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Evaluation of Behavior Subtypes of Sexual Addiction: a Latent Profile Analysis of Sexual Behaviors

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Evaluation of Behavior Subtypes of Sexual Addiction: a Latent Profile Analysis of Sexual Behaviors The University of Southern Mississippi The Aquila Digital Community Dissertations Summer 8-2013 Evaluation of Behavior Subtypes of Sexual Addiction: A Latent Profile Analysis of Sexual Behaviors Nicole Lea Blazek University of Southern Mississippi Follow this and additional works at: https://aquila.usm.edu/dissertations Part of the Clinical Psychology Commons Recommended Citation Blazek, Nicole Lea, "Evaluation of Behavior Subtypes of Sexual Addiction: A Latent Profile Analysis of Sexual Behaviors" (2013). Dissertations. 161. https://aquila.usm.edu/dissertations/161 This Dissertation is brought to you for free and open access by The Aquila Digital Community. It has been accepted for inclusion in Dissertations by an authorized administrator of The Aquila Digital Community. For more information, please contact [email protected]. The University of Southern Mississippi EVALUATION OF BEHAVIORAL SUBTYPES OF SEXUAL ADDICTION: A LATENT PROFILE ANALYSIS OF SEXUAL BEHAVIORS by Nicole Lea Blazek A Dissertation Submitted to the Graduate School of The University of Southern Mississippi in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Approved: Randolph C. Arnau, Ph.D. Bradley A. Green, Ph.D. Tammy Barry, Ph.D. Richard Mohn, Ph.D. Susan A. Siltanen . August 2013 The University of Southern Mississippi EVALUATION OF BEHAVIORAL SUBTYPES OF SEXUAL ADDICTION: A LATENT PROFILE ANALYSIS OF SEXUAL BEHAVIORS by Nicole Lea Blazek Abstract of a Dissertation Submitted to the Graduate School of The University of Southern Mississippi in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy August 2013 ABSTRACT EVALUATION OF BEHAVIORAL SUBTYPES OF SEXUAL ADDICTION: A LATENT PROFILE ANALYSIS OF SEXUAL BEHAVIORS by Nicole Lea Blazek August 2013 Sexual addiction has been characterized as out of control sexual behavior that leads to decreased functioning and negative consequences in a number of areas (Kafka, 2010). The current study aimed to demonstrate whether or not homogenous classes of individuals presenting for treatment and diagnosed with sexual addiction could be identified utilizing a person-centered approach, Latent Profile Analysis, using sexual behavior frequency scales from the Sexual Dependency Inventory-4.0 (SDI-4.0; Green, Arnau, & Carnes, 2013) as indicators. After identifying the distinct subclasses of sexual behaviors, the study examined the nature of the groups through an analysis of external correlates of group membership. Specific external correlates that were examined included personality and psychopathology traits measured by the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegan, 2008). The current study identified five latent classes of men presenting for treatment of sexual addiction based upon their sexual behaviors using Latent Profile Analysis. These classes could be described as one that engaged in below average levels of sexually addictive behaviors, one that engaged in humiliation, domination and pain exchange behaviors, another that reported average levels of sexual addiction behaviors, a fourth that reported the use of drugs, exhibitionism and anonymous sexual behaviors and a final class of individuals who used money and power to support their sexual behaviors. Participants in the current study shared a number of presenting concerns including engaging in ii compulsive sexual behaviors, being distressed about their actions and experiencing consequences related to their addiction. These similarities suggested these individuals’ presenting concerns may be best accounted for by shared phenomenon, such as a diagnosis of sexual addiction. However, the results of the current study also indicated that these classes differed in terms of personality traits, psychopathology, demographic variables and the types and number of consequences related to their sexually addictive behaviors. Therefore, careful assessment and treatment planning should be conducted in order to address these differences and to develop the most effective treatment interventions. iii COPYRIGHT BY NICOLE LEA BLAZEK 2013 ACKNOWLEDGMENTS I would like to thank my dissertation committee chair and mentor, Dr. Randolph Arnau, without whom this manuscript would never have been possible. His patience, dedication and own brand of wit helped me persevere and stay sane throughout the process. A special thanks to Dr. Bradley Green whose dedication to the database used for the analyses is greatly appreciated. His hard work and venerable devotion to numerous research projects never ceases to amaze. To Dr. Tammy Barry I am especially grateful as she stepped in right when I needed her without