Purpose of Review
Information on potential risk factors and clinical correlates of compulsive sexual behavior (CSB) may help inform more effective prevention and treatment measures. Sexual victimization, specifically, child sexual abuse (CSA), has been associated with CSB.
This systematic review describes 21 studies on the relationship between CSA and CSB. Most studies identified a significant association between CSA and CSB. However, variability in measurements, potential differences in links among community versus clinical samples, relevance of research among college samples, lack of support for gender-related differences, and the need for more longitudinal designs were identified.
Research would benefit from more formalized assessments of CSB across different populations. Prevention efforts should be aimed toward individuals who experienced CSA and/or other abuse, particularly if they report engaging in risky sexual behavior. Individuals with CSB who have experienced sexual abuse may benefit from trauma-focused treatment.
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Aalsma MC, Zimet GD, Fortenberry JD, Blythe M, Orr DP. Reports of childhood sexual abuse by adolescents and young adults: stability over time. J Sex Res. 2002. https://doi.org/10.1080/00224490209552149.
•• Aaron M. The pathways of problematic sexual behavior: a literature review of factors affecting adult sexual behavior in survivors of childhood sexual abuse. Sex Addict Compuls. 2012. https://doi.org/10.1080/10720162.2012.690678. This literature review examines why some individuals may respond to CSA by withdrawal, while others respond with impulsiveness. Specifically, it describes gender of the victim and age at onset of victimization as two factors that can account for differences.
• Abajobir AA, Kisely S, Maravilla JC, Williams G, Najman JM. Gender differences in the association between childhood sexual abuse and risky sexual behaviours: a systematic review and meta-analysis. Child Abuse Negl. 2017. https://doi.org/10.1016/j.chiabu.2016.11.023. This meta-analytic review found that childhood sexual abuse is a significant risk factor for a syndemic of risky sexual behaviors and the magnitude is similar both in females and males.
Ainsworth MDS, Blehar MC, Waters E, Wall SN. Patterns of attachment: A psychological study of the strange situation. In Patterns of Attachment: A Psychological Study of the Strange Situation. New York: Psychology Press. 2015. https://doi.org/10.4324/9780203758045.
Alexander PC. Application of attachment theory to the study of sexual abuse. J Consult Clin Psychol. 2005. https://doi.org/10.1037/0022-006x.60.2.185.
Bernstein DP, Fink L. Childhood Trauma Questionnaire: A retrospective self-report manual San Antonio, TX: The Psychological Corporation. 1998.
Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, … Zule W. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003. https://doi.org/10.1016/S0145-2134(02)00541-0.
Blain LM, Muench F, Morgenstern J, Parsons JT. Exploring the role of child sexual abuse and posttraumatic stress disorder symptoms in gay and bisexual men reporting compulsive sexual behavior. Child Abuse Negl. 2012. https://doi.org/10.1016/j.chiabu.2012.03.003.
Bowlby J. Attachment and Loss, Vol. 1: Attachment. Attachment and Loss. New York: Basic Books. 1969.
Bremner JD, Bolus R, Mayer EA. Psychometric properties of the early trauma inventory-self report. J Nerv Ment Dis. 2007. https://doi.org/10.1097/01.nmd.0000243824.84651.6c.
Carnes P. Contrary to love: helping the sexual addict. Center City: Hazelden; 1989.
Carnes P. Don’t call it love: recovery from sexual addiction. New York: Bantam Books; 1991.
Carnes PJ, Delmonico DL. Childhood abuse and multiple addictions: research findings in a sample of self-identified sexual addicts. Sex Addict Compuls. 1996. https://doi.org/10.1080/10720169608400116.
Carnes P, O’Hara S. Women’s Sexual Addiction Screening Test (W-SAST). Wickenburg: Unpublished Measure; 1994.
Carvalheira A, Price C, Neves CF. Body awareness and bodily dissociation among those with and without sexual difficulties: differentiation using the scale of body connection. J Sex Marital Ther. 2017. https://doi.org/10.1080/0092623X.2017.1299823.
