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Assessment and Treatment of Sexual People with Complaints of Hypersexuality

  • INTEGRATING THE PSYCHOSOCIAL (B McCARTHY, RT SEGRAVES, AND AH CLAYTON, SECTION EDITORS)
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Abstract

This article presents a literature review of contemporary research on the definition, diagnosis, assessment, and treatment methods of so-called “sexual compulsivity,” “sexual hyperactivity,” and “hypersexuality,” We review published literature on proposed diagnostic criteria, symptomatology, and treatments. The Sexual Compulsivity Scale (SCS), Compulsive Sexual Behaviour Inventory (CSBI), Sexual Addiction Screening Test (SAST), and Hypersexual Behaviour Inventory (HBI) were found to be the most frequently used assessment tools. Although all of these scales have demonstrated high internal consistency, each scale is based on a unique perspective and understanding of “hypersexuality.” This article discusses the validity and reliability, as well as applicable populations for assessment, foe each of the scales. These of multiple assessment strategies is encouraged in order to glean greater insight into the nature of hypersexuality sexual compulsivity. We briefly discuss the importance of multimodal intervention strategies, while providing in-depth evaluation of cognitive-behavioural psychotherapy and 12-step programs. The article also highlights and provides a discussion of the Sexual Behaviours Clinic (SBC) intervention strategies for individuals labelled as “sex addicts.” Finally, we suggest directions for future emphasis in research in diagnosis, assessment, and treatment in order to reduce conceptual ambiguity and enhance empirical efficacy.

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References

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

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Publishing; 2013.

    Google Scholar 

  2. The Society for Advancement of Sexual Health. Sexual Addiction. Retrieved August 30, 2013 from http://www.sash.net/ (2011).

  3. Wright PJ. Sexual compulsivity and 12-step peer and sponsor supportive communication: a cross-lagged panel analysis. Sex Addict Compulsivity. 2010;17(2):154–69. This study analyses the mechanism and role of 12-Step Programs as a treatment for sexual addiction.

    Article  Google Scholar 

  4. Gold SN, Seifer RE. Dissociation and sexual addiction/compulsivity: a contextual approach to conceptualization and treatment. J Trauma Dissociation. 2002;3(4):59–82.

    Article  Google Scholar 

  5. Cooper M, Lebo RA. Assessment and treatment of sexual compulsivity. J Soc Work Pract Addict. 2001;1(2):61–74.

    Article  Google Scholar 

  6. Del Guidice MJ, Kutinsky J. Applying motivational interviewing to the treatment of sexual compulsivity and addiction. Sex Addict Compulsivity. 2007;14(4):303–19.

    Article  Google Scholar 

  7. Hall P. A biopsychosocial view of sex addiction. Sex Relationsh Ther. 2011;26(3):217–28.

    Article  Google Scholar 

  8. World Health Organization. International classification of diseases: Classification of mental and behavioural disorders (10th Revision). Geneva, Switzerland: WHO: FD2.7; 2010.

  9. Kalichman SC, Rompa D. Sexual sensation seeking and sexual compulsivity scales: validity, and predicting HIV risk behaviour. J Pers Assess. 1995;65(3):587.

    Article  Google Scholar 

  10. Guigliano JR. Sexual impulsivity, compulsivity or dependence: an investigative inquiry. Sex Addict Compulsivity. 2008;15(2):139–57.

    Article  Google Scholar 

  11. Walters G, Knight R, Långström N. Is hypersexuality dimensional? Evidence for the DSM-5 from general population and clinical samples. Arch Sex Behav. 2011;40(6):1309–21. Authors evaluate and criticize the proposed criteria and dimensionality of Hypersexual Disorder as evidence for the DSM-5 [the proposed diagnosis was rejected]. Authors propose that Hypersexual Disorder exists as a continuum.

    Article  PubMed  Google Scholar 

  12. Kafka MP. Hypersexual disorder: a proposed diagnosis for DSM-V. Arch Sex Behav. 2010;39(2):377–400. Definitional criteria proposed to the DSM-5 for Hypersexual Disorder. Although this definition was rejected, the literature depicts progress towards a consistent conceptualization of the condition.

    Article  PubMed  Google Scholar 

  13. Lee TTC, Ritchey KA, Forbey JD, Gaither GA. Psychometrics and comparison of the compulsive sexual behavior inventory and the sexual compulsivity scale in a male college student sample. Sex Addict Compulsivity. 2009;16(2):146–67.

