Understanding the Etiology of Sexual Deviance: Implications for Prevention and Treatment

This blog post is based on the systematic review “Theories on the Etiology of Deviant Sexual Interests: A Systematic Review” by Schippers et al. (2024) published in Sexual Abuse.

Introduction

Sexual deviance remains a complex and often misunderstood phenomenon with significant implications for public health and safety. For professionals working in prevention and treatment, having a comprehensive understanding of how deviant sexual interests develop is crucial for designing effective interventions. This systematic review by Schippers et al. (2024) provides valuable insights into current theories on the etiology of sexual deviance, offering a foundation for evidence-based approaches in the field.

Definition of Sexual Deviance

In their systematic review, Schippers et al. (2024) found that there is no uniform definition of sexual deviance across the field. They noted that the included studies often defined general sexual deviance as sexual fantasies, interests, or behaviors that deviate from societal and judicial norms. Specifically, the authors report that sexual deviance was most frequently defined relative to a combination of social or societal norms (e.g., “contravenes the norms of society”) and judicial norms (e.g., “illegal” or “nonconsent”). Some definitions also referenced statistical norms (e.g., “atypical” or “unusual”) or psychopathological norms, including DSM classifications. Interestingly, the review found that definitions of masochism/sadism often did not explicitly couple these interests with sexual arousal, instead focusing on the interest in or behavior with painful or humiliating stimuli. The authors note that this broad definition encompasses both illegal behaviors (e.g., rape, exhibitionism) and unusual but potentially harmless interests (e.g., fetishism). This inclusive approach allows for a comprehensive examination of various deviant sexual interests and their potential interconnections.

Key Findings

1. Limited High-Quality Theories

The review identified a striking lack of high-quality theories explaining the etiology of sexual deviance. Out of 2,296 articles screened, only 47 theories were included in the final analysis, with a mere 7 meeting the criteria for acceptable quality. This highlights a significant gap in the theoretical understanding of how deviant sexual interests develop.

2. Common Etiological Themes

Despite the limited number of high-quality theories, several common themes emerged across the acceptable theories:

• Excitation transfer: The transfer of arousal between different emotions, potentially enhancing sexual response when presented closely with other strong emotions like fear or pain.
• Conditioning: Both classical and operant conditioning processes play a role in associating deviant stimuli with sexual arousal and reinforcing these associations.
• Problems with normative sexuality: Difficulties experiencing satisfying arousal from normative sexual stimuli may increase vulnerability to deviant interests.
• Social learning: Early sexual experiences, exposure to sexuality via parents or pornography, and traumatic sexual victimization may shape the development of deviant interests.

3. Alignment with Incentive Motivational Model

The synthesis of findings aligns well with the incentive motivational model commonly used in general sexology. This model views sexual motivation as an emotional response to sexually relevant stimuli that provide potential reward. The review suggests this framework can be extended to understand deviant sexual interests as well.

4. Limited Neurobiological Understanding

While recent neurobiological research has advanced knowledge, very few neurobiological theories met the inclusion criteria or quality standards of this review. This indicates a need for more comprehensive theory development integrating biological findings.

Implications for Prevention and Treatment Professionals

While Schippers et al. (2024) primarily focused on reviewing theories rather than providing direct treatment recommendations, their findings do suggest some potential implications for prevention and treatment professionals:

1. Need for Comprehensive Theoretical Framework

The review highlights a significant gap in high-quality theories explaining the etiology of sexual deviance. This underscores the need for professionals to approach prevention and treatment with caution, recognizing that the understanding of how deviant sexual interests develop is still limited.

2. Consideration of Multiple Factors

The common etiological themes identified (excitation transfer, conditioning, problems with normative sexuality, and social learning) suggest that professionals should consider multiple factors when assessing and addressing deviant sexual interests. A single-factor approach is likely to be insufficient.

3. Potential for Malleability

The roles of excitation transfer and conditioning in the development of deviant interests suggest that these interests may be, to some extent, malleable. However, it’s important to note that the review does not provide direct evidence for the effectiveness of interventions targeting these processes.

4. Importance of Normative Sexuality

The review’s findings on problems with normative sexuality as a potential factor suggest that promoting healthy, satisfying normative sexual experiences could be an important aspect of prevention efforts. However, more research is needed to confirm this approach.

5. Early Intervention Considerations

The role of social learning in the development of deviant interests points to the potential importance of early intervention and prevention efforts. This could include addressing early sexual experiences and exposure, though specific interventions were not evaluated in this review.

6. Need for Integrated Approach

The review’s alignment of findings with the incentive motivational model suggests that an integrated approach, considering both emotional and motivational factors, may be beneficial in understanding and addressing deviant sexual interests.

7. Research Gaps in Neurobiological Understanding

The limited inclusion of high-quality neurobiological theories highlights a significant gap in the current body of knowledge. Professionals should be aware of this limitation and stay informed about emerging neurobiological research that may inform future practice.

It’s important to note that these implications are derived from a review of theories, not from studies directly testing interventions. Therefore, while they provide valuable directions for consideration, they should be approached with caution and further research is needed to establish evidence-based practices in prevention and treatment of deviant sexual interests.

Conclusion

This systematic review provides a valuable foundation for understanding the etiology of sexual deviance. However, the review also underscores significant gaps in the theoretical understanding, particularly in integrating neurobiological findings. As professionals in the field, we must continue to support and engage with research efforts to develop more comprehensive, high-quality theories of sexual deviance etiology.

References