Castro Á, Ibáñez J, Maté B, Esteban J, Barrada JR. Childhood sexual abuse, sexual behavior, and revictimization in adolescence and youth: a mini review. Front Psychiatry. 2019;10(2018). https://doi.org/10.3389/fpsyg.2019.02018.
Chatzittofis A, Savard J, Arver S, Öberg KG, Hallberg J, Nordström P, et al. Interpersonal violence, early life adversity, and suicidal behavior in hypersexual men. J Behav Addict. 2017. https://doi.org/10.1556/2006.6.2017.027.
Chemezov EM, Petrova NN, Kraus SW. Compulsive sexual behavior in HIV-infected men in a community based sample, Russia. Sex Addict Compuls. 2019;26(1–2). https://doi.org/10.1080/10720162.2019.1582379.
Colangelo J, Keefe-Cooperman K. Understanding the impact of childhood sexual abuse on women’s sexuality. J Ment Health Couns. 2015. https://doi.org/10.17744/mehc.34.1.e045658226542730.
Coleman E, Miner M, Ohlerking F, Raymond N. Compulsive sexual behavior inventory: a preliminary study of reliability and validity. J Sex Marital Ther. 2001. https://doi.org/10.1080/009262301317081070.
Courtois CA. Complex trauma, complex reactions: assessment and treatment. Psychotherapy. 2004. https://doi.org/10.1037/0033-3184.108.40.2062.
Davis KA, Knight RA. The relation of childhood abuse experiences to problematic sexual behaviors in male youths who have sexually offended. Arch Sex Behav. 2019;48:2149–69. https://doi.org/10.1007/s10508-018-1279-3.
DeKeseredy W, Schwartz M. Thinking sociologically about image-based sexual. Abuse: The Contribution of Male Peer Support Theory. Sexualization, Media, & Society; 2016. https://doi.org/10.1177/2374623816684692.
Dickenson JA, Gleason N, Coleman E, Miner MH. Prevalence of distress associated with difficulty controlling sexual urges, feelings, and behaviors in the United States. JAMA Netw Open. 2018. https://doi.org/10.1001/jamanetworkopen.2018.4468.
Dodge B, Reece M, Cole SL, Sandfort TGM. Sexual compulsivity among heterosexual college students. J Sex Res. 2004. https://doi.org/10.1080/00224490409552241.
Erez G, Pilver CE, Potenza MN. Gender-related differences in the associations between sexual impulsivity and psychiatric disorders. J Psychiatr Res. 2014. https://doi.org/10.1016/j.jpsychires.2014.04.009.
Estévez A, Ozerinjauregi N, Herrero-Fernández D, Jauregui P. The mediator role of early maladaptive schemas between childhood sexual abuse and impulsive symptoms in female survivors of CSA. J Interpersonal Viol. 2019. https://doi.org/10.1177/0886260516645815.
Ferree MC. No stones: women redeemed from sexual shame. Fairfax: Xulon; 2002.
Finkelhor D, Browne A. The traumatic impact of child sexual abuse: a conceptualization. Am J Orthopsychiatry. 1985. https://doi.org/10.1111/j.1939-0025.1985.tb02703.x.
Finkelhor D, Shattuck A, Turner HA, Hamby SL. The lifetime prevalence of child sexual abuse and sexual assault assessed in late adolescence. J Adolesc Health. 2014. https://doi.org/10.1016/j.jadohealth.2013.12.026.
Forouzan E, Van Gijseghem H. Psychosocial adjustment and psychopathology of men sexually abused during childhood. Int J Offend Ther Comp Criminol. 2005. https://doi.org/10.1177/0306624X04273650.
Fromuth ME. The relationship of childhood sexual abuse with later psychological and sexual adjustment in a sample of college women. Child Abuse Negl. 1986. https://doi.org/10.1016/0145-2134(86)90026-8.
Garcia FD, Thibaut F. Sexual addictions. Am J Drug Alcohol Abuse. 2010;36(5):254–60. https://doi.org/10.3109/00952990.2010.503823.
