Sex Addiction

Compulsive sexual behavior disorder (CSBD) or hypersexuality is commonly referred to as sex

addiction. However, sex addiction as a condition is not formally accepted by all members of the
medical community.

Though a diagnosis of sex addiction does not formally exist, compulsive sexual behavior can
result in significant emotional pain and other devastating consequences. Many people may ask,
“Is sex addiction a real thing?” In reality, compulsive sexual behavior goes beyond desire, and
it’s a challenging reality for many people who live with it. In fact, approximately 3% to 6% of
the general population experiences symptoms of compulsive sexual behavior. CSBD involves a
variety of complex and intense unwanted sexual behaviors and fantasies that, at times, may
become harmful to you and others. The condition can be managed, though. It might require
seeking the help of a health professional and committing to long-term treatment.

Considerable controversy surrounds the diagnosis of “sex addiction.” It’s been excluded from the
fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5), but it’s
still written about and studied in psychology and counseling circles.
Additionally, it can still be diagnosedTrusted Source using both DSM-5 (as “Other specified
sexual dysfunction”) and the “International Statistical Classification of Diseases and Related
Health Problems” (ICD-10) criteria (as “Other sexual dysfunction not due to a substance or
known physiological condition”).

By way of a definition, “sex addiction” is described as a compulsive need to perform sexual acts
in order to achieve the kind of “fix” that a person with alcohol use disorder gets from a drink or
someone with opiate use disorder gets from using opiates. Sex addiction (the compulsive sexual
behavior described here) should not be confused with disorders such as pedophilia or bestiality.

For some people, sex addiction can be highly dangerous and result in considerable difficulties
with relationships. Like drug or alcohol dependence, it has the potential to negatively impact a
person’s physical and mental health, personal relationships, quality of life, and safety.
It’s purported to be somewhat common (although statistics are inconsistent), and some argue that
it’s often not diagnosed.
It’s believed that a person with sex addiction will seek out multiple sex partners, though this in
itself is not necessarily a sign of a disorder. Some report that it may manifest itself as a
compulsive need to masturbate, view pornography, or be in sexually stimulating situations.
A person with sex addiction may significantly alter their life and activities in order to perform
sexual acts multiple times a day and are reportedly unable to control their behavior, despite
severe negative consequences.

Prior studies on sex addiction have mostly relied on a narrow range of risk factors among small
and heterogeneous samples. The purpose of the present study was to examine the psychological
markers related to sex addiction in a large-scale community sample of Turkish adults. A total of
24,380 individuals completed a survey comprising the Sex Addiction Risk Questionnaire, the
Brief Symptom Inventory, the Positive and Negative Affect Schedule, the Personal-Wellbeing
Index Adult Form, the Toronto Alexithymia Scale, and the Experiences in Close Relationships-
Revised (50% males; mean age = 31.79 years; age range = 18 to 81 years). Utilizing hierarchical
regression analysis, sex addiction was associated with being male, being younger, having a lower
education level, being single, being an alcohol and nicotine user, psychiatric distress, low
personal wellbeing, positive and negative affect, alexithymia, and anxious attachment.

Compulsive sexual behavior, otherwise known as sexual addiction, is an emerging psychiatric

disorder that has significant medical and psychiatric consequences. Until recently, very little
empirical data existed to explain the biological, psychological, and social risk factors that
contribute to this condition. In addition, clinical issues, such as the natural course and best
practices on treating sexual addictions, have not been formalized. Despite this absence, the
number of patients and communities requesting assistance with this problem remains significant.
This article will review the clinical features of compulsive sexual behavior and will summarize
the current evidence for psychological and pharmacological treatment.

Sexuality in the United States has never been more socially acceptable. Sex has become part of
mainstream culture as reflected through the explicit coverage of sexual behaviors in the media,
movies, newspapers, and magazines. In many ways, sexual expression has become a form of
accepted entertainment similar to gambling, attending sporting events, or watching movies.
Internet pornography has become a billion-dollar industry, stretching the limits of the
imagination. Digital media offers portability, access, and visually explicit depictions of sexual
acts in high-definition that leave nothing to the imagination. Sales and rental of adult movies
through DVDs and pay-per-view services allow access to sex anywhere and at any time. The
adult entertainment industry generates close to $4 billion per year and its acceptability in society
is reflected in the mainstreaming of its products into traditional retail stores and the portrayal of
its actors and actresses as role models and celebrities. Strip clubs have evolved from backroom
cabarets into large multimillion dollar nightclubs and are present in virtually every state in the
US. Inside them, the degree of physical contact has also increased, as compared to a generation
ago, to the point where the boundaries of what constitutes sexual intercourse are blurred. Escort
services, massage parlors, and street prostitution continue to be available in every major city in
the US. Strengthening their presence and availability is the internet, which has created an
information portal for these services through online dating services, classified ads, and
discussion boards for those in pursuit of sexual gratification.

