Skip to main content
Log in

Sexual Addiction: Diagnostic Problems

  • Published:
International Journal of Mental Health and Addiction Aims and scope Submit manuscript

Abstract

In recent years clinicians report a great deal of concern about definition, diagnostic assessment, and treatment modalities when dealing with what might be called out-of-control sexual behavior. Many terms have been used to describe the phenomenon of problematic sexual behavior. Many of these concepts overlap, some are no longer popular, and some are used interchangeably. Without clear criteria and definitions, the diagnosis is difficult, if not impossible, to assign. This paper compares problematic sexual behavior with the common heuristic explanations from the current literature, which identify the problem as a compulsive, impulsive, or addictive disorder. Accordingly, this paper will look at the current treatment models employed despite these controversies.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Anthony, D., & Hollander, E. (1993). Sexual compulsions. In E. Hollander (Ed.), Obsessive-compulsive related disorders (pp. 139–150). Washington DC: American Psychiatric Press.

    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 

  • Barth, R. J., & Kinder, B. N. (1987). The mislabeling of sexual impulsivity. Journal of Sex & Marital Therapy, 13(1), 15–23.

    CAS  Google Scholar 

  • Beckerman, N. L., & Sarracco, M. (2007). Sexual compulsivity: A dyadic framework for the family therapist. Family Therapy, 34(1), 1–12.

    Google Scholar 

  • Björgvinsson, T., & Hart, J. (2008). Obsessive-compulsive disorder. In M. Hersen, & J. Rosqvist (Eds.), Handbook of psychological assessment, case conceptualization, and treatment. Adults (vol. 1, (pp. 237–262)). Hoboken, NJ: John Wiley & Sons Inc.

    Google Scholar 

  • Boelen, P. A., van den Hout, M. A., & van den Bout, J. (2008). The factor structure of posttraumatic stress disorder symptoms among bereaved individuals: A confirmatory factor analysis study. Journal of Anxiety Disorders, 22(8), 1377–1383.

    Article  PubMed  Google Scholar 

  • Camardese, G., Picello, A., & Bria, P. (2008). Venlafaxine: Successful treatment in impulsive disorders. Psychiatry and Clinical Neurosciences, 62(2), 241–242.

    Article  PubMed  Google Scholar 

  • Carnes, P. (1983). The sexual addiction. Minneapolis, MN: CompCare Publication.

    Google Scholar 

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

    Google Scholar 

  • Carnes, P. (1996). Addiction or compulsion: Politics or illness. Sexual Addiction & Compulsivity, 3(2), 127–150.

    Article  Google Scholar 

  • Carnes, P. (2002). Out of the shadows: Understanding sexual addiction. Minneapolis, MN: CompCare Publication.

    Google Scholar 

  • Cavaglion, G. (2008). Narratives of self-help of cyberporn dependents. Sexual Addiction & Compulsivity, 15(3), 195–216.

    Article  Google Scholar 

  • Chan, S. C. (2008). Review of Seminars in general adult psychiatry (2nd edition). Hong Kong Journal of Psychiatry, 18(2), 82.

    Google Scholar 

  • Coleman, E. (1986). Sexual compulsion vs. sexual addiction: The debate continues. SIECUS Report, 14(6), 7–11.

    Google Scholar 

  • Coleman, E. (1987). Sexual compulsivity: Definition, etiology, and treatment considerations. [Special Issue: Chemical dependency and intimacy dysfunction]. Journal of Chemical Dependency Treatment, 1(1), 189–204.

    Article  Google Scholar 

  • Coleman, E. (1991). Compulsive sexual behavior: New concepts and treatments. Journal of Psychology and Human Sexuality, 4(2), 37–52.

    Article  Google Scholar 

  • Coleman, E. (1992). Is your patient suffering from compulsive sexual behavior? Psychiatric Annals, 22, 320–325.

    Google Scholar 

  • Coleman, E. (2007). Sexual Health: Definitions and Construct Development. In M. S. Tepper, & A. Owens-Fuglsang (Eds.), Sexual health. Psychological foundations (vol. 1, (pp. 1–15)). Westport, CT: Praeger Publishers/Greenwood Publishing Group.

