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Epidemiology, prevalence, and natural history of compulsive sexual behavior
Research into CSB is hindered by the lack of a generally accepted definition and reliable and valid assessment tools. Despite these limitations, evidence indicates that CSB is relatively common in the general adult population, causes substantial personal distress, and is a source of significant psychosocial disability. CSB appears to begin early in life, to have a male preponderance, and to run a chronic or episodic course. It is also commonly associated with psychiatric comorbidity, typically mood, anxiety, substance use, and personality disorders. Further research is needed to better our understanding of the disorder and improve our ability to develop specific interventions.
CSB is compulsive sexual behavior.
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Treatment of compulsive cybersex behavior
Compulsive cybersex has become a significant problem for many men and women who have fallen prey to the accessibility, affordability, and anonymity of online sexual behaviors. Some patients develop problems with compulsive cybersex due to predisposition or accidental conditioning experiences. Other compulsive users of cybersex present with underlying trauma, depression, or addiction. Three case studies highlighted obsession, compulsion, and consequence in the pathogenesis of compulsive cybersex. While men and women differ somewhat in their use of cybersex, both genders exhibit maladaptive coping, conditioned behavior, dissociative reenactment of life trauma, courtship disorder, intimacy dysfunction, and addictive behavior. Comprehensive treatment of compulsive cybersex would include the following components: relapse prevention, intimacy enhancement, lovemap reconstruction, dissociative states therapy, arousal reconditioning, and coping skills training. Thanks to recent treatment advances in several fields, help is available for those caught in the dark side of the net.
What is a lovemap?
The dark side of the net?
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Sexual behavior that is “out of control”: a theoretical conceptual approach
At this stage of our knowledge, it seems reasonable to assume that out-of-control sexual behavior results from a variety of etiological mechanisms associated with different behavioral patterns that share Goodman’s two key features of addictive behavior:
(1) a recurrent failure to control the sexual behavior; and
(2) continuation of the behavior despite harmful consequences.
Any overriding definition relevant to clinical management seems premature until we better understand the various patterns and their likely determinants. The concepts of “compulsivity” and “addiction” may have explanatory value in some cases, but are not helpful when used as general terms for this class of behavior problem. Stein and colleagues suggested that, in these circumstances, we use the term “hypersexuality.” In my opinion, out-of-control sexual behavior or “impulse control disorders” as proposed by Barth and Kinder are more appropriate nonspecific terms because they focus on the issue of control rather than on high levels of sexuality. A number of clinically relevant and researchable hypotheses need to be addressed in further research, which hopefully will lead to more etiologically or therapeutically relevant subcategories of out-of-control sexual behavior.
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