominantly independent taxa for various persons reporting hypersexual behavior. Core personality features may also be present in persons with hypersexual behavior. Clinical implications and future research directions are discussed.

Men and women have been seeking professional assistance to help control hypersexual urges and behaviors since the nineteenth century. Despite that the literature emphasizes that cases of hypersexuality are highly diverse with regard to clinical presentation and comorbid features, the major models for understanding and treating hypersexuality employ a “one size fits all” approach. That is, rather than identify which problematic behaviors might respond best to which interventions, existing approaches presume or assert without evidence that all cases of hypersexuality (however termed or defined) represent the same underlying problem and merit the same approach to intervention. The present article instead provides a typology of hypersexuality referrals that links individual clinical profiles or symptom clusters to individual treatment suggestions. Case vignettes are provided to illustrate the most common profiles of hypersexuality referral that presented to a large, hospital-based sexual behaviors clinic, including: (1) Paraphilic Hypersexuality, (2) Avoidant Masturbation, (3) Chronic Adultery, (4) Sexual Guilt, (5) the Designated Patient, and (6) better accounted for as a symptom of another condition.

After a long history of privileging psychosexual etiological factors over pain and physiological processes, dyspareunia has enjoyed 1 decade of pointed research focused on the presenting problem of pain. Although it is generally acknowledged that certain affective and cognitive styles may play a role in an individual's experience of pain in general, investigations into these questions specifically as they pertain to pain that occurs during sex are relatively scarce. To add to this growing body of knowledge, 759 women aged 18 to 29 completed questionnaires about current sexual functioning, gynecologic history, expectations about intercourse, and various personality and health-related anxiety measures. One-hundred-one women (14% of the sample) reported pain during intercourse on at least 50% of attempts. This group of women significantly differed from 536 women reporting pain on less than 10% of intercourse attempts on personality constructs related to emotional and relational well-being (e.g., neuroticism, extraversion, agreeableness), as well as anxiety sensitivity, anxiety related to physical health concerns, and the amplification of somatosensory experiences. This affective and cognitive profile is consistent with previous studies that have found an attentional hypervigilance to health and pain-related information in women with dyspareunia, all of which could prove germane to cognitive-behavioral treatments targeting this disorder.