Objective: Childhood sexual abuse is associated with compulsive sexual behavior, depression, and anxiety in men. Furthermore, both depression and anxiety have been linked to compulsive sexual behaviors. However, whether anxiety and depression mediate the relationship between childhood sexual abuse and compulsive sexual behaviors has yet to be tested. We investigated whether symptoms of depression and anxiety mediate the relationship between childhood sexual abuse and compulsive sexual behaviors in 222 men seeking treatment for such behaviors. Methods: Participants completed the Sexual Compulsivity Scale, Childhood Trauma Questionnaire, Beck Depression Inventory, and Beck Anxiety Inventory. A cross-sectional parallel mediation analysis was conducted. Results: The prevalence of childhood sexual abuse in our sample was 57%. Significant correlations were found between childhood sexual abuse and compulsive sexual behaviors, depression, and anxiety. The results of the mediation analyses suggested that depression (B = 0.07, standard error [SE] = 0.03, 95%CI 0.02 to 0.15), but not anxiety (B = 0.02, SE = 0.02, 95%CI -0.2 to 0.07), mediated the link between childhood sexual abuse and compulsive sexual behaviors. The pattern of our results remained the same when controlling for other types of childhood trauma. Conclusions: Depression, not anxiety, appears to mediate the relationship between childhood sexual abuse and compulsive sexual behaviors in men. Future research that tests our mediation analyses using a prospective longitudinal study would be highly informative.

Objective: There is a lack of studies on negative mood states and sexual risk behavior in men of all sexual orientations who seek treatment for excessive sexual behavior (ESB). We aim to examine sexual compulsivity (SC), anxiety, depression, and sexual risk behavior in a treatment-seeking sample of men and controls. Methods: We enrolled 88 (37 [42%] gay or bisexual and 51 [58%] heterosexual) ESB outpatients and 64 controls. Assessments included the Sexual Compulsivity Scale (SCS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and sexual risk behaviors. Results: Compared to controls, ESB outpatients showed increased SC, anxiety, and depression, which were correlated. Regarding sex with casual partners, ESB outpatients reported more sexual intercourse, a greater number of partners, more anal intercourse, and unprotected anal intercourse. Anxiety, depression, and SC were associated with protected vaginal intercourse with a main partner, whereas they were associated with unprotected anal intercourse with a casual partner. Depression was associated with unprotected vaginal intercourse with a casual partner. Condomless anal intercourse was predicted by SC and was also reported by the heterosexual ESB outpatients (36%). Conclusion: The data contribute to the field by providing information on men of all sexual orientations who are searching for mental healthcare. The connections among these psychopathological factors and sexual risk behavior have implications for public health, clinicians, and research.