8 Hypersexual Disorder

overview of hypersexual disorder

Sexual addiction, hypersexuality, sexual compulsivity, and sexual impulsivity are all terms that describe a psychological disorder that is characterized by a person’s inability to control his or her sexual behavior. This spectrum of symptoms are often referred to as sexual addiction disorder. Whether excessive sexual behavior should be regarded as an addiction, or a compulsion, or an impulse control disorder is arguable, as each label indicates a specific etiological model and treatment plan (Sahithya & Kashyap, 2022). Sexual addiction disorder has been largely ignored by the clinicians, although it causes significant emotional and behavioral problems among the patients. Fortunately, in the recent years, this disorder is gaining recognition, and attempts have been made to understand it through research. The present article aims to systematically review and summarize the recent understanding and research on phenomenology, clinical characteristics, etiology, assessment, and management of sexual addiction disorder (Sahithya & Kashyap, 2022). Sex addiction, also known as hypersexual disorder, does not have an official diagnostic criterion in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). However, there are proposed criteria that have been widely referenced in clinical settings and researched.

proposed diagnostic criterion

The proposed diagnostic criteria for hypersexual disorder, adapted from various sources, include:

1. Preoccupation with Sexual Activities:
   • Excessive time consumed by sexual fantasies, urges, and behaviors.
   • Recurrent and intense sexual fantasies, urges, and behaviors.
2. Loss of Control:
   • Repeated unsuccessful efforts to control or reduce these sexual fantasies, urges, and behaviors.
3. Adverse Consequences:
   • Engaging in sexual activities in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability).
   • Engaging in sexual activities in response to stressful life events.
   • Continued excessive sexual behaviors despite the risk of physical or emotional harm to oneself or others.
4. Impairment in Daily Life:
   • Significant impairment or distress in personal, social, occupational, or other important areas of functioning due to the preoccupation with sexual activities.
5. Duration:
   • The pattern of sexual fantasies, urges, and behaviors persists for at least six months.

Assessment Tools

Several assessment tools have been developed to help diagnose and understand hypersexual behavior, such as:

• The Sexual Addiction Screening Test (SAST)
• The Hypersexual Behavior Inventory (HBI)
• The Compulsive Sexual Behavior Inventory (CSBI)

critical thinking questions

Considerations

It’s important to note that hypersexual disorder should be diagnosed by a qualified mental health professional. Mislabeling normal variations in sexual behavior as addiction can lead to unnecessary stigma and psychological distress. A thorough assessment should consider cultural, moral, and personal values related to sexuality. Culture differences may impact what is acceptable with sexuality, so a licensed counselor should conduct proper assessments to determine if there is a disorder.

supplemental video

references

Karila L, Wéry A, Weinstein A, Cottencin O, Petit A, Reynaud M, Billieux J. Sexual addiction or hypersexual disorder: different terms for the same problem? A review of the literature. Curr Pharm Des. 2014;20(25):4012-20. doi: 10.2174/13816128113199990619. PMID: 24001295.

Sahithya BR, Kashyap RS. Sexual Addiction Disorder— A Review With Recent Updates. Journal of Psychosexual Health. 2022;4(2):95-101. doi:10.1177/26318318221081080