A Model of Experiential Avoidance and Executive Function Deficits Affecting Hypersexual Behavior with the Mediating Role of Self-compassion: Suggesting an Integrated Intervention Protocol

Background: Hypersexuality (HS) is characterized by individuals' repeated unsuccessful efforts to manage or decrease the duration of their involvement in sexual fantasies, urges, and behaviors. Objectives: The interplay between experiential avoidance (EA) and executive function deficits (EFDs) was explored, examining self-compassion (SC)'s mediating role in HS within a comprehensive framework. An additional objective was to create and validate an integrated intervention protocol for hypersexual behaviors. Materials and Methods: A cross-sectional study was conducted with 370 unmarried students in Bojnord city, Iran, during 2023 - 2024. Data were collected using the Hypersexual Behavior Inventory (HBI), Abbreviated Multidimensional Experiential Avoidance Questionnaire (BEAQ), Barkley Deficits in Executive Functioning Scale (BDEFS), and Self-compassion Inventory-Short Form (SCI-SF). The integrated protocol was evaluated by six psychotherapy specialists for content validity. Structural equation modeling (SEM) was performed using AMOS-23, while SPSS-26 analyzed descriptive data. Results: The analysis, conducted after verifying the statistical assumptions, revealed that hypersexual behavior was significantly associated with EA (β = 0.251, P = 0.001) and EFDs (β = 0.357, P = 0.001). Also, SC mediated the relationship between EA, EFDs, and hypersexual behavior (indirect effects: B = 0.154 for EA and B = 0.117 for EFDs, P = 0.001). The proposed integrated protocol was validated by confirming the Content Validity Ratio (CVR = 1) and Index (CVI ~ 0.83 to 1). Conclusions: The EA and EFDs were significantly linked to hypersexual behavior. The SC mediated these associations, relating to better emotional regulation and impulse control. It enables adaptable emotional management, reducing reliance on sexually aggressive behaviors. Thus, therapies targeting SC and executive function may better address HS.