Attention Deficit Hyperactivity Disorder and Sexual Functioning - is there a connection?
DOI:
https://doi.org/10.12775/QS.2024.27.55095Keywords
ADHD, attention deficit hyperactivity disorder, sexuality, sexual dysfunction, athletes with ADHD, hyperkinetic syndromeAbstract
Understanding how ADHD affects sexual functioning is key to providing comprehensive care. This review looks into the current research on sexual health in people with ADHD, focusing on how common sexual dysfunction is, how ADHD symptoms might impact sexual behavior, and what role medications play. By summarizing the existing studies, this review aims to highlight what we don’t know yet and suggest future research to improve treatment and patient outcomes. The review covers literature related to sexual functioning in ADHD, particularly looking at connections to hypersexuality, paraphilias, and various sexual behaviors. A thorough search of electronic databases, including PubMed, PsycINFO, and Google Scholar, was conducted using relevant keywords such as 'ADHD,' 'hypersexuality,' 'paraphilias,' 'sexuality,' 'sexual behavior,' and 'sexual violence.' The study duration was 6 months. Common features of ADHD, such as impulsivity, poor impulse control, and difficulties with self-regulation, may contribute to risky sexual behaviors, compulsive sexual behavior, or the development of paraphilic interests. It's important for doctors dealing with ADHD in children to discuss sexual health as the patient nears adolescence and offer guidance on safe sex. Treatment should combine medication with therapy. Since impulsivity seems to play a big role in risky sexual behavior, making contraceptives readily available could be important for sexual health. Longitudinal studies are necessary to better understand the temporal relationships and progression of sexual behaviors and ADHD symptoms over time. Given the potential impact of ADHD on sexual behavior and functioning, healthcare providers should consider screening for ADHD in patients presenting with issues related to hypersexuality, paraphilias, or other sexual concerns.
References
Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942-8. doi: 10.1176/ajp.2007.164.6.942
Bőthe B, Koós M, Tóth-Király I, Orosz G, Demetrovics Z. Investigating the Associations Of Adult ADHD Symptoms, Hypersexuality, and Problematic Pornography Use Among Men and Women on a Largescale, Non-Clinical Sample. The Journal of Sexual Medicine. 2019;16(4):489-99. doi: 10.1016/j.jsxm.2019.01.312
Niazof D, Weizman A, Weinstein A. The contribution of ADHD and attachment difficulties to online pornography use among students. Compr Psychiatry. 2019;93:56-60. doi: 10.1016/j.comppsych.2019.07.002
Bob P, Konicarova J, Raboch J. Disinhibition of Primitive Reflexes in Attention Deficit and Hyperactivity Disorder: Insight Into Specific Mechanisms in Girls and Boys. Front Psychiatry. 2021;12:430685. doi: 10.3389/fpsyt.2021.430685
Soldati L, Bianchi-Demicheli F, Schockaert P, Köhl J, Bolmont M, Hasler R, Perroud N. Sexual Function, Sexual Dysfunctions, and ADHD: A Systematic Literature Review. J Sex Med. 2020;17(9):1653-64. doi: 10.1016/j.jsxm.2020.03.019
Flory K, Molina BS, Pelham WE, Jr., Gnagy E, Smith B. Childhood ADHD predicts risky sexual behavior in young adulthood. J Clin Child Adolesc Psychol. 2006;35(4):571-7. doi: 10.1207/s15374424jccp3504_8
Wilens TE, Spencer TJ. Understanding attention-deficit/hyperactivity disorder from childhood to adulthood. Postgrad Med. 2010;122(5):97-109. doi: 10.3810/pgm.2010.09.2206
Rokeach A, Wiener J. The Romantic Relationships of Adolescents With ADHD. J Atten Disord. 2018;22(1):35-45. doi: 10.1177/1087054714538660
Margherio SM, Capps ER, Monopoli JW, Evans SW, Hernandez-Rodriguez M, Owens JS, DuPaul GJ. Romantic Relationships and Sexual Behavior Among Adolescents With ADHD. J Atten Disord. 2021;25(10):1466-78. doi: 10.1177/1087054720914371
