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The impact of childhood trauma, personality, and sexuality on the development of paraphilias

Published onSep 09, 2022
The impact of childhood trauma, personality, and sexuality on the development of paraphilias
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Abstract

Purpose: Paraphilia can be defined as a condition in which the sexual excitement rely on fantasizing and/or participating in unusual sexual behaviour. The last decades have been rich with new studies investigating the prevalence of paraphilic desires and behaviours among the general population as well as clarifying the boundary between paraphilic and normophilic. However, few studies have focused on paraphilic interests’ nomological network.

Methods: The project aimed to assess the prevalence of paraphilias among the general population, including a sub-group of people with self-reported atypical sexual interests. Furthermore, the relationship between Childhood Traumatic Experiences, Personality Traits, Hypersexuality, Pornography Consumption and Paraphilic Arousal was examined through mediation analysis. Analyses were conducted on a sample of N = 372 participants.

Results: Analyses revealed a difference in the prevalence between sexual fantasy and sexual arousal, with a majority of self-reported arousal being lower than fantasy. Furthermore, mediation analyses revealed that the relationship between trauma and arousal is mediated by hypersexuality, problematic pornography consumption and personality traits.

Conclusions: Abuses during childhood are the starting point of an over-involvement in sexuality, which increase the likelihood of developing atypical sexual interest or behaviour. Implications will be discussed.

Keywords: Paraphilia, Personality Traits, Trauma, Hypersexuality, Pornography.

The Diagnosis and Description of Paraphilic Disorders

The World Health Organisation ([WHO], 2019), in its 11th Revision of the International Classification of Diseases (ICD-11), defines paraphilic disorders “as persistent and intense patterns of atypical sexual arousal, manifested by sexual thoughts, fantasies, urges, or behaviours, the focus of which involves others whose age or status renders them unwilling or unable to consent and on which the person has acted or by which he or she is markedly distressed”. The Diagnostic and Statistical Manual of Mental Disorders - 5th Editions ([DSM-5] American Psychiatric Association [APA], 2013), the most influential handbook for the categorization and diagnosis of mental disorders in psychology and psychiatry, defines paraphilias as “any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physiologically mature, consenting human partners” (p.685).

Sexual interests can be categorized as normophilic (normal), or paraphilic (anomalous; Joyal, 2018). To encompass that some individuals might engage in atypical sexual behaviours without being labelled with a mental disorder, the DSM-5 has clarified the distinction between paraphilia (atypical sexual interest or behaviour) and paraphilic disorder. The latter can be defined as a mental disorder stemming from atypical behaviour that last for more than 6 months and that is causing personal distress or “involves another person’s psychological distress, injury or death, or a desire for sexual behaviours involving unwilling persons or persons unable to give legal consent” (p.685).

The DSM-5 proposes eight categories of paraphilic disorder: Voyeurism (e.g., achieving sexual arousal from observing an unsuspecting and non-consenting person who is naked or engaged in sexual activity), exhibitionism (e.g., exposing genitals to unsuspecting strangers and becoming sexually aroused by it), frotteurism (e.g., touching or rubbing one’s genitals the body of a non-consenting stranger for sexual pleasure), masochism (e.g., intentionally participating in an activity that involves being humiliated, beaten, or otherwise abused in order to achieve sexual excitement and climax), sadism (e.g., inflicting psychological or physical suffering on another person to stimulate sexual excitement and climax), pedophilia (e.g., sexual attraction, fantasies and behaviours towards prepubescent children), fetishism (e.g., becoming sexually aroused by wearing or touching a non-inanimate object), and transvestism (e.g., aroused from cross-dressing). Paraphilic disorder that are less common and are not included in this list fall under the label of Paraphilia Not Otherwise Specified, a problematic category with validity and reliability issues (For more details, see Longpré et al., 2020a).

While some research has been conducted on human sexuality and paraphilias, there is still limited scientific understanding on the prevalence of paraphilic and normophilic fantasies and behaviours. The etiology of paraphilia remains unclear because, in part, of its complex and multifactorial nature. Furthermore, most research on paraphilias is focusing on paraphilic disorders (Seto et al., 2020), and few research focuses on atypical sexual interest or behaviour without being labelled with a mental disorder (i.e., Paraphilias; Joyal, 2018). Researchers often refer to paraphilia as a sexual drive “outside the normal” that compromises “sexual behaviour that deviates significantly from the norm” (Bradford & Ahmed, 2014, pp. 11-12), but what these norms are is unclear (Joyal, 2018). Moreover, research is primarily limited to the study of disorders that lead to sexual offending (e.g., pedophilia, sexual sadism; Stefanska et al., 2022).

Therefore, the present paper aimed to study the nomological network of paraphilia and explored potential developmental factors that increase the likelihood of developing atypical sexual interest or behaviour, with a focus on childhood victimization, hypersexuality, problematic pornography consumption and personality traits. Furthermore, in regard to the DSM-5’s distinction between paraphilia and paraphilic disorder, this paper focused on atypical sexual interest or behaviour without being labelled with a mental disorder, namely paraphilia over paraphilic disorder.

Problems With the DSM

Beliefs about what is morally and socially acceptable and unacceptable shifts across cultures and over time, and there are substantial differences between societies on what constitutes appropriate behaviours. Clinicians and researchers have argued that the DSM definition of paraphilias poses problems, and what constitutes an unusual (or usual) sexual fantasy/ behaviour is not always clear (Joyal et al., 2015). For example, until 1973, the DSM classified homosexuality as deviating from “normal” sexual development, along paraphilia such as sadism and masochism (Herdt & Stoller, 1990). Furthermore, an important problem of the DSM diagnostic criteria of paraphilias is its poor reliability and validity (Zander, 2008). Even though the DSM-5 has specified 8 different paraphilias, over 100 specific paraphilias have been portrayed in the literature (Federoff & Marshall, 2010). This highlights a key problem with the DSM classification, which is primarily based on descriptions of symptoms and behaviours instead of the underlying causes. Identifying what constitutes deviant sexual fantasies and behaviours is crucial for clinical purposes (e.g., providing suitable treatment for the individual in need) and for forensic and legal purposes (e.g., criminal responsibility; Joyal, 2018).

Paraphilias and the General Population

The presence of atypical sexual fantasies is not necessarily indicative of a paraphilic behaviour (Joyal, 2018). According to Leitenberg and Henning (1995), both females and males tend to have similar sexual fantasies; with males appearing to fantasize more about domination, while women tend to fantasize more about submission. A study found that over 60% of male university students reported desires about sadism and bondage (Williams et al., 2009). Chivers et al. (2004) found that an important number of females reported that for “rape fantasies” to occur, they require a significant level of consent, indicating fantasies about submission rather than rape. The above studies focused only on university students who, given age (lower) and education (higher), are considered partially different from the general population (Laumann et al., 1994). Therefore, recruiting participants from outside university environments may contribute to more accurate information and may be more applicable to the general population. A recent study by Stefanska et al. (2022) revealed that while male and female slightly differ in the number of self-reported atypical sexual fantasies, with male presenting more, they tend to be similar on the number of self-reported atypical sexual behaviours.

