Cybersex, mental health and intimacy: an exploratory study with a population in treatment of substance use disorders

Background: Cybersex refers to using the Internet to access various online sexual activities. Several authors mention that problematic cybersex has substance addiction as a comorbidity, but there are no studies that demonstrate this.

Method:This is an exploratory and descriptive study, that use a quantitative methodology. It was investigated the prevalence of cybersex use in a sample of 100 people under treatment of substance use disorders, in a portuguese Substance Dependence Treatment Center. It was also studied the relationships that the use of cybersex has with mental health, with subjective complaints in daily life due to cybersex activities and the potential symptoms of cybersex addiction, as well as the intimacy of the couple (according to the participant's perception). It was also analyzed the association between mental health and subjective complaints in everyday life due to cybersex activities and potential symptoms of cybersex addiction. In addition, it was studied the relation between four characteristics of the sample (age, sex, psychoactive substance of choice and marital status) and the use of cybersex. It was applied a questionnaire composed of a Participant Characterization Questionnaire, a Cybersex Use Questionnaire, the Short Internet Addiction Test Adapted to Cybersex (Portuguese version), the Anxiety, Depression and Stress Scales, and the Psychological Well-Being Scales (reduced trial version). The collected data where analyzed using the Statistical Package for Social Sciences (SPSS), version 25.

Results: There is a high prevalence of cybersex use throughout life in the population with psychoactive substance use disorders (78% used it at least once in life); individuals who have cocaine as drug of choice have significantly (p = 0.033) longer time of use of pornography and means of frequency of use of most of the cybersex activities than those who have alcohol as substance of choice; male (86%) and younger individuals are the ones with the highest prevalence of cybersex use in the last 6 months; the frequency of use does not vary between sexes in any of the online sexual activities studied; the frequency of use of pornography and the search for information on sex or sexual practices are related to symptoms of cybersex dependence and to subjective complaints in the daily life (rporn = 0.373; p = 0.016 vs. rinfosex = 0.585; p = 0.007); while the frequency of exchange of messages and / or images of sexual content is related to psychological well-being (r = 0.600; p = 0.030). The results also show that participants who are involved in stable relationships have the perception that cybersex positively influences the relationship of intimacy with the partner (Z = -2.462; p = 0.014) and that those who are not in a stable relationship have a tendency to use cybersex more often, to present worse mental health, more subjective everyday complaints due to online sexual activities and more potential symptoms of cybersex addiction.

Conclusions: Cybersex use and sexuality must be more addressed subjects in the treatment of substance use disorders, knowing that cybersex use is present in both sexes, at all ages, knowing that in individuals without a stable love relationship the use of cybersex tends to be more frequent and with more negative consequences for their own mental health and knowing that pornography and search for online information about sex or sexual practices were the most commonly used online sexual activities.