Gerdner A, Allgulander C. Psychometric properties of the Swedish version of the Childhood Trauma Questionnaire - Short Form (CTQ-SF). Nordic J Psychiatry. 2009. https://doi.org/10.1080/08039480802514366.
Gold SN, Heffner CL. Sexual addiction: many conceptions, minimal data. Clin Psychol Rev. 1998. https://doi.org/10.1016/S0272-7358(97)00051-2.
Grant JE. Impulse control disorders: a clinician’s guide to understanding and treating behavioral addictions. New York: WW Norton and Company; 2008.
Greene T, Neria Y, Gross R. Prevalence, detection and correlates of PTSD in the primary care setting: a systematic review. J Clin Psychol Med Settings. 2016;23:160–80. https://doi.org/10.1007/s10880-016-9449-8.
Griffee K, O’Keefe SL, Stroebel SS, Beard KW, Swindell S, Young DH. On the brink of paradigm change? evidence for unexpected predictive relationships among sexual addiction, masturbation, sexual experimentation, and revictimization, child sexual abuse, and adult sexual risk. Sex Addict Compuls. 2012. https://doi.org/10.1080/10720162.2012.705140.
Herman J, Hirschman L. Families at risk for father-daughter incest. Am J Psychiatr. 1981. https://doi.org/10.1176/ajp.138.7.967.
Hernandez A, Gallardo-Pujol D, Pereda N, Arntz A, Bernstein DP, Gaviria AM, … Gutiérrez-Zotes JA. Initial validation of the Spanish Childhood Trauma Questionnaire-Short Form: factor structure, reliability and association with parenting. J Interpersonal Violence. 2013. https://doi.org/10.1177/0886260512468240.
• Homma Y, Wang N, Saewyc E, Kishor N. The relationship between sexual abuse and risky sexual behavior among adolescent boys: a meta-analysis. J Adolesc Health. 2012. https://doi.org/10.1016/j.jadohealth.2011.12.032. This meta-analysis found that sexually abused boys were significantly more likely than non-abused boys to report unprotected sexual intercourse, multiple sexual partners, and pregnancy involvement.
Johnson M, Mishna F, Okumu M, Daciuk J. Non-consensual sharing of sexts: behaviours and attitudes of Canadian youth. 2018. https://doi.org/https://mediasmarts.ca/research.policy.
Kafka MP. Hypersexual disorder: a proposed diagnosis for DSM-V. Arch Sex Behav. 2010;39:377–400. https://doi.org/10.1007/s10508-009-9574-7.
Kalichman SC, Cain D. The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic. J Sex Res. 2004. https://doi.org/10.1080/00224490409552231.
Kalichman SC, Rompa D. Sexual sensation seeking and sexual compulsivity scales: reliability, validity, and predicting HIV risk behavior. J Pers Assess. 1995. https://doi.org/10.1207/s15327752jpa6503_16.
Kalichman SC, Johnson JR, Adair V, Rompa D, Multhauf K, Kelly JA. Sexual sensation seeking: scale development and predicting AIDS-risk behavior among homosexually active men. J Pers Assess. 1994. https://doi.org/10.1207/s15327752jpa6203_1.
Katehakis A. Affective neuroscience and the treatment of sexual ddiction. Sex Addict Compuls. 2009. https://doi.org/10.1080/10720160802708966.
Kendall-Tackett KA, Williams LM, Finkelhor D. Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychol Bull. 1993. https://doi.org/10.1080/01612840701869791.
King LA, King DW, Vogt DS, Knight J, Samper RE. Deployment risk and resilience inventory: a collection of measures for studying deployment-related experiences of military personnel and veterans. Mil Psychol. 2006. https://doi.org/10.1207/s15327876mp1802_1.
Kingston DA, Graham FJ, Knight RA. Relations between self-reported adverse events in childhood and hypersexuality in adult male sexual offenders. Arch Sex Behav. 2017;46:707–20. https://doi.org/10.1007/s10508-016-0873-5.