In the last decades, new studies have investigated the prevalence of paraphilic desires and behaviours among the general population, trying to clarify the boundary between paraphilic and normophilic (e.g., Bártová et al., 2021; Joyal et al., 2015; Joyal and Carpentier, 2017, Seto et al., 2020; Stefanska et al., 2022). Joyal and Carpentier (2017) found a difference between individuals' desire and behaviour, with individual reporting at least one paraphilic fantasy (45.6%) as opposed to engaging in at least one paraphilic behaviour during their lifetime (33.9%). This moderate concordance between fantasies and behaviours was replicated in recent studies (e.g., Bártová et al., 2021; Joyal & Carpentier, 2022; Seto et al., 2020). Joyal and Carpentier (2017) showed that voyeurism was the most common paraphilic fantasy and behaviour in the general population, followed by fetishism, exhibitionism, frotteurism and masochism. While this trend was found across gender, slight differences were also found between males and females, with males reporting higher rates of fantasies and behaviours for voyeurism and frotteurism while females reporting higher rates of fantasies and behaviours for masochism. Furthermore, Bártová et al. (2021) found that 15.5% of males and 5% of females reported more than one paraphilic preference, supporting Abel et al.’s (1988) early work, who revealed that multiple paraphilic preferences can co-exist.

Hypothesis on the Etiology of Paraphilias

It is hypothesized that a combination of neurobiological, interpersonal, and cognitive processes plays a role in the development of paraphilia and paraphilic disorders (For more details, see Craig & Bartels, 2021). Neurological and neurodevelopmental correlates, as well as genetic factors have been linked to the development of pedophilia (Cantor & Blanchard, 2012; McPhail et al., 2018). Overactive amygdala and underactive frontal regions have been associated to sexual coercion and sexual sadism, through its relationship with psychopathic traits and hypersexuality (Longpré et al., 2018b). Furthermore, childhood trauma and conditioning throughout masturbation, where nonsexual objects become sexually arousing, have been associated to the development of paraphilias (Walters, 1997). However, as mentioned, most research on paraphilias is focusing on paraphilic disorders (Seto et al., 2020), and our understanding of the etiology of paraphilias is elusive. There are still several gaps (Craig & Bartels, 2021), stressing the needs for more evidence-based data.

The Etiology of Paraphilias: Child Abuse and Neglect

Hillis et al. (2016) reported that up to 1 billion children between the ages of 2 and 17 have experienced Childhood Traumatic Experiences (CTE) in the forms of physical, sexual or emotional abuse or, physical or emotional neglect. Nearly 300 million children worldwide between the ages of 2 and 4 regularly experienced physical punishment and/or emotional manipulation by their parents and caregivers (WHO, 2020). One in five women and one in 13 men disclosed having been sexually abused as a child before age 18 (WHO, 2020). The Centers for Disease Control and Prevention (CDC; 2020) surveyed over 17,000 individuals and found that at least two thirds of respondents had experienced at least one form of childhood maltreatment or household dysfunction, and nearly 13% reported four or more.

Understanding the dynamics of the psychosocial history of a person is an important component to understand of how deviant sexual desires can be developed in early life (Bancroft, 2012; Longpré et al., 2018a). The impact of neglect and physical, sexual and/ or emotional abuse, either alone or in combination (Davis & Knight, 2019), in the development of sexual coercion (Malamuth et al., 2021; Trottier et al., 2021), rape (Knight & Sims-Knight, 2006), sexual sadism (Longpré et al., 2018ab; Robertson et al., 2018) and child molesting (Chopin et al., 2022; Daversa & Knight, 2007) is well-known. However, research on the role of child abuse and neglect in the development of paraphilias are scarce (Maletzky, 1993). Knight et al. (2019) found a relationship between CTE, and frotteurism, exhibitionism and voyeurism among juvenile sexual offenders. Emotional abuse was found to be a developmental risk factor for exhibitionism (Lee, 2002), pedophilia (Daversa & Knight, 2007; Lee, 2002) and sadism (Longpré et al., 2018a). Paraphilic disorder was associated to childhood physical abuse, sexual abuse and male caregiver psychological abuse (Davis & Knight, 2019).

Abusive or neglectful parenting can leave a child with low self-esteem, poor social skills, lack of effective coping methods and inability to maintain long-term relationships (Marshall & Barbaree, 1990), which in turn increase the risk of altering psychosocial development (Bancroft, 2012). It can be suggested that these abuses may increase the risk of seeking sexual gratification by using non-traditional routes that involve few physical contacts (e.g., voyeurism, exhibitionism, frotteurism), physical contacts without consent (e.g., sadism) or may lead them to pursue sexual gratification with inappropriate age-group target (e.g., children). It is hypothesized that paraphilic disorder and hypersexuality share etiological roots, throughout CTE (Davis & Knight, 2019) and brain functioning (Kafka, 2010), and that paraphilic disorder increase the likelihood of sexually coercive behavior’s persistence (Knight et al., 2019). Previous studies have revealed that CTE increase the likelihood of developing paraphilic disorder; however, the focus is usually on the most severe forms, and it is still unclear how these experiences may lead to the development of paraphilia.

The Etiology of Paraphilias: Hypersexuality

Hypersexuality is defined as a condition in which there are intense and frequent sexual urges or sexual activities that produce distress or impairment to the individual (Kafka, 2010). Historically, hypersexuality has been described as taxon (i.e., nonhypersexuality vs hypersexuality), which was mirrored by the DSM-5 Paraphilias sub workgroup’ recommendation to conceptualize the hypersexual disorder as a categorical disorder (Graham et al., 2016; Kafka, 2010; Kafka & Hennen, 2003). However, recent studies have supported the dimensional structure of hypersexuality (e.g., Graham et al., 2016; Kafka, 2010, Knight & Dui, 2021; Walters et al., 2011), where hypersexuality would be located on the upper hand of a continuum of normophilic sexual behavior (Graham et al., 2016), with asexuality on the other end. The estimated prevalence of hypersexuality is ranging between 2% and 6% in the general population (Odlaug et al., 2013) and is much higher among sex offenders (Hanson et al., 2007). While hypersexuality was not included in the DSM-5 final version (Walters et al., 2011), the World Health Organization (WHO) has proposed to include hypersexuality under the label compulsive sexual behaviour disorder. As mentioned by Ciocca et al. (2018), the “impossibility to diagnose hypersexuality according to DSM-5 criteria does not mean that this condition does not exist” and simply highlights that more research is needed.

