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Clinicians’ Beliefs, Observations, and Treatment Effectiveness Regarding Clients’ Sexual Addiction and Internet Pornography Use

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Abstract

This study addressed how sex addiction and problematic IP use present to mental health professionals (MHPs), and how MHPs conceptualize and treat these issues. MHPs (N = 183) reported on beliefs about, experiences with, and treatment of problematic sexual behaviors (PBS). Most MHPs saw clients with PBS, but most do not feel competent to treat PBS. Specialized MHPs endorsed seeing more clients with PBS and feeling more effective than nonspecialists. Sexual addiction and problematic IP use share similarities, but differ in etiology and co-occurring problems. Diagnostic ambiguity, insufficient knowledge, and limited dissemination may hinder MHPs ability to assess and treat PBSs

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Notes

  1. Unfortunately, the recruited subsample of clinicians endorsing specialization in impulse-control problems was too small to examine possible differences in the experiences, attitudes, observations and practices of these MHPs.

References

  • American Psychiatric Association. (2010). DSM-5: The future of psychiatric diagnosis. Retrieved from http://www.dsm5.org/Pages/Default.aspx.

  • Annon, J. S. & Robinson, C. H. (1978). The use of vicarious learning in the treatment of sexual concerns. Handbook of sex therapy perspectives in sexuality, pp. 35–56.

  • Ayres, M. M., & Haddock, S. A. (2009). Therapists’ approaches in working with heterosexual couples struggling with male partner’s online sexual behavior. Sexual Addiction & Compulsivity, 16(1), 55–78.

    Article  Google Scholar 

  • Bancroft, J., & Vukadinovic, Z. (2004). Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model. Journal of Sex Research, 41(3), 225–234.

    Article  PubMed  Google Scholar 

  • Bird, M. H. (2006). Sexual addiction and marriage and family therapy: Facilitating individual and relationship healing through couple therapy. Journal of Marriage and Family Therapy, 32(2), 291–311.

    Google Scholar 

  • Black, D. W. (2000). The epidemiology and phenomenology of compulsive sexual behavior. CNS Spectrums, 5(1), 26–72.

    Article  CAS  PubMed  Google Scholar 

  • Black, D. W., Kehrberg, L. L. D., Flumerfelt, D. L., & Schlosser, S. S. (1997). Characteristics of 36 subjects reporting compulsive sexual behavior. American Journal of Psychiatry, 154(2), 243–249.

    Article  CAS  PubMed  Google Scholar 

  • Boies, S. C., Cooper, A., & Osborne, C. S. (2004). Variations in internet-related problems and psychosocial functioning in online sexual activities: Implications for social and sexual development of young adults. Cyberpsychology and Behavior, 7(2), 207–230.

    Article  PubMed  Google Scholar 

  • Bostwick, J. M., & Bucci, J. A. (2008). Internet sex addiction treated with naltrexone. Mayo Clinical Procedures, 83(2), 226–230.

    Article  Google Scholar 

  • Braun-Courville, D. K., & Rojas, M. (2009). Exposure to sexually explicit Web sites and adolescent sexual attitudes and behaviors. Journal of Adolescent Health, 45(2), 156–162.

    Article  PubMed  Google Scholar 

  • Cameron, K. A., Salazar, L. F., Bernhardt, J. M., Burgess-Whitman, N., Wingood, G. M., & DiClemente, R. J. (2005). Adolescents’ experience with sex on the web: Results from online focus groups. Journal of Adolescence, 28, 535–540.

    Article  PubMed  Google Scholar 

  • Carnes, P. J. (1991). Don’t call it love: Recovery from sexual addiction. New York, NY: Bantam Books.

    Google Scholar 

  • Carnes, P. J. (2000). Sexual addiction and compulsion: Recognition, treatment, and recovery. CNS Spectrum, 5(10), 63–72.