pause. She never hesitates to take on a project and help others and has always been an inspiration for the type of researcher and professional I aspire to become. Finally, I would like to thank Dr. Richard Mohn for being willing to participate on my committee and for his advice about statistical procedures. This work was supported, in part, by Grant #2012-50 from the American Foundation for Addiction Research to Dr. Patrick Carnes and by a grant from the University of Minnesota Press to Randolph C. Arnau and Bradley A. Green. iv TABLE OF CONTENTS ABSTRACT ....................................................................................................................... ii ACKNOWLEDGMENTS ................................................................................................. iv LIST OF TABLES ............................................................................................................ vii LIST OF ILLUSTRATIONS ........................................................................................... viii CHAPTER I. INTRODUCTION .........................................................................................1 Conceptualizations of Excessive Sexual Behaviors Assessment of Sexual Addiction DSM-IV and DSM-5 Conceptualization of Sexual Acting Out Personality and Psychopathology Correlates of Sexual Addiction MMPI-2 and MMPI-2-RF and Sexual Addiction The Current Study II. METHOD .....................................................................................................24 Participants Participants Instruments Procedures III. RESULTS ....................................................................................................33 Latent Profile Analysis Differences in SDI-4.0 Behavior Scale Means for the Five Class Model External Validation of Classes IV. DISCUSSION ..............................................................................................69 Class Makeup Based upon Sexual Behaviors Differences Between the Classes on External Variables Implications from the Current Study for Sexual Addiction Conceptualizations and Diagnoses Implications for Assessment of Sexual Addiction Sexual Addiction Treatment Implications Limitations and Future Research Conclusions v APPENDIXES .................................................................................................................100 REFERENCES ................................................................................................................107 vi LIST OF TABLES Table 1. Goodness of Fit for SDI-4.0 Behavior Scale Models Based on Different Number of Classes ...............................................................................................................34 2. Mean SDI-4.0 Behavior Scale T-Scores and ANOVA results for Five Class Latent Profile Model ........................................................................................................46 3. Mean MMPI-2-RF Higher-Order Scale scores and ANOVA results for Five Class Latent Profile Model ..............................................................................................53 4. Mean Restructured Clinical Scale Scores and ANOVA results for Five Class Latent Profile Model ..............................................................................................55 5. Mean Somatic/Cognitive Scale Scores and ANOVA results for Five Class Latent Profile Model .........................................................................................................58 6. Mean Internalizing Scale Scores and ANOVA results for Five Class Latent Profile Model .........................................................................................................59 7. Mean Externalizing and Interpersonal Scale Scores and ANOVA results for Five Class Latent Profile Model ....................................................................................62 8. Mean Psychopathology-Five Scale Scores and ANOVA results for Five Class Latent Profile Model ..............................................................................................65 9. Mean Consequences Experienced due to Sexual Behaviors Total Scores and ANOVA results for Five Class Latent Profile Model ............................................68 vii LIST OF ILLUSTRATIONS Figure 1a. Average MMPI-2-RF Higher-Order Scale Scores for the Total Sample ...............29 1b. Average MMPI-2-RF Restructured Clinical Scale Scores for the Total Sample .30 1c. Average MMPI-2-RF Somatic/Cognitive and Internalizing Scale Scores for the Total Sample ..........................................................................................................30 1d. Average MMPI-2-RF Externalizing, Interpersonal and Interest Scale Scores for the Total Sample ...................................................................................................31
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