While the inclusion of hypersexuality in the DSM-5 is still under investigation (Kingston et al., 2017; Knight & Graham, 2017), its location within developmental models of sexual violence is supported by empirical evidence (e.g., Kingston et al., 2017; Knight & Sims-Knight, 2006; Långström & Hanson, 2006). Hypersexuality has been associated with higher sex rate and unconventional sex activities in a sample of men with paraphilias and paraphilia-related disorder. (Kafka & Hennen, 2003). Furthermore, there is some evidence of a correlation between high rates of sexual activity and paraphilias (Kingston et al., 2017; Seto et al., 2014), and it hypothesizes that hypersexuality play a role in the development of paraphilia (Seto et al., 2014). Many individuals presenting hypersexuality are reporting challenges in managing their sexual activities, which often causes significant levels of distress, low self-esteem and mental health issues (Reid et al., 2012). Individuals may also be worried about their sexual preoccupation, which can be worsened by any conflict between the person's personal beliefs (such as their religious or cultural values) and their sexual preferences (Grubbs et al., 2015).

Hypersexuality is composed of two sub-factors (i.e., high sex drive & problematic sexuality; Knight & Graham, 2017) that can manifest in different forms such as masturbation, pornography use, cybersex, and/or other compulsive sex-related behaviours (Wéry et al., 2016). Kafka and Hennen (1999), in a study on paraphilia and paraphilia-related disorders, found that the prevalence rate of uncontrollable masturbation was of 70% in their sample. Moreover, 50% of their sample disclosed pornography dependency, which was positively correlated with sex dependency and compulsive masturbation. More recent studies highlight compulsive masturbation and pornography dependency as factors associated with hypersexuality (Knight & Graham, 2017; Reid et al., 2012). Therefore, both appear to be two important manifestations of hypersexuality. Additionally, Långström and Hanson (2006) found a relationship between hypersexuality and exhibitionism, voyeurism, masochism and sadism – suggesting a link between hypersexuality and paraphilias. One implication of the association between hypersexuality and paraphilia is that high rates of sexual activity can lead individuals to develop sexual inclinations and desires to explore outside the realm of normophilic behaviours. Recent studies have also linked problematic pornography consumption with paraphilias (Paquette et al., 2022; Stefanska et al., 2021) and sexual offending against children (Paquette et al., 2022), indicating a relationship between hypersexuality and problematic pornography consumption, either as a dual process or as a manifestation of high sex drive and problematic sexuality, and paraphilias. However, data are scarce, and most studies have primarily focused on males.

The Etiology of Paraphilias: Personality Disorder and Traits

The impact of CTE in the development of Personality Disorders (PDs) is supported by several research (e.g., Cattane et al., 2017), with Borderline Personality Disorder (BPD) as the most frequent outcome (Porter et al., 2020). However, there is no all-inclusive theory on the development of PDs; the different clusters reflect different patterns of behaviours, and so different clusters as well as different PDs developed in different ways (i.e., Multifinality; Cicchetti, 1996). One aspect that is believed to be similar across all PDs is that the various behaviour patterns were fairly stable and can be linked back to childhood and early adolescence, indicating that either genetic or developmental influences may be significant across PDs (Davey, 2015). Similarly, Paris (2005) investigated childhood experiences and developmental influences for the origins of these severe and recurrent patterns of behaviour and observed CTE experiences can be found in the history of many PDs.

The impact of PDs in the developmental model of sexual violence is supported by several empirical research (e.g., Knight & Sims-Knight, 2006; Malamuth et al., 2021). Two recent models have highlighted the relationship between CTE, PDs and sexual sadism (Longpré et al., 2018a; Robertson et al., 2018). Masochism was linked to BPD and CTE among women (Frías et al., 2017), and Sadism was linked to BPD, APD and CTE among men and women from the general population (Longpré et al., 2018ab). Antisocial, Psychopathic and Narcissistic traits were associated to paraphilic interests among undergraduates (Watts et al., 2019). Dark traits were associates to sexual coercion (Beckett & Longpré, 2022; Tachmetzidi Papoutsi & Longpré, 2022) and paraphilic interests among undergraduates (Snow & Longpré, 2022). While the relationship between PDs and child molesting is supported by empirical evidence (Daversa & Knight, 2007), it is more complicated with pedophilia. This lack of clear relationship might be explained by the uncertainties around the latent structure of pedophilia and child molesting (e.g., McPhail et al., 2018; Schmidt et al., 2013; Stephens et al., 2017).

Aims

Thus, the aim of this study was to fill some of the gaps in our understanding of paraphilias and its nomological network across genders. First, the prevalence of paraphilias among the general population, including a sub-group of people with self-reported atypical sexual interests, was assessed. Furthermore, the relationship between childhood trauma, personality traits, hypersexuality, pornography consumption and paraphilic interests were assessed through mediation analysis. Based on previous studies, four exploratory hypotheses were formulated:

H1: The prevalence of self-reported paraphilic fantasy and arousal, and similar to Joyal and Carpentier (2017; 2022), would be neither rare nor unusual, apart from Necrophilia, Pedo-hebepho-ephebophilie, and Zoophilia.

H2: The presence of self-reported paraphilic sexual arousal would be lower than the presence of self-reported paraphilic fantasy.

H3: The nomological network of paraphilic interests would be multifactorial, and childhood trauma, personality traits, hypersexuality and pornography consumption would all be significant predictors of self-reported paraphilic arousal.

H4: Hypersexuality and pornography consumption would be stronger predictors of self-reported paraphilic arousal than personality traits.

The present research added to our knowledge on what constitutes paraphilic and normophilic sexual interests in the general population. Furthermore, it sheds a light on which risk factors are linked to the development of paraphilic interests. To our knowledge, few research has studied the nomological network of paraphilia and explored potential developmental factors that increase the likelihood of developing atypical sexual interest or behaviour.

Methods

Participants

The original sample was composed of 432 participants recruited from Amazon Mechanical Turk (MTurk, n = 206) and social media platforms (Facebook, Snapchat, Twitter and Instagram, n = 49) and FetLife (n = 177). Of the original sample, 60 participants were withdrawn because their survey contained too many missing answers. Analyses were conducted on the final sample of N = 372 participants (n = 195 males; n = 166 females; n = 11 non-binary) aged between 18 and 75 years old (Mean = 37.31; SD = 15.01), with the age groups of 18 to 39 years old the most prevalent (n = 223; 59.9%). At the time of testing, the majority of the sample was heterosexual (n = 240; 64.5%), in a relationship (n = 233; 62.63%) and employed (n = 273; 74%). To our knowledge, none of our participants had previous convictions for sexual offences.