Kowalewska E, Grubbs JB, Potenza MN, Gola M, Draps M, Kraus SW. Neurocognitive mechanisms in compulsive sexual behavior disorder. Curr Sex Health Rep. 2018;10:255–64. https://doi.org/10.1007/s11930-018-0176-z.
Krahé B, Berger A. Gendered pathways from child sexual abuse to sexual aggression victimization and perpetration in adolescence and young adulthood. Child Abuse Negl. 2017. https://doi.org/10.1016/j.chiabu.2016.10.004.
Kraus SW, Voon V, Potenza MN. Should compulsive sexual behavior be considered an addiction? Addiction. 2016;111(12):2097–106. https://doi.org/10.1111/add.13297.
Kraus SW, Krueger RB, Briken P, First MB, Stein DJ, Kaplan MS, … Reed GM. Compulsive sexual behaviour disorder in the ICD-11. World Psychiatry. 2018 https://doi.org/10.1002/wps.20499.
•• Kuzma JM, Black DW. Epidemiology, prevalence, and natural history of compulsive sexual behavior. Psychiatr Clin N Am. 2008. https://doi.org/10.1016/j.psc.2008.06.005. This review article describes the core features, prevalence, common psychiatric and medical comorbidities, gender distribution, natural history, family history and risk factors associated with CSB.
Lacelle C, Hébert M, Lavoie F, Vitaro F, Tremblay RE. Sexual health in women reporting a history of child sexual abuse. Child Abuse Negl. 2012. https://doi.org/10.1016/j.chiabu.2011.10.011.
Långström N, Hanson RK. High rates of sexual behavior in the general population: correlates and predictors. Arch Sex Behav. 2006. https://doi.org/10.1007/s10508-006-8993-y.
Leeb RT, Paulozzi LJ, Melanson C, Simon TR, Arias I. Child maltreatment surveillance: uniform definitions for public health and recommended data elements, version 1.0. Annu Rev Clin Psychol. 2008. https://doi.org/10.1177/1077559599004001005.
Lisak D, Beszterczey S. The cycle of violence: the life histories of 43 death row inmates. Psychol Men Masculinity. 2007. https://doi.org/10.1037/1524-9220.127.116.11.
Loeb TB, Williams JK, Vargas J, Wyatt GE, O’Brien AA. Child sexual abuse: associations with the sexual functioning of adolescents and adults. Annu Rev Sex Res. 2002;13:307–45.
Marshall LE, Marshall WL. Sexual addiction in incarcerated sexual offenders. Sex Addict Compuls. 2006. https://doi.org/10.1080/10720160601011281.
McPherson S, Clayton S, Wood H, Hiskey S, Andrews L. The role of childhood experiences in the development of sexual compulsivity. Sex Addict Compuls. 2013. https://doi.org/10.1080/10720162.2013.803213.
Meston CM, Heiman JR, Trapnell PD. The relation between early abuse and adult sexuality. J Sex Res. 1999. https://doi.org/10.1080/00224499909552011.
Meyer D, Cohn A, Robinson B, Muse F, Hughes R. Persistent complications of child sexual abuse: sexually compulsive behaviors, attachment, and emotions. J Child Sexual Abuse. 2017. https://doi.org/10.1080/10538712.2016.1269144.
Murray LK, Nguyen A, Cohen JA. Child sexual abuse. Child Adolesc Psychiatr Clin N Am. 2014;23(2):321–37. https://doi.org/10.1016/j.chc.2014.01.003.
Najman JM, Dunne MP, Purdie DM, Boyle FM, Coxeter PD. Sexual abuse in childhood and sexual dysfunction in adulthood: an Australian population-based study. Arch Sex Behav. 2005. https://doi.org/10.1007/s10508-005-6277-6.
Noll JG, Trickett PK, Putnam FW. A prospective investigation of the impact of childhood sexual abuse on the development of sexuality. J Consult Clin Psychol. 2003. https://doi.org/10.1037/0022-006X.71.3.575.
Odlaug BL, Lust K, Schreiber LRN, Christenson G, Derbyshire K, Harvanko A, …, Grant JE. Compulsive sexual behavior in young adults. Ann Clin Psychiatry 2013;25(3):193–200. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23926574.
