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Sexual Abuse: A Journal of Research and Treatment
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Hypersexual Desire in Males: Are Males With Paraphilias Different From Males With Paraphilia-Related Disorders?

Martin P. Kafka

McLean Hospital, Belmont, Massachusetts, mpkafka{at}aol.com, Harvard Medical School, Boston, Massachusetts

John Hennen

Biostatistics Laboratory, McLean Hospital, Belmont, Massachusetts

The assessment of current sexual behavior (fantasies, urges, and activities) and sexual preoccupation (measured in minlday) associated with both conventional (i.e., adult relationship-associated) or unconventional (paraphilia and paraphilia-related) sexual behavior were ascertained from a sample of 120 consecutively evaluated males with paraphilias (PA; n = 88, including sex offender paraphiliacs ; n = 60) and paraphilia-related disorders (PRD; n = 32). In addition, an assessment of hypersexual desire, defined as the highest sustained period (at least 6 months minimum duration) ofpersistently enacted sexual behavior (total sexual outlet/week [TSO] after age 15) was assessed. In almost all measures, the PA and PRD groups were not statistically significantly different. The average PA or PRD reported a mean hypersexual TSO of 11.7 ± 7.3, a mean age of 21.6 ± 7.1 years at onset of peak hypersexual behavior, and a mean duration of 6.2 ± 7.6 years of hypersexual TSO. When the sample was stratified into three subgroups on the basis of the lifetime number of PAs+PRDs as a proxy measure of the severity of sexual impulsivity, the "high" group, with at least 5 lifetime PAs and PRDs, consisted of all paraphilic males, predominantly sex offenders, who self-reported the highest hypersexual desire (14.3 ± 7.9), the highest current TSO/week (9.9 ± 8.1), the most current sexual preoccupation (2-4 hr/day), and the highest likelihood of incarceration secondary to paraphilic sex-offending behavior. Although hypersexual desire, a quantitative measure of enacted sexual behaviors, may be a meaningful construct for clinically derived samples, the incidence and prevalence of hypersexual desire in community samples of males with paraphilias and paraphilia-related disorders is unknown.

Key Words: hypersexual • paraphilia • paraphilia-related disorder • sexual desire • sexual preoccupation • total sexual outlet • sex offender • sexual addiction.

Sexual Abuse: A Journal of Research and Treatment, Vol. 15, No. 4, 307-321 (2003)
DOI: 10.1177/107906320301500407
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