Procedures

The study has received ethical approval by a university in England & Wales. Consent form, socio-demographic questions, scales, and debrief form were added in Qualtrics, a web-based tool that allows to create and distribute surveys. It also allowed for anonymity as respondents and researchers are never in contact. A pilot was first conducted on social media (n = 15) to ensure instructions were clear, to identify potential weaknesses in the survey and to examine participants' willingness to take part. The survey was then distributed via social media, Amazon Mechanical Turk (MTurk), and FetLife. This tri-modal sampling method was used to have a better representativeness of the general population. MTurk is a crowdsourcing Internet marketplace that allows researchers to find participants online that have similar demographics to the overall Internet population (Ross et al., 2010) in exchange for monetary compensation. FetLife is a social networking website for individuals interested in BDSM, fetishism, and kink. All members have a personal profile and can join group (s) based on their sexual interest (s). Only the participants recruited via MTurk were financially compensated (e.g., 2 US$).

Measures

For the purpose of this study, five scales were used. For each scale, the total score was used in the analyses.

The Paraphilic Fantasy and Arousal Scale (PF-AS) was developed in order to examine paraphilic sexual fantasy and sexual arousal. This homemade scale is composed of items used in previous research (e.g., Pedohebephilia [Seto et al., 2021]; Zoophilia [Bártová et al., 2021]), items labelled differently across studies (e.g., Biastophilia [Seto et al., 2012]; PCD [Knight et al., 2013]; PC+ [Longpré et al., 2020a]), as well as new items (e.g., Algolagnia; Piquerism). The scale is composed of 24 items relating to paraphilic fantasies and 24 items regarding paraphilic arousal. The statements remained the same for both scales in order to assess fantasies (e.g., “I have fantasized about performing oral or sexual intercourse with an animal”) and sexual arousal (e.g., “I have been sexually aroused about performing oral or sexual intercourse with an animal”). Respondents were asked whether and how often they had fantasized and be aroused in the activity (1- never; 2- once; 3- A few times [between 2–10 times in a lifetime]; 4- Often [more than 10 times lifetime]). For a description of each item, see supplemental material.

The Hypersexuality Scale (MIDSA, 2011) is composed of 45 items breakdown in 7 sub-components: (1) sexual coping [1-Never, 2- Once or a few times, 3- A few times a year, 4- Once or twice a month, 5- Once or twice a week, 6- Almost every day], (2) sociosexuality (i.e., engaging in sexual activity outside of a committed relationship) [1- Definitely false, 2- Possibly false, 3- Not sure, 4- Possibly true, 5- Definitely true], (3) sex consequence [1- Never, 2- Once, 3- 2 to 10 times, 4-11 to 50 times, 5- Over 50 times], (4) sexual preoccupation [1-Never, 2- Once or a few times, 3- A few times a year, 4- Once or twice a month, 5- Once or twice a week, 6- Almost every day], (5) sexual excitation [1- Definitely false, 2- Possibly false, 3- Not sure, 4- Possibly true, 5- Definitely true], (6) sexual compulsivity [1-Never, 2- Once or a few times, 3- A few times a year, 4- Once or twice a month, 5- Once or twice a week, 6- Almost every day] and (7) sexual regret [1- Definitely false, 2- Possibly false, 3- Not sure, 4- Possibly true, 5- Definitely true]. In the present study, Cronbach’s alphas were respectively .95, .60, .93, .87, .82, .95 and .79.

The Problematic Pornography Consumption Scale (PPCS, Bőthe et al., 2017) is an 18-item scale that measure online pornography consumption. The items were scored on a 7-point Likert-scale (1- never, 2- Rarely, 3- Occasionally, 4- Sometimes, 5- Often, 6- Very Often, 7- All the time). In the present study, Cronbach's alpha was .98.

The Childhood Trauma Questionnaire Short Form ([CTQ-SF], Bernstein et al., 2003) is a 28 items self-report measure composed of 5 types of maltreatment: (1) emotional (2) physical and (3) sexual abuse, and (4) emotional and (5) physical neglect – ranging from 5 (low level) to 25 (high level). The items were scored on a 5-point scale (1- Never true, 2- Rarely true, 3- Sometimes, 4- Often true, 5- Very often true). In the present study, Cronbach’s alpha was .90.

Personality Diagnostic Questionnaire-4+ ([PDQ-4+], Hyler, 1994) is a self-report measure used to identify the presence of personality traits. Items that assess Schizoid (7 items, cut-off = 4), Avoidant (7 items, cut-off = 4), Narcissism (9 items, cut-off = 5), Borderline (9 items, cut-off = 5) and Antisocial (8 items, cut-off = 4) PD traits were used from the original scale. The items were scored on a true/false format. In the present study, Cronbach’s alphas were respectively .61, .73, .65, .73 and .66.

Data Analyses

First, frequency analysis was conducted on the Paraphilic Fantasy and the Paraphilic Arousal scores. Analyses were performed using SPSS version 26 (SPSS, Chicago, IL).

In a second step, mediation analyses were conducted. Mediation analysis is used to determine how the relationship between two variables is influenced by the inclusion of a third variable. Rather than measuring the direct relationship between two variables, a mediation model proposes that the independent variable (IV) influences the mediator, which in turn influences the dependent variable (DV). In the current study, four models were tested: (1) Childhood trauma (IV), Personality Traits [Schizoid; Avoidant; Antisocial; Narcissistic; Borderline (mediator)], and Paraphilias/ Arousal (DV), (2) Childhood trauma (IV), Hypersexuality (mediator), and Paraphilias/ Arousal (DV), (3) Childhood trauma (IV), Pornography consumption (mediator), and Paraphilias/ Arousal (DV), and (4) Childhood trauma (IV), Pornography consumption (mediator), Hypersexuality (mediator) and Paraphilias/ Arousal (DV). Mediation analyses were performed using Hayes' Process Macro v3.3 with SPSS version 26 (SPSS, Chicago, IL).

Results

The prevalence of self-report sexual fantasy and sexual arousal. First, an analysis of the prevalence of self-report sexual fantasy and sexual arousal was conducted. Results were broken down across different levels of involvement (Never, Once, A few times, Often). Results are presented in Table 1. Algolagnia (Often [27.5%]), Asphyxiophilia (Often [21%]), Masochism (Often [29.2%]), Narratophilia (Often [33.3%]), Odaxelagnia (Often [31.3%]), Coerced (Often [23.5%]), Coercing (Often [21.3%]), and Zoophilia (Often [21%]) were the most self-reported fantasies. Algolagnia (Often [22%]), Asphyxiophilia (Often [20.4%]), Narratophilia (Often [33.8%]), and Odaxelagnia (Often [28.9%]) were the most self-reported arousal. In a second step, the prevalence of self-report sexual fantasy and sexual arousal were broken down between men and women. As can be seen from Table 1, while there are some gender variations, for example men reported more sadistic fantasies and women reported more arousal toward masochism, the overall trend was similar across genders.

Mediation Analyses

The current findings showed that the presence of a sexual fantasy is not necessarily indicative of a corresponding sexual arousal, with a majority of self-reported arousal being lower than fantasy. While concordance analyses were not conducted in this paper, these results were consistent with previous research on the concordance of paraphilic interests, either between fantasy and behaviours (Joyal & Carpentier, 2017, 2022; Seto et al., 2020; Stefanska et al., 2022) or arousal (Bártová et al., 2021). Therefore, mediation models were conducted on Paraphilic Arousal (total score), as fantasies were not necessarily indicative of an actualisation outside of the fantasy realm, but arousal was more likely (e.g., Bártová et al., 2021). Furthermore, in order to facilitate direct comparison between coefficients, standardize beta path coefficients were presented.

