Comparison of risk of recidivism among sexual offenders with and without sexual preference disorders using the STATIC-99R instrument.

Purpose: The STATIC-99 instrument is one of the tools used for the assessment of the risk of recidivism, in line with the actuarial approach. One of the risk factors indicated by the scientific literature as having the greatest significance is sexual preference disorder. The aim of the study was to verify whether sexual offenders diagnosed with sexual preference disorders have a higher risk of recidivism. The study also aimed to present, for the first time in Poland, a quantitative scoring of individual risk factors in STATIC-99R and their prevalence, allowing for the verification of the theoretical validity of the STATIC-99R instrument in the analysis of the population of sexual offenders in Poland. Methods: The study material consisted of 100 court and penitentiary files of perpetrators of crimes against sexual freedom from 11 Polish penal institutions and remand centers. We used the STATIC-99R to evaluate each case. Results: The distribution of the individual STATIC-99R risk factors in the population of the Polish sexual offenders is presented. The diagnosis of sexual preference disorders had no influence on the total STATIC-99R score but was associated with its individual factors. Conclusions: It can be concluded that the theoretical validity of the STATIC-99R tool is also relevant to the Polish study population and may be used in clinical practice.

Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective.

INTRODUCTION: The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed "hypersexual disorder," "sexual addiction," "porn addiction," "sexual compulsivity," and "out-of-control sexual behavior." OBJECTIVES: To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them. METHODS: A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues. RESULTS: CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent "unhealthy" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed. CONCLUSIONS: Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related "out-of-control sexual behaviors" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.

An analysis of placental chorionic villous and decidual basalis tissue immunoreactivity in patients after cesarean section due to a placenta accreta spectrum disorder and elective cesarean section followed by the depressed mood.

An analysis of placental chorionic villous and decidual basalis tissue immunoreactivity in patients after cesarean section due to a placenta accreta spectrum disorder and elective cesarean section followed by a depressed mood. RESEARCH BACKGROUND: Over the past few years, interest in investigating immune dysfunction in patients with psychiatric disorders has increased. B7-H4 is a molecule with immunosuppressive properties that seems to play a key role in establishing maternal tolerance against fetal antigens. The aim of this study was to compare the B7-H4 immunoreactivity levels in patients after cesarean section. METHODS: Placental and decidual tissue samples were obtained from 49 women who delivered at Bielanski Hospital in Warsaw between 2009 and 2015. Fifteen of the patients developed postpartum depression and 14 had a diagnosis of placenta accreta spectrum. The control group consisted of 20 healthy patients on whom cesarean section was performed due to breech presentation at term. RESULTS: The highest levels of B7-H4 immunoreactivity were found in the placental chorionic villous and decidual basalis tissue samples of the patients who later developed postpartum depression, while the lowest levels were found in the samples of those patients with a placenta accreta spectrum disorder. The difference between the B7-H4 immunoreactivity levels of these two groups was statistically significant. The B7-H4 expression levels were statistically significantly higher in the women in the postpartum depression group than in the control group. CONCLUSION: Postpartum depression follows a disturbance of the suppressive milieu responsible for rebalancing the maternal immune system after the initial cytotoxic activation during labor.

FOXP3-positive cell infiltration in the chorionic villi is increased in the placenta accreta and decreased in the placental abruption.

OBJECTIVES: Growing data suggest a role of Treg cells in placentation. The aim of the study was to evaluate Treg cells (FOXP3-positive cells) placental bed infiltration in patients with placenta accrete syndrome (PAS) and patients who experienced placental abruption. MATERIAL AND METHODS: The study group included 13 patients with PAS and the control group consisted of 66 women who had caesarean (CD) delivery of whom, 44 patients with elective caesarean (EC) delivery, and 22 patients with urgent caesarean (UC) delivery due to placental abruption. FOXP3 cell infiltration was assessed by means of immunohistochemistry in placental chorionic villous (CV) and in the decidua (D) and cumulatively in the placental bed (PB). RESULTS: We observed significant difference in the degree of FOXP3-positive cell CV infiltration between studied groups (p = 0.04). FOXP3-positive cells were the most commonly observed in PAS patients, while, they were the least frequently presented in patients after UC. The immunoreactivity for FOXP3-positive cells in CV were as follows: PAS 5 (38%), urgent CS 1 (5%) and elective CS 8 (18%) subjects. We found no difference in the presence of FOXP3-positive cells in the D (p = 0.35) and in the PB (p = 0.23) of analyzed groups. FOXP3-cell infiltration was not related with patient age, BMI, gestational age and neonatal birth weight. CONCLUSIONS: Our study provides further evidence that abnormal invasive placentation is an associated disturbance of the maternal immune response. Accordingly, we have theorized that alteration of the FOXP3-positive Treg cell infiltration into the placental bed allows trophoblast cell invasion.

