Paraphilic fantasies and behavior in attention deficit/hyperactivity disorder and their association with hypersexuality

Daniel Turner; Priscilla Gregório Hertz; Laura Biedermann; Steffen Barra; Wolfgang Retz

doi:10.1038/s41443-024-00891-w

Paraphilic fantasies and behavior in attention deficit/hyperactivity disorder and their association with hypersexuality

Int J Impot Res. 2024 Apr 18. doi: 10.1038/s41443-024-00891-w. Online ahead of print.

Authors

Daniel Turner¹, Priscilla Gregório Hertz², Laura Biedermann², Steffen Barra³, Wolfgang Retz^{2

3}

Affiliations

¹ Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany. daniel.turner@unimedizin-mainz.de.
² Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
³ Institute for Forensic Psychology and Psychiatry, University Medical Center Homburg, Homburg, Germany.

PMID: 38637719
DOI: 10.1038/s41443-024-00891-w

Abstract

Previous research has found some peculiarities in sexual functioning of adults with attention deficit/hyperactivity disorder (ADHD). Using a set of questionnaires that had to be answered online, we assessed the prevalence of paraphilic fantasies and behaviors in a sample of 160 adults with ADHD in comparison to 75 adults without ADHD and evaluated the association between paraphilias and hypersexuality in the ADHD group. Both groups reported high rates of paraphilic fantasies and behaviors. ADHD individuals were more likely to report about very sexually arousing paraphilic fantasies (ADHD: 58.2% vs. non-ADHD: 40.5%; χ² = 6.323, p = 0.01) and behaviors (ADHD: 44.9% vs. non-ADHD: 28.4%; χ² = 5.774, p = 0.02). Furthermore, ADHD individuals reported on average about more very sexually arousing paraphilic behaviors compared to non-ADHD individuals (ADHD: M = 1.28, SD = 0.10 vs. non-ADHD: M = 0.81, SD = 0.09; T = 2.68, p < 0.01). Furthermore, in ADHD individuals both very sexually arousing paraphilic interests in masturbation fantasies (r(158) = 0.17, p = 0.03) and in sexual behaviors (r(158) =0.19, p = 0.02) showed a significant correlation with hypersexuality. In non-ADHD individuals no such significant correlation could be found. Altogether, it can be concluded that individuals with ADHD seem to be more prone to develop and act out paraphilic sexuality than those without ADHD, however, found differences were rather small. The results of the present study add to the current trend to depathologize paraphilic sexuality in the general as well as in clinical populations.