Mediation Model 1: Personality Traits. In the first mediation model, the relationship between Trauma, Personality Traits [Schizoid; Avoidant; Antisocial; Narcissistic; Borderline] and Paraphilic Arousal was tested. The path (direct effect) between Trauma and Arousal was positive and statistically significant (b = .486, s.e. = .039, p < .001). The path (direct effect) between Trauma and Schizoid was positive and statistically significant (b = .466, s.e. = .004, p < .001). Finally, the path (direct effect) between Schizoid and Arousal was positive and statistically significant (b = .144, s.e. = .432, p = .005). The indirect effect (IE = .053) was statistically significant (95% CI [.015, .090]). The model explained a significant increase in variance of Arousal ΔR2 = .237, F(370) = 114.67, p < .001. For more details, see Figure 1.

The path (direct effect) between Trauma and Paraphilic Arousal was positive and statistically significant (b = .486, s.e. = .039, p < .001). The path (direct effect) between Trauma and Avoidant was positive and statistically significant (b = .394, s.e. = .005, p < .001). Finally, the path (direct effect) between Avoidant and Arousal was not significant (b = .047, s.e. = .343, p = .347). The indirect effect (IE = .014) was not significant (95% CI [-.014, .040]). The model explained a significant increase in variance of Arousal ΔR2 = .237, F(370) = 114.67, p < .001. For more details, see Figure 1.

The path (direct effect) between Trauma and Paraphilic Arousal was positive and statistically significant (b = .486, s.e. = .039, p < .001). The path (direct effect) between Trauma and Antisocial was positive and statistically significant (b = .553, s.e. = .004, p < .001). Finally, the path (direct effect) between Antisocial and Arousal was positive and statistically significant (b = .381, s.e. = .405, p < .001). The indirect effect (IE = .165) was statistically significant (95% CI [.116, .219]). The model explained a significant increase in variance of Arousal ΔR2 = .236, F(370) = 114.68, p < .001. For more details, see Figure 1.

The path (direct effect) between Trauma and Paraphilic Arousal was positive and statistically significant (b = .486, s.e. = .039, p < .001). The path (direct effect) between Trauma and Narcissism was positive and statistically significant (b = .488, s.e. = .005, p < .001). Finally, the path (direct effect) between Narcissism and Arousal was positive and statistically significant (b = .283, s.e. = .338, p < .001). The indirect effect (IE = .108) was statistically significant (95% CI [.069, .150]). The model explained a significant increase in variance of Arousal ΔR2 = .237, F(370) = 114.67, p < .001. For more details, see Figure 1.

The path (direct effect) between Trauma and Paraphilic Arousal was positive and statistically significant (b = .486, s.e. = .039, p < .001). The path (direct effect) between Trauma and Borderline was positive and statistically significant (b = .489, s.e. = .007, p < .001). Finally, the path (direct effect) between Borderline and Arousal was positive and statistically significant (b = .368, s.e. = .319, p = .001). The indirect effect (IE = .064) was statistically significant (95% CI [.025, .106]). The model explained a significant increase in variance of Arousal ΔR2 = .237, F(370) = 114.68, p < .001. For more details, see Figure 1.

Mediation Model 2: Hypersexuality. In the second mediation model, the relationship between Trauma, Hypersexuality and Paraphilic Arousal was tested. The path (direct effect) between Trauma and Arousal as positive and statistically significant (b = .486, s.e. = .036, p < .001). The path (direct effect) between Trauma and Hypersexuality was positive and statistically significant (b = .308, s.e. = .095, p < .001). Finally, the path (direct effect) between Hypersexuality and Arousal was positive and statistically significant (b = .505, s.e. = .016, p < .001). The indirect effect (IE = .122) was statistically significant (95% CI [.080, .165]). The model explained a significant increase in variance of Arousal ΔR2 = .237, F(370) = 114.68, p < .001. For more details, see Figure 2.

Mediation Model 3: Problematic Pornography Consumption. In the second mediation model, the relationship between Trauma, Problematic Pornography Consumption and Paraphilic Arousal was tested. The path (direct effect) between Trauma and Arousal was positive and statistically significant (b = .486, s.e. = .036, p < .001). The path (direct effect) between Trauma and Pornography was positive and statistically significant (b = .547, s.e. = .034, p < .001). Finally, the path (direct effect) between Pornography and Arousal was positive and statistically significant (b = .495, s.e. = .063, p < .001). The indirect effect (IE = .211) was statistically significant (95% CI [.154, .278]). The model explained a significant increase in variance of Arousal ΔR2 = .237, F(370) = 114.67, p < .001. For more details, see Figure 2.

Mediation Model 4: Problematic Pornography Consumption & Hypersexuality: Finally, in the fourth model, the relationship between Trauma, Problematic Pornography Consumption, Hypersexuality and Paraphilic Arousal was tested. The path (direct effect) between Trauma and Arousal was positive and statistically significant (b = .486, s.e. = .036, p < .001). The path (direct effect) between Trauma and Hypersexuality was positive and statistically significant (b = .309, s.e. = .095, p < .001). The path (direct effect) between Trauma and Pornography was positive and statistically significant (b = .495, s.e. = .063, p < .001). The path (direct effect) between Hypersexuality and Arousal was positive and statistically significant (b = .307, s.e. = .021, p < .001). Finally, the path (direct effect) between Pornography and Arousal was positive and statistically significant (b = .319, s.e. = .032, p < .001). The indirect effect (IE = .074) via Hypersexuality was statistically significant (95% CI [.045, .107]). The indirect effect (IE = .124) via Pornography was statistically significant (95% CI [.071, .180]). The model explained a significant increase in variance of Arousal ΔR2 = .237, F(370) = 114.67, p < .001. For more details, see Figure 2.

Discussion

Overview of the results

The aim of the present study was to assess the prevalence of self-reported Paraphilic Fantasy and Paraphilic Arousal among the general population, including a sub-group of people with self-reported atypical sexual interests. Furthermore, in a second step, this study was aiming to assess the relationship between Trauma, Personality traits [Schizoid; Avoidant; Antisocial; Narcissistic; Borderline], Hypersexuality, Pornography consumption and Paraphilic Arousal throughout mediation analyses.

Algolagnia, Asphyxiophilia, Masochism, Narratophilia, Odaxelagnia, Coerced, Coercing and Zoophilia were the most self-reported fantasies. However, analyses also revealed a difference between sexual fantasy and sexual arousal, with a majority of self-reported arousal being lower than fantasy. Algolagnia, Asphyxiophilia, Narratophilia, and Odaxelagnia were the most self-reported arousal. Our findings were similar to other studies on the concordance between paraphilic interests, either between fantasy and behaviours (Joyal & Carpentier, 2017, 2021; Seto et al., 2020; Stefanska et al., 2022) or arousal (Bártová et al., 2021), and support H1 and H2.