Assessment of the effect of mindfulness monotherapy on sexual dysfunction symptoms and sex-related quality of life in women.

Background: Mindfulness-based therapies (MBTs) are frequently used in the treatment of sexual dysfunctions. So far, there has not been sufficient evidence for the effectiveness of interventions based on mindfulness monotherapy. Aim: The aim of the study was to assess the effect of mindfulness monotherapy on the reduction of sexual dysfunction symptoms and sex-related quality of life. Methods: We conducted 4 weeks of MBT for 2 groups of heterosexual females: 1 with psychogenic sexual dysfunction (WSD) and 1 with no sexual dysfunction (NSD). Overall 93 women were recruited for the study. We collected data via an online survey regarding sexual satisfaction, sexual dysfunctions, and mindfulness-related features at baseline, 1 week after MBT, and follow-up 12 weeks after MBT. Research tools included the Female Sexual Function Index, Five Facet Mindfulness Questionnaire, and Sexual Satisfaction Questionnaire. Outcomes: Participating in the mindfulness program had a positive effect on women with and without sexual dysfunction. Results: The overall risk for sexual dysfunction decreased from 90.6% at baseline to 46.7% at follow-up in the WSD group and from 32.5% at baseline to 6.9% at follow-up in the NSD group. Participants in the WSD group reported a significant increase in levels of sexual desire, arousal, lubrication, and orgasm between measurements, although not in the pain domain. Participants in the NSD group reported a significant increase in the level of sexual desire between measurements but not in levels of arousal, lubrication, orgasm, and pain. A significant increase in sex-related quality of life was observed in both groups. Clinical Implications: The results of the study have a chance to translate into an introduction of a new therapeutic program for specialists and more effective help offered to women experiencing sexual dysfunctions. Strengths and Limitations: This mindfulness monotherapy research project, which included assessment of meditation "homework," is the first to verify the potential of MBT in reducing symptoms of psychogenic sexual dysfunctions among heterosexual females. Major limitations include the lack of randomization, an adequate control group, and a validated measure of sexual distress. Conclusion: The applied training was beneficial in the treatment of sexual dysfunctions in terms of increasing desire and arousal as well as the ability to reach orgasm. However, this approach needs more investigation before it can be recommended in the treatment of sexual dysfunction. The study should be replicated under a more rigorous research design, including adequate control groups and random allocation of participants to study conditions.

Assessing compulsive sexual behavior disorder: The development and international validation of the compulsive sexual behavior disorder-diagnostic inventory (CSBD-DI).

Background and aims: The World Health Organization's International Classification of Diseases (ICD-11) includes Compulsive Sexual Behavior Disorder (CSBD), a new diagnosis that is both controversial and groundbreaking, as it is the first diagnosis to codify a disorder related to excessive, compulsive, and out-of-control sexual behavior. The inclusion of this novel diagnosis demonstrates a clear need for valid assessments of this disorder that may be quickly administered in both clinical and research settings. Design: The present work details the development of the Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI) across seven samples, four languages, and five countries. Setting: In the first study, data were collected in community samples drawn from Malaysia (N = 375), the U.S. (N = 877), Hungary (N = 7,279), and Germany (N = 449). In the second study, data were collected from nationally representative samples in the U.S. (N = 1,601), Poland (N = 1,036), and Hungary (N = 473). Findings: Across both studies and all samples, results revealed strong psychometric qualities for the 7-item CSBD-DI, demonstrating evidence of validity via correlations with key behavioral indicators and longer measures of compulsive sexual behavior. Analyses from nationally representative samples revealed residual metric invariance across languages, scalar invariance across gender, strong evidence of validity, and utility in classifying individuals who self-identified as having problematic and excessive sexual behavior, as evidenced by ROC analyses revealing suitable cutoffs for a screening instrument. Conclusion: Collectively, these findings demonstrate the cross-cultural utility of the CSBD-DI as a novel measure for CSBD and provide a brief, easily administrable instrument for screening for this novel disorder.