    Article  Google Scholar 

  14. Seegers JA. The prevalence of sexual addiction symptoms on the college campus. Sex Addict Compulsivity. 2003;10(4):247–58.

    Article  Google Scholar 

  15. Reece M, Dodge B. Exploring indicators of sexual compulsivity among men who cruise for sex on campus. Sex Addict Compulsivity. 2004;11(3):87–113.

    Article  Google Scholar 

  16. Dodge B, Reece M, Cole SL, Sandfort TGM. Sexual compulsivity among heterosexual college students. J Sex Res. 2004;41(4):343–50.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Bancroft J, Vukadinovic Z. Sexual addiction, sexual compulsivity, sexual impulsivity, or what? towards a theoretical model. J Sex Res. 2004;41(3):225–34.

    Article  PubMed  Google Scholar 

  18. Benotsch EG, Kalichman SC, Pinkerton SD. Sexual compulsivity in HIV-positive men and women: prevalence, predictors, and consequences of high-risk behaviors. Sex Addict Compulsivity. 2001;8(2):83–99.

    Article  Google Scholar 

  19. McBride KR, Reece M, Sanders SA. Predicting negative outcomes of sexuality using the compulsive sexual behavior inventory. Int J Sex Health. 2008;19(4):51–62.

    Article  Google Scholar 

  20. Reid RC, Garos S, Carpenter BN. Reliability, validity, and psychometric development of the hypersexual behavior inventory in an outpatient sample of men. Sex Addict Compulsivity. 2011;18(1):30–51. First published findings of the assessment measure Hypersexual Behaviour Inventory, based on [rejected] DSM-5 proposed criteria of hypersexual disorder.

    Article  Google Scholar 

  21. Fedoroff P, Moran B. Myths and misconceptions about sex offenders. Can J Hum Sex. 1997;6(4):263–76.

    Google Scholar 

  22. Womack SD, Hook JN, Ramos M, Davis DE, Penberthy JK. Measuring hypersexual behavior. Sex Addict Compulsivity. 2013;20(1-2):65–78. This is an excellent, in-depth analysis and summary of 32 existing assessment measures for sexual compulsivity, sexual addiction and hypersexuality.

    Google Scholar 

  23. Kalichman SC, Rompa D. The sexual compulsivity scale: further development and use with HIV-positive persons. J Pers Assess. 2001;76(3):379–95.

    Article  CAS  PubMed  Google Scholar 

  24. McBride KR, Reece M, Saunders SA. Using the sexual compulsivity scale to predict outcomes of sexual behavior in young adults. Sex Addict Compulsivity. 2008;15(2):97–115.

    Article  Google Scholar 

  25. Winters J, Christoff K, Gorzalka B. Dysregulated sexuality and high sexual desire: distinct constructs? Arch Sex Behav. 2010;39(5):1029–43.

    Article  PubMed  Google Scholar 

  26. Hook JN, Hook JP, Davis DE, Worthington EL, Penberthy JK. Measuring sexual addiction and compulsivity: a critical review of instruments. J Sex Marital Ther. 2010;36(3):227–60. Analysis of the reliability, validity, structure and conceptual bases of 17 scales assessing sexual addiction and sexual compulsivity.

    Article  PubMed  Google Scholar 

  27. Zuckerman M, Kolin EA, Price L, Zoob I. Development of a sensation-seeking scale. J Consult Psychol. 1964;28(6):477–82.

    Article  Google Scholar 

  28. Coleman E, Miner M, Ohlerking F, Raymond N. Compulsive sexual behavior inventory: a preliminary study of reliability and validity. J Sex Marital Ther. 2001;27(4):325–32.

    Article  CAS  PubMed  Google Scholar 

  29. Carnes P, Green B, Carnes S. The same yet different: refocusing the sexual addiction screening test (SAST) to reflect orientation and gender. Sex Addict Compulsivity. 2010;17(1):7–30. Discussing revised and specialized versions of the SAST assessment intended for reliable, valid use in different populations.

    Article  Google Scholar 

  30. Nelson KG, Oehlert ME. Psychometric exploration of sexual addiction screening test in veterans. Sex Addict Compulsivity. 2008;15(1):39–58.