Finally, mediation analyses revealed that the relationship between childhood trauma and paraphilic sexual arousal is mediated by hypersexuality, problematic pornography consumption and personality traits, which partially support H3 and is in-line with H4. Childhood victimisation is the starting point of an over-involvement in sexuality, which can lead to an unhealthy sexual life and can increase the likelihood of developing atypical sexual interest or behaviour. Those results have several implications.

Paraphilia in the General Population

Results showed that a majority of the 24 paraphilic interests that were being investigated in the current study were neither rare, nor unusual in a nonclinical sample of adults. However, some paraphilic interests, such as Necrophilia, Pedo-hebepho-ephebophilie and Zoophilia remain rare, which is consistent with previous research (i.e., Bártová et al., 2021; Joyal & Carpentier, 2017, 2022; Seto et al., 2020; Stefanska et al., 2022). The decrease in the endorsement between paraphilic fantasy and arousal was consistent with Joyal and Carpentier (2021), who also found that paraphilic sexual fantasies are not necessarily indicative of an actualization outside of the fantasy realm. In some instances, the relationship between fantasizing and then arousal (e.g., Narratophilia) was strong, while in most cases a drop in the prevalence was observed, with a higher prevalence for fantasies over arousal (e.g., Zoophilia).

These findings are aligned with previous studies who revealed that paraphilic interests in the general population are more common than previously thought, not only in terms of fantasies but also regarding arousal. The convergence of results across studies supports the recent reconsideration on how the DSM distinguished paraphilia and paraphilic disorder. It is vital to identify which are considered normophilic and anomalous among the general population. Having a paraphilic fantasy, arousal or behaviour does not always equate to the person having a mental illness; they can exist in less severe forms that are not deleterious. Furthermore, the fact that normophilic sexual behaviours can be labelled as unhealthy is concerning and raises serious Type I error issues. It is therefore imperative to determine the line between normophilic and paraphilic, based on non-arbitrary threshold and on empirical findings. Recently, Chan (2021) found that individuals presenting paraphilic interests are more likely to engage in sexual risk-taking behaviours, stressing the needs to develop inclusive and non-judgmental prevention programs (Stefanska et al., 2022).

In order to obtain a better understanding between normophilic and paraphilic sexual practices, the present study recommends that future research should assess the extent of distress that may or may not be triggered by the nature of such sexual practices and urges. The reliability and validity of a measure is not determined by a single study but by the convergence of findings across studies (Longpré et al., 2020b). Therefore, the assessment of reliability and validity regarding paraphilias is an ongoing process. Furthermore, the notion of consent should be central in the assessment of paraphilias. Consensual BDSM practices cover two actual DSM diagnoses, which highlight a problem of stigmatization in the absence of pathognomonic symptoms and has led to the abolishment of sexual sadism diagnosis in Sweden and Finland (Nitschke et al., 2012).

The Relationship Between Trauma, Personality Traits and Deviant Arousal

In a second step, this study proposed to assess the nomological network of paraphilic interests. To our knowledge, few research has studied the developmental factors that increase the likelihood of developing paraphilia, and its nomological network. Furthermore, these studies mostly focused on pedophilia and sexual sadism, stressing the need for more research. The relationship between childhood trauma and personality traits is supported by several research (e.g., Cattane et al., 2017). Furthermore, the impact of personality traits in the developmental model of rape (e.g., Knight & Sims-Knight, 2006), sexual coercion (e.g., Malamuth et al., 2021), sexual sadism (e.g., Longpré et al., 2018a; Robertson et al., 2018) and child molesting (e.g., Chopin et al., 2022; Daversa & Knight, 2007) is well documented. This impact is also observed across gender (e.g., Fontaine et al., 2018; Parent et al., 2018). While genetic or developmental influences may be significant in the development of personality traits (Davey, 2015; Paris, 2005), the present paper focused solely on developmental influences.

Our results revealed a good relationship between childhood trauma and personality traits, with Antisocial traits presenting the highest standardized coefficient. However, the relationship between personality traits and paraphilia was weaker. Direct and indirect effects were significant for Schizoid, Antisocial, Narcissistic and Borderline personality traits but not for Avoidant personality traits. Finally, across models, the explained variance was of approximately 24%, indicating that other variables absent in our models also explain deviant sexual arousal. Those results support, in part, the relationship between childhood trauma, personality traits and paraphilic sexual arousal. However, the current study used a retrospective research design and warrant for a careful interpretation. These results need to be replicated in longitudinal studies.

The development of deviant sexual arousal is multifactorial, with childhood trauma as the starting point in a majority of cases (Knight & Sims-Knight, 2006), which in turns affect the psychosocial development (Longpré et al., 2018a). Childhood trauma can lead to inappropriate coping strategies or low self-esteem (Marshall & Barbaree, 1990), impulsivity (Marshall & Barbaree, 1990), early delinquency (Proulx et al., 2007), cognitive distortions (Chopin et al., 2022) and substance abuse (Chopin et al., 2022; Longpré et al., 2018a). These factors were not available for the mediation analyses, which might explain in part why the models explained roughly one fourth of the variance. Future studies should consider measuring these factors to improve our understanding of the etiology of paraphilias. Furthermore, as reported in previous study (e.g., Joyal, 2018; Joyal & Carpentier, 2022), the line between normophilic and anomalous paraphilias is not well-defined and our results need to be interpreted carefully. While the development factors leading to normophilic and anomalous paraphilias appeared to be similar to the development factors leading to sexual violence, normophilic paraphilias can exist in consensual forms that are not harmful.

Future research should focus on two important points. First, there is a vibrant need to reconsider how unusual sexual fantasies, arousal, and practices are defined and categorize. The last version of the DSM has moved in the right direction, and strong empirical research is needed to guide the paraphilias’ sub-workgroup. In order to develop effective practices, we need to properly define, without stigmatization and supported by empirical evidence, what exactly unusual sexual fantasies, arousal and practices are. Furthermore, more research is needed to understand the causes of unusual sexual fantasies, arousal, and practices. In order to develop effective prevention and treatment strategies, it is important to understand which individual factors are involved, especially those involving unlawful behaviours such as Necrophilia. Furthermore, it is important to understand why for some individuals the nature of such sexual fantasies, arousal and practices cause significant distress.