Together, these cultural changes have increased the acceptability and availability of sexual
rewards. For some, though, this increase in availability has uncovered an inability to control
sexual impulses resulting in continued engagement in these behaviors despite the creation of
negative consequences—otherwise known as sexual addiction. This term has been used
synonymously with others, such as compulsive sexual behaviors, hypersexuality, and excessive
sexual desire disorder.1 It can take many forms, and although it may seem obvious to diagnose,
standardized criteria have yet to be developed. Furthermore, debate is ongoing about where this
behavioral pattern fits into the American Psychiatric Association's Diagnostic and Statistical
Manual (DSM-IV), and how it should be classified and conceptualized.2 Is it an addictive
disorder, an impulse-control disorder, or a variant of obsessive compulsive disorders? Does it
merit enough empirical evidence to stand alone as a separate disorder? Finally, what are the
boundaries and limits that distinguish disease patterns, at-risk behaviors, and socially appropriate
expression?

Compulsive sexual behavior has not yet received extensive attention from researchers and
clinicians. To date, there have been very few formalized studies of compulsive sexual behaviors.
As an example, a keyword search on PubMed, as of October, 2006, for “sexual addiction”
yielded 518 articles, while “compulsive sexual behavior” yielded 264 (in comparison, “substance
abuse” yields 164,104). Funding agencies, such as the National Institutes of Health (NIH), and
pharmaceutical companies have not supported research into the etiology and mechanisms of
compulsive sexual behavior and, as a result, evidenced-based treatments are limited. Despite the
paucity of research, a significant number of patients with sexual addictions do present for
treatment. This is evidenced by the number of treatment centers dedicated to the treatment of
sexual addictions in both residential and intensive outpatient settings. Mental health
professionals in any setting are likely to encounter patients with this hidden addiction and require
better tools to diagnose and manage them. This article will review the terminology, the
epidemiology, and the existing treatments that are currently available for compulsive sexual
behaviors.

The American Psychiatric Association (APA) do not classify compulsive sexual behavior as a
diagnosable mental health disorder.
Debate continues as to whether the APA should include compulsive sexual behavior in
the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The World Health
Organization (WHO) included compulsive sexual behavior in the International Classification of
Diseases (ICD-11) and defined it as an impulse disorder “characterized by a persistent pattern of
failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual
behavior.”

The APA describe addiction as a condition that causes “changes in the areas of the brain that
relate to judgment, decision making, learning, memory, and behavior control.” These changes
can be visible on brain scans.However, the APA define addiction as a dependency on a substance
and not an activity.

The following characteristics indicate compulsive sexual behavior: repetitive sexual activities
that become a central focus of the person’s life, to the point of neglecting health and personal
care or other interests, activities, and responsibilities, numerous unsuccessful efforts to
significantly reduce repetitive sexual behavior, continued repetitive sexual behavior despite
adverse consequences or deriving little or no satisfaction from it, a pattern of failure to control
intense sexual impulses or urges and the resulting repetitive sexual behavior over an extended
period, for example, 6 months, persistent behaviors that cause marked distress or significant
impairment in personal, family, social, educational, and occupational function, as well as in other
important areas

Distress that relates entirely to moral judgments and disapproval of sexual impulses, urges, or
behaviors is not sufficient to meet this requirement.
Mental health authorities have not yet established compulsive sexual behavior as a medical
condition, although it can adversely affect families, relationships, and lives. One of the
difficulties of identifying compulsive sexual behavior is that one person might have a different
sex drive, or libido, from the next. As a result, someone may consider their partner’s behavior to
be sexually compulsive only because they have a higher sex drive. More research is necessary to
determine whether doctors should treat compulsive sexual behavior as a disorder.

References:

Kircaburun, K., Ünübol, H., Sayar, G. H., Çarkçı, J., & Griffiths, M. D. (2021). Sex addiction in
Turkey: A large-scale survey with a national community sample. Current Psychology.
https://doi.org/10.1007/s12144-021-01632-8

Tyler, M. (2018, July 26). Sex addiction: Symptoms, treatment, and outlook. Healthline.
Retrieved from https://www.healthline.com/health/addiction/sex

Fong T. W. (2006). Understanding and managing compulsive sexual behaviors. Psychiatry

(Edgmont (Pa. : Township)), 3(11), 51–58.

MediLexicon International. (n.d.). Compulsive sexual behavior (sexual addiction): What to

know. Medical News Today. Retrieved from
https://www.medicalnewstoday.com/articles/182473#what-is-compulsive-sexual-behavior

Gillette, H. (2021, March 3). What is sexual addiction and what are its signs? Psych Central.
Retrieved from https://psychcentral.com/lib/what-is-sexual-addiction