News and future perspectives of non-surgical treatments for erectile dysfunction.

The significant discontinuation rate of available therapies and the paucity of curative options promoted the research on potential novel treatments suitable for erectile dysfunction patients. The aim of this study was to provide a summary of available evidence regarding the news and future perspectives related to the non-surgical treatment of erectile dysfunction. A narrative review of the literature was performed. A comprehensive search in the MEDLINE, Embase, and Scopus databases was done. Papers in English-language, published until April 2022, were included. No chronological restriction was applied. Retrospective and prospective clinical studies, as well as meta-analyses, were considered. Oro-dispersible formulations of phosphodiesterase type 5 inhibitors are particularly indicated in patients who have difficulty in swallowing solid dosage form; in addition, they constitute a discrete route of administration not requiring water. Low-intensity extracorporeal shock wave therapy is indicated in mild vasculogenic erectile dysfunction and in patients with vasculogenic erectile dysfunction poorly responsive to phosphodiesterase type 5 inhibitors. Stem cell therapy, platelet-rich plasma injections, and gene therapy seem promising regenerative treatments for selected patients with erectile dysfunction. Novel oral formulations of drugs commonly used in erectile dysfunction patients have recently become part of standard clinical practice. Regenerative treatments have been emerging in recent years and could become routine curative options in the near future. Further well-designed randomized controlled trials are needed to provide conclusive evidence on this topic and guide appropriate recommendations.

Withdrawal and tolerance as related to compulsive sexual behavior disorder and problematic pornography use - Preregistered study based on a nationally representative sample in Poland.

Background: The addiction model of compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) predicts the presence of withdrawal symptoms and increased tolerance for sexual stimuli in the disorder phenotype. However, clear empirical evidence supporting this claim has largely been lacking. Methods: In the preregistered, nationally representative survey (n = 1,541, 51.2% women, age: M = 42.99, SD = 14.38), we investigated the role of self-reported withdrawal symptoms and tolerance with respect to CSBD and PPU severity. Results: Both withdrawal and tolerance were significantly associated with the severities of CSBD (ß = 0.34; P < 0.001 and ß = 0.38; P < 0.001, respectively) and PPU (ß = 0.24; P < 0.001 and ß = 0.27; P < 0.001, respectively). Of the 21 withdrawal symptom types investigated, the most often reported symptoms were frequent sexual thoughts that were difficult to stop (for participants with CSBD: 65.2% and with PPU: 43.3%), increased overall arousal (37.9%; 29.2%), difficult to control level of sexual desire (57.6%; 31.0%), irritability (37.9%; 25.4%), frequent mood changes (33.3%; 22.6%), and sleep problems (36.4%; 24.5%). Conclusions: Changes related to mood and general arousal noted in the current study were similar to the cluster of symptoms in a withdrawal syndrome proposed for gambling disorder and internet gaming disorder in DSM-5. The study provides preliminary evidence on an understudied topic, and present findings can have significant implications for understanding the etiology and classification of CSBD and PPU. Simultaneously, drawing conclusions about clinical importance, diagnostic utility and detailed characteristics of withdrawal symptoms and tolerance as a part of CSBD and PPU, as well as other behavioral addictions, requires further research efforts.

Characteristics of attachment styles in adults diagnosed with psychotic disorders - a research review. / Charakterystyka stylów przywiazania u doroslych osób z rozpoznaniem zaburzen psychotycznych ­ przeglad badan.

Attachment theory offers a coherent conceptualisation of emotional bond formation, social functioning and affect regulation, which can be helpful in explaining the onset and course of mental disorders, as well as optimising the healing process. Despite the growing interest in the importance of attachment in psychopathology, this issue has not been explored in the population of patients suffering from psychotic disorders (PD) in Poland. The aim of this study is a comprehensive approach to attachment in adults in the context of PD, i.e. to integrate existing reports on the specificity of attachment in adults with PD and the role of attachment in the aetiology of PD, its course, patients' functioning, and the healing process. Attachment can provide an important theoretical perspective, offering opportunities to understand PD and to plan clinical strategies tailored to the individual needs of patients. Among people with psychotic disorders, insecure attachment patterns are more common, which corresponds to reports of increased prevalence of traumatising childhood experiences in this group. Insecure attachment can negatively affect the psychosocial functioning of people diagnosed with psychotic disorders in interpersonal relations, metacognitive skills and affect regulation. Relationships between insecure attachment and the severity and specificity of productive symptoms, especially hallucinations and delusions have been demonstrated. Patient attachment patterns can affect the interpersonal component of psychosis treatment, including relationships with psychiatric staff and therapeutic alliance. Considering this perspective by adjusting interactions to patient attachment patterns, as well as increasing safety in the therapeutic relationship can translate into improved patient treatment.

