Skip to main content

Advertisement

SpringerLink
Log in

Exploring Gender Differences in the Relationship Between Dispositional Mindfulness and Compulsive Sexual Behavior Among Adults in Residential Substance Use Treatment

  • ORIGINAL PAPER
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

Objectives

Compulsive sexual behavior (CSB) is overrepresented among adults with substance use disorders (SUD), yet there is no empirically supported CSB treatment for this population. Cross-sectional and single case designs supported dispositional mindfulness as a potential CSB intervention target. However, the relations between CSB and each of the five dispositional mindfulness facets remain unknown.

Methods

Extending prior research to inform intervention efforts, we reviewed medical records for 1993 adults (77.6% male) in residential treatment for SUD to examine gender differences in the relations between dispositional mindfulness facets (acting with awareness, observation of experience, describing with words, nonjudging of inner experience, and nonreactivity to inner experience) and five CSB indicators (loss of control, relationship disturbance, preoccupation, affect disturbance, and internet problems).

Results

For men, path analyses revealed that acting with awareness, nonjudging of inner experience, describing with words, nonreactivity to inner experience, alcohol/drug use and problems, and depression and anxiety symptoms related to CSB (p range .00–.04). For women, acting with awareness, nonjudging of inner experience, alcohol/drug use and problems, and depression symptoms related to several CSB indicators (p range .00–.04).

Conclusions

Mindfulness-based CSB interventions should evaluate the benefit of increasing intentional responses towards present-moment experiences among adults with SUD. Targeting alcohol/drug misuse, negative affect, and judgment towards thoughts and emotions may be beneficial.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Book  Google Scholar 

  • Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). The alcohol use disorders identification test: guideline for use in primary care (2nd ed.). Geneva: World Health Organization.

    Google Scholar 

  • Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504.

    Article  Google Scholar 

  • Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., Walsh, E., Duggan, D., & Williams, J. M. G. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342. https://doi.org/10.1177/1073191107313003.

    Article  Google Scholar 

  • Bancroft, J., & Vukadinovic, Z. (2004). Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model. Journal of Sex Research, 41, 225–234.

    Article  PubMed  Google Scholar 

  • Bergomi, C., Tschacher, W., & Kupper, Z. (2013). The assessment of mindfulness with self-report measures: existing scales and open issues. Mindfulness, 4, 191–202.

    Article  Google Scholar 

  • Bowen, S., & Enkema, M. C. (2014). Relationship between dispositional mindfulness and substance use: findings from a clinical sample. Addictive Behaviors, 39, 532–537.

    Article  PubMed  Google Scholar 

  • Brem, M. J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2017a). Depression, anxiety, and compulsive sexual behavior among men in residential treatment for substance use disorders: the role of experiential avoidance. Journal of Clinical Psychology and Psychotherapy, 24, 1246–1253.

    Article  PubMed  Google Scholar 

  • Brem, M. J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2017b). Dispositional mindfulness, shame, and compulsive sexual behaviors among men in residential treatment for substance use disorders. Mindfulness, 8(6), 1552–1558.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brem, M. J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2017c). Experiential avoidance as a mediator of the relationship between dispositional mindfulness and compulsive sexual behaviors among men in residential substance use treatment. Sexual Addiction and Compulsivity, 24(4), 257–269.

    Article  PubMed  Google Scholar 

  • Brem, M. J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2018). Dispositional mindfulness and compulsive sexual behavior among women in residential treatment for substance use disorders. Mindfulness, 9(1), 98–104. https://doi.org/10.1007/s12671-017-0748-4.

    Article  Google Scholar 

  • Brem, M. J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2018). Does experiential avoidance explain the relationships between shame, PTSD symptoms, and compulsive sexual behavior among women in substance use treatment? Clinical Psychology and Psychotherapy, 25(5), 692–700. https://doi.org/10.1007/s12671-017-0748-4.

  • Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Mindfulness: theoretical foundations and evidence for its salutary effects. Psychological Inquiry, 18(4), 211–237.

    Article  Google Scholar 

  • Carnes, P. (2001). Out of the shadows: understanding sexual addiction. Center City: Hazelden Publishing.

