Background In spite of a growing interest in research on hypersexuality, consensus about its etiology and best treatment strategy has not been achieved. Aim To further the empirical and clinical understanding of hypersexuality by exploring the structure of its symptoms using a network analytic approach. Methods In 2014, an online survey advertised as focusing on Internet pornography, sexual health, and relationships was carried out among Croatian men and women aged 18–60 years (Mage = 31.1 years, SD = 9.67). In a sample of 3,028 participants, we applied a network analytic approach to explore the structure of hypersexuality symptoms. In the network, nodes represented hypersexuality symptoms and associated sexual behaviors, while their connections were operationalized as partial correlations. 4 Research questions were addressed: (1) does the hypersexuality network differ between genders; (2) which symptoms are centrally positioned; (3) what is the topological location of pornography use; and (4) are there distinct clusters (“communities”) of symptoms in the network? Outcomes We estimated and plotted hypersexuality networks by gender using items from the Hypersexual Disorder Screening Inventory and the Hypersexual Behavioral Consequences Scale, as well as indicators of sexual desire, pornography use, sexual intercourse, and masturbation frequency. Results The structure of the hypersexuality network was surprisingly similar in women and men, both in terms of symptom centrality and the clustering of symptoms. Psychological distress and negative emotions triggered by sexual fantasies and/or behaviors, together with a loss of control over sexual feelings, occupied central positions in the networks. Pornography use was located peripherally in both the men’s and women’s hypersexuality networks. Clinical Translation Psychological distress and negative emotions triggered by sexual fantasies and/or behaviors constituted the core of the hypersexuality network, which makes them potential prime targets for clinical intervention and calls for normalization of (presumably self-stigmatized) sexual expression through affirmative therapy and interventions that enhance self-care, self-compassion, and adaptive coping mechanisms. Strengths & Limitations This is the first network analytic approach to hypersexuality. Apart from its novel insights about the structure of hypersexuality, the study employed several methods to assure reliability and robustness of findings. Considering that networks were estimated in a convenience-based community sample, the findings might not generalize to clinically distressed individuals. Conclusion Our results demonstrate the usefulness of network analytics to hypersexuality in a non-clinical sample and we encourage future clinical and longitudinal explorations of hypersexuality using this novel approach.

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Background Few factor analyses and no network analyses have examined the structure of DSM phobic fears or tested the specificity of the relationship between panic disorder and agoraphobic fears. Methods Histories of 21 lifetime phobic fears, coded as four-level ordinal variables (no fear to fear with major interference) were assessed at personal interview in 7514 adults from the Virginia Twin Registry. We estimated Gaussian Graphical Models on individual phobic fears; compared network structures of women and men using the Network Comparison Test; used community detection to determine the number and nature of groups in which phobic fears hang together; and validated the anticipated specific relationship between panic disorder and agoraphobia. Results All networks were densely and positively inter-connected; networks of women and men were structurally similar. Our most frequent and stable solution identified four phobic clusters: (i) blood-injection, (ii) social-agoraphobia, (iii) situational, and (iv) animal-disease. Fear of public restrooms and of diseases clustered with animal and not, respectively, social and blood-injury phobias. When added to the network, the three strongest connections with lifetime panic disorder were all agoraphobic fears: being in crowds, going out of the house alone, and being in open spaces Conclusions Using network analyses applied to a large epidemiologic twin sample, we broadly validated the DSM-IV typography but did not entirely support the distinction of agoraphobic and social phobic fears or the DSM placements for fears of public restrooms and diseases. We found strong support for the specificity of the relationship between panic disorder and agoraphobic fears.

Problems related to low sexual desire in women are common clinical complaints, and the aetiology is poorly understood. We investigated predictors of change in levels of sexual desire using a novel network approach, which assumes that mental disorders arise from direct interactions between symptoms. Using population-based data from 1,449 Finnish women, we compared between-subject networks of women whose sexual desire decreased, increased, or remained stable over time. Networks were estimated and analyzed at T1 (2006) and replicated at T2 (2013) using R. Domains included were, among others, sexual functions, sexual distress, anxiety, depression, body dissatisfaction, and relationship status. Overall, networks were fairly similar across groups. Sexual arousal, satisfaction, and relationship status were the most central variables, implying that they might play prominent roles in female sexual function; sexual distress mediated between general distress and sexual function; and sexual desire and arousal showed different patterns of relationships, suggesting that they represent unique sexual function aspects. Potential group-differences suggested that sex-related pain and body dissatisfaction might play roles in precipitating decreases of sexual desire. The general network structure and similarities between groups replicated well; however, the potential group-differences did not replicate. Our study sets the stage for future clinical and longitudinal network modelling of female sexual function.