Halkett A, Hinshaw SP. Initial Engagement in Oral Sex and Sexual Intercourse Among Adolescent Girls With and Without Childhood Attention-Deficit/Hyperactivity Disorder. Arch Sex Behav. 2021;50(1):181-90. doi: 10.1007/s10508-020-01733-8
Heywood W, Patrick K, Smith AM, Pitts MK. Associations between early first sexual intercourse and later sexual and reproductive outcomes: a systematic review of population-based data. Arch Sex Behav. 2015;44(3):531-69. doi: 10.1007/s10508-014-0374-3
Vasilenko SA, Kugler KC, Rice CE. Timing of First Sexual Intercourse and Young Adult Health Outcomes. J Adolesc Health. 2016;59(3):291-7. doi: 10.1016/j.jadohealth.2016.04.019
Hechtman L, Swanson JM, Sibley MH, Stehli A, Owens EB, Mitchell JT, Arnold LE, Molina BS, Hinshaw SP, Jensen PS, Abikoff HB, Perez Algorta G, Howard AL, Hoza B, Etcovitch J, Houssais S, Lakes KD, Nichols JQ. Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results. J Am Acad Child Adolesc Psychiatry. 2016;55(11):945-52.e2. doi: 10.1016/j.jaac.2016.07.774
Young S, Cocallis K. A Systematic Review of the Relationship Between Neurodiversity and Psychosexual Functioning in Individuals with Autism Spectrum Disorder (ASD) or Attention-Deficit/Hyperactivity Disorder (ADHD). Neuropsychiatr Dis Treat. 2023;19:1379-95. doi: 10.2147/ndt.S319980
Hua MH, Huang KL, Hsu JW, Bai YM, Su TP, Tsai SJ, Li CT, Lin WC, Chen TJ, Chen MH. Early Pregnancy Risk Among Adolescents With ADHD: A Nationwide Longitudinal Study. J Atten Disord. 2021;25(9):1199-206. doi: 10.1177/1087054719900232
Langevin R, Marshall C, Wallace A, Gagné ME, Kingsland E, Temcheff C. Disentangling the Associations Between Attention Deficit Hyperactivity Disorder and Child Sexual Abuse: A Systematic Review. Trauma Violence Abuse. 2023;24(2):369-89. doi: 10.1177/15248380211030234
Halkett A, O'Grady SM, Hinshaw SP. An Exploratory Investigation of Childhood Sexual Abuse and Other Theory-Driven Predictors of Sex Work Among Women with and without Childhood ADHD. J Child Adolesc Trauma. 2022;15(4):949-62. doi: 10.1007/s40653-022-00467-0
Puri N, Shannon K, Nguyen P, Goldenberg SM. Burden and correlates of mental health diagnoses among sex workers in an urban setting. BMC Womens Health. 2017;17(1):133. doi: 10.1186/s12905-017-0491-y
Rohacek AM, Firkey MK, Woolf-King SE, Antshel KM. Moderation of Risks to Sexual Health by Substance Use in College Students With ADHD. J Clin Psychiatry. 2022;83(4). doi: 10.4088/JCP.21m14240
Berry MS, Sweeney MM, Dolan SB, Johnson PS, Pennybaker SJ, Rosch KS, Johnson MW. Attention-Deficit/Hyperactivity Disorder Symptoms Are Associated with Greater Delay Discounting of Condom-Protected Sex and Money. Arch Sex Behav. 2021;50(1):191-204. doi: 10.1007/s10508-020-01698-8
Weyandt L, DuPaul GJ, Shepard E, Labban JD, Francis A, Beatty A, Anastopoulos AD. Longitudinal Examination of Sexual Risk Behavior in College Students With and Without Attention-Deficit/Hyperactivity Disorder. Arch Sex Behav. 2023;52(8):3505-19. doi: 10.1007/s10508-023-02660-0
Soldati L, Bianchi-Demicheli F, Schockaert P, Köhl J, Bolmont M, Hasler R, Perroud N. Association of ADHD and hypersexuality and paraphilias. Psychiatry Res. 2021;295:113638. doi: 10.1016/j.psychres.2020.113638
Bőthe B, Tóth-Király I, Potenza MN, Griffiths MD, Orosz G, Demetrovics Z. Revisiting the Role of Impulsivity and Compulsivity in Problematic Sexual Behaviors. J Sex Res. 2019;56(2):166-79. doi: 10.1080/00224499.2018.1480744
Korchia T, Boyer L, Deneuville M, Etchecopar-Etchart D, Lancon C, Fond G. ADHD prevalence in patients with hypersexuality and paraphilic disorders: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci. 2022;272(8):1413-20. doi: 10.1007/s00406-022-01421-9
Hertz PG, Turner D, Barra S, Biedermann L, Retz-Junginger P, Schöttle D, Retz W. Sexuality in Adults With ADHD: Results of an Online Survey. Front Psychiatry. 2022;13:868278. doi: 10.3389/fpsyt.2022.868278