Mental and sexual health perspectives of the International Classification of Diseases (ICD-11) Compulsive Sexual Behavior Disorder •.

After introduction of compulsive sexual behavior disorder (CSBD) in the ICD-11, many questions regarding etiology, classification and diagnostic criteria remain unanswered, providing rationale for further research. In this commentary, we critically review the ongoing discussion reflected in some relevant articles, and try to point out the risks of oversimplification of the broad clinical phenomenon, as well as attract attention to the neglected aspects, such as psychosexual development, intimacy disorder and the role of sexological expertise in the assessment and treatment of individuals presenting with out-of-control sexual behaviors. We also advocate for multimodal, transtheoretical approach and suggest that CSBD may be reconsidered as a condition related to sexual health.

Predictors of Compulsive Sexual Behavior Among Treatment-Seeking Women.

BACKGROUND: Compulsive Sexual Behavior Disorder is currently included in the forthcoming eleventh revision of the International Classification of Diseases (ICD-11); however, prior studies have been conducted mostly on heterosexual, White/European male samples. AIM: To examine the correlates of compulsive sexual behaviors (CSB) with sociodemographic and sexual history characteristics, as well as predictors of CSB in a sample of treatment-seeking Polish women. METHODS: Six hundred seventy-four (674) Polish women aged 18-66 completed an online-based survey. OUTCOMES: Polish adaptation of the Sexual Addiction Screening Test-Revised (SAST-PL) was used to assess the severity of CSB symptoms. Brief Pornography Screen was used to measure problematic pornography use. The bivariate associations between SAST-PL scores and demographic and sexual history characteristics were also examined. A linear regression analysis was performed to identify variables related to the severity of CSB symptoms. RESULTS: Thirty one percent (31.8%) of women in the studied sample reported treatment seeking for CSB in the past. Problematic pornography use was the strongest predictor of CSB symptoms. Higher severity of CSB symptoms were observed among divorced/separated and single women compared to those who were married or in informal relation. Severity of CSB was positively related to the number of sexual partners during the last year, number of dyadic sexual intercourse during the last 7 days, and negatively associated with age of first sexual intercourse. CLINICAL IMPLICATIONS: Our results suggest that CSB is a significant concern among women and more research is needed to identify protective (eg, relationship status) and risk (eg, problematic pornography use, number of past year sexual partners, frequency of past week masturbation) factors associated with CSB symptom severity among treatment-seeking women. STRENGTHS & LIMITATIONS: Our study is one of very few investigating predictors of CSB among women. Given the lack of precise estimates of the prevalence, as well as lack of psychometrically validated instruments measuring CSB in women, present findings should not be considered indicative of CSB prevalence among Polish women. CONCLUSION: The lack of clinical data on women reporting issues with CSB remains an important target for future clinical research exploration. Kowalewska E, Gola M, Lew-Starowicz M, et al. Predictors of Compulsive Sexual Behavior Among Treatment-Seeking Women. Sex Med 2022;10:100525.

Dyadic relationships of people with schizophrenia. / Zwiazki diadyczne osób chorujacych na schizofrenie.

Creating successful partnerships is important for the overall quality of life. People suffering from schizophrenia experience significant difficulties in entering and maintaining dyadic relationships due to psychotic symptoms, consequences of the disease and its treatment or social stigmatization. Difficulties in creating intimate relationships are noticed already during adolescence, constituting one of the elements of prepsychotic changes. Among people diagnosed with schizophrenia, women more often than men create dyadic relationships, which may be due to the later onset of the disease, better indicators of social functioning, and favorable socio-cultural patterns. Among coupled individuals, the quality of their relationships is important for the course of the disease and treatment. People with schizophrenia often prefer to bond with other patients because of the possibility of creating a balanced relationship providing acceptance and support. Healthy partners of people with schizophrenia, due to the burden arising from the specificity of the disease and commitment to care for a sick partner, also need professional support. Issues regarding dyadic relationships should be included in a holistic therapeutic approach to people diagnosed with schizophrenia.

Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin.

BACKGROUND: A set of enduring conditions have been reported in the literature involving persistent sexual dysfunction after discontinuation of serotonin reuptake inhibiting antidepressants, 5 alpha-reductase inhibitors and isotretinoin. OBJECTIVE: To develop diagnostic criteria for post-SSRI sexual dysfunction (PSSD), persistent genital arousal disorder (PGAD) following serotonin reuptake inhibitors, post-finasteride syndrome (PFS) and post-retinoid sexual dysfunction (PRSD). METHODS: The original draft was designed using data from two published case series (Hogan et al., 2014 and Healy et al., 2018), which represent the largest public collections of data on these enduring conditions. It was further developed with the involvement of a multidisciplinary panel of experts. RESULTS: A set of criteria were agreed upon for each of the above conditions. Features of PSSD, PFS and PRSD commonly include decreased genital and orgasmic sensation, decreased sexual desire and erectile dysfunction. Ancillary non-sexual symptoms vary depending on the specific condition but can include emotional blunting and cognitive impairment. PGAD presents with an almost mirror image of unwanted sensations of genital arousal or irritability in the absence of sexual desire. A new term, post-SSRI asexuality, is introduced to describe a dampening of sexual interest and pleasure resulting from a pre-natal or pre-teen exposure to a serotonin reuptake inhibitor. CONCLUSIONS: These criteria will help in both clinical and research settings. As with all criteria, they will likely need modification in the light of developments.

Polish adaptation of emotional Stroop test in assessment of pedophilia - a pilot study. / Polska adaptacja zadania Stroopa w warunku emocjonalnym do oceny preferencji pedofilnych ­ badania pilotazowe.

OBJECTIVES: A pilot study was conducted in order to construct a Polish adaptation of emotional Stroop test in assessment of pedophilia. METHODS: The study consisted of two stages. The first stage involved creating test material by ranking words in adequate lists by competent experts. The second stage consisted of empirical verification of the principle of emotional Stroop test in a non-clinical population. RESULTS: Based on the assessment of five competent experts, words were ordered from the most to the least sexually arousing (Kendall's W from 0.368 to 0.693). Six ranked lists were obtained, and the competent experts were subsequently asked to assess whether these lists were suitable for the study (Lawshe's Content Validity Ratio from 0.6 to 1.0). Two categories of words were merged. Five ranked lists were obtained, and the competent experts were subsequently asked again to assess whether these lists were suitable for the study (Lawshe's Content Validity Ratio 1.0). The created lists of words were approved by allcompetent experts. Based on the experimental study conducted on a non-clinical population, it was shown that, in accordance with the principle of the test, the mean response time for sexually related words was longer that for neutral words. The mean response time for children-related words did not differ significantly from response time for neutral words. CONCLUSIONS: Based on the study with competent experts and conducted experiments, an initial Polish adaptation of the emotional Stroop test for diagnosis of pedophilia has been created. Further studies with persons with pedophilia are needed to implement the test in clinical setting.

Sexual Inhibition and Sexual Excitation Scales in Men: Psychometric Properties of a Polish Adaptation.

The present study aimed to develop a Polish version of the Sexual Inhibition/Sexual Excitation Scale (SIS/SES-PL) and explore its psychometric validity in a sample of 498 men aged between 18 and 55 years. We used exploratory and confirmatory factor analyses to obtain the best model fit. Out of the 45 items in the original scale, 32 items with eight subscales and three higher-order factors: (sexual excitation [SES], sexual inhibition due to performance failure [SIS1], and sexual inhibition due to performance consequences [SIS2]) were included in the SIS/SES-PL. The SIS/SES-PL was found to have a good and satisfactory fit (comparative fit index = .87; Tucker-Lewis Index = .85; root mean square error of approximation = .054; χ2 = 1108.7; p < .001; test-retest reliability Cronbach's alpha = .93). A small correlation between age and the SIS1 and SIS2 scores was detected. However, forward multiple regression analysis revealed a significant correlation only between age and SIS1 [ß = .23, p < .001, R2 for model = .05; F(1, 494) = 27.52, p < .001]. Furthermore, a moderate correlation between SIS1 and SES2, as well as SIS1 and general inhibition properties (measured using the Behavioral Inhibition Scale), was noted. In the case of SIS2, only small effects were observed, with the highest values for engaging in risky sexual behavior. Out of the total number of 42 variables, a moderate correlation between SES and the following was described: importance of sex, hypersexual behaviors, frequency of masturbation, frequency of sexual activities per month, sexual risk-taking, high promiscuity (measured using the Sociosexual Orientation Inventory Revised-Drive), general activation properties (measured using the Behavioral Activation Scale), neuroticism, and erotophilic tendencies (measured using the Sexual Opinion Survey-Short Form). The results of the study allowed us to conclude that the SIS/SES-PL might be a useful tool for tailoring therapy for men with sexual problems, as well as in the field of clinical research on sexual inhibition and excitation. Furthermore, it is a reliable and useful tool for measuring propensities for sexual excitement and inhibition.