    Google Scholar 

  • Carnes, P., Green, B., & Carnes, S. (2010). The same yet different: refocusing the sexual addiction screening test (SAST) to reflect orientation and gender, sexual addiction and compulsivity. The Journal of Treatment and Prevention, 17(1), 7–30.

    Google Scholar 

  • Chiesa, A., & Serretti, A. (2014). Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence. Substance Use and Misuse, 49(5), 492–512.

    Article  PubMed  Google Scholar 

  • Crowe, K., & McKay, D. (2016). Mindfulness, obsessive-compulsive symptoms, and executive dysfunction. Cognitive Therapy and Research, 40(5), 627–644.

    Article  Google Scholar 

  • Deneke, E., Knepper, C., Green, B. A., & Carnes, P. J. (2015). Comparative study of three levels of care in a substance use disorder inpatient facility on risk for sexual addiction. Sexual Addiction and Compulsivity, 22(2), 109–125.

    Article  Google Scholar 

  • Eisenlohr-Moul, T. A., Walsh, E. C., Charnigo, R. J., Jr., Lynam, D. R., & Baer, R. A. (2012). The “what” and the “how” of dispositional mindfulness: using interactions among subscales of the five-facet mindfulness questionnaire to understand its relation to substance use. Assessment, 19(3), 276–286.

    Article  PubMed  PubMed Central  Google Scholar 

  • Enders, C. K. (2010). Applied missing data analysis. New York: Guilford Press.

    Google Scholar 

  • Ferree, M. C. (2001). Females and sex addiction: myths and diagnostic implications. Sexual Addiction & Compulsivity, 8, 287–300.

    Article  Google Scholar 

  • Giugliano, J. R. (2013). Sex addiction as a mental health diagnosis: Coming together or coming apart? Sexologies, 22, e77–e80.

    Article  Google Scholar 

  • Gola, M., Wordecha, M., Sescousse, G., Lew-Starowicz, M., Kossowski, B., Wypych, M., Makeig, S., Potenza, M. N., & Marchewka, A. (2017). Can pornography be addictive? An fMRI study of men seeking treatment for problematic pornography use. Neuropsychopharmacology, 42(10), 2021–2031. https://doi.org/10.1038/npp.2017.78.

    Article  PubMed  PubMed Central  Google Scholar 

  • Grossman, P., & Van Dam, N. T. (2011). Mindfulness, by any other name…: trials and tribulations of sati in western psychology and science. Contemporary Buddhism, 12(1), 219–239. https://doi.org/10.1080/14639947.2011.564841.

  • Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: model, processes and outcomes. Behavior Research and Therapy, 44, 1–25.

    Article  Google Scholar 

  • Hook, J. N., Reid, R. C., Penberthy, J. K., Davis, D. E., & Jennings, D. J. (2014). Methodological review of treatments for nonparaphilic hypersexual behavior. Journal of Sex and Marital Therapy, 40(4), 1–15.

    Article  Google Scholar 

  • Kabat-Zinn, J. (1994). Wherever you go, there you are: mindfulness meditation in everyday life. New York: Hyperion.

    Google Scholar 

  • Kafka, M. P. (2010). Hypersexual disorder: a proposed diagnosis for DSM-V. Archives of Sexual Behavior, 39, 377–400.

    Article  PubMed  Google Scholar 

  • Kline, R. B. (2010). Principles and practice of structural equation modeling (3rd ed.). New York: Guilford Press.

    Google Scholar 

  • Kraus, S. W., Krueger, R. B., Briken, P., First, M. B., Stein, D. J., Kaplan, M. S., Voon, V., Adbo, C. H. N., Grant, J. E., Atalla, E., & Reed, G. M. (2018). Compulsive sexual behavior disorder in the ICD-11. World Psychiatry, 17(1), 109–110.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kuzma, J. M., & Black, D. W. (2008). Epidemiology, prevalence, and natural history of compulsive sexual behavior. The Psychiatric Clinics of North America, 31(4), 603–611.

    Article  PubMed  Google Scholar 

  • Lindell, M. K., & Whitney, D. J. (2001). Accounting for commonmethod variance in cross-sectional research designs. Journal of Applied Psychology, 86(1), 114.

    Article  Google Scholar 

  • McKeague, E. L. (2014). Differentiating the female sex addict: a literature review focused on themes of gender difference used to inform recommendations for treating women with sex addiction. Sexual Addiction and Compulsivity, 21, 203–224.

