Compulsive Sexual Behaviour Disorder
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References
- Briken, P. (2020). An integrated model to assess and treat compulsive sexual behaviour disorder. Nature Reviews Urology, 17. https://doi.org/10.1038/s41585-020-0343-7
- Although the word ‘compulsive’ is included in the name because that is a very common way of referring to this phenomenon in the literature, sexual behaviour in CSBD is not considered a true compulsion that occurs in relation to intrusive, unwanted and typically anxiety provoking thoughts (obsessions) as in OCD. Rather, CSBD is a repetitive, typically initially rewarding behaviour pattern that the person feels unable to control, which appears to have both impulsive and compulsive elements [106][1]. Early in the development of the behaviour pattern, impulsivity and positive reinforcement (pleasure) are the most important elements. Later in the course of the disorder, compulsive aspects and negative reinforcement (e.g. temporary improvement of negative mood) are likely to become increasingly important in sustaining the behaviors [107][2]. The most thoroughly investigated theoretical model on the interplay between excitatory and inhibitory influences on sexual behaviour is the dual control model [108][3], according to which CS BD could be a problem when sexual self-control is relatively low and sexual responsiveness/excitability is relatively high [109[4], 110[5]]. Clinically, the lack of self-control is often subjectively experienced as urgency, while sex in CSBD may fulfill a variety of different functions. Treatment therefore focuses on improvement of sexual self-control as well as coping with the underlying emotional states and motives. Briken in Stein, D. J., Szatmari, P., Gaebel, W., Berk, M., Vieta, E., Maj, M., de Vries, Y. A., Roest, A. M., de Jonge, P., Maercker, A., Brewin, C. R., Pike, K. M., Grilo, C. M., Fineberg, N. A., Briken, P., Cohen-Kettenis, P. T., & Reed, G. M. (2020). Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies. BMC Medicine, 18(1), 21. p. 17.
- Available evidence suggests a prevalence of 10–12% for men and 7% for women for sexual compulsivity; however, the new CSBD guidelines are yet to be used in epidemiological studies (e.g. [111–113]). Ibid.
Treatment
- See First- step treatment goals and Second- step therapy goals in Briken, P. (2020). An integrated model to assess and treat compulsive sexual behaviour disorder. Nature Reviews Urology, 17. https://doi.org/10.1038/s41585-020-0343-7
- The treatment goals and the development of a treatment plan vary but should consider the symptoms first and then the existing comorbidities and the under lying hypothesis for the development of the disorder. Thus, dividing the treatment goals and the treatment plan into different steps seems reasonable [38][6]. Ibid.
See also
- Leonhardt, N. D., Busby, D. M., & Willoughby, B. J. (2020). Do You Feel in Control? Sexual Desire, Sexual Passion Expression, and Associations with Perceived Compulsivity to Pornography and Pornography (t sexual drive is associated with higher pornography use, providing some support for Prause et al. hypothesis, namely, sexual drive, rather then addiction, leads to compulsive sexual behavior. )
- Kraus, S. W., Krueger, R. B., Briken, P., First, M. B., Stein, D. J., Kaplan, M. S., Voon, V., Abdo, C. H. N., Grant, J. E., Atalla, E., & Reed, G. M. (2018). Compulsive sexual behaviour disorder in the ICD-11. World Psychiatry, 17(1), 109–110. https://doi.org/https://doi.org/10.1002/wps.20499
- Gola, M., Lewczuk, K., Potenza, M., Kingston, D., Grubbs, J., Stark, R., & Reid, R. (2020). What should be included in the criteria for compulsive sexual behavior disorder? Journal of Behavioral Addictions. https://doi.org/10.1556/2006.2020.00090
- Furthermore, researchers have raised questions about whether models dichotomizing CSB involving the presence or absence of moral incongruence are as distinct as proposed (Brand, Antons, Wegmann, & Potenza, 2019)[7]. Thus, although moral incongruence may have clinical relevance in what motivates individuals to seek treatment for CSB (Kraus & Sweeney, 2019)[8], its role in the etiology of and definition of CSBD warrants additional understanding.
- ↑ Leeman RF, Rowland BHP, Gebru NM, Potenza MN. Relationships among impulsive, addictive and sexual tendencies and behaviours: a systematic review of experimental and prospective studies in humans. Philos Trans R Soc Lond Ser B Biol Sci. 2019;374(1766):20180129. https://doi.org/10.1098/rstb.2018.0129.
- ↑ Briken P, Basdekis-Jozsa R. Sexual addiction? When sexual behavior gets out of control. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2010;53(4):313–8. https://doi.org/10.1007/s00103-010-1033-z.
- ↑ Bancroft J, Vukadinovic Z. Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model. J Sex Res. 2004;41:225–34.
- ↑ Rettenberger M, Klein V, Briken P. The relationship between hypersexual behavior, sexual excitation, sexual inhibition, and personality traits. Arch Sex Behav. 2016;45:219–33.
- ↑ Walton MT, Bhullar N. Hypersexuality, higher rates of intercourse, masturbation, sexual fantasy, and early sexual interest relate to higher sexual excitation/arousal. Arch Sex Behav. 2018;47:2177–83.
- ↑ Briken, P. & Basdekis- Jozsa, R. [Sexual addiction? When sexual behavior gets out of control]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 53, 313–318 (2010).
- ↑ Brand, M., Antons, S., Wegmann, E., & Potenza, M. N. (2019) Theoretical assumptions on pornography problems due to moral incongruence and mechanisms of addictive or compulsive use of pornography: Are the two “conditions” as theoretically distinct as suggested?. Archives of Sexual Behavior, 48(2), 417–423.
- ↑ Kraus, S. W., & Sweeney, P. J. (2019). Hitting the target: Considerations for differential diagnosis when treating individuals for problematic use of pornography. Archives of Sexual Behavior, 48, 431–435.