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 Sexual intercourse (or coitus or copulation) is a sexual activity typically involving the insertion and thrusting of the penis into the vagina for sexual pleasure or reproduction.Sexual intercourse most commonly means penile–vaginal pene ...

, despite negative consequences. The concept is contentious; neither of the two major mainstream medical categorization systems recognise sex addiction as a real medical condition, instead categorizing such behavior under labels such as

compulsive sexual behavior 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 ...

Concept

Proponents of a diagnostic model for sexual addiction consider it to be one of several sex-related disorders within hypersexual disorder. The term ''sexual dependence'' is also used to refer to people who report being unable to control their

sexual urges Sexual desire is an emotion and motivational state characterized by an interest in sexual objects or activities, or by a drive to seek out sexual objects or to engage in sexual activities. It is an aspect of sexuality, which varies significantly ...

, behaviors, or thoughts. Related or synonymous models of pathological sexual behavior include

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 ...

(nymphomania and satyriasis),

erotomania Erotomania, also known as de Clérambault's Syndrome, named after French psychiatrist Gaëtan Gatian de Clérambault, is listed in the DSM-5 as a subtype of a delusional disorder. It is a relatively uncommon paranoid condition that is character ...

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 ...

, and

paraphilia Paraphilia (previously known as sexual perversion and sexual deviation) is the experience of intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals. It has also been defined as sexual interest in anything ot ...

-related disorders. The concept of sexual addiction is contentious. There is considerable debate among

psychiatrists A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are physicians and evaluate patients to determine whether their sy ...

psychologist A psychologist is a professional who practices psychology and studies mental states, perceptual Perception () is the organization, identification, and interpretation of sensory information in order to represent and understand the pre ...

sexologist Sexology is the scientific study of human sexuality, including human sexual interests, behaviors, and functions. The term ''sexology'' does not generally refer to the non-scientific study of sexuality, such as social criticism. Sexologists a ...

s, and other specialists whether compulsive sexual behavior constitutes an addiction, and therefore its classification and possible diagnosis.

Animal research Animal testing, also known as animal experimentation, animal research, and ''in vivo'' testing, is the use of non-human animals in experiments that seek to control the variables that affect the behavior or biological system under study. This ...

has established that compulsive sexual behavior arises from the same

transcriptional Transcription is the process of copying a segment of DNA into RNA. The segments of DNA transcribed into RNA molecules that can encode proteins are said to produce messenger RNA (mRNA). Other segments of DNA are copied into RNA molecules calle ...

and

epigenetic In biology, epigenetics is the study of stable phenotypic changes (known as ''marks'') that do not involve alterations in the DNA sequence. The Greek prefix '' epi-'' ( "over, outside of, around") in ''epigenetics'' implies features that are ...

mechanisms that mediate

drug addiction Addiction is a neuropsychological disorder characterized by a persistent and intense urge to engage in certain behaviors, one of which is the usage of a drug, despite substantial harm and other negative consequences. Repetitive drug use oft ...

in laboratory animals; however, sexual addiction is not a clinical diagnosis in either the DSM or

ICD The International Classification of Diseases (ICD) is a globally used Diagnosis, diagnostic tool for epidemiology, health management and clinical purposes. The ICD is maintained by the World Health Organization (WHO), which is the directing and c ...

medical classifications of diseases and medical disorders. Some argue that applying such concepts to normal behaviors such as sex can be problematic, and suggest that applying medical models such as addiction to human sexuality can serve to pathologise normal behavior and cause harm. The

ICD-11 The ICD-11 is the eleventh revision of the International Classification of Diseases (ICD). It replaces the ICD-10 as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the World H ...

created a new condition classification, compulsive sexual behavior disorder, to cover "a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour". However, CSBD is not considered to be an addiction, and the

WHO Who or WHO may refer to: * Who (pronoun), an interrogative or relative pronoun * Who?, one of the Five Ws in journalism * World Health Organization Arts and entertainment Fictional characters * Who, a creature in the Dr. Seuss book '' Horton He ...

does not support a diagnosis of sex addiction.

Classification

None of the official diagnostic classification frameworks list "sexual addiction" as a distinct disorder.