    Article  Google Scholar 

  • Mclean, C., & Follette, V. M. (2015). Acceptance and commitment therapy as a non-pathologizing intervention approach for survivors of trauma. Journal of Trauma and Dissociation, 17(2), 138–150.

    Article  Google Scholar 

  • Muthén, L. K., & Muthén, B. (2006). Mplus: the comprehensive modeling program for applied researchers. Los Angeles: Muthén & Muthén.

    Google Scholar 

  • Öst, L. (2014). The efficacy of acceptance and commitment therapy: an updated systematic review and meta-analysis. Behaviour Research and Therapy, 61, 105–121.

    Article  PubMed  Google Scholar 

  • Perera, B., Reece, M., Monahan, P., Billingham, R., & Finn, P. (2009). Childhood characteristics and personal dispositions to sexually compulsive behavior among young adults. Sexual Addiction & Compulsivity, 16, 131–145.

    Article  Google Scholar 

  • Peters, J. R., Erisman, S. M., Upton, B. T., Baer, R. A., & Roemer, L. (2011). A preliminary investigation of the relationships between dispositional mindfulness and impulsivity. Mindfulness, 2(4), 228–235.

    Article  Google Scholar 

  • Podsakoff, P. M., MacKenzie, S. B., Lee, J., & Podsakoff, N. P. (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879–903.

    Article  Google Scholar 

  • Quaglia, J. T., Braun, S. E., Freeman, S. P., McDaniel, M. A., & Brown, K. W. (2016). Meta-analytic evidence for effects of mindfulness training on dimensions of self-reported dispositional mindfulness. Psychological Assessment, 28(7), 803–818.

    Article  PubMed  Google Scholar 

  • Rau, H. K., & Williams, P. G. (2016). Dispositional mindfulness: a critical review of construct validation research. Personality and Individual Differences, 93, 32–43.

    Article  Google Scholar 

  • Reid, R. C., & Meyer, M. D. (2016). Substance use disorders in hypersexual adults. Current Addiction Reports, 3(4), 400–405. https://doi.org/10.1007/s40429-016-0124-9.

    Article  Google Scholar 

  • Reid, R. C., Carpenter, B. N., Spackman, M., & Willes, D. L. (2008). Alexithymia, emotional instability, and vulnerability to stress proneness in patients seeking help for hypersexual behavior. Journal of Sex & Marital Therapy, 34, 133–149. https://doi.org/10.1080/00926230701636197.

    Article  Google Scholar 

  • Reid, R. C., Harper, J. M., & Anderson, E. H. (2009). Coping strategies used by hypersexual patients to defend against the painful effects of shame. Clinical Psychology & Psychotherapy, 16, 125–138.

    Article  Google Scholar 

  • Reid, R. C., Carpenter, B. N., Hook, J. N., Garos, S., Manning, J. C., Gilliland, R., Cooper, E. B., McKittrick, H., Davtian, M., & Fong, T. (2012). Report of findings in a DSM-5 field trial for hypersexual disorder. Journal of Sexual Medicine, 9, 2868–2877.

    Article  PubMed  Google Scholar 

  • Reid, R. C., Bramen, J. E., Anderson, A., & Cohen, M. S. (2014). Mindfulness, emotion dysregulation, impulsivity, and stress proneness among hypersexual patients. Journal of Clinical Psychology, 70(4), 313–321.

    Article  PubMed  Google Scholar 

  • Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction, 88, 791–804.

    Article  PubMed  Google Scholar 

  • Schneider, J. P., & Irons, R. R. (2001). Assessment and treatment of addictive sexual disorders: relevance for chemical dependency relapse. Substance Use & Misuse, 36(13), 1795–1820. https://doi.org/10.1081/JA-100108428.

    Article  Google Scholar 

  • Shorey, R. C., Elmquist, J., Gawrysiak, M. J., Anderson, S., & Stuart, G. L. (2016). The relationship between mindfulness and compulsive sexual behavior in a sample of men in treatment for substance use disorders. Mindfulness, 7(4), 866–873.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stavro, K., Rizkallah, E., Dinh-Williams, L., Chiasson, J. P., & Potvin, S. (2013). Hypersexuality among a substance use disorder population. Sexual Addiction & Compulsivity, 20(3), 210–216.

