Compulsive sexual behaviour disorder (CSBD), also known as hypersexual disorder, is a pattern of behavior involving intense preoccupation with
sexual fantasies
A sexual fantasy or erotic fantasy is a mental image or pattern of thought that stirs a person's sexuality and can create or enhance sexual arousal. A sexual fantasy can be created by the person's imagination or memory, and may be triggered aut ...
and behaviours that cause distress, are inappropriately used to cope with stress, cannot be voluntarily curtailed, and risk or cause harm to oneself or others. This disorder can also cause impairment in social, occupational or other important functions.
CSBD is not a diagnosis found in
ICD-10
ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, ...
or
DSM-5
The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatric ...
. It was proposed in 2010 for inclusion in the
Diagnostic and Statistical Manual of Mental Disorders
The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langua ...
Fifth Edition (DSM-5) of the
American Psychiatric Association
The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 37,000 members are involve ...
(APA), but was ultimately not approved. ICD-11 currently includes a diagnosis for "Compulsive Sexual Behaviour Disorder",
which is categorized under "Impulse Control Disorders".
Diagnosis
ICD-11
ICD-11 includes a diagnosis for "Compulsive Sexual Behaviour Disorder".
"Compulsive Sexual Behaviour Disorder" is defined as a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour.
Symptoms may include repetitive sexual activities becoming a central focus of the person's life to the point of neglecting health and personal care or other interests, activities and responsibilities; numerous unsuccessful efforts to significantly reduce repetitive sexual behaviour; and continued repetitive sexual behaviour despite adverse consequences or deriving little or no satisfaction from it.
Criteria:
#Pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behaviour
#Manifested over an extended period of time (e.g., 6 months or more)
#Causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning (distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours is not sufficient to meet this requirement)
It has been argued that the CSBD diagnosis is not based upon sex research.
DSM-5
DSM-5
The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatric ...
and DSM-5-TR have no such diagnosis.
Different literature descriptions
People with hypersexual disorder experience multiple, unsuccessful attempts to control or diminish the amount of time spent engaging in sexual fantasies, urges, and behaviors. Individuals may engage in sexual behaviors that they experience as compulsive, despite knowledge of adverse medical, legal, and/or interpersonal consequences, and may neglect social and recreational activities and role responsibilities.
For a valid diagnosis of hypersexual disorder to be established, symptoms must persist for a period of at least 6 months and occur independently of
mania
Mania, also known as manic syndrome, is a mental and behavioral disorder defined as a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together wit ...
or a medical condition.
Treatment
Medicines
As of end of 2019, FDA had approved no medicines for it.
Cognitive-behavioural perspective
Some treatment guides suggest shame at the core of CSBD mechanism. The shame is associated with the cognitive schema of self-defectiveness, a feeling of social pain and isolation and functions in two ways. Firstly, chronic shame derived from social stigma or early traumatic experiences augments the soothing function of sexual behaviour. That makes sexual behaviour compulsive. And secondly, that excessive or inappropriate sexual behaviour, as it is considered socially unacceptable, causes extra shame and forms a self-sustaining cycle of CSBD. Therefore, treatment is primarily aimed at shame reduction and social reintegration.
History
Hypersexual disorder was recommended for inclusion in the
DSM-5
The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatric ...
(Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) by the Sexual and Gender Identity Disorders Workgroup (Emerging Measures and Models, Conditions for Further Study). It was ultimately not approved.
The term ''hypersexual disorder'' was reportedly chosen because it did not imply any specific theory for the causes of
hypersexuality
Hypersexuality is extremely frequent or suddenly increased libido. It is controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomania and satyriasis were terms previously used for the c ...
, which remain unknown.
[Kafka, M. P. (2010). Hypersexual Disorder: A proposed diagnosis for DSM-V. ''Archives of Sexual Behavior, 39,'' 377–400.] A proposal to add
sexual addiction
According to proponents of the concept, sexual addiction, also known as sex addiction, is a state characterized by compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences. The con ...
to the DSM system had been previously rejected by the APA, as not enough evidence suggested to them that the condition is analogous to substance addictions, as that name would imply.
Rory Reid, a research psychologist in the Department of Psychiatry at the
University of California Los Angeles
The University of California, Los Angeles (UCLA) is a public land-grant research university in Los Angeles, California. UCLA's academic roots were established in 1881 as a teachers college then known as the southern branch of the California ...
(UCLA), led a team of researchers to investigate the proposed criteria for Hypersexual Disorder. Their findings were published in the ''
Journal of Sexual Medicine
''The Journal of Sexual Medicine'' (''JSM'') is a peer-reviewed medical journal published on behalf of the International Society for Sexual Medicine. Besides the latter society, it is also an official journal for the International Society for t ...
'' where they concluded that the given criteria are valid and the disorder could be reliably diagnosed.
The
DSM-IV-TR
The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langua ...
, published in 2000, includes an entry called "Sexual Disorder—Not Otherwise Specified" (Sexual Disorder NOS), for disorders that are clinically significant but do not have code. The DSM-IV-TR notes that Sexual Disorder NOS would apply to, among other conditions, "distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used".
[American Psychiatric Association. (2000). ''Diagnostic and statistical manual of mental disorders'' (4th ed., text revision). Washington, DC: Author.]
See also
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Compulsive masturbation
Masturbation is the sexual stimulation of one's own genitals for sexual arousal or other sexual pleasure, usually to the point of orgasm. The stimulation may involve hands, fingers, everyday objects, sex toys such as vibrators, or combinatio ...
*
Don Juanism
Don Juanism or Don Juan syndrome is a non-clinical term for the desire, in a man, to have sex with many different female partners.
The name derives from the Don Juan of opera and fiction. The term satyriasis is sometimes used as a synonym for Don J ...
*
Klüver–Bucy syndrome
Klüver–Bucy syndrome is a syndrome resulting from bilateral lesions of the medial temporal lobe (including amygdaloid nucleus). Klüver–Bucy syndrome may present with compulsive eating, hypersexuality, insertion of inappropriate objects in ...
*
Persistent sexual arousal syndrome
Persistent genital arousal disorder (PGAD), previously called persistent sexual arousal syndrome, is spontaneous, persistent, unwanted and uncontrollable genital arousal in the absence of sexual stimulation or sexual desire, and is typically not ...
*
Pornography addiction
Pornography addiction is the controversial application of an addiction model to the use of pornography. Pornography may be part of compulsive sexual behavior with negative consequences to one's physical, mental, social, or financial well-being. Wh ...
*
Sexual obsessions Sexual obsessions are persistent and unrelenting thoughts about sexual activity. In the context of obsessive-compulsive disorder (OCD), these are extremely common, and can become extremely debilitating, making the person ashamed of the symptoms and ...
References
External links
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WikiSaurus:libidinist
{{sex
Sexual dysfunctions
Human sexuality
Sexual health
Sexual addiction