    Article  CAS  Google Scholar 

  • Carroll, J. S., Badger, S., & Yang, C. (2006). The ability to negotiate or the ability to love? Evaluating the developmental domains of marital competence. Journal of Family Issues, 27, 1001–1032.

    Article  Google Scholar 

  • Carroll, J. S., Padilla-Walker, L. M., Nelson, L. J., Olson, C. D., McNamara Barry, C., & Madsen, S. D. (2008). Generation XXX: Pornography acceptance and use among emerging adults. Journal of Adolescent Research, 23(1), 6–30.

    Article  Google Scholar 

  • Clarkson, J., & Kopaczewski, S. (2013). Pornography addiction and the medicalization of free speech. Journal of Communication Inquiry, 14, 1–21.

    Google Scholar 

  • Cooper, A. (2000). Cybersex: The dark side of the force. Philadelphia: Brunner-Routledge.

    Google Scholar 

  • Cooper, A., Delmonico, D. L., & Burg, R. (2000). Cybersex users, abusers, and compulsives: New findings and implications. Sexual Addiction & Compulsivity, 7(1–2), 5–29.

    Article  Google Scholar 

  • Cooper, A., Putnam, D. E., Planchon, L. A., & Boies, S. C. (1999). Online sexual compulsivity: Getting tangled in the net. Sexual Addiction & Compulsivity, 6, 79–104.

    Article  Google Scholar 

  • Dodge, B., Reece, M., Cole, S. L., & Sandfort, T. G. (2004). Sexual compulsivity among heterosexual college students. Journal of Sex Research, 41, 343–350.

    Article  PubMed  PubMed Central  Google Scholar 

  • Earle, R., & Earle, M. (1995). Sex addiction: Case studies and management. New York, NY: Brunner Mazel.

    Google Scholar 

  • Egan, V., & Parmar, R. (2013). Dirty habits? Online pornography use, personality, obsessionality, and compulsivity. Journal of Sex and Marital Therapy, 39(5), 394–409.

    Article  PubMed  Google Scholar 

  • Fong, T. W., Reid, R. C., & Parhami, I. (2012). Behavioral addictions: Where to draw the line? Psychiatric Clinics of North America, 35, 279–296.

    Article  PubMed  Google Scholar 

  • Giugliano, J. R. (2008). Sexual impulsivity, compulsivity, or dependence: An investigative inquiry. Sexual Addiction & Compulsivity, 15(2), 139–157.

    Article  Google Scholar 

  • Gold, S. N., & Heffner, C. L. (1998). Sexual addiction: Many conceptions, minimal data. Clinical Psychology Review, 18(3), 367–381.

    Article  CAS  PubMed  Google Scholar 

  • Goodman, A. (1992). Sexual addiction: Designation and treatment. Journal of Sex & Marital Therapy, 18(4), 303–314.

    Article  CAS  Google Scholar 

  • Goodson, P., McCormick, D., & Evans, A. (2001). Searching for sexually explicit materials on the Internet: An exploratory study of college students’ behavior and attitudes. Archives of Sexual Behavior, 30(2), 101–118.

    Article  CAS  PubMed  Google Scholar 

  • Grant, J. E., & Kim, S. W. (2001). A case of kleptomania and compulsive sexual behavior treated with naltrexone. Annals of Clinical Psychiatry, 13(4), 229–231.

    Article  PubMed  Google Scholar 

  • Grubbs, J. B., Stauner, N., Exline, J. J., Pargament, K. I., & Lindberg, M. J. (2015). Perceived addiction to Internet pornography and psychological distress: Examining relationships concurrently and over time. Psychology of Addictive Behaviors, 29(4), 1056–1067.

    Article  PubMed  Google Scholar 

  • Häggström-Nordin, E., Hanson, U., & Tyden, T. (2005). Associations between pornography consumption and sexual practices among adolescents in Sweden. International Journal of STD & AIDS, 16(1), 102–107.

    Article  Google Scholar 

  • Hald, G. M., & Malamuth, N. M. (2008). Self-perceived effects of pornography consumption. Archives of Sexual Behavior, 37, 614–625.