DSM

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 invo ...

(APA) publishes and periodically updates 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 langu ...

(DSM), a widely recognized compendium of mental health diagnostics. The version published in 1987 (DSM-III-R), referred to "distress about a pattern of repeated sexual conquests or other forms of nonparaphilic sexual addiction, involving a succession of people who exist only as things to be used." The reference to sexual addiction was subsequently removed. The DSM-IV-TR, published in 2000 (DSM-IV-TR), did not include sexual addiction as a mental disorder.American Psychiatric Association. (2000). ''Diagnostic and Statistical Manual of Mental Disorders'' (fourth edition, text revision). Washington, DC: Author. Some authors suggested that sexual addiction should be re-introduced into the DSM system; however, sexual addiction was rejected 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 Psychiatri ...

, which was published in 2013. Darrel Regier, vice-chair of the DSM-5 task force, said that " though '

' is a proposed new addition... he phenomenonwas not at the point where we were ready to call it an addiction." According to the APA, the proposed diagnosis was not included due to a lack of research into diagnostic criteria for compulsive sexual behavior. DSM-5-TR, published in March 2022, does not recognize a diagnosis of sexual addiction.

ICD

The World Health Organization produces the International Classification of Diseases (ICD), which is not limited to mental disorders. The most recent approved version of that document, ICD-10, includes "excessive sexual drive" as a diagnosis (code F52.7), subdividing it into ''satyriasis'' (for males) and ''nymphomania'' (for females). However, the ICD categorizes these diagnoses as compulsive behaviors or impulse control disorders and not addiction. The most recent version of that document, ICD-11, includes " compulsive sexual behavior disorder" as a diagnosis (code 6C72) – however, it does not use the addiction model.

CCMD

The

Chinese Society of Psychiatry The Chinese Society of Psychiatry (CSP; ) is the largest organization for psychiatrists in China. It publishes the Chinese Classification of Mental Disorders ("CCMD"), first published in 1985. The CSP also publishes clinical practice guidelines; pr ...

produces the

Chinese Classification of Mental Disorders The Chinese Classification of Mental Disorders (CCMD; ), published by the Chinese Society of Psychiatry (CSP), is a clinical guide used in China for the diagnosis of mental disorders. It is on a third version, the CCMD-3, written in Chinese and E ...

(CCMD), which is currently in its third edition the CCMD-3 does not include sexual addiction as a diagnosis.

Other

Some mental health providers have proposed various, but similar, criteria for diagnosing sexual addiction, including Patrick Carnes, Aviel Goodman, and the late Jonathan Marsh. Carnes authored the first clinical book about sex addiction in 1983, based on his own empirical research. His diagnostic model is still largely utilized by the thousands of certified sex addiction therapists (CSATs) trained by the organization he founded. No diagnostic proposal for sex addiction has been adopted into any official medical diagnostic manual, however. During the update of the Diagnostic and Statistical Manual to version 5 (DSM-5), the APA rejected two independent proposals for inclusion. In 2011, the

American Society of Addiction Medicine The American Society of Addiction Medicine (ASAM), founded in 1954, is a professional medical society representing over 6,000 physicians, clinicians and associated professionals in the field of addiction medicine. ASAM is dedicated to increasing ...

(ASAM), the largest medical consensus of physicians dedicated to treating and preventing addiction, redefined addiction as a chronic brain disorder, which for the first time broadened the definition of addiction from substances to include addictive behaviors and reward-seeking, such as gambling and sex.

Borderline personality disorder

The ICD, DSM and CCMD list promiscuity as a prevalent and problematic symptom for

Borderline Personality Disorder Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a personality disorder characterized by a long-term pattern of unstable interpersonal relationships, distorted sense of self, and strong ...

. Individuals with this diagnosis sometimes engage in sexual behaviors that can appear out of control, distressing the individual or attracting negative reactions from others. There is therefore a risk that a person presenting with sex addiction, may in fact have Borderline Personality Disorder. This may lead to inappropriate or incomplete treatment.

