Skip to main content

Sex Addiction

  • Chapter
  • First Online:
Textbook of Addiction Treatment

Abstract

This chapter reviews the concept of ‘sex addiction’ and discusses what we know of its history, nosology, neurobiology, prevalence and comorbidity, as well as assessment and treatment approaches. Excessive sexual behaviour has been documented clinically in the western world since the eighteenth century. Most recently, a classification of Compulsive Sexual Behaviour Disorder was included as an impulse control disorder in the latest revision of the International Classification of Diseases (ICD-11, 2018). While both its inclusion and classification remain controversial, the hope is that this recognition would spur further research in the area.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Arnow BA, Desmond JE, Banner LL, Glover GH, Solomon A, Plan ML, Lue TF, Atlas SW. Brain activation and sexual arousal in healthy heterosexual males. Brain. 2002;125(PT5):1014–23.

    Article  Google Scholar 

  2. Association of Partners of Sex Addicts Trauma Specialists. Home page. 2019. https://www.apsats.org/. Accessed 15 May 2019.

  3. Black DW, Kehrberg LL, Flumerfelt DL, Schlosser SS. Characteristics of 36 subjects reporting compulsive sexual behaviour. Am J Psychiatry. 1997;154(2):243–9.

    Article  CAS  Google Scholar 

  4. Black DW. The epidemiology and phenomenology of compulsive sexual behaviour. CNS Spectr. 2000;5:26–72.

    Article  CAS  Google Scholar 

  5. Black C, Tripodi C. Intimate treason: healing the trauma for partners confronting sex addiction. Las Vegas: Central Recovery Press; 2012.

    Google Scholar 

  6. Blankenship R, Laaser M. Sexual addiction and ADHD: is there a connection? J Sex Addict Compuls. 2004;11:7–20.

    Article  Google Scholar 

  7. Bostwick JM, Bucci JA. Internet sex addiction treated with naltrexone. Mayo Clin Proc. 2008;83:226–36.

    Article  Google Scholar 

  8. Carnes P. Out of the shadows: understanding sexual addiction. Minneapolis: CompCare Publications; 1983.

    Google Scholar 

  9. Carnes P. Contrary to love. Center City: Hazelden; 1989.

    Google Scholar 

  10. Carnes P. Don’t call it love: recovery from sexual addiction. New York: Bantam; 1991.

    Google Scholar 

  11. Carnes P. Facing the shadow: starting sexual and relationship recovery. 3rd ed. Carefree: Gentle Path; 2005.

    Google Scholar 

  12. Carnes P, Green B, Carnes S. The same yet different: refocusing the sexual addiction screening test (SAST) to reflect orientation and gender. Journal of Sex Addiction and Compulsivity. 2010;12:79–120.

    Article  Google Scholar 

  13. Carnes P, Green BA, Merlo LJ, Polles A, Carnes S, Gold MS. A brief screening application for assessing sexual addiction. J Addict Med. 2012;6(1):29–34.

    Article  Google Scholar 

  14. Coleman E, Dickenson JA, Girard A, Rider GN, Candelario-Perez LE, Becker-Warner R, Kovic AG, Munns R. An integrative biopsychosocial and sex positive model of understanding and treatment of impulsive/compulsive sexual behaviour. Sex Addict Compuls. 2018;25(2–3):125–52.

    Article  Google Scholar 

  15. De Alarcon R, de la Iglesia JI, Casado NM, Montejo AL. Online porn addiction: what we know and what we don't – a systematic review. J Clin Med. 2019;8(1):91. Published online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352245/

    Article  Google Scholar 

  16. De Tubino Scanavino M, Ventuneac A, Abdo CHN, Tavares H, Sant’Ana do Amaral ML, Messina B, Caramello dos Reis S, Lian JP, Martins B, Parsons JT. Compulsive sexual behaviour and psychopathology among treatment-seeking me in Sao Paulo, Brazil. Psychiatry Res. 2013;209(3):518–24.

    Article  Google Scholar 

  17. Di Ciara G. A motivational learning hypothesis of the role of mesolimbic dopamine in compulsive drug use. J Psychopharmacol. 1998;12:54–67.

    Article  Google Scholar 

  18. Dryer JA, Lijtmaer RM. Cyber-sex as twilight zone between virtual reality and virtual fantasy: creative play space or destructive addiction? Psychoanal Rev. 2007;94(1):39–61.