Opitz DM, Tsytsarev SV, Froh J. Women’s sexual addiction and family dynamics, depression and substance abuse. Sex Addict Compuls. 2009;16(4):324–40. https://doi.org/10.1080/10720160903375749.
Parsons JT, Grov C, Golub SA. Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: further evidence of a syndemic. Am J Public Health. 2012. https://doi.org/10.2105/AJPH.2011.300284.
Parsons JT, Rendina HJ, Moody RL, Ventuneac A, Grov C. Syndemic production and sexual compulsivity/hypersexuality in highly sexually active gay and bisexual men: further evidence for a three group conceptualization. Arch Sex Behav. 2015. https://doi.org/10.1007/s10508-015-0574-5.
Parsons JT, Millar BM, Moody RL, Starks TJ, Rendina HJ, Grov C. Syndemic conditions and HIV transmission risk behavior among HIV-negative gay and bisexual men in a U.S. national sample. Health Psychol. 2017. https://doi.org/10.1037/hea0000509.
Pedrero Pérez EJ, Rodríguez Monje MT, Gallardo Alonso F, Fernández Girón M, Pérez López M, Chicharro Romero J. Validación de un instrumento para la detección de trastornos de control de impulsos y adicciones: El MULTICAGE CAD-4. Trastornos Adictivos. 2007. https://doi.org/10.1016/S1575-0973(07)75656-8.
Perera B, Reece M, Monahan P, Billingham R, Finn P. Childhood characteristics and personal dispositions to sexually compulsive behavior among young adults. Sex Addict Compuls. 2009. https://doi.org/10.1080/10720160902905421.
Plant M, Plant M, Miller P. Childhood and adult sexual abuse: relationships with ‘addictive’ or ‘problem’ behaviours and health. J Addict Dis. 2005. https://doi.org/10.1300/J069v24n01.
Price C. Dissociation reduction in body therapy during sexual abuse recovery. Complement Ther Clin Pract. 2007. https://doi.org/10.1016/j.ctcp.2006.08.004.
Putnam FW. Ten-year research update review: child sexual abuse. J Am Acad Child Adolesc Psychiatry. 2003. https://doi.org/10.1097/00004583-200303000-00006.
Rellini AH, Meston CM. Sexual self-chemas, sexual dysfunction, and the sexual responses of women with a history of childhood sexual abuse. Arch Sex Behav. 2011. https://doi.org/10.1007/s10508-010-9694-0.
Rind B, Tromovitch P. A meta-analytic review of findings from national samples on psychological correlates of child sexual abuse. J Sex Res. 1997. https://doi.org/10.1080/00224499709551891.
• Rooney BM, Tulloch TG, Blashill AJ. Psychosocial syndemic correlates of sexual compulsivity among men who have sex with men: a meta-analysis. Arch Sex Behav. 2018. https://doi.org/10.1007/s10508-017-1032-3. This meta-analysis of MSM examining CSA and other factors as syndemic predictors of sexual compulsivity found a statistically significant small effect size between CSA and CSB.
Schloredt KA, Heiman JR. Perceptions of sexuality as related to sexual functioning and sexual risk in women with different types of childhood abuse histories. J Trauma Stress. 2003. https://doi.org/10.1023/A:1023752225535.
Schneider JP, Irons RR. Assessment and treatment of addictive sexual disorders: relevance for chemical dependency relapse. Subst Use Misuse. 2001. https://doi.org/10.1081/JA-100108428.
Schwartz MF, Southern S. Compulsive cybersex: the new tea room. Sex Addict Compuls. 2000. https://doi.org/10.1080/10720160008400211.
Scoglio AAJ, Kraus SW, Saczynski J, Jooma S, Molnar BE. Systematic review of risk and protective factors for revictimization after child sexual abuse. Trauma Violence Abuse. 2019. https://doi.org/10.1177/1524838018823274.