Medical reviews and position statements

In November 2016, the American Association of Sexuality Educators, Counselors and Therapists (AASECT), the official body for sex and relationship therapy in the United States, issued a position statement on sex addiction declaring that their organization "does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy." In 2017, three new USA sexual health organizations found no support for the idea that sex or adult films were addictive in their position statement. On 16 November 2017 the

Association for the Treatment of Sexual Abusers The Association for the Treatment and Prevention of Sexual Abuse (ATSA) is an international, multi-disciplinary, non-profit organization with a stated goal of making society safer by preventing sexual abuse. ATSA promotes sound research, evidence- ...

(ATSA) published a position against sending sex offenders to sex addiction treatment facilities. Those centers argued that "illegal" behaviors were symptoms of sex addiction, which ATSA challenged they had no scientific evidence to support. Neuroscientists who are sex researchers state sex is not addictive. Addiction criteria were not met for sexual behaviours: “experimental studies do not support key elements of addiction such as escalation of use, difficulty regulating urges, negative effects, reward deficiency syndrome, withdrawal syndrome with cessation, tolerance, or enhanced late positive potentials.” Аs well as evidence of a key neurobiological feature of addiction is scarce in case of sex.

Yet, despite these advances, research related to sexual addiction remains in its infancy. A lack of theoretical integration, deficits in methodological rigor, a paucity of clinical samples, over reliance on convenience samples (i.e., university students or Mechanical Turk samples), the complete absence of epidemiological studies, widespread inconsistencies in the definitions and measurements of CSB, and a lack of treatment studies all still plague the literature related to sexual addiction. If scientists, researchers, and clinicians in this domain want to bring the field forward and provide evidence-based care to people who report out-of control sexual behaviors, all of the above are needed. (Grubbs et al. 2020)

Diagnosis

ICD-11

The Compulsive Sexual Behavior Disorder is determined by following criteria: *Persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour *The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behaviour is manifested over an extended period of time (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 ICD-11 added pornography to CSBD. CSBD is not an addiction and should not be conflated with sex addiction.

Possible mechanisms

Animal research involving rats that exhibit compulsive sexual behavior has identified that this behavior is mediated through the same molecular mechanisms in the brain that mediate drug addiction. Sexual activity is an intrinsic reward that has been shown to act as a

positive reinforcer In behavioral psychology, reinforcement is a consequence applied that will strengthen an organism's future behavior whenever that behavior is preceded by a specific antecedent stimulus. This strengthening effect may be measured as a higher fre ...

, strongly activate the

reward system The reward system (the mesocorticolimbic circuit) is a group of neural structures responsible for incentive salience (i.e., "wanting"; desire or craving for a reward and motivation), associative learning (primarily positive reinforcement and cla ...

, and induce the accumulation of

ΔFosB Protein fosB, also known as FosB and G0/G1 switch regulatory protein 3 (G0S3), is a protein that in humans is encoded by the FBJ murine osteosarcoma viral oncogene homolog B (''FOSB'') gene. The FOS gene family consists of four members: FOS, F ...

in part of the

striatum The striatum, or corpus striatum (also called the striate nucleus), is a nucleus (a cluster of neurons) in the subcortical basal ganglia of the forebrain. The striatum is a critical component of the motor and reward systems; receives gluta ...

(specifically, the

nucleus accumbens The nucleus accumbens (NAc or NAcc; also known as the accumbens nucleus, or formerly as the ''nucleus accumbens septi'', Latin for "nucleus adjacent to the septum") is a region in the basal forebrain rostral to the preoptic area of the hyp ...

). Chronic and excessive activation of certain pathways within the reward system and the accumulation of ΔFosB in a specific group of neurons within the nucleus accumbens has been directly implicated in the development of the compulsive behavior that characterizes addiction. In humans, a

dopamine dysregulation syndrome Dopamine dysregulation syndrome (DDS) is a dysfunction of the reward system observed in some individuals taking dopaminergic medications for an extended length of time. It typically occurs in people with Parkinson's disease (PD) who have taken d ...

