Attachment Anxiety and Avoidance in Dysregulated Sexuality and the Role of Mentalizing Ability

Mentalizing ability - the capacity to understand behavior as motivated by intentional mental states - develops within attachment relationships and has recently been suggested to influence sexual health. This study examined whether mentalizing ability and attachment insecurity (anxiety, avoidance) are associated with dysregulated sexuality (hypersexual behavior, low sexual desire), and whether mentalizing ability mediates these associations. Participants recruited online were classified according to self-reported high (n = 221 women, n = 732 men) or low sex drive (n = 680 women, n = 262 men), completed questionnaires on attachment, mentalizing ability, sexual desire, and hypersexual behavior. Among men and women with high sex drive, both attachment anxiety and avoidance were positively associated with hypersexual behavior, while mentalizing ability was negatively associated with hypersexual behavior. Moreover, mentalizing ability partially mediated the association between attachment insecurity and hypersexual behavior. Among participants with low sex drive, mentalizing ability partially mediated the negative association between attachment avoidance and sexual desire only in men. Similarly, only among men, both attachment anxiety and mentalizing ability were positively associated with sexual desire, yet no mediation was found. Overall, mentalizing ability appears to be a mechanism linking insecure attachment to hypersexual behavior, while being less central to low sexual desire.