Skegg K, Nada-Raja S, Dickson N, Paul C. Perceived “out of control” sexual behavior in a cohort of young adults from the Dunedin Multidisciplinary Health and Development study. Arch Sex Behav. 2010;39:968–78. https://doi.org/10.1007/s10508-009-9504-8.
Smith PH, Potenza MN, Mazure CM, Mckee SA, Park CL, Hoff RA. Compulsive sexual behavior among male military veterans: prevalence and associated clinical factors. J Behav Addict. 2014. https://doi.org/10.1556/JBA.3.2014.4.2.
Stappenbeck CA, George WH, Staples JM, Nguyen H, Davis KC, Kaysen D, … Kajumulo KF. In-the-moment dissociation, emotional numbing, and sexual risk: the influence of sexual trauma history, trauma symptoms, and alcohol intoxication. Psychol Violence 2016. https://doi.org/10.1037/a0039978.
Stark R, Klucken T, Potenza MN, Brand M, Strahler J. A current understanding of the behavioral neuroscience of compulsive sexual behavior disorder and problematic pornography use. Curr Behav Neurosci Rep. 2018;5:218–31. https://doi.org/10.1007/s40473-018-0162-9.
Sullivan H. The interpersonal theory of psychiatry. J Nerv Ment Dis. 1954. https://doi.org/10.1097/00005053-195407000-00064.
Townsend C, Rheingold AA. Estimating a child sexual abuse prevalence rate for practitioners: studies. Charleston, S.C., Darkness to Light. 2013. Retrieved from https://www.D2L.org.
Tucker RD, Harris SS, Simpson WB, McKinlay JB. The relationship between adult or adolescent sexual abuse and sexual dysfunction: preliminary results from the Boston Area Community Health Survey (BACH). Ann Epidemiol. 2004;14(8):621. https://doi.org/10.1016/j.annepidem.2004.07.079.
Vaillancourt-Morel M-P, Godbout N, Labadie C, Runtz M, Lussier Y, Sabourin S. Avoidant and compulsive sexual behaviors in male and female survivors of childhood sexual abuse. Child Abuse Negl. 2015. https://doi.org/10.1016/j.chiabu.2014.10.024.
Vaillancourt-Morel MP, Godbout N, Sabourin S, Briere J, Lussier Y, Runtz M. Adult sexual outcomes of child sexual abuse vary according to relationship status. J Marital Fam Ther. 2016. https://doi.org/10.1111/jmft.12154.
Walker EA, Gelfand A, Katon WJ, Koss MP, Von Korff M, Bernstein D, et al. Adult health status of women with histories of childhood abuse and neglect. Am J Med. 1999. https://doi.org/10.1016/S0002-9343(99)00235-1.
Walsh K, Blaustein M, Knight WG, Spinazzola J, van der Kolk BA. Resiliency factors in the relation between childhood sexual abuse and adulthood sexual assault in college-age women. J Child Sexual Abuse. 2007. https://doi.org/10.1300/J070v16n01_01.
Womack SD, Hook JN, Ramos M, Davis DE, Penberthy JK. Measuring hypersexual behavior. Sex Addict Compuls. 2013. https://doi.org/10.1080/10720162.2013.768126.
World Health Organization. (1999). Report of the consultation on child abuse prevention (WHO/HSC/PVI/ 99.1). Retrieved from http://www.who.int/mip2001/files/2017/childabuse.pdf.
World Health Organization. (2003). Management of Substance Abuse: the GENACIS Project. Retrieved from https://www.who.int/substance_abuse/publications/en/GENACISFactSheet.pdf?ua=1.
World Health Organization. (2018). International statistical classification of diseases and related health problems (11th Revision). Retrieved from https://icd.who.int/browse11/l-m/en
Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number T32DA037801.
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Slavin, M.N., Scoglio, A.A.J., Blycker, G.R. et al. Child Sexual Abuse and Compulsive Sexual Behavior: A Systematic Literature Review. Curr Addict Rep 7, 76–88 (2020). https://doi.org/10.1007/s40429-020-00298-9
- Compulsive sexual behavior
- Child sexual abuse