Is hypersexuality dimensional? Evidence for the DSM-5 from general population and clinical samples

Hypersexual Disorder is currently being considered for inclusion in the DSM-5. To inform this process, we investigated the latent structure of the hypersexuality construct using Meehl's (1995) taxometric method. Data on sexual interests and behaviors were obtained from 2,101 general population males and females in Sweden and 716 male sex offenders from the United States. Taxometric analyses of self-report indicators of hypersexuality supported a dimensional interpretation of latent structure in both samples. These findings suggest that individual differences in hypersexuality are quantitative (matter of degree) rather than qualitative (difference in kind) in nature, at least when self-report data were used. This is another way of saying that hypersexuality is organized along a continuum of increasing sexual frequency and preoccupation, with clinical cases of hypersexuality falling at the upper end of the continuum or dimension. We conclude that the proposed inclusion of Hypersexual Disorder in the DSM-5 should acknowledge the lack of non-arbitrary breaks in the latent symptoms continuum which runs from very low to very high engagement in sexual behavior and preoccupation. The diagnostic threshold should therefore be decided from an analysis of external data on severity, comorbidity, and prognosis for individuals with sub-threshold and full diagnoses, respectively. Additionally, dimensional assessment of Hypersexual Disorder should be part of clinical diagnostic practice.