Sexual pleasure is central to current understandings of sexual function, health, and wellbeing. In this article, we suggest that we lack a sufficiently specific, yet encompassing, definition of sexual pleasure and that we therefore lack comprehensive assessments of sexual pleasure. We introduce a definition of sexual pleasure and position it centrally in an adapted framework of the sexual response. In the framework, we include a taxonomy of rewards which can be retrieved from sex and thereby aim to capture the multifaceted nature of sexual pleasure. We arrive at the definition, framework, and taxonomy by integrating theories of sexual motivation and response with the literature on sexual pleasure and basic rewards. We position this literature within theories of affect and personality which allows us to differentiate between the experience of and the tendency to experience sexual pleasure (i.e., state versus trait sexual pleasure). We shortly discuss how this conceptualization of sexual pleasure could be reflected in self-report assessments to quantitatively assess sexual pleasure. The framework may aid to focus on the role of the diverse facets of sexual pleasure in sexual function, health, and wellbeing and contribute to giving sexual pleasure the center position it deserves in sex research and therapy. [The four manuscript versions have been (re)submitted on July 15 2021, March 19 2022, August 19 2022, and January 3 2023 respectively. The fourth version is currently under review.]

Background Sexual function after hysterectomy can be a concern for patients, and research remains inconclusive about changes in sexual function associated with hysterectomy. Aim We meta-analyzed studies on change in sexual function from pre- to posthysterectomy and the role of total vs subtotal hysterectomy and concomitant bilateral salpingo-oophorectomy (BSO) in differences in such change. Methods We searched PubMed, Embase, and Cochrane databases from inception to January 2022. Two reviewers screened and included studies if they were published in a peer-reviewed journal and reported on sexual function pre- and posthysterectomy for benign nonprolapse indication. Methodological quality was assessed with the STROBE checklist. We used random effects multilevel models to meta-analyze standardized mean differences in pre- to postoperative sexual function and the posthysterectomy Female Sexual Function Index mean across study groups in R (RStudio). Outcomes Outcomes included overall sexual function, dyspareunia, desire, arousal, lubrication, and orgasm. Results Thirty-two articles were analyzed: 8 randomized controlled trials, 20 prospective studies, 2 retrospective studies, 1 cross-sectional study, and 1 secondary analysis, comprising a total of 4054 patients. Each study provided data for at least 1 outcome. Study quality was moderate, and effect sizes showed large between-study heterogeneity. Hysterectomy was not associated with significant change in overall sexual function irrespective of surgical route, with patients tending to report potentially remaining sexual dysfunction posthysterectomy. Cervix removal was not significantly associated with differences in magnitude of change. Hysterectomy without BSO was associated with significantly stronger improvement in lubrication and orgasm than hysterectomy with BSO, which was not the case for desire, arousal or overall sexual function. However, these significant differences were not replicated within studies that directly compared cases with and without BSO. Clinical Implications Clinicians should address remaining sexual dysfunction posthysterectomy, and BSO should not be considered if not medically required. Strengths and Limitations We analyzed a comprehensive number of trials and studied clinically relevant factors that might relate to differences in change in sexual function. Conclusions need to be interpreted with caution since many studies showed moderate methodological quality and large effect size heterogeneity. Conclusion Subtotal and total hysterectomy was not associated with significant change in overall sexual function irrespective of surgical route, with patients tending to report potentially remaining sexual dysfunction posthysterectomy. Hysterectomy without BSO was associated with significantly stronger improvement in lubrication and orgasm than hysterectomy with BSO. Future research on hysterectomy should analyze predictors of sexual function change trajectories, such as different indications.

Scientific theories reflect some of humanity's greatest epistemic achievements. The best theories motivate us to search for discoveries, guide us towards successful interventions, and help us to explain and organize knowledge. Such theories require a high degree of specificity, and specifying them requires modeling skills. Unfortunately, in psychological science, theories are often not precise, and psychological scientists often lack the technical skills to formally specify existing theories. This problem raises the question: How can we promote formal theory development in psychology, where there are many content experts but few modelers? In this paper, we discuss one strategy for addressing this issue: a Many Modelers approach. Many Modelers consist of mixed teams of modelers and non-modelers that collaborate to create a formal theory of a phenomenon. We report a proof of concept of this approach, which we piloted as a three-hour hackathon at the SIPS 2021 conference. We find that (a) psychologists who have never developed a formal model can become excited about formal modeling and theorizing; (b) a division of labor in formal theorizing could be possible where only one or a few team members possess the prerequisite modeling expertise; and (c) first working prototypes of a theoretical model can be created in a short period of time.

We studied the Amsterdam Sexual Pleasure Inventory’s (ASPI, Vol. 1.0) psychometric properties to present evidence regarding its intended interpretation and use. The ASPI is a theory-based and revised self-report battery which aims to assess different domains of state and trait sexual pleasure in survey-research in gender-diverse, sex-diverse, and relationship-diverse populations. We collected quantitative (n = 1371) and qualitative data (n = 637) using a cross-sectional multi-method design targeting the general (German-speaking) population. The theory-based 5-factor ESEM showed good and the PCA of the two general exploratory index-scales showed acceptable structural validity evidence. Measurement invariance of the 5-factor models was given for male and female (assigned-at-birth) participants and for sexually functional-scoring and dysfunctional-scoring people. Coefficient omega indicated that all scales, except those of one facet, showed acceptable to very good internal consistency reliability. The ASPI’s convergent and discriminant associations with sexological and psychological constructs demonstrated good overall construct validity evidence and the scales showed differential utility in differentiating known-groups. Participants understood the items as intended and felt that the ASPI covers relevant facets of sexual pleasure. The ASPI might help understand how individuals differ in experiencing sexual pleasure and how different contexts enable some people to experience pleasure while disadvantaging others.