Problematic sexual behavior in young adults: Associations across clinical, behavioral, and neurocognitive variables

Abstract A notable number of young adults struggle to control impulsive behavior, resulting in impairment and distress. Assessments of problematic sexual behavior (PSB) have noted clinical differences relative to other populations, but neurocognitive findings have varied. This analysis assesses the clinical presentation and neurocognitive profile of patients with PSB relative to participants without PSB symptoms. A total of 492 participants (18–29) were recruited for a study on impulsivity in young adults. Participants completed diagnostic, self-report, and neurocognitive measures which assessed several cognitive domains. PSB was defined as endorsing fantasies, urges, or sexual behavior that felt out of control or was causing distress. In the sample, 54 (11%) participants reported current PSB. This group was older, reported earlier sexual experiences and alcohol use, and lower quality of life and self-esteem. Comorbidity was greater in the PSB group, particularly for depression and alcohol dependence. The PSB group also showed differences in impulsivity, decision making, spatial working memory, problem solving, and emotional dysregulation. Results suggest associations between PSB psychosocial dysfunction, greater comorbidity, and neurocognitive differences. These associations suggest a more salient impact than typical sexual behavior. Furthermore, this study demonstrated several neurocognitive deficits in the PSB group which have found more mixed support previously.