Motivational, emotional, and cognitive profiles of dysregulated sexual behavior: a multilevel exploratory study

Background: Dysregulated sexual behavior (DSB) is clinically heterogeneous and may involve partially distinct motivational, emotional, and cognitive processes. This exploratory study examined whether descriptive profiles could be observed across these three domains in adults reporting loss of control over sexual behavior. Methods: In this cross-sectional exploratory study, 76 French adults reporting DSB were recruited through clinical and non-clinical channels. Participants completed self-report measures assessing sexual dysregulation, psychological distress, impulsivity, emotional reactivity, emotion regulation difficulties, alexithymia, cognitive distortions, and cognitive insight. Multiple correspondence analyses followed by hierarchical cluster analyses were conducted separately at the motivational/dynamic, emotional, and cognitive levels, and bootstrap-based stability analyses were used to assess the robustness of the clustering solutions. Results: Descriptive groupings were observed at each level, with three motivational profiles, four emotional profiles, and three cognitive profiles retained in this sample. Motivational profiles were suggestive of reward sensitivity, distress-related coping, and more habitual or cognitively maintained patterns. Emotional profiles reflected either greater emotion-processing limitations, heightened emotional reactivity, or more preserved regulation. Cognitive profiles differed mainly in the degree of cognitive distortions and cognitive insight. These profiles were only weakly associated with behavioral modalities such as paraphilic versus normophilic practices, cybersexual activity, and sexual behavior associated with psychoactive substance use. Bootstrap-based stability analyses supported the overall robustness of the retained solutions. Conclusions: A multilevel descriptive approach highlighted heterogeneous psychological configurations among French adults reporting DSB. Although these findings do not establish a validated typology, they suggest that distinguishing motivational, emotional, and cognitive domains may help generate clinically relevant hypotheses and inform future research on heterogeneity in dysregulated sexual behavior.