In addition, patients with both disorders had similar scores, as well as significantly lower scores than healthy controls, on four of the personality dimensions measured by the Temperament and Character Inventory–Revised (TCI-R): reward dependence, persistence, self-directedness, and cooperativeness.
Both patient groups also showed similar scores for mood and anxiety problems. This is notable, the investigators said, because it has been posited that patients often use gambling to regulate negative emotions associated with stressful life events and frustration; sexual compulsions also are considered to be a mechanism for regulating negative affect.
The only sociodemographic variable that differed between sexual addiction and gambling disorder was socioeconomic status, which was higher in sexual addiction. In fact, high socioeconomic status was a major predictor of sexual addiction. “This could be explained by the fact that many patients with gambling disorder tend to have a low educational level and a low income,” Dr. Farre and his associates wrote.
Yet the two disorders differed from each other to the extent that personality traits could be used to distinguish between them. Patients with gambling disorder had notably higher scores than normal for harm avoidance, novelty seeking, and self-transcendence, while patients with sexual addiction had higher scores for harm avoidance only and had low scores for novelty seeking. Also, patients with sexual addiction had low scores on persistence, compared with those with gambling disorder, indicating poorer perseverance and more difficulty managing frustrations.
Patients with both disorders would benefit from treatment aimed at increasing internal locus of control, learning to take responsibility for one’s own decisions, increasing planning capacity, and improving perception of self-efficacy and satisfaction with one’s abilities. Patients with gambling disorder should aim for improved self-control strategies and emotional regulation, while those with sexual addiction should focus on improving interpersonal relationships and deficiencies in socialization factors such as cooperation, empathy, and tolerance.
Patients with sexual addiction also would benefit from enhancing their ability to identify potentially hazardous conditions and to foresee the negative consequences of certain decisions, the investigators said.
The investigators cited several limitations of the study. One is the cross-sectional design, which they said, did not allow them to make causal inferences. Also, the sample sizes of the three groups were not balanaced.
Nevertheless, they said, their findings expand the understanding of sexual addiction, a condition “that has not been studied in depth,” which in turn opens up new directions for future research.
This study was supported by Fondo de Investigacion Sanitaria of Spain, Ministerio de Economia y Competitividad, and Generalitat de Catalunya. Dr. Farré and his associates did not report their financial disclosures.