    Google Scholar 

  • Steele, C. M., & Josephs, R. A. (1990). Alcohol myopia: its prized and dangerous effects. American Psychologist, 45(8), 921.

    Article  PubMed  Google Scholar 

  • Stuart, G. L., Moore, T. M., Kahler, C. W., & Ramsey, S. E. (2003a). Substance abuse and relationship violence among men court-referred to batterers’ intervention programs. Substance Abuse, 24(2), 107–122.

    PubMed  Google Scholar 

  • Stuart, G. L., Moore, T. M., Ramsey, S. E., & Kahler, C. W. (2003b). Relationship aggression and substance use among women court-referred to domestic violence intervention programs. Addictive Behaviors, 28(9), 1603–1610.

    Article  PubMed  Google Scholar 

  • Tomlinson, E. R., Yousaf, O., Vittersø, A. D., & Jones, L. (2018). Dispositional mindfulness and psychological health: a systematic review. Mindfulness, 9(1), 23–43.

    Article  Google Scholar 

  • Van Gordon, W., Shonin, E., & Griffiths, M. D. (2016). Meditation awareness training for the treatment of sex addiction: a case study. Journal of Behavioral Addictions, 5(2), 363–372.

    Article  PubMed  PubMed Central  Google Scholar 

  • World Health Organization. (2018). International Classification of Diseases and Related Health Problems (11th rev.). Geneva: Author.

    Google Scholar 

  • Zimmerman, M. (2002). The psychiatric diagnostic screening questionnaire manual. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Zimmerman, M., & Mattia, J. I. (2001). The Psychiatric Diagnostic Screening Questionnaire: development, reliability, and validity. Comprehensive Psychiatry, 42, 175–189.

    Article  PubMed  Google Scholar 

  • Zimmerman, M., Sheeran, T., Chelminski, I., & Young, D. (2004). Screening for psychiatric disorders in outpatients with DSM-IV substance use disorders. Journal of Substance Abuse and Treatment, 26, 181–188.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Psychology Department, University of Tennessee-Knoxville, 204 Austin Peay Building, Knoxville, TN, 37996, USA

    Meagan J. Brem & Gregory L. Stuart

  2. University of Wisconsin-Milwaukee, Milwaukee, WI, USA

    Meagan J. Brem, Scott Anderson & Gregory L. Stuart

  3. Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA

    Ryan C. Shorey

  4. Cornerstone of Recovery, Louisville, TN, USA

    Scott Anderson

Authors
  1. Meagan J. Brem
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ryan C. Shorey
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Scott Anderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gregory L. Stuart
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MJB: conceptualized the research questions, collected, cleaned, and analyzed data, and wrote the paper. RCS: aided in data analysis and collaborated in the writing and editing of the final manuscript. SA: collaborated in the writing and editing of the final manuscript. GLS: collaborated in the writing and editing of the final manuscript.

Corresponding author

Correspondence to Meagan J. Brem.

Ethics declarations

Conflict of Interest

Gregory Stuart conducts psychoeducational treatment groups for patients at Cornerstone of Recovery for a maximum of 4 h per week. None of this research project pertains to any of the psychoeducational groups. Dr. Stuart does not ever do any study recruitment, is not informed which patients do or do not participate in research, and does not mention anything about research to the patients attending groups. Ryan Shorey works as a research consultant at Cornerstone. There is no restriction on what Ryan can publish and his research consultation does not influence the study results in any way. Ryan does not interact with Cornerstone patients. Ryan has reported all his consultation activities to the University of Wisconsin, Milwaukee, and no concern about financial conflict of interest has been raised.

Ethics Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The University of Tennessee’s Institutional Review Board approved the procedures used in the present study.

Informed Consent

Informed consent to have their de-identified medical records used for research purposes was obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Brem, M.J., Shorey, R.C., Anderson, S. et al. Exploring Gender Differences in the Relationship Between Dispositional Mindfulness and Compulsive Sexual Behavior Among Adults in Residential Substance Use Treatment. Mindfulness 10, 1592–1602 (2019). https://doi.org/10.1007/s12671-019-01117-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-019-01117-7

Keywords

Search

Navigation