    Google Scholar 

  • Coleman, E., Gratzer, T., Nesvacil, L., & Raymond, N. C. (2000). Nefazodone and the treatment of nonparaphilic compulsive sexual behavior: A retrospective study. Journal of Clinical Psychiatry, 61(4), 282–284.

    PubMed  CAS  Google Scholar 

  • Copper, A., Golden, G., & Marshall, W. (2006). Online sexuality and online sexual problems: Skating on thin ice. In W. Marshall, Y. Fernandez, L. Marshall, & G. Serran (Eds.), Sexual offender treatment: Controversial issues (pp. 79–91). New York, NY: John Wiley & Sons Ltd.

    Google Scholar 

  • Corley, M. D., & Schneider, J. P. (2003). Sex addiction disclosure to children: The parents’ perspective. Sexual Addiction & Compulsivity, 10(4), 291–324.

    Article  Google Scholar 

  • DellOsso, B., Marazziti, D., Hollander, E., & Altamura, A. C. (2007). Traditional and newer impulse control disorders: A clinical update. Clinical Neuropsychiatry: Journal of Treatment Evaluation, 4(1), 30–38.

    Google Scholar 

  • Delmonico, D. L. (2004). Editorial: Reflecting and Projecting. Sexual Addiction & Compulsivity, 11(1–2), 1–2.

    Google Scholar 

  • Delmonico, D. L. (2005). Editorial: Sexual Addiction and Compulsivity: Watching the Field Evolve. Sexual Addiction & Compulsivity, 12(1), 1–2.

    Article  Google Scholar 

  • De Silva, P., & Rachman, S. (2004). Obsessive-compulsive disorder, 3rd ed. The facts. New York, NY: Oxford University Press.

    Google Scholar 

  • Earle, R. H., & Crow, G. M. (1990). Sexual addiction: Understanding and treating the phenomenon. Contemporary Family Therapy: An International Journal, 12(2), 89–104.

    Article  Google Scholar 

  • Elmore, J. L. (2005). Psychotropic medication control of non-paraphilic sexual addiction in a female. Sexual and Relationship Therapy, 20(2), 211–213.

    Article  Google Scholar 

  • Finlayson, A. J. R., Sealy, J., & Martin, P. R. (2001). The differential diagnosis of problematic hypersexuality. Sexual Addiction & Compulsivity, 8(3–4), 241–251.

    Google Scholar 

  • Fong, T. W. (2006). Understanding and Managing Compulsive Sexual Behaviors. Psychiatry, 3(11), 51–57.

    Google Scholar 

  • Fong, T. W., De La Garza II, R., & Newton, T. F. (2005). A Case Report of Topiramate in the Treatment of Nonparaphilic Sexual Addiction. Journal of Clinical Psychopharmacology, 25(5), 512–514.

    Article  PubMed  Google Scholar 

  • Fuller, J., & Morgan, O. J. (2005). Spirituality and Addictions Counseling. In V. Kelly, & G. Juhnke (Eds.), Critical incidents in addictions counseling (pp. 47–52). Alexandria, VA: American Counseling Association.

    Google Scholar 

  • Gallant, J., Storch, E. A., Merlo, L. J., Ricketts, E. D., Geffken, G. R., Goodman, W. K., & Murphy, T. K. (2008). Convergent and discriminant validity of the Children’s Yale-Brown Obsessive Compulsive Scale-Symptom Checklist. Journal of Anxiety Disorders, 22(8), 1369–1376.

    Article  PubMed  Google Scholar 

  • Giles, J. (2006). No such thing as excessive levels of sexual behavior: A response to Langström and Hanson (2006) [Letter to the Editor]. Archieves of Sexual Behavior, 35.

  • Ginsberg, D. L. (2005). Topiramate treatment of sexual addiction. Primary Psychiatry, 12(11), 31–32.

