No abstract

The authors examined self-conscious emotions as predictors of hypersexual behavior among 235 college students. Among men, shame-proneness and externalization predicted higher hypersexual behavior, whereas guilt-proneness and detachment were associated with lower hypersexual behavior. Detachment predicted higher hypersexual behavior among women.Keywords: hypersexual behavior, shame, guilt, gender differences Multiple labels exist for sexual behavior that is compulsive or nonnormative (Goodman, 2001;Kafka, 2010;Reid, 2013). Researchers and counselors may refer to nonnormative behaviors as sexual impulsivity, sexual addiction, sexual compulsivity, out-of-control sexual behavior, sexual dependency, or hypersexuality. For the purpose of this study, we refer to distressing or compulsive sexual behaviors as hypersexuality. Kafka (2010) proposed criteria for hypersexual disorder to appear in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), including feeling a loss of control; spending an increased amount of time in sexual fantasies, urges, or behaviors; engaging in sexual behaviors in response to stress or negative affective states; and having a disregard for the risk of harm. Although hypersexual disorder was not included in the DSM-5, the prevalence and problematic outcomes of hypersexuality are well documented in the literature and warrant further attention (Carnes, 1991;Coleman, 1991;Kuzma & Black, 2008;Reid et al., 2012).Calculating hypersexuality prevalence rates is challenging because of the lack of a standardized definition. For example, Sussman, Lisha, and Griffiths (2011) purported that 3% of adults in the United States have a sexual addiction, whereas Coleman (1991) estimated 5%. In a New Zealand sample, Skegg, Nada-Raja, Dickson, and Paul (2010) found that 12.7% of men and 6.7% of women experienced out-of-control sexual fantasies and urges in the previous year. These findings may indicate differences result-

Court-ordered outpatient psychotherapy (COT) has been used in the criminal justice system for treatment of adolescents and adults for a number of problems such as mental illness, substance use, and sex offenses, and the number and frequency of such orders has grown at a dramatic rate. Practitioners are being asked to treat someone even though they are not free to exercise the normal duties they would have toward their voluntary patients. This circumstance creates a number of potential ethical dilemmas regarding informed consent, potential loyalty conflicts, violations of confidentiality, and the risk of therapeutic ruptures that clinicians typically do not encounter on daily basis. This chapter will explore these ethical issues and provide examples of questions practitioners should take into account when working with this population.