, characterized by drug-induced compulsive engagement in sexual activity or gambling, has also been observed in some individuals taking

dopaminergic Dopaminergic means "related to dopamine" (literally, "working on dopamine"), dopamine being a common neurotransmitter. Dopaminergic substances or actions increase dopamine-related activity in the brain. Dopaminergic brain pathways facilitate do ...

medications. Current experimental models of addiction to natural rewards and drug reward demonstrate common alterations in

gene expression Gene expression is the process by which information from a gene is used in the synthesis of a functional gene product that enables it to produce end products, protein or non-coding RNA, and ultimately affect a phenotype, as the final effect. T ...

in the

mesocorticolimbic projection Dopaminergic pathways (dopamine pathways, dopaminergic projections) in the human brain are involved in both physiological and behavioral processes including movement, cognition, executive functions, reward, motivation, and neuroendocrine control. ...

is the most significant

gene transcription Transcription is the process of copying a segment of DNA into RNA. The segments of DNA transcribed into RNA molecules that can encode proteins are said to produce messenger RNA (mRNA). Other segments of DNA are copied into RNA molecules called ...

factor involved in addiction, since its viral or genetic overexpression in the

necessary and sufficient In logic and mathematics, necessity and sufficiency are terms used to describe a conditional or implicational relationship between two statements. For example, in the conditional statement: "If then ", is necessary for , because the truth o ...

for most of the neural adaptations and plasticity that occur; it has been implicated in addictions to

alcohol Alcohol most commonly refers to: * Alcohol (chemistry), an organic compound in which a hydroxyl group is bound to a carbon atom * Alcohol (drug), an intoxicant found in alcoholic drinks Alcohol may also refer to: Chemicals * Ethanol, one of sev ...

cannabinoid Cannabinoids () are several structural classes of compounds found in the cannabis plant primarily and most animal organisms (although insects lack such receptors) or as synthetic compounds. The most notable cannabinoid is the phytocannabinoid tet ...

cocaine Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Am ...

nicotine Nicotine is a naturally produced alkaloid in the nightshade family of plants (most predominantly in tobacco and '' Duboisia hopwoodii'') and is widely used recreationally as a stimulant and anxiolytic. As a pharmaceutical drug, it is use ...

opioids Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid u ...

phenylcyclidine Phencyclidine or phenylcyclohexyl piperidine (PCP), also known as angel dust among other names, is a dissociative anesthetic mainly used recreationally for its significant mind-altering effects. PCP may cause hallucinations, distorted perception ...

, and

substituted amphetamines Substituted amphetamines are a class of compounds based upon the amphetamine structure; it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with sub ...

. ΔJunD is the transcription factor which directly opposes ΔFosB. Increases in nucleus accumbens ΔJunD expression can reduce or, with a large increase, even block most of the neural alterations seen in chronic drug abuse (i.e., the alterations mediated by ΔFosB). ΔFosB also plays an important role in regulating behavioral responses to natural rewards, such as palatable food, sex, and exercise. Natural rewards, like drugs of abuse, induce ΔFosB in the nucleus accumbens, and chronic acquisition of these rewards can result in a similar pathological addictive state.Table 1
Thus, ΔFosB is also the key transcription factor involved in addictions to natural rewards as well, and sexual addictions in particular, since ΔFosB in the nucleus accumbens is critical for the reinforcing effects of sexual reward. Research on the interaction between natural and drug rewards suggests that psychostimulants and sexual reward possess cross-sensitization effects and act on common biomolecular mechanisms of addiction-related neuroplasticity which are mediated through ΔFosB.

Treatment

Counseling

As of 2017, none of the official regulatory bodies for Psycho-sexual Counseling or Sex and Relationship therapy, have accepted sex addiction as a distinct entity with associated treatment protocols. Indeed, some practitioners regard sex addiction as a potentially harmful diagnosis and draw parallels with gay conversion therapy. As a result, treatment for sex addiction is more often provided by addiction professionals in the counseling field than psychosexual specialists. These counseling professionals typically hold advanced degrees of education including master's degrees or Doctorates in counseling or a related field like psychology. These counselors can also hold certifications like Licensed Professional Counselors (LPC-S) who are required to hold a master's degree or higher level of education. Therapists and Psychologists usually also hold a Master's in a related field of study.