    Google Scholar 

  • Giugliano, J. (2004). A Sociohistorical Perspective of Sexual Health: The Clinician’s Role. Sexual Addiction & Compulsivity, 11(1–2), 43–55.

    Google Scholar 

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

    Article  Google Scholar 

  • Goodman, A. (1993). Diagnosis and treatment of sexual addiction. Journal of Sex and Marital Therapy, 19(3), 225–250.

    PubMed  CAS  Google Scholar 

  • Goodman, A. (2001). What’s in a name? Terminology for designating a syndrome of driven sexual behavior. Sexual Addiction & Compulsivity, 8(3–4), 191–213.

    Google Scholar 

  • Hollander, E. (1993). Obsessive-compulsive-related disorders. Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Hook, J. N., Hook, J. P., & Hines, S. (2008). Reach out or act out: Long-term group therapy for sexual addiction. Sexual Addiction & Compulsivity, 15(3), 217–232.

    Article  Google Scholar 

  • Jaffe, S. L. (2008). Review of Alcohol problems in adolescents and young adults: Epidemiology, neurobiology, prevention and treatment. The American Journal on Addictions, 17(3), 253–254.

    Article  Google Scholar 

  • Jenike, M. A. (1989). Obsessive and related disorders. New England Journal of Medicine, 321, 539–541.

    PubMed  CAS  Google Scholar 

  • Kafka, M. P. (2003). The monoamine hypothesis for the pathophysiology of paraphilic disorders: An update. Annual New York Academy of Sciences, 989, 86–94.

    Article  Google Scholar 

  • Kafka, M. P. (2007). Paraphilia-related disorders: The evaluation and treatment of nonparaphilic hypersexuality. In S. R. Leiblum (Ed.), Principles and Practices of Sex Therapy (pp. 442–476, 4th ed.). New York: The Guilford Press.

    Google Scholar 

  • Kafka, M. P., & Hennen, J. (2003). Hypersexual desire in males: Are males with paraphilias different from males with paraphilia-related disorders? Sexual Abuse: A Journal of Research and Treatment, 15, 307–321.

    Article  Google Scholar 

  • Kaplan, H. S. (1995). The sexual desire disorders: Dysfunctional regulation of sexual motivation. New York: Brunner/Mazel.

    Google Scholar 

  • Kaplan, L. V. (2008). Sexual psychopathy, public policy, and the liberal state. International Journal of Law and Psychiatry, 31(2), 172–188.

    Article  PubMed  Google Scholar 

  • Laaser, M. R. (2003). Pastors and sexual addiction. Sexual Addiction & Compulsivity, 10(2–3), 139–149.

    Google Scholar 

  • Martin, P. R., Weinberg, B. A., & Bealer, B. K. (2007). Healing addiction: An integrated pharmacopsychosocial approach to treatment. Hoboken, NJ: John Wiley & Sons Inc.

    Google Scholar 

  • McCarthy, B. (1994). Sexual compulsive men and inhibited sexual desire. Journal of Sex & Marital Therapy, 20(3), 200–209.

    CAS  Google Scholar 

  • Miner, M. H., Coleman, E., Center, B. A., Ross, M., & Rosser, B. R. S. (2007). The Compulsive Sexual Behavior Inventory: Psychometric properties. Archives of Sexual Behavior, 36(4), 579–587.

    Article  PubMed  Google Scholar 

  • ODonohue, G. B. (2005). Sex addiction, sexual compulsivity, and sexual impulsivity: A model for improving diagnosis and treatment of out-of-control sexual behaviors. Dissertation Abstracts International: Section B: The Sciences and Engineering, 65(8-B), 4299.

    Google Scholar 

  • Osborne, C. S. (2004). A group model for the treatment of problematic Internet related sexual behaviours. Sexual and Relationship Therapy, 19(1), 87–99.

    Article  Google Scholar 

  • Oxford, J. (1978). Hypersexuality: Implications for a theory of dependence. British Journal of Addiction, 73, 299–310.

    Article  Google Scholar 

  • Potenza, M. N. (2006). Should addictive disorders include non-substance-related conditions? Addiction, 101(suppl. 1), 142–151.