    Article  PubMed  Google Scholar 

  • Halpern, A. L. (2011). The proposed diagnosis of hypersexual disorder for inclusion in DSM-5: Unnecessary and harmful. Archives of Sexual Behavior, 40(3), 487–488.

    Article  PubMed  Google Scholar 

  • Kafka, M. P. (2000). Psychopharmacologic treatments for nonparaphilic compulsive sexual behaviors. CNS Spectrum, 5(1), 49–59.

    Article  CAS  Google Scholar 

  • Kafka, M. P. (2010a). Hypersexual disorder: A proposed diagnosis for DSM-V. Archives of Sexual Behavior, 39, 377–400.

    Article  PubMed  Google Scholar 

  • Kafka, M. P. (2010b). “What is sexual addiction?” A Response to Stephen Levine. Journal of Sex & Marital Therapy, 36, 276–281.

    Article  Google Scholar 

  • Kafka, M. P., & Hennen, J. (2000). Psychostimulant augmentation during treatment with selective serotonin reuptake inhibitors in men with paraphilia-related disorders: A case series. Journal of Clinical Psychiatry, 61(9), 664–670.

    Article  CAS  PubMed  Google Scholar 

  • Kafka, M. P., & Prentky, R. (1992). Fluoxetine treatment of nonparaphilic sexual addictions and paraphilias in men. Journal of Clinical Psychology, 53(1), 351–358.

    CAS  Google Scholar 

  • Kaplan, M. S., & Krueger, R. B. (2010). Diagnosis, assessment, and treatment of hypersexuality. Journal of Sex Research, 47(2), 181–198.

    Article  PubMed  Google Scholar 

  • Levine, S. B. (2010). What is sexual addiction? Journal of Sex & Marital Therapy, 36(1), 261–275.

    Article  Google Scholar 

  • Mehta, M. D. (2001). Pornography in usenet: A study of 9,800 randomly selected images. Cyberpsychology and Behavior, 4(6), 695–703.

    Article  CAS  PubMed  Google Scholar 

  • Mick, T. M., & Hollander, E. (2006). Impulsive-compulsive sexual behavior. CNS Spectrums, 11(12), 944–955.

    Article  PubMed  Google Scholar 

  • Mitchell, K. J., Becker-Blease, K., & Finkelhor, D. (2005). Inventory of problematic internet experiences encountered in clinical practice. Professional Psychology: Research & Practice, 36(5), 498–509.

    Article  Google Scholar 

  • Mitchell, K. J., & Wells, M. (2007). Problematic Internet experiences: Primary or secondary presenting problems in persons seeking mental health care? Social Science and Medicine, 65, 1136–1141.

    Article  PubMed  Google Scholar 

  • Morrison, T. G., Harriman, R., Morrison, M. A., Bearden, A., & Ellis, S. R. (2004). Correlates of exposure to sexually explicit material among Canadian post-secondary students. Canadian Journal of Human Sexuality, 13(1), 143–156.

    Google Scholar 

  • Moser, C. (2011). Hypersexual disorder: Just more muddled thinking. Archives of Sexual Behavior, 40(2), 227–229.

    Article  PubMed  Google Scholar 

  • Orford, J. (1978). Hypersexuality: Implications for a theory of dependence. British Journal Addiction Alcohol Other Drugs, 73(3), 299–310.

    Article  CAS  Google Scholar 

  • Parker, J., & Guest, D. (2002). The integration of psychotherapy and 12-step programs in sexual addiction treatment. In P. J. Carnes & K. M. Adams (Eds.), Clinical management of sexual addiction (pp. 11–124). New York, NY: Brunner-Routledge.

    Google Scholar 

  • Paul, B., & Shim, J. W. (2008). Gender, sexual affect, and motivations for Internet pornography use. International Journal of Sexual Health, 20, 187–199.