Cognitive behavioral therapy Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...

is a common form of behavioral treatment for addictions and maladaptive behaviors in general. Dialectical behavior therapy has been shown to improve treatment outcomes as well. Certified Sex Addiction Therapists (CSAT) a group of sexual addiction therapists certified by the International Institute for Trauma and Addiction Professionals offer specialized behavioral therapy designed specifically for sexual addiction.Stefanie Carnes. Mending a Shattered Heart: A Guide for Partners of Sex Addicts. Gentle Path Press; Second Edition. (4 October 2011) page 139 Their treatments have yet to be subject to peer-review, so it is unclear if they help or harm patients.

In-person support groups

In-person support groups are available in most of the developed world. None yet have any scientific evidence to show whether or not they are helpful, so attendees do so at their own risk. The groups include: * Sex Addicts Anonymous: For those who want to reduce or eliminate their use of pornography, masturbation, and/or unwanted sexual activity. *

Sex and Love Addicts Anonymous Sex and Love Addicts Anonymous (SLAA) is a twelve-step program for people recovering from sex addiction and love addiction. SLAA was founded in Boston, Massachusetts in 1976, by a member of Alcoholics Anonymous (AA). Though he had been a membe ...

: Similar to the above. *

Sexaholics Anonymous Sexaholics Anonymous (SA) founded in 1979 is one of several twelve-step programs for compulsive sexual behavior based on the original twelve steps of Alcoholics Anonymous. SA takes its place among various twelve-step groups that seek recovery fr ...

: For those who want to eliminate their use of pornography, masturbation, unwanted sexual activity, and/or sex outside of marriage. Has a stricter definition of sexual sobriety than its competitors. * SMART Recovery. In places where none of the above are available, open meetings of

Alcoholics Anonymous Alcoholics Anonymous (AA) is an international mutual aid fellowship of alcoholics dedicated to abstinence-based recovery from alcoholism through its spiritually-inclined Twelve Step program. Following its Twelve Traditions, AA is non-professi ...

Narcotics Anonymous Narcotics Anonymous (NA), founded in 1953, describes itself as a "nonprofit fellowship or society of men and women for whom drugs had become a major problem." Narcotics Anonymous uses a 12-step model developed for people with varied subst ...

may be a second-best option. At open AA and NA meetings, non-alcoholics/non-addicts are welcome to observe but not participate. Support groups may be useful for uninsured or under-insured individuals. (See also: .) They may also be useful as an adjunct to professional treatment. In addition, they may be useful in places where professional practices are full (i.e. not accepting new patients), scarce, or nonexistent, or where these practices have waiting lists. Finally, they may be useful for patients who are reluctant to spend money on professional treatment.

Medications

Antiviral drugs

The term "pre-exposure prophylaxis" (PrEP) generally refers to the use of

antiviral drugs Antiviral drugs are a class of medication used for treating viral infections. Most antivirals target specific viruses, while a broad-spectrum antiviral is effective against a wide range of viruses. Unlike most antibiotics, antiviral drugs do n ...

to help prevent AIDS. PrEP is an optional treatment for people who are HIV-negative, but have a substantial risk of getting an HIV infection. In the US, most insurance plans cover these drugs.

Epidemiology

According to a systematic review from 2014, observed prevalence rates of sexual addiction/hypersexual disorder range from 3% to 6%. Some studies suggest that sex addicts are disproportionately male, at 80%.

History

Sex addiction as a term first emerged in the mid-1970s when various members of

sought to apply the principles of 12-steps toward sexual recovery from serial infidelity and other unmanageable compulsive sex behaviors that were similar to the powerlessness and un-manageability they experienced with alcoholism. Multiple 12-step style self-help groups now exist for people who identify as sex addicts, including Sex Addicts Anonymous,

, and

Sexual Compulsives Anonymous Sexual Compulsives Anonymous (SCA) is a twelve-step program for people who want to stop having compulsive sex. SCA founding is attributed variously to 1982 in New York City and to 1973 in Los Angeles. Although the fellowship originally sought to ...

