Mood and Sexual Wellbeing in Women at Risk of Compulsive Sexual Behaviour: Evidence from a Large Western Sample

Abstract

Compulsive sexual behaviour (CSB) in women remains woefully understudied, despite emerging evidence that up to 30% of individuals struggling with CSB are female. Thus, in this thesis, I investigated some psychological correlates and mechanisms related to CSB in women using cross-sectional data from the International Sex Survey (N ≈ 20,000 women). Specifically, I examined associations between CSB and aspects of sexual wellbeing, including sexual function, desire, distress, and sexual and relationship satisfaction, as well as the role of sensation-seeking and mood symptoms (depression and anxiety). Notable proportions of the sample reported sexual dysfunction (16.4%), sexual distress (20.8%), anxiety (23%), and depression (21.9%), with 2.2% meeting the clinical threshold for compulsive sexual behaviour disorder (CSBD). Twelve percent of women meeting criteria for depression also reported high sexual desire. Women at risk of CSB reported poorer sexual function; higher sexual desire, sexual distress, sensation-seeking, depression, and anxiety; and lower sexual and relationship satisfaction than women not at risk. Confirming previous research, CSB showed significant, moderate, and robust positive associations with both depression and anxiety. However, for women, sexual desire predicted CSBD symptoms at all levels of depression, not anxiety. Relatedly, high sexual desire accounted for a small portion of the association between depression and CSB. Sensation-seeking and sexual distress strengthened the link between desire and CSB, and relationship satisfaction attenuated it, but these factors did not alter the indirect effect of depression on CSB. My results highlight a constellation of factors—depression, elevated sexual desire, distress, sensation-seeking, and relationship dissatisfaction—which might contribute to CSB and interfere with women’s sexual wellbeing. These findings may inform the development of treatment protocols and underscore the need for more nuanced, gender-inclusive conceptualizations of CSB. Further research is needed to clarify the directionality of associations and causal mechanisms specific to women.