    Article  Google Scholar 

  • Peter, J., & Valkenburg, P. M. (2006a). Adolescents’ exposure to sexually explicit online material and recreational attitudes toward sex. Journal of Communication, 56(4), 639–660. doi:10.1111/j.1460-2466.2006.00313.x.

    Article  Google Scholar 

  • Peter, J., & Valkenburg, P. M. (2006b). Adolescents’ exposure to sexually explicit material on the internet. Communication Research, 33, 178–204.

    Article  Google Scholar 

  • Peter, J., & Valkenburg, P. M. (2008). Adolescents’ exposure to sexually explicit internet material, sexual uncertainty, and attitudes toward uncommitted sexual exploration: Is there a link? Communication Research, 35(5), 579–601.

    Article  Google Scholar 

  • Philaretou, A. G., Malhfouz, A. Y., & Allen, K. R. (2005). Use of internet pornography and men’s well-being. International Journal of Men’s Health, 4(2), 149–169.

    Article  Google Scholar 

  • Raviv, M. (1993). Personality characteristics of sexual addicts and pathological gamblers. Journal of Gambling Studies, 9, 17–30.

    Article  Google Scholar 

  • Raymond, N. C., Grant, J. E., Kim, S. W., & Coleman, E. (2003). Treatment of compulsive sexual behavior with naltrexone and serotonin reuptake inhibitors: Two case studies. International Clinical Psychopharmacology, 17(4), 201–205.

    Article  Google Scholar 

  • Reece, M. (2003). Sexual compulsivity and HIV serostatus disclosure among men who have sex with men. Sexual Addiction & Compulsivity, 11(3), 87–113.

    Article  Google Scholar 

  • Reid, R. C. (2013). Personal perspectives on hypersexual disorder. Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention, 20(1–2), 4–18. doi: 10.1080/10720162.2013.772876.

    Google Scholar 

  • Reid, R. C., Carpenter, B. N., Draper, E. D., & Manning, J. C. (2010). Exploring psychopathology, personality traits, and marital distress among women married to hypersexual men. Journal of Couple & Relationship Therapy, 9(3), 203–222.

    Article  Google Scholar 

  • Reid, R. C., Carpenter, B. N., & Fong, T. W. (2011). Neuroscience research fails to support claims that excessive pornography consumption causes brain damage. Surgical Neurology International, 2, 64.

    Article  PubMed  PubMed Central  Google Scholar 

  • Reid, R. C., Carpenter, B. N., Hook, J. N., Garos, S., Manning, J. C., Gilliland, R. ,…, Fong, T. (2012). Report of findings in a DSM-5 field trial for hypersexual disorders. Journal of Sexual Medicine, 9, 2868–2877. doi:10.1111/j.1743-6109.2012.02936.x.

    Article  PubMed  Google Scholar 

  • Reid, R. C., Dhuffar, M. K., Parhami, I., & Fong, T. W. (2012). Exploring facets of personality in a patient sample of hypersexual women compared with hypersexual men. Journal of Psychiatric Practice, 18(4), 262–268.

    Article  PubMed  Google Scholar 

  • Reid, R. C., & Woolley, S. R. (2006). Using emotional focused therapy for couples to resolve attachment ruptures creased by hypersexual behavior. Sexual Addiction & Compulsivity, 13, 219–239.

    Article  Google Scholar 

  • Reissing, E. D., & Giulio, G. D. (2010). Practicing clinical psychologists’ provision of sexual health care services. Professional Psychology: Research and Practice, 41(1), 57–63.

    Article  Google Scholar 

  • Robinson, B. E., Manthei, R., Scheltema, K., & Rich, R. (1999). Therapeutic uses of sexually explicit materials in the United States and the Czech and Slovak Republics: A qualitative study. Journal of Sex and Marital Therapy, 25(2), 103–119.

    Article  CAS  PubMed  Google Scholar 

  • Samenow, C. P. (2010). A biopsychosocial model of hypersexual disorder/sexual addiction. Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention, 17(2), 69–81.

