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An increasing number of studies are concerned with various aspects of cybersex addiction, the difficulty some persons have in limiting cybersex use despite a negative impact on everyday life.
The aim of this study was to assess potential links between the outcome variable cybersex addiction, assessed with the Compulsive Internet Use Scale (CIUS) adapted for cybersex use, and several psychological and psychopathological factors, including sexual desire, mood, attachment style, impulsivity, and self-esteem, by taking into account the age, sex, and sexual orientation of cybersex users.
A Web-based survey was conducted in which participants were assessed for sociodemographic variables and with the following instruments: CIUS adapted for cybersex use, Sexual Desire Inventory, and Short Depression-Happiness Scale. Moreover, attachment style was assessed with the Experiences in Close Relationships-Revised questionnaire (Anxiety and Avoidance subscales). Impulsivity was measured by using the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency Impulsive Behavior Scale. Global self-esteem was assessed with the 1-item Self-Esteem Scale.
A sample of 145 subjects completed the study. Addictive cybersex use was associated with higher levels of sexual desire, depressive mood, avoidant attachment style, and male gender but not with impulsivity.
Addictive cybersex use is a function of sexual desire, depressive mood, and avoidant attachment.
The internet is widely used in everyday life, including for health-related queries [
Moderate use of cybersex may contribute to the expansion of sexual knowledge and enhance offline intimate interactions and sexual communications with partners [
Several studies have reported similarities between addictive cybersex and other addictive disorders, including reduction in executive prefrontal control (the ability to select actions or thoughts in relation to internal goals) [
Possible determinants of addictive cybersex have nonetheless received preliminary attention. Sexual desire reflects the powers that draw a person toward or away from sexual behavior [
The attachment theory argues that as a result of their childhood interactions with parents and relatives, people develop beliefs about their relations to others that come to shape their future affective, intimate, and sexual relationships and behaviors according to their attachment styles [
Such adult attachment styles seem to influence sexual experiences, intimate relationships, and sexual behaviors and satisfaction [
Moreover, impulsivity is a multifaceted psychological and neuropsychological construct leading to the fulfillment of behaviors without careful anticipation [
A recent self-report measure of impulsivity is the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency (UPPS-P) Impulsive Behavior Scale, which has been translated with stable factor structure into numerous languages [
Despite a possible broader conception, sexual orientation can be described as homosexuality, bisexuality, or heterosexuality [
The aim of this study was to assess the links between cybersex addiction and several psychological and psychopathological factors, including sexual desire, mood, attachment style, and impulsivity, by taking into account the age, sex, and sexual orientation (heterosexual, homosexual, or bisexual) of cybersex users. We expected to find an influence of the selected variables on cybersex addiction.
The participants consisted of users of cybersex sites and forums recruited via advertising on specialized forums and websites (pornographic sites, chat rooms, and dating sites). To be included, participants had to be more than 18 years old and to understand the languages of the questionnaires (French or English). There was no incentive for participation. The participants gave consent and then completed the questionnaires anonymously via SurveyMonkey links. The survey responses were sent over a secure—Secure Sockets Layer—encrypted connection. Internet protocol addresses were used only to check for double participation. The study did not use the participants’ names, nicknames, or email addresses, and the data were analyzed anonymously. The study protocol was approved by the Ethical Committee of the Geneva University Hospitals.
The recruitment procedure resulted in 761 people clicking on the link to participate in the study, of whom 605 gave their consent. The participant completion rate decreased along the length of the questionnaire. Among the 605 subjects who gave their consent, 358 continued past the demographics section. Only 226 subjects continued to the last part, the questionnaire section. After missing values were removed, the final sample included 145 participants.
The Compulsive Internet Use Scale (CIUS) [
Consisting of 14 items on a Likert scale, the Sexual Desire Inventory (SDI) was used to evaluate sexual desire (eg, “When you first see an attractive person, how strong is your desire?”) [
Four items are scored from 0 (not at all) to 7 (more than once a day). The other items are answered on a 9-point Likert scale ranging from 0 (no desire) to 8 (strong desire). Higher SDI scores reveal higher sexual desire.