    Article  Google Scholar 

  19. Erez G, Pilver CE, Potenza MN. Gender related differences in the associations between sexual impulsivity and psychiatric disorders. J Psychiatr Res. 2014;55:117–25.

    Article  Google Scholar 

  20. Fisher WA, Barak A. Internet pornography: a social psychological perspective on internet sexuality. J Sex Res. 2001;38(4):312–23.

    Article  Google Scholar 

  21. George M, Maheshwan S, Chandran S, Rao S, Shwanand M, Sathyanardyana Rao TS. Psychosocial intervention for sexual addiction. Indian J Psychiatry. 2018;60(8):510–3.

    Article  Google Scholar 

  22. Goodman A. Sexual addiction: an integrated approach. Madison: International Universities Press; 1998.

    Google Scholar 

  23. Goodman A. A neurobiology of addiction: an integrative review. Biochem Pharmacol. 2008;75:266–322.

    Article  CAS  Google Scholar 

  24. Gottesman HG, Schubert DS. Low dose oral medroxyprogesterone in the management of paraphilias. J Clin Psychiatry. 1993;54(5):182–8.

    CAS  Google Scholar 

  25. Grant JE, Levine L, Kim D, Potenza MN. Impulse control disorders in adult psychiatric patients. Am J Psychiatry. 2005;162(11):2184–8.

    Article  Google Scholar 

  26. Grant JE, Almaca M, Fineberg NA, Fontenelle LF, Marsunaga H, Reddy YCJ, Simpson HB, Thomson PH, van den Heuvel OA, Veale D, Woods DW, Stein DJ. Impulse control disorders and ‘behavioural addictions’ in the ICD-11. World Psychiatry. 2014;13(2):125–7.

    Article  Google Scholar 

  27. Guay DRP. Drug treatment of paraphilic and non-paraphilic sexual disorders. Clin Ther. 2009;31(1):1–31.

    Article  CAS  Google Scholar 

  28. Herring B. Book reviews (breaking the cycle of shame: free yourself from sex addiction, porn addiction, and shame, by George N. Collins). J Sex Marital Ther. 2013;39:193–4.

    Article  Google Scholar 

  29. Hertlein KM, Piercy FP. Therapists’ assessment and treatment of internet infidelity cases. J Marital Fam Ther. 2008;34:481–97.

    Article  Google Scholar 

  30. International Institute of Trauma and Addiction Professionals. Home page. 2019. http://www.iitap.com/. Accessed 15 May 2019.

  31. Holden C. Behavioural addictions: do they exist? Science. 2001;294:980–2.

    Article  CAS  Google Scholar 

  32. Irvine JM. Reinventing perversion: sex addiction and cultural anxieties. J Hist Sex. 1995;5(3):429–50.

    Google Scholar 

  33. Jones K, Hertlein KM. Four key dimensions for distinguishing internet infidelity from internet sex addiction: concepts and clinical application. Am J Fam Ther. 2012;40(2):115–25.

    Article  Google Scholar 

  34. Kafka MP. Sertraline pharmacotherapy for paraphilias and paraphilia-related disorders: an open trial. Ann Clin Psychiatry. 1994;6(3):189–95.

    Article  CAS  Google Scholar 

  35. Kafka MP. Hypersexual desire in males: an operational definition and clinical implications for males with paraphilias and paraphilic related disorders. Archives of Sexual Behaviour. 1997;26:505–26.

    Article  CAS  Google Scholar 

  36. Kafka MP. The monoamine hypothesis for the pathophysiology of paraphilic disorders: an update. Ann N Y Acad Sci. 2003;989:86–94.

    Article  Google Scholar 

  37. Kafka MP. Hypersexual disorder: a proposed diagnosis for DSM-V. Archives of Sexual Behaviour. 2010;39:377–400.

    Article  Google Scholar 

  38. Karim R, Chaudhri P. Behavioural addictions: an overview. J Psychoactive Drugs. 2012;44(1):5–17.

    Article  Google Scholar 

  39. Krause SW, Meshberg-Cohen S, Martino S, Quinones LJ, Potenza MN. Treatment of compulsive pornography with naltrexone. Am J Psychiatry. 2015;172(12):1260–1.