The Relationship Between Trauma, Hypersexuality, Pornography and Deviant Arousal

In a third step, the relationship between childhood trauma, hypersexuality, problematic pornography consumption and paraphilic arousal were assessed. Mediation analyses (Models 2, 3 & 4) revealed that the relationship between childhood trauma and paraphilic arousal was mediated by hypersexuality and problematic pornography consumption. Furthermore, the relationship between hypersexuality, problematic pornography consumption and arousal was much stronger than between PDs and arousal, indicating that an over-involvement of sexual behaviours is probably a better predictor of paraphilias than PDs. The relationship between childhood trauma and hypersexuality was also found in previous research (e.g., Kingston et al., 2017). Furthermore, the interaction between problematic pornography consumption, and hypersexuality, mostly throughout its sub-components sexual preoccupation and compulsivity, is documented (e.g., Stein et al., 2001) and is consistent with Seto et al. (2014) who found that paraphilias are often comorbid with high rates of sexual activities.

The mediation models also supported the work of other studies in this area, linking problematic pornography consumption with hypersexuality (e.g., Knight & Graham, 2017) and paraphilias (e.g., Stefanska et al., 2022). Problematic pornography consumption has been associated with external problems such as poorer psychosocial functioning and normalization of unusual practices and coercion (Harper & Hodgins, 2016). However, to our knowledge, no study has looked at the interaction between childhood traumatic experiences, problematic pornography consumption, hypersexuality and paraphilic arousal in one research design. Our findings are supporting the notion that over-involvement of sexual behaviours, throughout hypersexuality and problematic pornography consumption, can result in individuals being more susceptible to experimenting in paraphilic-related intercourse, which is consistent with the literature.

As mentioned above, the causes of unusual sexual fantasies, arousal, and practices are not well known, and the focus is usually on the most severe forms (i.e., sadism, pedophilia). Mediation analyses revealed that paraphilic arousal steamed, in part, from childhood trauma, problematic pornography consumption, and hypersexuality, which were found to be associated to higher risk of sexual coercion and sexual violence in previous studies. Schwartz and Southern (2000) found that dysfunctional sexual coping strategies were established for men and women who reported higher rates and severity of traumas, specifically sexual abuse. It can be inferred that individuals may engage in risky sexual behaviours as a coping mechanism. The current study highlights the impact of childhood abuse and neglect in the etiology of paraphilic interests, as well as the multi-factorial etiology. While having a paraphilia is not associated to an increase of risk of reoffending (e.g., Brouillette-Alarie et al., 2022), deviant sexual fantasy is recognized as a risk factor of sexual reoffending (e.g., Brankley et al., 2021). This research provides a foundation to use and to build upon for future research. However, as explained, the results steamed from retrospective research design and warrant for a careful interpretation. In order to develop effective treatment for paraphilias, more research is needed on the causes and replication study across samples and studies is the key (Longpré et al., 2020b).

Limitations

This study is not without limitations. First, data relied on self-reported information regarding sensitive topics, which might have been influenced by an inherent desire to appear in a socially desirable manner. Furthermore, there is a possibility that participants did not answer the questions accurately due to the retrospective nature of the study. Several control measures and safeguarding measures were taken to minimize the risk of using inaccurate responses, ranging from voluntary participation, to complete anonymity, to financial compensation (MTurk participants), to the analysis of completion time in an attempt to mitigate the risk of presenting social desirability bias. While our results are consistent with previous study, they should be interpreted with caution.

Furthermore, the sample used in the present study is uncommon, as part of the sample used were recruited on FetLife. Users of FetLife are actively engaging in consensual and non-traditional intimate behaviours, which might have inflated rates of self-reported paraphilic interests. Furthermore, some discrepancies between the current sample and the general population were found. For example, 64.5% of our sample is identifying as heterosexual, which is significantly lower than the general population (e.g., In the UK, 93.7% of the population is identifying as heterosexual [Office for National Statistic, 2019]). Although marketing the study on FetLife can explain why some paraphilia received high response rates and why some discrepancies were found, FetLife members are still part of the general population, and it was established that BDSM community does not present atypical psychological profiles (Robertson, 2014). Furthermore, in order to understand the nomological network of paraphilias, it was important to use a sample that is covering a larger spectrum of sexual fantasy and arousal. Conducting studies in an echo chamber has an impact on measurement error (Longpré et al., 2020a). Additionally, this approach was used in previous studies, such as Seto et al. (2012) who used a sample of men with self-reported interests is sadistic activities and provided reliable results. Thus, the tri-modal sampling method used in this study has allowed a better generalization of the results. Therefore, while the mediation models should be interpreted with caution, and replicated, the present study provides important information on the development of unusual sexual practices.

Conclusion

The aim of the present study was to assess the prevalence of paraphilias among the general population and to study the relationship between Childhood Trauma, Personality traits [Schizoid; Avoidant; Antisocial; Narcissistic; Borderline], Hypersexuality, Pornography consumption and Arousal. Similar to previous study, findings revealed that the presence of a sexual fantasy is not necessarily indicative of a corresponding sexual arousal, with a majority of self-reported arousal being lower than fantasy. Finally, mediation analyses revealed that the relationship between trauma and paraphilic sexual arousal is mediated by hypersexuality, problematic pornography consumption and personality traits.

This study has provided an updated support for existing findings that paraphilic interest is more common in the general population than previously thought, not only in terms of fantasies but also arousal. Analyses also revealed a difference between sexual fantasy and arousal, as fantasies are not always translated into arousal. These results support previous studies on the concordance of paraphilic interests. Furthermore, analyses revealed that abuses in the past are the starting point of an over-involvement in sexuality, namely hypersexuality and problematic pornography consumption, which can lead to an unhealthy sexual life. Future study should focus on studying the developmental causes of paraphilias, and on understanding why for some individuals normophilic paraphilias cause significant distress in order to develop effective treatment for paraphilias.

Compliance with Ethical Standards

Conflict of interest: The authors declare that they have no conflict of interest.

Ethical Approval: 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 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent: Informed consent was obtained from all individual participants included in the study.

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Tables

Table 1. Frequency of Sexual Fantasy and Sexual Arousal Across Categories

Categories

Sexual Fantasy (% Total [Men/ Women])

Sexual Arousal (% Total [Men/ Women])

Never

Once

A few times*

Often**

Never

Once

A few times*

Often**

Algolagnia

29.6 [34.9, 23.5]

16.9 [13.8, 20.5]

26.9 [27.7, 25.9]

26.6[23.6, 30.1]

37.4 [44.1, 29.5]

16.1[12.3, 20.5]

25.2 [22.6, 28.3]

21.3 [21, 21.7]

Asphyxiophilia

46.5 [60, 26.5]

15.8[15.4, 16.9]

17.2 [11.3, 24.1]

20.5 [13.3, 32.5]

41.3 [53.8, 26.5]

17.2 [17.4, 16.9]

20.8 [17.9, 24.1]

20.8 [10.8, 32.5]

Autassassinophilia

63.2 [67.2, 58.4]

16.1 [15.9, 16.3]

14.1 [9.2, 19.9]

6.6 [7.7, 5.4]

68.1 [73.3, 62]

15.5 [10.8, 21.1]

9.1 [7.2, 11.4]

