FRIDAY, Oct. 26 (HealthDay News) -- In recent years, media
reports of celebrities -- usually men -- citing "sex addiction" as
the reason they've been unfaithful have made headlines.
But is what's known to psychologists as "hypersexual disorder" a
real pathology or just a lame excuse for bad behavior?
The issue is a real one, since there's been talk of including
hypersexual disorder in the upcoming revision of the Diagnostic and
Statistical Manual of Mental Disorders (DSM), considered the
"bible" for psychologists and psychiatrists.
Now, a team of experts has formulated criteria that could help
therapists correctly identify the disorder, with an eye to
To test the criteria, the researchers interviewed and conducted
psychological testing on 207 patients treated at several U.S.
mental health clinics. All of the participants were seeking help
for out-of-control sexual behavior, a substance abuse disorder or
another psychiatric condition such as depression or anxiety.
Applying their proposed criteria to the data they gathered from
the participants, the researchers said the criteria accurately
spotted 93 percent of people with hypersexual disorder.
According to one of the researchers, the critical issue is
whether the out-of-control sexual behavior is interfering with a
person's life and they feel powerless to change it.
"It's about having sex that's causing problems, out of control, risking infection," said guidelines co-author Rory Reid, an assistant professor of psychiatry at the University of California, Los Angeles. "It's usually the consequences [of the hypersexual behavior] that bring people through the door."
Reid added that he believes the lay term "sex addiction" is a
misnomer. "I wouldn't call it sex addiction because we're lacking
information about whether it is indeed a compulsion," he
To meet the criteria for hypersexual disorder, the behavior must
be causing harm. "If a patient is engaging in a particular sexual
behavior and it's not hurting them or others, it's not a problem,"
So what do they mean by "causing harm"? For one particularly
disturbing example, Reid described one patient, an air cargo pilot,
who engaged in auto-erotic asphyxiation about once a month ---
masturbating at high altitude to the point of passing out.
The study findings, published in the October issue of the
Journal of Sexual Medicine, support a set of criteria that
show what should be considered a hypersexual disorder.
The criteria include:
Certain things that would rule out a diagnosis of hypersexual
disorder would include drug abuse (the sexual fantasies or
behaviors typically occur while under the influence), underlying
medical conditions, or youth (diagnosis typically isn't made for
anyone under the age of 18).
However, Reid added that the study did find the disorder most
often has its roots in adolescence or early adulthood. The most
common sexual behaviors associated with the problem included
masturbation and excessive use of pornography, sex with a
consenting adult, and cybersex ("virtual" sex conducted online).
Other risk factors included sex with prostitutes, repeated affairs,
or having an average of 15 different sex partners in a year.
The good news is that hypersexual disorder can be treated.
According to Reid, treatment typically includes cognitive
behavioral therapy or experiential therapy to help people process
their emotions and develop coping skills, mindfulness meditation to
help patients increase their tolerance for cravings and 12-step
Still, some may wonder if labeling out-of-control sexual
behavior a pathology is simply turning normal adult behavior into
an illness. But James Maddux, professor emeritus of psychology at
George Mason University in Fairfax, Va., says that in this case,
that's probably not what's happening.
"I'm always skeptical of a new so-called disorder but in this case I think it's probably justified," he said. The key, he said, is that "the research is based on people who actually sought help and are disturbed about it."
Reid said that getting the new criteria into the DSM-5 would
"put everyone on the same page" when it comes to diagnosing these
sexual problems. He added that it would also provide
well-structured criteria on which outcome studies could be
However, Reid doesn't believe the criteria will make it into the
main section of the next edition of the DSM. "They've already made
a decision that if this disorder is included in the DSM-5, it will
not be in the front pages but as an appendix item -- which means
more research is needed. It won't show up as a full-blown
psychiatric dysfunction [in the new edition]," he said.
There's more on sexual health at the
U.S. National Library of Medicine.
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