Variability of Pornographic Content Consumed and Longest Session of Pornography Use Associated With Treatment Seeking and Problematic Sexual Behavior Symptoms.

INTRODUCTION: Most of the previous studies on problematic pornography use and related behavior have focused on such descriptors of pornography use habits as frequency or time devoted to pornography use. AIM: We argue that this constitutes a narrow view and indicators that characterize other aspects of explicit content consumption, namely (i) longest session of pornography viewing (which may be related to binge behavior), as well as (ii) variability of consumed pornographic content, can also be useful indicators. METHODS: An online study based on a sample of 132 heterosexual men seeking treatment for problematic pornography use, referred by therapists after their initial visit and 437 non-treatment seekers in the control group. MAIN OUTCOME MEASURES: The main outcomes of this study are reported longest, non-stop session of viewing pornography, variability in consumed pornographic content (including paraphilic and violent pornography), actual treatment seeking for problematic pornography use and severity of symptoms, and average weekly time devoted to pornography use. RESULTS: Our analysis showed that longest session of viewing pornographic content as well as the variety of consumed pornography influenced the decision to seek treatment and the severity of symptoms even when the sheer amount of time devoted to pornography use was controlled. CONCLUSION: This is one of the few studies examining the role of engagement in prolonged sessions of pornography use and the variability of consumed pornographic content in the clinical context of problematic sexual behavior. The study's main limitations are its relatively narrow method of operationalization of variability of pornographic content and longest session of pornography viewing, as well as its cross-sectional, online, and anonymous character. As the described factors have an important influence on treatment seeking and the severity of experienced symptoms, they should be considered in the process of assessing compulsive sexual behavior disorder and related symptoms. Lewczuk K, Lesniak J, Lew-Starowicz M, et al. Variability of Pornographic Content Consumed and Longest Session of Pornography Use Associated With Treatment Seeking and Problematic Sexual Behavior Symptoms. Sex Med 2021;9:100276.

Spotlight on Compulsive Sexual Behavior Disorder: A Systematic Review of Research on Women.

PURPOSE OF REVIEW: World Health Organization recently included compulsive sexual behavior disorder (CSBD) to the upcoming 11th edition of International Classification of Diseases (6C72). Despite the potential benefits of this decision (eg, the acceleration of research in the field will allow the development of effective treatments), previous research focused mainly on men, and as a result, we do not have an accurate clinical picture of compulsive sexual behavior (CSB) among women. Therefore, in this systematic review, we aim to present available knowledge on this topical subject. Literature search was conducted in the guideline of PRISMA methodology. Studies were identified from multiple databases including Academic Search Ultimate, SocINDEX, PsycARTICLES, PsycINFO, PubMed, and MEDLINE. Out of a total of 10,531 articles identified and screened, 58 were included in this review. Included studies covered the following topics: prevalence and etiology of CSB, behavioral and cognitive processes involved, comorbidities, personality traits, psychosocial and interpersonal difficulties, traumatic experiences, and treatments. RECENT FINDINGS: Available studies indicate that CSB symptom severity is lower in women than in men. Overall, women reported consuming pornography less often than men and exhibit lower rates of feeling urges to these materials. CSB symptoms (including problematic pornography use) have been found to be positively related to trait psychopathy, impulsivity, sensation seeking, attention-deficit/hyperactivity disorder symptoms, obsessive-compulsive disorder, pathological buying, sexual dysfunctions, general psychopathology, child sexual abuse, while negatively related to dispositional mindfulness. SUMMARY: Conclusions that can be drawn from prior studies are considerably limited. There are no accurate estimates of the CSB prevalence or severity among women, and studies have been mostly conducted on non-clinical populations, which has limited application for women diagnosed with CSBD.