Sexual Behaviors and Group Personality Profiles

The relationship between personality traits and sexual behavior has been examined repeatedly in personality and sexual research, with only modest results in terms of finding correlations between specific sexual disorders and specific personality traits. For the most part, studies have reported on the personality characteristics of sexual offenders. Despite multiple attempts to establish a correlation between personality and specific sexual dysfunction, there have been no robust findings such that any specific sexual dysfunction can be associated with any personality profile.

Comorbidity studies of sexual disorders and dysfunctions using Axis II (personality disorder) diagnoses of the DSM-IV-TRexamine the question of personality from a pathological perspective. For example, among a sample of pedophilic men, 60 percent met the criteria for a personality disorder, the chief among them being:

  • obsessive-compulsive (25%),
  • antisocial (22.5%),
  • narcissistic (20%),
  • avoidant (20%).

Although diagnostic categorical data provide information about personality limitations, they cannot provide the more comprehensive view that a dimensional personality group profile might supply. Knowledge of personality strengths, not merely vulnerabilities rooted in the disorder, are helpful in developing a treatment plan.

An example of a dimensional examination of personality and sexual disorders is found in a study completed in our Sexual Behaviors Consultation Unit (SBCU) at Johns Hopkins. In this study, we found that men with paraphilic behaviors who presented for evaluation and treatment had a distinct group profile as measured by the five-factor personality model of the NEO-PI-R. The clinical sample (N _ 51) had high Neuroticism, high Openness to Fantasy, low Agreeableness, and low Conscientiousness. Interpreting these domains suggests that the paraphilic group has a higher than average vulnerability to negative affect. This may have been an artifact of studying a sample from a clinical population, but in any case, the participants in the study described themselves as being chronically distressed. The paraphilic group also had a rich fantasy life. This supports the belief that paraphilia is primarily a cognitive phenomenon that may or may not be amenable to change. The treatment challenge is to assist the patient to avoid acting out the fantasy in criminal or otherwise harmful behaviors. The paraphilic group tended to have a more narcissistic focus and, last, had difficulty in performing consistently and conscientiously in their activities. These latter traits posed distinct treatment challenges that I discuss below.

In contrast to the men with paraphilia, who had a group personality profile with scale scores outside the average range, age-matched men with erectile dysfunction had a group personality profile that was in the average range for each of the five major factors. While certainly many of the individual men had facets and factors that were above or below the average range, for the group no factor was high or low. The pooling of their individual profiles resulted in a regression to the mean. As a result, one cannot predicate any personality traits that may be held in common by men with sexual dysfunction, as was done for the group of paraphilic men.

Two conclusions were drawn from the finding that the paraphilic group had a distinct personality profile and the men with sexual dysfunction did not:

  1. some sexual behaviors (e.g., paraphilia) might be correlated with personality traits;
  2. when no distinct group profile emerges (all scale scores are within the average range), then clinical attention should be directed to the individual personality profile of the patient to see what traits may be contributing to the response of the sexual disorder or behavior.

To this task I now turn.

Sexual Behaviors and Individual Personality Profiles Although sex is usually relational in its expressions, individual persons express that sexual behavior. The individual person has enduring qualities and traits that, however they may have developed, shape sexual behaviors and attitudes. Likewise, these same traits may influence the person to react in patterned responses to various influences—both internal and environmental. It is important to assess the relative strengths and vulnerabilities of the traits in the individual with a sexual disorder, so that one can design a treatment program that uses the strengths and minimizes as much as possible the limitations.

While group profiles are helpful in terms of generating hypotheses about the personalities of individuals with a shared sexual behavior, for the most part the contribution of the dimension perspective lies in the attention it pays to the unique array of traits within the individual. Over the past fourteen years, at the SBCU we have used the NEO-PI-R to measure the personalities of individuals with sexual disorders and problems. The NEO-PI-Ris not an instrument, such as the Minnesota Multi – phasic Personality Inventory (MMPI), that measures psychopathology. It is, rather, a self-report inventory that yields a profile of the five factors of normal personality structure. The five factors of Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness provide a comprehensive assessment of normal personality dimensions. It gives the clinician a picture of the personality of the individual who is seeking help for a sexual problem. Employing a personality inventory such as the NEO-PI-R at the initial evaluation permits the clinician to hypothesize what trait strengths and vulnerabilities may have been involved in the genesis of the sexual problem and what personality resources are available for treatment.

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