The Short Depression-Happiness Scale (SDHS) was used to evaluate mood variation from depressive mood (eg, “I felt dissatisfied with my life”) to happiness (eg, “I felt happy”) during the last 7-day period. It consists of 6 items, 3 positive and 3 negative, rated on a 4-point Likert scale ranging from 0 (never) to 3 (often). The lower the score, the higher the depressive symptoms [
This Experiences in Close Relationships-Revised (ECR-R) questionnaire was used to evaluate attachment style [
The UPPS-P Impulsive Behavior Scale [
This 1-item scale (“I have high self-esteem”) was used to measure global self-esteem [
Age, gender (male or female), marital status (single, in a relationship—married, in a relationship—not married, widow, or widower), and sexual orientation (measured with a question asking whether the subject described himself or herself as heterosexual, homosexual, or bisexual) were also assessed.
Due to the small sample size for sexual orientation and marital status, demographics were compared between men and women by using the Fisher exact test, whereas the Wilcoxon rank sum test was performed for age. Regarding the different scales, when missing items represented less than or equal to 10% of all items on a specific scale (16.6% for the SDHS because it has only 6 items), the missing answer was replaced with the mean of the subject’s responses to the items on that scale (person-mean imputation). Internal consistency was assessed with Cronbach alpha [
A linear mixed model is a statistical model containing both fixed effects, as in a classical linear regression, and random effects [
To determine whether the tested model was valid, we performed residual analyses and collinearity diagnostics. Residual analysis showed graphically that residuals were normally distributed, that there were no extreme values, and that they were homoscedastic. Regarding collinearity diagnostics, no variance inflation factor was higher than 4, which suggests that no collinearity problems were present [
The study involved 145 participants. When we compared the 145 included subjects with those who at least provided their age, sex, and sexual orientation, no statistical differences were found.
Demographics of the participants.
Characteristic | Whole sample | Women (n=58) | Men (n=87) | ||
Age, median (range) | 31 (18-70) | 28 (18-70) | 36.5 (18-70) | .014a | |
0.87 | |||||
Heterosexual | 113 (77.9) | 44 (38.9) | 69 (61.1) | ||
Homosexual | 11 (7.6) | 5 (45.5) | 6 (54.5) | ||
Bisexual | 21 (14.5) | 9 (42.9) | 12 (57.1) | ||
0.49 | |||||
Single | 58 (40.0) | 21 (36.2) | 37 (63.8) | ||
In a relationship | 87 (60.0) | 37 (42.5) | 50 (57.5) |
aW statistic for the Wilcoxon rank sum test is 2500.5.
bWomen/men proportions are within sexual orientation categories.
cWomen/men percentages are within marital status categories.
The results of the linear mixed model are reported in
Description of the instruments.
Instrument | Mean (SD) | Cronbach alpha | 95% CI | |
Compulsive Internet Use Scale | 14.64 (9.84) | .89 | 0.89-0.91 | |
Sexual Desire Inventory | 70.83 (17.66) | .87 | 0.84-0.90 | |
Short Depression-Happiness Scale | 11.29 (4.38) | .86 | 0.83-0.90 | |
Anxious attachment | 3.39 (1.33) | .92 | 0.91-0.94 | |
Avoidant attachment | 3.07 (1.04) | .89 | 0.86-0.91 | |
Positive urgency | 10.44 (2.57) | .74 | 0.67-0.81 | |
Negative urgency | 8.64 (3.04) | .86 | 0.82-0.89 | |
Lack of premeditation | 7.45 (2.64) | .80 | 0.75-0.85 | |
Lack of perseverance | 7.34 (2.66) | .84 | 0.80-0.88 | |
Sensation seeking | 11.31 (2.70) | .80 | 0.74-0.85 | |
Single-Item Self-Esteem Scale | 2.61 (0.83) | —b | — |
aUrgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency.
bNot applicable.
Results of the linear mixed model.
