Hypersexual behavior and attachment styles in a non-clinical sample: the mediation role of depression and post-traumatic stress symptoms

Introduction: Hypersexuality is a complex behavioral dysfunction concerning the excess of sexual activities. In this study, we aim to investigate the role of attachment styles, post-traumatic and depression symptoms in hypersexual behavior. Methods: We recruited through an online platform a snowball convenience sample of 1025 subjects (females: n=731; 71.3%; males: 294; 28.7%; age: 29.62±10.90) and we administered them a sociodemographic questionnaire, with a psychometric protocol composed by the Hypersexual Behavior Inventory (HBI) to assess hypersexuality, the Relationship Questionnaire (RQ) for the attachment styles, the International Trauma Questionnaire (ITQ) to evaluate the trauma and Patient Health Questionnaire (PHQ) for depression. Results: We found a significant and predictive impact of preoccupied and fearful attachment styles on hypersexual behavior (β=.116; p<.0001 and β=.121p<.0001, respectively). The categorical analysis of RQ confirmed also statistically significant differences between secure attachment style with fearful and preoccupied ones in terms of HBI levels (secure=30.01±10.79; preoccupied=35.50±14.46; fearful=36.57±13.50). Moreover, we found that depression symptoms and the total score of ITQ also resulted predictive for hypersexuality (β=.323; p<.0001 and β=.063; p<.04). However, in our model, depression and post-traumatic symptoms played a mediation role between insecure attachment and hypersexual behavior. Conclusion: This study found a fundamental role of insecure attachment styles, post-traumatic and depression symptoms in the development of problematic sexuality. Hypersexual behavior is related in a causal manner with an insecure attachment style, fearful and preoccupied attachment, particularly. Nevertheless, the traumatic core of personality together with depression symptoms could play a mediation role towards the hypersexual behavior.