Society and culture

Controversy

The controversy surrounding sexual addiction is centered around its identification, through a diagnostic model, in a clinical setting. As noted in current medical literature reviews, compulsive sexual behavior has been observed in humans; drug-induced compulsive sexual behavior has also been noted clinically in some individuals taking

drugs. Moreover, some research suggests compulsive engagement in sexual behavior despite negative consequences in animal models. Since current diagnostic models use drug-related concepts as diagnostic criteria for addictions, these are ill-suited for modelling compulsive behaviors in a clinical setting. Consequently, diagnostic classification systems, such as the DSM, do not include sexual addiction as a diagnosis because there is currently "insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders". A systematic review on sexual addiction conducted in 2014 argued that the "lack of empirical evidence on sexual addiction is the result of the disease's complete absence from versions of the Diagnostic and Statistical Manual of Mental Disorders." There have been debates regarding the definition and existence of sexual addictions for decades, as the issue was covered in a 1994 journal article.Francoeur, R. T. (1994). ''Taking sides: Clashing views on controversial issues in human sexuality,'' p. 25. Dushkin Pub. Group. The

Mayo Clinic The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research. It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staf ...

considers sexual addiction a form of

obsessive compulsive disorder Obsession may refer to: Psychology * Celebrity worship syndrome, obsessive addictive disorder to a celebrity's personal and professional life * Fixation (psychology), a persistent attachment to an object or idea * Idée fixe (psychology), a pr ...

and refer to it as "sexual compulsivity" (note that addiction has been defined as a compulsion toward rewarding stimuli, although the ASAM now describe it as "a primary, chronic disease of brain reward, motivation, memory and related circuitry.")). A paper dating back to 1988 and a journal comment letter published in 2006 asserted that sex addiction is itself a myth, a by-product of cultural and other influences. The 1988 paper argued that the condition is instead a way of projecting

social stigma Social stigma is the disapproval of, or discrimination against, an individual or group based on perceived characteristics that serve to distinguish them from other members of a society. Social stigmas are commonly related to culture, gender, ra ...

onto patients. "Love addiction" falls into the same controversial area as well since it refers to a frequent pattern of intimate relationships which can be a by product of cultural norms and commonly accepted morals. In a report from 2003,

Marty Klein Marty Ralph Klein (born 1950) is an American sex therapist, author, educator and public policy analyst. Klein has spent his career supporting the healthy sexual expression of men, women and couples in a wide range of ways. He is critical of cen ...

, stated that "the concept of sex addiction provides an excellent example of a model that is both sex-negative and politically disastrous." Klein singled out a number of features that he considered crucial limitations of the sex addiction model and stated that the diagnostic criteria for sexual addiction are easy to find on the internet. Drawing on the '' Sexual Addiction Screening Test'', he stated that "the sexual addiction diagnostic criteria make problems of nonproblematic experiences, and as a result pathologize a majority of people." It has been argued that the CSBD diagnosis is not based upon sex research.

Popular culture

Sexual addiction has been the main theme in a variety of films including ''

Diary of a Sex Addict ''Diary of a Sex Addict'' is a 2001 drama film directed by Joseph Brutsman and co-written by Anthony Peck, son of Gregory Peck. It premiered at the Venice Film Festival in August 2001. Plot A middle-aged chef in a luxurious restaurant reveals t ...

'', '' I Am a Sex Addict'', '' Black Snake Moan'', '' Confessions of a Porn Addict'', ''

Shame Shame is an unpleasant self-conscious emotion often associated with negative self-evaluation; motivation to quit; and feelings of pain, exposure, distrust, powerlessness, and worthlessness. Definition Shame is a discrete, basic emotion, d ...

'', '' Thanks for Sharing'', ''

Don Jon ''Don Jon'' is a 2013 American romantic comedy-drama film written and directed by Joseph Gordon-Levitt in his feature directorial debut. The film stars Gordon-Levitt, Scarlett Johansson, and Julianne Moore, with Rob Brown, Glenne Headly, Bri ...

'', and '' Choke''.

Concept

Classification

DSM

ICD

CCMD

Other

Borderline personality disorder

Medical reviews and position statements

Diagnosis

ICD-11

Possible mechanisms

Treatment

Counseling

In-person support groups

Medications

Antiviral drugs

Epidemiology

History

Society and culture

Controversy

Popular culture

See also

References

Further reading