Characteristics and measures | Regression coefficient | Standard error | Standardized coefficients | |||
Female versus male | −3.82 | 1.75 | −2.18 (128) | .03 | −0.19 | |
Homosexual | 0.08 | 3.67 | 0.02 (128) | .98 | 0.07 | |
Bisexual | −1.37 | 2.61 | −0.52 (128) | .60 | 0.10 | |
Homosexual | 1.62 | 5.58 | 0.29 (128) | .77 | 0.08 | |
Bisexual | 5.81 | 4.13 | 1.41 (128) | .16 | 0.29 | |
Sexual Desire Inventory | ||||||
Self-esteem | −0.68 | 1.00 | −0.67 (128) | .50 | −0.06 | |
Positive urgency | 0.19 | 0.33 | 0.57 (128) | .57 | 0.06 | |
Negative urgency | −0.15 | 0.37 | −0.39 (128) | .69 | −0.04 | |
Lack of premeditation | 0.31 | 0.34 | 0.92 (128) | .35 | 0.08 | |
Lack of perseverance | −0.07 | 0.36 | −0.20 (128) | .84 | −0.02 | |
Sensation seeking | 0.07 | 0.30 | 0.25 (128) | .80 | 0.02 | |
Short Depression-Happiness Scale | − |
− |
− |
|||
Anxiety | −0.56 | 0.70 | −0.81 (128) | .42 | −0.08 | |
Avoidance |
aItalics represents significant regression parameters.
bUrgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency.
The aim of this study was to study cybersex addiction and to assess the links between cybersex addiction and possible determinants of such behavior, namely, sexual desire, mood, attachment style, and impulsivity, by taking into account the age, sex, and sexual orientation of cybersex users. We concluded that addictive cybersex use, as assessed by the CIUS adapted for sexual activities, is associated with sexual desire, depressive mood, an avoidant attachment style, and male gender. As shown in
Sexual desire is an important drive for sexual behavior and is positively associated with emotional intimacy [
Our finding of an association between addictive cybersex use and depressive mood is congruent with other studies that showed the importance of links between addictive cybersex and diverse assessments of psychological distress and mood [
We also found an association between addictive cybersex use and avoidant attachment but not anxious attachment. These results are congruent with those of other studies showing the implications of insecure attachment in excessive internet use [
Impulsivity and cybersex addiction were not significantly associated in our study. The results of the study at hand contrast with those of other studies regarding the links between the UPPS-P and internet-related addictive behaviors [
In light of such observations across studies, one may hypothesize that some impulsivity facets may contribute to addictive cybersex without having a main determinant effect on such behavior. This may contribute to disparities between studies. Furthermore, such differences are possibly influenced by sample size, the specific type of cybersex activities (ie, possible differences between porn use and sex dating), and other assessments involved in the analyses. For instance, our study included measures of attachment, a construct not included in the previously mentioned studies. However, we cannot exclude the possibility of modifications in executive functions when an individual faces specific cybersex cues [
Self-esteem had no impact on CIUS scores. This result contradicts those of other studies that show, for instance, an association between low self-esteem and adolescent sexting (sharing sexual photos) [
This study also showed an association between addictive cybersex and male gender, as has repeatedly been found [
Among a population of cybersex users, our study showed no association between age and cybersex addiction. Most studies on cybersex have involved adolescents and young adults [
In this study, sexual orientation had no effect on the assessed behavior. Similarly, no effect was found in the interactions between gender and sexual orientation. However, sexual orientation was assessed in only 3 main categories (heterosexual, bisexual, and homosexual). Future studies would benefit from more refined evaluations of sexual orientation [
Cybersex is associated with addictive use for only a small number of users [
The findings of this study have clinical implications. It seems important to consider cybersex addiction in terms of its principal connections with several psychological dimensions. Particular attention should be given to the patient’s patterns of attachment. Psychotherapeutic treatment has to be tailored to the specific needs of each patient. People with avoidant attachment, for example, may benefit from a psychotherapeutic approach designed to integrate treatment of addiction and attachment disturbances. Future studies for the assessment and treatment of cybersex addiction are needed in clinical settings.
Several limitations of the study must be considered. The sample was relatively small but adequate for the study statistics. Furthermore, the sample was exposed to self-selection biases [
Despite these limitations, this study indicates that addictive cybersex is influenced by an avoidant attachment style, depressive mood, and sexual desire. Males are at increased risk. Self-esteem and impulsivity do not seem to have a significant influence on addictive cybersex. Further research, including prospective studies, is needed in the field.
Compulsive Internet Use Scale
Experiences in Close Relationships-Revised
Short Depression-Happiness Scale
Sexual Desire Inventory
Single-Item Self-Esteem Scale
Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency) Impulsive Behavior Scale
No funding was received for this study. The authors thank the study participants.
NV, YK, FBD, and SR were involved in the study concept and design. SR, YK, and NV were involved in statistical analysis and interpretation of data. TL, KJ, and YK were involved in the recruitment of participants. NV, YK, KJ, TL, SR, and FBD were involved in writing of the manuscript.
None declared.