Investigating the Associations Of Adult ADHD Symptoms, Hypersexuality, and Problematic Pornography Use Among Men and Women on a Largescale, Non-Clinical Sample

Introduction: Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent comorbid disorders in hypersexuality; however, previous studies only examined the associations of ADHD and hypersexuality among men seeking treatment. Although problematic pornography use (PPU) might be considered the most frequent manifestation of hypersexuality, no previous research examined its association with ADHD symptoms. Aim: To (i) examine ADHD symptoms in relation to hypersexuality and PPU and (ii) identify possible similarities and differences in relationship with hypersexuality and PPU in a large, non-clinical sample between both sexes. Methods: Multi-group structural equation modeling was conducted to investigate the hypothesized associations among adult ADHD symptoms, hypersexuality, and PPU between men and women (N = 14,043 participants; women = 4,237; mean age = 33.5 years, SD = 10.9). Main Outcome Measures: Adult ADHD symptoms were assessed in relation to hypersexuality and PPU via self-reported measures. Results: Results indicated that hypersexuality had positive and moderate association with problematic pornography use among women (r[14041] = .50, P < .01) and positive and strong association among men (r [14041] = .70, P < .01). ADHD symptoms had positive and moderate associations with hypersexuality in both men and women (beta = .50, P < .01; beta = .43; P < .01; respectively). Regarding men, ADHD symptoms had a positive, moderate association with PPU (beta = .45, P < .01), whereas ADHD symptoms had a positive, but weak, association with PPU in the case of women (beta = .26, P < .01). Clinical Implications: When men have high levels of hypersexuality or PPU, ADHD should be assessed as a potential comorbid disorder. With regard to women, ADHD should be assessed as a potential comorbid disorder only in the case of hypersexuality. Strength & Limitations: Applying self-report methods have possible biases that should be taken into account when interpreting the present findings. However, the present study was conducted on a large community sample and examined the differentiated role of ADHD symptoms in hypersexuality and PPU, not only in men but also in women, that has never been addressed in the literature. Conclusion: ADHD symptoms might play an important role in the severity of hypersexuality between both sexes, whereas ADHD symptoms might only play a stronger role in PPU among men but not women. The findings corroborate previous results that PPU may not be unambiguously considered as a subcategory of hypersexuality. In addition, potential background mechanisms behind problematic pornography use should be examined separately between men and women. Copyright (C) 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.