Amani Jabalkandi S, Raisi F, Shahrivar Z, Mohammadi A, Meysamie A, Firoozikhojastefar R, Irani F. A study on sexual functioning in adults with attention-deficit/hyperactivity disorder. Perspect Psychiatr Care. 2020;56(3):642-8. doi: 10.1111/ppc.12480
Arrondo G, Osorio A, Magallón S, Lopez-Del Burgo C, Cortese S. Attention-deficit/hyperactivity disorder as a risk factor for being involved in intimate partner violence and sexual violence: a systematic review and meta-analysis. Psychol Med. 2023;53(16):7883-92. doi: 10.1017/s0033291723001976
Privara M, Bob P. Sexual development in ADHD and internet pornography consumption. Front Psychiatry. 2023;14:1240222. doi: 10.3389/fpsyt.2023.1240222
Wymbs BT, Dawson AE, Suhr JA, Bunford N, Gidycz CA. ADHD Symptoms as Risk Factors for Intimate Partner Violence Perpetration and Victimization. J Interpers Violence. 2017;32(5):659-81. doi: 10.1177/0886260515586371
Ohlsson Gotby V, Lichtenstein P, Långström N, Pettersson E. Childhood neurodevelopmental disorders and risk of coercive sexual victimization in childhood and adolescence - a population-based prospective twin study. J Child Psychol Psychiatry. 2018;59(9):957-65. doi: 10.1111/jcpp.12884
Snyder JA. The Link Between ADHD and the Risk of Sexual Victimization Among College Women: Expanding the Lifestyles/Routine Activities Framework. Violence Against Women. 2015;21(11):1364-84. doi: 10.1177/1077801215593647
Wymbs BT, Gidycz CA. Examining Link Between Childhood ADHD and Sexual Assault Victimization. J Atten Disord. 2021;25(11):1612-22. doi: 10.1177/1087054720923750
Bijlenga D, Vroege JA, Stammen AJM, Breuk M, Boonstra AM, van der Rhee K, Kooij JJS. Prevalence of sexual dysfunctions and other sexual disorders in adults with attention-deficit/hyperactivity disorder compared to the general population. Atten Defic Hyperact Disord. 2018;10(1):87-96. doi: 10.1007/s12402-017-0237-6
Meza JI, Owens EB, Hinshaw SP. Childhood predictors and moderators of lifetime risk of self-harm in girls with and without attention-deficit/hyperactivity disorder. Dev Psychopathol. 2021;33(4):1351-67. doi: 10.1017/s0954579420000553
Dalsgaard S, Nielsen HS, Simonsen M. Consequences of ADHD medication use for children's outcomes. J Health Econ. 2014;37:137-51. doi: 10.1016/j.jhealeco.2014.05.005
Ruiz-Goikoetxea M, Cortese S, Aznarez-Sanado M, Magallón S, Alvarez Zallo N, Luis EO, de Castro-Manglano P, Soutullo C, Arrondo G. Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2018;84:63-71. doi: 10.1016/j.neubiorev.2017.11.007
Francis AR, Oster DR, Weyandt L, DuPaul GJ, Anastopoulos AD, Gudmundsdottir BG, Beatty A. Factor Structure of the Sexual Risk Survey Among U.S. College Students with and without ADHD: Assessing Clinical Utility with a High-Risk Population. Arch Sex Behav. 2022;51(6):2931-42. doi: 10.1007/s10508-021-02249-5
Faraone SV, Antshel KM. Diagnosing and treating attention-deficit/hyperactivity disorder in adults. World Psychiatry. 2008;7(3):131-6. doi: 10.1002/j.2051-5545.2008.tb00179.x
Young S, Klassen LJ, Reitmeier SD, Matheson JD, Gudjonsson GH. Let's Talk about Sex… and ADHD: Findings from an Anonymous Online Survey. Int J Environ Res Public Health. 2023;20(3). doi: 10.3390/ijerph20032037
Marwick C. Survey says patients expect little physician help on sex. Jama. 1999;281(23):2173-4. doi: 10.1001/jama.281.23.2173
Pedersen H, Skliarova T, Pedersen SA, Gråwe RW, Havnen A, Lara-Cabrera ML. Psychoeducation for adult ADHD: a scoping review about characteristics, patient involvement, and content. BMC Psychiatry. 2024;24(1):73. doi: 10.1186/s12888-024-05530-8
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Copyright (c) 2024 Julia Skwara, Konstancja Węgrzyn, Marcin Wasilewski, Maciej Nowicki, Gustaw Laskowski, Agnieszka Góra, Dawid Barański, Anna Salińska, Piotr Węgrzyn, Natalia Dąbrowska
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