    Article  Google Scholar 

  • Schaeffer, B. (2009). Sexual addiction. Transactional Analysis Journal, 39(2), 153–162.

    Article  Google Scholar 

  • Schneider, J. P. (1994). Sex addiction: Controversy within mainstream addiction medicine, diagnosis based on DSM-III-R, and physician case histories. Sexual Addiction & Compulsivity, 1, 19–44. doi:10.1080/10720169408400025.

    Article  Google Scholar 

  • Schneider, J. P. (2000a). A qualitative study of cybersex participants: Gender differences, recovery issues, and implications for therapists. Sexual Addiction & Compulsivity, 7(1), 249–278.

    Article  Google Scholar 

  • Schneider, J. P. (2000b). Compulsive and addictive sexual disorders and the family. CNS Spectrum, 5(10), 53–62.

    Article  CAS  Google Scholar 

  • Short, M. B., Black, L., Smith, A., Wetterneck, C. T., & Wells, D. (2012). A review of Internet pornography use research: Methodology and content from the past 10 years. Cyberpsychology, Behavior, and Social Networking, 15, 13–23.

    Article  Google Scholar 

  • Southern, S. (2008). Treatment of compulsive cybersex behaviors. Psychiatric Clinics of North America, 31(4), 697–712.

    Article  PubMed  Google Scholar 

  • Swisher, S. H. (1995). Therapeutic interventions recommended for treatment of sexual addiction/compulsivity. Sexual Addiction & Compulsivity, 2(1), 31–39.

    Article  Google Scholar 

  • Turner, M. (2009). Uncovering and treating sex addiction in couples therapy. Journal of Family Psychotherapy, 20(2–3), 283–302.

    Article  Google Scholar 

  • Twohig, M. P., & Crosby, J. M. (2010). Acceptance and commitment therapy as a treatment for problematic internet pornography viewing. Behavior Therapy, 41(1), 285–295.

    Article  PubMed  Google Scholar 

  • Twohig, M. P., Crosby, J. M., & Cox, J. M. (2009). Viewing internet pornography: For whom is it problematic, how, and why? Sexual Addiction & Compulsivity, 16, 253–266.

    Article  Google Scholar 

  • Weinberg, M., Williams, C., Kleiner, S., & Irizarry, Y. (2010). Pornography, normalization, and empowerment. Archives of Sexual Behavior, 39, 1389–1401.

    Article  PubMed  Google Scholar 

  • Wetterneck, C. T., Burgess, A. J., Short, M. B., Smith, A. H., & Cervantes, M. E. (2012). The role of sexual compulsivity, impulsivity, and experiential avoidance, in internet pornography use. The Psychological Record, 62(1), 3–17.

    Google Scholar 

  • Young, K. S. (2008). Internet sex addiction: Risk factors, stages of development, and treatment. American Behavioral Scientist, 52(1), 21–37.

    Article  Google Scholar 

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Authors and Affiliations

  1. University of Houston-Clear Lake, 2700 Bay Area Blvd, Houston, TX, 77058, USA

    Mary B. Short & Steven L. Bistricky

  2. Rogers Memorial, 34700 Valley Road, Oconomowoc, WI, 53066, USA

    Chad T. Wetterneck

  3. Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA

    Tim Shutter

  4. University of Houston, 126 Heyne Building, Houston, TX, 77204, USA

    Tannah E. Chase

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  1. Mary B. Short
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  2. Chad T. Wetterneck
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  4. Tim Shutter
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  5. Tannah E. Chase
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Correspondence to Mary B. Short.

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Short, M.B., Wetterneck, C.T., Bistricky, S.L. et al. Clinicians’ Beliefs, Observations, and Treatment Effectiveness Regarding Clients’ Sexual Addiction and Internet Pornography Use. Community Ment Health J 52, 1070–1081 (2016). https://doi.org/10.1007/s10597-016-0034-2

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  • DOI: https://doi.org/10.1007/s10597-016-0034-2

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