Neurocognitive Mechanisms in Compulsive Sexual Behavior Disorder


Purpose of Review

The current review summarizes the latest findings concerning neurobiological mechanisms of compulsive sexual behavior disorder (CSBD) and provides recommendations for future research specific to the diagnostic classification of the condition.

Recent Findings

To date, most neuroimaging research on compulsive sexual behavior has provided evidence of overlapping mechanisms underlying compulsive sexual behavior and non-sexual addictions. Compulsive sexual behavior is associated with altered functioning in brain regions and networks implicated in sensitization, habituation, impulse dyscontrol, and reward processing in patterns like substance, gambling, and gaming addictions. Key brain regions linked to compulsive sexual behavior features include the frontal and temporal cortices, amygdala, and striatum, including the nucleus accumbens.


Despite much neuroscience research finding many similarities between CSBD and substance and behavioral addictions, the World Health Organization included CSBD in the ICD-11 as an impulse-control disorder. Although previous research has helped to highlight some underlying mechanisms of the condition, additional investigations are needed to fully understand this phenomenon and resolve classification issues surrounding CSBD.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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This work supported by: The Department of Veterans Affairs, Veterans Health Administration, VISN 1 New England Mental Illness Research, Education, and Clinical Center (SK); Jubilee Grant for doctoral students of the Interdisciplinary Doctoral Studies financed by SWPS University of Social Sciences and Humanities in Poland (EK); The Polish National Science Centre grant “OPUS” (2014/15/B/HS6/03792) (MG, EK, and MW); The Connecticut Council on Problem Gambling (MNP); The Connecticut Department of Mental Health and Addiction Services (MNP). The views expressed are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, United States government, or other funding agencies.

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Correspondence to Shane W. Kraus.

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Ewelina Kowalewska, Joshua B. Grubbs, Mateusz Gola, Małgorzata Draps, and Shane W. Kraus each declare no potential conflicts of interest.

Marc N. Potenza reports consulting fees from Jazz Pharmaceuticals, Opiant (Lightlake) Pharmaceuticals, Las Vegas Sands, Legal firms, Shire Pharmaceuticals, and research support to Yale from Mohegan Sun Casino.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Sexual Orientation and Identity

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Kowalewska, E., Grubbs, J.B., Potenza, M.N. et al. Neurocognitive Mechanisms in Compulsive Sexual Behavior Disorder. Curr Sex Health Rep 10, 255–264 (2018).

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  • Compulsive sexual behavior
  • Neuroscience
  • Gender