Hypo- or hyperfunction? Differential relationships between compulsive sexual behavior disorder facets and sexual health.

This article investigates how distinct facets of compulsive sexual behavior disorder (CSBD), a multidimensional condition defined in ICD-11, differentially relate to sexual health. Using two online studies with Polish participants—a convenience sample (n=812) and a representative adult sample (n=1526)—researchers assessed CSBD symptoms via the CSBD-19 scale and sexual functioning via the Arizona Sexual Experience Scale (ASEX). Results consistently showed that higher severity in CSBD facets "salience" (sexual activities as a central life focus) and "relapse" (difficulty reducing sexual behavior) predicted sexual hyperfunction (stronger sex drive, easier arousal, and orgasm), while higher severity in "negative consequences" and "dissatisfaction" facets predicted sexual hypofunction (weaker desire, arousal difficulties, and less satisfying orgasms). The facet "control" (difficulty stopping sexual behavior) was not a significant predictor when accounting for other facets. These findings suggest that different CSBD symptom domains are linked to opposing sexual functioning profiles, highlighting the importance of assessing individual symptom severity in clinical settings to better understand and address sexual health difficulties in CSBD patients.