The Serious Reality of Sex Addiction

October 2nd 2015

Phoebe Petersen

Although celebrities including Tiger Woods, Kanye West, and Russell Brand have all claimed to suffer from sex addiction, debate continues as to whether or not sex addiction is a real scientific disorder. It's clear that some people struggle to control their sexual impulses, but the scientific community has yet to come to a consensus about where sex addiction falls.

Is sex addiction an impulse control-disorder, such as compulsive shopping or pyromania, or a more serious substance-related and addictive disorder or something else entirely?

Sex addiction vs. hypersexuality

In recent years, the debate around sex addiction, or hypersexuality, has primarily centered on the nature of the compulsive tendencies, as well the struggle to classify and diagnose it. Researchers are trying to understand sex addiction in part by comparing it to widely researched addictive disorders such as drugs and alcohol. But, it turns out that sex addiction is not so easy to pin down. In two recent studies, researchers found contrasting evidence related to the neurological responses in the brains of self-described sex addicts.

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A 2013 study in the journal of Socioaffective Neuroscience and Psychology did not find a correlation between sex addiction and neural response to sexual images. Instead they found that libido was a better indicator of strong neural responses to sexual images. People with a higher libido responded more actively to sexual images than people with lower libidos, but self-described sex addicts did not exhibit a traditional addiction response to stimuli.

In contrast, a 2014 study conducted at the University of Cambridge found that three areas of the brain, the dorsal anterior cingulate, ventral striatum, and the amygdala were activated more in people with compulsive sexual behavior when presented with sexual images. These areas of the brain, associated with cravings, motivation, and reward, are the same ones activated in the brains of people addicted to drugs. This study suggests that there is a neurological explanation for sex addiction, which would put it in the same category as drugs and alcohol.

This lack of clarity when it comes to sex addiction explains the American Psychiatric Association’s decision to leave sex addiction out of the Diagnostic and Statistical Manual, Fifth Edition (DSM-5), the authoritative manual for psychiatric diagnoses published by the AMA.

The AMA made the decision to leave sex addiction out of the DSM-5 because, in the words of Dr. Rory Reid, the principal investigator of sex addiction for the DSM-5, “I don’t think there is enough evidence to conclude that patterns of hypersexual behavior constitute a bona fide disorder in the scientific realm, but we also don’t have enough evidence to dismiss that possibility.” All evidence suggests, however, that until there is more extensive and conclusive research on the nature of sex addiction, it will continue to be categorized as an unspecified disorder.

Lack of recognition in the DSM-5, however, does not stop people from suffering from sexual compulsions and obsessions—the question is whether or not these symptoms are pathological. “There is no question [these people] are suffering. Their behavior is having a negative impact on multiple levels of function, especially social function,” reported Dr. Valerie Voon, the principal author of the 2014 study, to ABC News. As one might expect, overwhelming sexual urges and obsessions negatively impact people’s relationships as well as their social and professional lives. As a result, there are rehab centers and other treatment options exclusively dedicated to sex addiction to help patients manage their compulsions. The Sexual Recovery Institute, Sex and Love Addicts Anonymous, and the Society for the Advancement of Sexual Health all exist to help people suffering with sexual impulses get the resources they need. 

The Institute for Sexual Health is also working to develop and implement effective treatment for partners of sex addicts, who they claim are often left out of traditional treatment models, and who often suffer trauma from emotional abuse, infidelity, or other negative aspects of their partner’s sexual behavior. 

Without the DSM-5’s stamp of legitimacy, sex addiction remains a non-diagnosable disorder. This makes it more difficult to provide treatment to addicts, their partners, and any other victims. While the AMA is right to not rush to conclusions, it is clear that more research must be done to understand the nature of sex addiction and provide resources to those who are suffering.

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