    Article  PubMed  Google Scholar 

  • Phillips, L. A. (2006). Literature Review of Research in Family Systems Treatment of Sexual Addiction. Sexual Addiction & Compulsivity, 13(2–3), 241–246.

    Google Scholar 

  • Quadland, M. C. (1985). Compulsive sexual behavior: Definition of a problem and an approach to treatment. Journal of Sex & Marital Therapy, Summer, 11(2), 121–132.

    CAS  Google Scholar 

  • Quadland, M. C., & Shattls, W. D. (1987). AIDS, sexuality, and sexual control. Journal of Homosexuality, 14(1–2), 277–298.

    Article  PubMed  CAS  Google Scholar 

  • Ragan, P. W., & Martin, P. R. (2000). The psychobiology of sexual addiction. Sexual Addiction & Compulsivity, 7(3), 161–175.

    Article  Google Scholar 

  • Rinehart, N. J., & McCabe, M. P. (1997). Hypersexuality: Psychopathology or normal variant of sexuality. Journal of Sex and Marital Therapy, 12, 45–60.

    Google Scholar 

  • Schneider, J. (1988). Back from betrayal: Recovering from his sexual affairs. Minneapolis, MN: Hazelden Publishers/ Harper & Row.

    Google Scholar 

  • Schneider, J. P. (2004). Understanding and diagnosing sex addiction. In R. H. Coombs (Ed.), Handbook of Addictive Disorders: A Practical Guide to Diagnosis and Treatment Hoboken (pp. 197–232). New Jersey: Wiley.

    Google Scholar 

  • Schwartz, M. F. (2004). Review of Sexual Addiction: An Integrated Approach. Archives of Sexual Behavior, 33(5), 520.

    Article  Google Scholar 

  • Schwartz, S., & Abramowitz, J. (2005). Contrasting Nonparaphilic Sexual Addictions and OCD. In J. S. Abramowitz, & A. C. Houts (Eds.), Concepts and controversies in obsessive-compulsive disorder (pp. 177–184). New York, NY: Springer.

    Chapter  Google Scholar 

  • Schwartz, M. F., & Masters, W. H. (1983). Conceptual factors in the treatment of paraphilias: A preliminary report. Journal of Sex & Marital Therapy, 9(1), 3–18.

    CAS  Google Scholar 

  • Stein, D. J. (2008). Is disorder X in category or spectrum Y? General considerations and application to the relationship between obsessive-compulsive disorder. Depression and Anxiety, 25(4), 330–335.

    Article  PubMed  Google Scholar 

  • Sunderwirth, S., Milkman, H., & Jenks, N. (1996). Neurochemistry and sexual addiction. Sexual Addiction & Compulsivity, 3(1), 22–32.

    Article  Google Scholar 

  • Travin, S. (1995). Compulsive sexual behaviors. Psychiatric Clinics of North America, 18, 155–169.

    PubMed  CAS  Google Scholar 

  • Tripodi, C. (2006). Long Term Treatment of Partners of Sex Addicts: A Multi-Phase Approach. Sexual Addiction & Compulsivity, 13(2–3), 269–288.

    Google Scholar 

  • Vesga-Lopez, O., Schmidt, A., & Blanco, C. (2007). Update on sexual addictions. Directions in Psychiatry, 27(2), 143–158.

    Google Scholar 

  • Wines, D. (1997). Exploring the applicability of criteria for substance dependence to sexual addiction. Sexual Addiction & Compulsivity, 4(3), 195–220.

    Article  Google Scholar 

  • Zurowski, B., Wahl, K., Hohagen, F., & Kordon, A. (2007). Symptom remission in OCD after discontinuation of pharmacotherapy with fluoxetine: A case for looking beyond serotonin. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 31(4), 959–960.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John R. Giugliano.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Giugliano, J.R. Sexual Addiction: Diagnostic Problems. Int J Ment Health Addiction 7, 283–294 (2009). https://doi.org/10.1007/s11469-009-9195-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11469-009-9195-3

Keywords

Navigation