    Article  Google Scholar 

  40. Krause SW, Krueger RB, Briken P, First MB, Stein DJ, Kaplan MS, Voon V, Abdo CHN, Grant JE, Atalla E, Reed GM. Compulsive sexual behaviour in the ICD-11. World Psychiatry. 2018;17(1):109–10.

    Article  Google Scholar 

  41. Langstrom H, Hanson RK. High rates of sexual behaviour in the general population: correlates and predictors. Arch Sex Behav. 2006;35:37–52.

    Article  Google Scholar 

  42. Madeo P. The effects of citalopram and fluoxetine on sexual behaviour in healthy men: evidence of delayed ejaculation and unaffected sexual desire a randomised, placebo controlled double blind double dummy, parallel study. J Sex Med. 2008;10:2431–41.

    Article  CAS  Google Scholar 

  43. Money J. Responses: paraphilia defined. Harv Rev Psychiatry. 1994;2:41–2.

    Article  Google Scholar 

  44. Park K, Seo JJ, Ryu SB, Kim HJ, Jeong GW. A new potential of blood oxygenation level dependent (BOLD) functional MRI for evaluating centres of penile erection. Int J Impot Res. 2001;13(2):73–81.

    Article  CAS  Google Scholar 

  45. Raymond NC, Coleman E, Miner MH. Psychiatric comorbidity and compulsive/impulsive traits in compulsive sexual behaviour. Compr Psychiatry. 2003;44:370–80.

    Article  Google Scholar 

  46. Reid R, Garos S, Fong T. Psychometric development of the Hypersexual Behavior Consequences Scale. Journal of Behavioral Addictions. 2012;1:115–122. https://doi.org/10.1556/JBA.1.2012.001.

  47. Ross MW, Månsson SA, Daneback K. Prevalence, severity, and correlates of problematic sexual internet use in Swedish men and women. Archives of Sexual Behaviour. 2012;41:459–66.

    Article  Google Scholar 

  48. Schneider JP, Levinson B. Ethical dilemmas related to disclosure issues: sex addiction therapists in the trenches. Journal of Sex Addiction and Compulsivity. 2006;13(1):1–39.

    Article  Google Scholar 

  49. Smith PH, Potenza MN, Mazure CM, McKee SA, Park CL, Hoff RA. Compulsive sexual behaviour among male military veterans: prevalence and associated clinical factors. J Behav Addict. 2014;3(4):214–22.

    Article  Google Scholar 

  50. Society for the Advancement of Sexual Health. Mission statement. 2019. https://www.sash.net/mission-statement. Accessed 15 May 2019.

  51. Stein DJ, Hollander E, Anthony DT, Schneier FR, Fallon BA, Liebowitz MR, Klein DF. Serotonergic medications for sexual obsessions, sexual addictions, and paraphilias. J Clin Psychiatry. 1992;53:267–71.

    CAS  Google Scholar 

  52. Thibaut F, De La Barra F, Gordon H, Cosyns P, Bradford JM. The world Federation of Societies of biological psychiatry (WFSPB) guidelines for the biological treatment of paraphilias. World J Biol Psychiatry. 2010;1(4):51–63.

    Google Scholar 

  53. van Wormer K. Co-dependency: implications for women and therapy. Women Ther. 1989;8(4):51–63.

    Article  Google Scholar 

  54. Vilas P, Pont-Sunyer C, Tolosa E. Impulse control disorders. Parkinsonism Relat Disord. 2012;18(1):580–4.

    Google Scholar 

  55. Weinberg MI, Muench Fm Morgenstern J, Hollander E, Irwin TW, Parsons JT, Allen A, O’Leary A. A double blind study of citalopram versus placebo in the treatment of compulsive sexual behaviours in gay and bisexual gay men. J Clin Psychiatry. 2006;67(12):1968–73.

    Article  Google Scholar 

  56. World Health Organization. Compulsive sexual behaviour disorder. 2018. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1630268048. Accessed 15 May 2019.

  57. Young K. Internet Addiction: Diagnosis and Treatment Considerations. Journal of Contemporary Psychotherapy. 2009;39(4):241–46.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hertzsprung, M., Amadala, S. (2021). Sex Addiction. In: el-Guebaly, N., Carrà, G., Galanter, M., Baldacchino, A.M. (eds) Textbook of Addiction Treatment. Springer, Cham. https://doi.org/10.1007/978-3-030-36391-8_70

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-36391-8_70

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-36390-1

  • Online ISBN: 978-3-030-36391-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics