Alexithymia and problematic sexual behaviour: the mediation of dissociative patterns

Sex addiction is a behavioural addiction that has received increasing scientific attention in recent years. Indeed, problematic sexual behaviours represent a growing clinical concern, often associated with significant emotional distress and interpersonal difficulties. In light of this, the present study aimed to investigate its psychological antecedents by exploring the role of alexithymia and dissociation, and by examining the effect of gender as a covariate.

A sample of 326 participants completed validated self-report measures assessing alexithymia, dissociative experiences, and problematic sexual behaviour. Data analysis included ANOVAs, regression models, and a path analysis.

The results showed that two subdimensions of alexithymia (difficulty in identifying feelings and difficulty in describing feelings) were significantly associated with higher levels of sex addiction. Moreover, the dissociation subdimension of absorption significantly mediated both relationships, while dissociative amnesia and depersonalization/derealization did not show significant mediation effects. Gender also played a role, with male participants reporting higher levels of problematic sexual behaviour.

These findings offer novel insight into the emotional and dissociative processes underlying sex addiction. The results emphasize the central role of absorption (a form of dissociation involving deep immersion in internal experience) as a potential emotional avoidance strategy that may sustain compulsive sexual behaviours. Understanding these mechanisms can guide future research and inform the development of targeted clinical interventions. Additionally, the relevance of gender differences suggests the importance of considering sex-specific pathways in assessment and treatment planning.