    Article  Google Scholar 

  31. Marshall LE, Marshall WL. Sexual addiction in incarcerated sexual offenders. Sex Addict Compulsivity. 2006;13(4):377–90.

    Article  Google Scholar 

  32. Gordon-Lamoureux RJ. Exploring the possibility of sexual addiction in men arrested for seeking out prostitutes: a preliminary study. J Addict Nurs. 2007;18(1):21–9.

    Article  Google Scholar 

  33. Reid RC, Carpenter BN, Hook JN, Garos S, Manning JC, Gilliland R, et al. Report of findings in a DSM-5 field trial for hypersexual disorder. J Sex Med. 2012;9(11):2868–77.

    Article  PubMed  Google Scholar 

  34. Fedoroff JP. Forensic and diagnostic concerns arising from the proposed DSM-5 criteria for sexual paraphilic disorder. J Am Acad Psychiatry Law. 2011;39:238–41.

    PubMed  Google Scholar 

  35. Shepherd L. Cognitive behavior therapy for sexually addictive behavior. Clin Case Stud. 2010;9(1):18–27.

    Article  Google Scholar 

  36. Klontz BT, Garos S, Klontz PT. The effectiveness of brief multimodal experiential therapy in the treatment of sexual addiction. Sex Addict Compulsivity. 2005;12(4):275–94.

    Article  Google Scholar 

  37. Parsons JT, Kelly BC, Bimbi DS, Muench F, Morgenstern J. Accounting for the social triggers of sexual compulsivity. J Addict Dis. 2007;26(3):5–16.

    Article  PubMed  Google Scholar 

  38. Weiss R. Treating sex addiction. In: Coombs RH, editor. Handbook of addictive disorders: A practical guide to diagnosis and treatment. New York: Wiley; 2004. p. 233–74.

    Google Scholar 

  39. Guigliano J. Out of control sexual behavior: a qualitative investigation. Sex Addict Compulsivity. 2006;13(4):361–75.

    Article  Google Scholar 

  40. Thibaut F, De La Barra F, Gordon H, Cosyns P, Bradford JMW. The world federation of societies of biological psychiatry guidelines for the biological treatment of paraphilias. World J Biol Psychiatry. 2010;11(4):604–55.

    Article  PubMed  Google Scholar 

  41. Fedoroff JP. The paraphilic world. In: Levine SB, editor. Handbook of clinical sexuality for mental health professionals. New York: Brunner/Routledge; 2003.

    Google Scholar 

  42. Murphy L, Bradford J, Fedoroff JP. Treatment of paraphilias and paraphilic disorders. In: Gabbard GO, editors. Gabbard’s treatments of psychiatric disorders. 5th ed. American Psychiatric Association Publishing, Inc.; in press.

  43. Fedoroff JP. Serotonergic drug treatment of deviant sexual interests. Ann Sex Res. 1994;6:105–7.

    Article  Google Scholar 

  44. Fedoroff JP, Peyser C, Franz ML, Folstein SE. Sexual disorders in Huntington’s disease. J Neuropsychiatry Clin Neurosci. 1994;6:147–53.

    CAS  PubMed  Google Scholar 

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Compliance with Ethics Guidelines

Conflict of Interest

J. Paul Fedoroff has received grant support from the University of Ottawa Medical Research Fund and the American Academy of Psychiatry and the Law Institute for Education and Research.

Hannah Stewart declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by any of the authors. With regard to the authors’ research cited in this paper, all procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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Authors and Affiliations

  1. Carleton University, 1125 Carleton University, Ottawa, Ontario, Canada

    Hannah Stewart

  2. Division of Forensic Psychiatry, University of Ottawa, Ottawa, Ontario, Canada

    J. Paul Fedoroff

  3. Forensic Research, Institute of Mental Health Research, Ottawa, Ontario, Canada

    J. Paul Fedoroff

  4. Integrated Forensic Program, The Royal/1145 Carling Avenue, Ottawa, Ontario, Canada, K1Z 7K4

    J. Paul Fedoroff

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  1. Hannah Stewart
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  2. J. Paul Fedoroff
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Correspondence to J. Paul Fedoroff.

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This article is part of the Topical Collection on Integrating the Psychosocial

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Stewart, H., Fedoroff, J.P. Assessment and Treatment of Sexual People with Complaints of Hypersexuality. Curr Sex Health Rep 6, 136–144 (2014). https://doi.org/10.1007/s11930-014-0017-7

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