Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed “hypersexual disorder,” “sexual addiction,” “porn addiction,” “sexual compulsivity,” and “out-of-control sexual behavior.”
Objectives
To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them.
Methods
A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues.
Results
CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent “unhealthy” sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed.
Conclusions
Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related “out-of-control sexual behaviors” on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine–informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Sexual Medicine Reviews |
| Vol/bind | 12 |
| Udgave nummer | 3 |
| Sider (fra-til) | 355-370 |
| Antal sider | 16 |
| ISSN | 2050-0513 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:
J.G.P. is chair of the ISSM Subcommittee on Compulsive Sexual Behavior Disorder and Hypersexuality. The views expressed in this article are those of the authors and do not represent the official policies or positions of the World Health Organization. Research from J.G.P.\u2019s laboratory was supported in part by the Canadian Institutes of Health Research (project grant 162264) and by the Grantov\u00E1 agentura \u010Cesk\u00E9 republiky (GA23-06662S). M.L.-S. was supported by the Centre of Postgraduate Medical Education statutory research funding (project 501-1-065-38-22) and receives funding for noncommercial research on pharmacologic interventions in compulsive sexual behavior disorder from the Polish Medical Research Agency (grant 2022/ABM/03/00039). B.B. was supported by a postdoctoral fellowship from the SCOUP Team\u2013Sexuality and Couples\u2013Fonds de recherche du Qu\u00E9bec, Soci\u00E9t\u00E9 et Culture, and by the Banting Postdoctoral Fellowship from the Social Sciences and Humanities Research Council of Canada. S.W.K. has been supported by grants from the International Center for Responsible Gaming, MGM Resorts International, Center for the Application of Substance Abuse Technologies (University of Nevada, Reno), Massachusetts General Hospital, and Kindbridge Research Institute (GR15685).
Funding Information:
Research from J.G.P.\u2019s laboratory was supported in part by the Canadian Institutes of Health Research (project grant 162264) and by the Grantov\u00E1 agentura \u010Cesk\u00E9 republiky (GA23-06662S). M.L.-S. was supported by the Centre of Postgraduate Medical Education statutory research funding (project 501-1-065-38-22) and receives funding for noncommercial research on pharmacologic interventions in compulsive sexual behavior disorder from the Polish Medical Research Agency (grant 2022/ABM/03/00039). B.B. was supported by a postdoctoral fellowship from the SCOUP Team\u2013Sexuality and Couples\u2013Fonds de recherche du Qu\u00E9bec, Soci\u00E9t\u00E9 et Culture, and by the Banting Postdoctoral Fellowship from the Social Sciences and Humanities Research Council of Canada. S.W.K. has been supported by grants from the International Center for Responsible Gaming, MGM Resorts International, Center for the Application of Substance Abuse Technologies (University of Nevada, Reno), Massachusetts General Hospital, and Kindbridge Research Institute (GR15685).
Publisher Copyright:
© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society of Sexual Medicine.
ID: 398462496