7.2 [8.7, 5.4]

Dacryphilia

47.9 [37.9, 59.6]

16.9 [18.4, 15.1]

19.9 [23.6, 15.7]

15.2 [20, 9.6]

69.8 [70.3, 69.3]

13 [12.3, 13.8]

12.5 [12.8, 12]

4.7 [4.6, 4.8]

Exhibitionism

54 [54.9, 53]

16.9 [15.4, 18.7]

18.6 [20, 16.9]

10.5 [9.7, 11.4]

64 [66.2, 61.4]

16.3 [11.3, 22.3]

15.5 [17.9, 12.7]

4.2 [4.6, 3.6]

Fetishism

60.1 [60, 60.2]

15.8 [14.9, 16.9]

16.6 [16.9, 16.3]

7.5 [8.2, 6.6]

64.8 [64.1, 65.7]

15.2 [15.9, 14.4]

12.2 [11.3, 13.3]

7.8 [8.7, 6.6]

Forniphilia

69.5 [70.3, 68.7]

12.5 [10.3, 15.1]

11.6 [11.8, 11.4]

6.4 [7.7, 4.8]

70.1 [70.3, 69.9]

13.6 [13.8, 13.2]

11.1 [10.3, 12]

5.3 [5.6, 4.8]

Frotteurism

60.7 [62.2, 59]

17.4 [12.8, 22.9]

15.5 [16.4, 14.5]

6.4 [8.7, 3.6]

66.8 [66.7, 66.9]

15.3 [12.8, 18.1]

13 [14.4, 11.4]

5 [6.2, 3.6]

Hematolagnia

65.7 [65.6, 65.7]

11.7 [10.3, 13.2]

17.2 [17.4, 16.9]

5.5 [6.7, 4.2]

53.2 [44.2, 63.9]

14.7 [15.9, 13.2]

22.4 [25.6, 18.7]

9.7 [14.4, 4.2]

Hybristophilia

62 [67.7, 55.4]

15.5 [9.2, 22.9]

16.1 [16.4, 15.7]

6.4 [6.7, 6]

70.6 [70.8, 70.5]

12.5 [12.3, 12.6]

8.6 [8.7, 8.4]

8.3 [8.2, 8.4]

Masochism

36.8 [43.1, 29.5]

18.3 [17.9, 18.7]

17.8 [17.4, 18.1]

27.1 [21.5, 33.7]

45.2 [53.8, 34.9]

16.1 [13.3, 19.3]

20.2 [18.5, 22.3]

18.6 [14.4, 23.5]

Narratophilia

22.2 [22.1, 22.3]

19.1 [15.9, 22.9]

26.6 [26.1, 27.1]

32.1 [35.9, 27.7]

26.6 [23.6, 30.1]

16.6 [16.9, 16.3]

23.8 [22.6, 25.3]

33 [36.9, 28.3]

Necrophilia

69.5 [70.3, 68.7]

13.5 [12.8, 14.5]

13 [13.3, 12.7]

3.9 [3.6, 4.2]

72.3 [74.9, 69.3]

13.1 [10.3, 16.3]

13.9 [14.7, 12.7]

0.8 [.2, 1.6]

Objectophilia

69.8 [70.3, 69.3]

13.6 [12.8, 14.5]

11.6 [12.3, 10.8]

5 [4.6, 5.4]

71.5 [73.8, 68.7]

12.8 [8.7, 17.5]

13.3 [15.4, 10.8]

2.5 [2.1, 3]

Odaxelagnia

24.1 [25.6, 22.3]

19.1 [19, 19.3]

26 [25.6, 26.5]

30.7 [29.7, 31.9]

31.6 [33.3, 29.5]

15.2 [15.9, 14.5]

26.9 [23.1, 27.1]

28.3 [27.7, 28.9]

Pedo-hebepho-ephebophilie

56 [49.2, 63.9]

16.4 [15.9, 16.9]

18.8 [20.5, 16.9]

8.9 [14.4, 2.4]

65.9 [64, 68.1]

13.3 [12.8, 13.8]

14.4 [14.9, 13.9]

6.4 [8.2, 4.2]

Piquerism

57.9 [55.9, 60.2]

13 [10.8, 15.7]

17.5 [20.5, 13.9]

11.6 [12.8, 10.2]

64.3 [63.6, 65.1]

16.9 [14.9, 19.3]

14.7 [16.4, 12.7]

4.2 [5.1, 3]

Coerced

35.7 [36.9, 34.3]

19.2 [18.4, 19.9]

22.2 [24.2, 19.9]

23 [20.5, 25.9]

45.7 [48.7, 42.2]

21 [19, 23.5]

19.9 [20.5, 19.3]

13.3 [11.8, 15.1]

Coercing

37.1 [29.2, 46.4]

21.1 [19.5, 22.9]

20.5 [20.5, 20.5]

21.3 [30.8, 10.2]

45.2 [36.4, 55.4]

16.6 [19, 13.8]

23.8 [26.2, 21.1]

14.4 [18.5, 9.6]

Sexual Sadism

41.6 [31.8, 53]

18 [16.4, 19.9]

19.4 [21, 17.5]

21.1 [30.8, 9.6]

44.9 [34.3, 57.2]

15.3 [16.4, 13.8]

19.9 [22.1, 17.5]

19.9 [27.2, 11.4]

Somnofilia

41.3 [35.4, 48.2]

18.6 [15.9, 21.7]

26 [30.8, 20.5]

14.1 [17.9, 9.6]

37.1 [31.3, 44]

18.9 [21.5, 15.6]

27.1 [27.2, 27.1]

16.9 [20, 13.3]

Transvestitism

54.6 [51.8, 57.8]

15.9 [17.4, 13.9]

19.7 [18.5, 21.1]

10 [12.3, 7.2]

61.8 [60, 63.9]

16.6 [13.8, 19.9]

15 [17.4, 12]

6.6 [8.7, 4.2]

Voyeurism

34.3 [26.2, 44]

21.6 [19.5, 24.1]

29.6 [35.9, 22.3]

14.4 [18.5, 9.6]

52.6 [47.2, 59]

19.9 [20.5, 19.3]

17.5 [20.5, 16.3]

10 [11.8, 7.8]

Zoophilia

63.4 [61, 66.3]

14.4 [13.8, 15.1]

14.1 [14.4, 13.9]

8 [10.8, 4.8]

70.6 [71.8, 69.3]

13.6 [10.8, 16.9]

14.4 [15.4, 13.3]

1.4 [2.1, .6]

Note. *Between 2 and 10 times in a lifetime ** More than 10 times in a lifetime

Figure 1. Mediations Analysis – Model 1: Personality Traits

Note. ** = p < .01, *** = p < .001.

Diagram Description automatically generated

Figure 2. Mediations Analysis – Models 2, 3 and 4: Hypersexuality and Problematic Pornography Consumption

Note. *** = p < .001.

Diagram Description automatically generated

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