There’s a laundry list of celebrities, like Tiger Woods, Michael Douglas and Kanye West to name a few, that have claimed an addiction to sex in the past several years. This put sex addiction, which is defined as sexual thoughts, urges, or behaviors that appear extreme in frequency, in the pop culture spotlight.
However, with the release of the fifth edition of the Diagnostic and Statistical Manual of Psychiatric Disorders in May 2013, DSM-5 is no longer including sex addiction or hyper-sexual behavior disorder in the manual.
The American Psychiatric Association’s decision to exclude sex addiction in the DSM-5 is raising a lot of eyebrows in the mental healthcare community, especially among therapists who treat patients with out-of-control sexual behaviors. But a sexual desire study done at UCLA is backing up the APA’s decision.
The researchers felt that if sex can be addictive, then the brain’s response to pornography in sex addicts should be similar to an alcoholic’s or drug addict’s brain response when shown their substance of choice. The study found no correlation between high-frequency sexual issues and the brain’s response to sexual images.
“Most people describe high-frequency sexual problems as addiction,” says Dr. Nicole Prause, an assistant research scientists in UCLA’s department of psychiatry. “That’s how the public and even many clinicians talk about it. But this data challenges the addiction model and forces us to reconsider how we think and talk about these problems.”
A Dirty Little Not-So-Secret Controversy
Some psychiatrists, though, are openly expressing disappointment with the APA’s decision to leave hypersexual behavior disorder out of the DSM-5. They argue that leaving the condition out of the manual could lead to a lack of effective treatment for an obvious problem, and that insurance companies will no longer make proper therapy accessible.
Dr. Eli Coleman of the University of Minnesota Medical School challenged the data of the UCLA study. “One of the big problems with the term ‘sex addiction’ is that it immediately assumes you can apply the same methodologies and treatments that you would use for substance addiction,” he said. “There are no sex receptors in the brain to develop tolerance and dependence, as there are with alcohol and drug addiction. It’s really very complex.”
While there is no official diagnosis for sexual addiction, many psychiatrists specializing in this field believe that the presence of any three of the below criteria represent of a compulsive sexual problem.
What are the Criteria for a Sexual Problem or Sex Addiction?
- Regularly craving and being preoccupied with sex
- Wanting to cut down on sexual activity and being unsuccessful
- Unintentionally engaging in more sex and with more partners
- Neglecting obligations, such as work, family or school in pursuit of sex
- Considerable time spent in activities related to sex, such as cruising for partners or visiting pornographic websites
- Continually engaging in sexual behaviors despite negative consequences, like potential health risks or the loss of important relationships
- Feeling irritable when unable to engage in sexual behavior
- An escalation in frequency and scope of sexual behavior in order to achieve a desired feeling or effect, such as more visits to prostitutes
Because there have been so few studies on hypersexual behavior disorder, there are very few statistics on the matter. One estimate claims that 3 to 5 percent of the population in the United States suffers from a sexual compulsion disorder. This number is based on the number of people seeking treatment for the condition.
The controversy about whether sex addiction is a mental health disorder will definitely continue. Those truly suffering from any compulsive behaviors, though, should not feel shame or the need to hide in the shadows and not seek proper treatment.