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Elena This term has been used synonymously with others, such as compulsive sexual behaviors, hypersexuality, and excessive sexual desire disorder. Furthermore, debate is ongoing about where this behavioral pattern fits into the American Psychiatric Association s Diagnostic and Statistical Manual DSM-IV , and how it should be classified and conceptualized. Does it merit enough empirical evidence to stand alone as a separate disorder?
Finally, what are the boundaries and limits that distinguish disease patterns, at-risk behaviors, and socially appropriate expression? Compulsive sexual behavior has not yet received extensive attention from researchers and clinicians.
To date, there have been very few formalized studies of compulsive sexual behaviors. Funding agencies, such as the National Institutes of Health NIH , and pharmaceutical companies have not supported research into the etiology and mechanisms of compulsive sexual behavior and, as a result, evidenced-based treatments are limited.
This article will review the terminology, the epidemiology, and the existing treatments that are currently available for compulsive sexual behaviors. In fact, the only place where compulsive sexual behaviors might be included is within the context of sexual disorder, not otherwise specified NOS or as part of a manic episode. Some of the reasons for why there is a lack of formalized criteria include the lack of research as well as an agreed-upon terminology. This is due, in part, to the heterogeneous presentation of compulsive sexual behaviors.
Others will demonstrate elements of an impulse control disorder, namely reporting irresistible urges and impulses, both physically and mentally, to act out sexually without regard to the consequences.
Finally, there are patients who demonstrate sexual obsessions and compulsions to act out sexually in a way that resembles obsessive compulsive disorders. They do so to quell anxiety and to minimize fears of harm. For these patients, the thoughts and urges to act out sexually are ego-dystonic, whereas other types of patients describe ego-syntonic feelings about their sexual behaviors.
One important feature to note is that hypersexuality is not necessarily symbolic or diagnostic of compulsive sexual behaviors. Libido and sexual drive can be seen as similar to other biological drives, such as sleep and appetite. States of hypersexuality induced by substances of abuse, mania, medications Often, it may not be the primary reason for seeking treatment and the symptoms are not revealed unless inquired about. Despite the lack of formalized criteria, there are common clinical features that are typically seen in compulsive sexual behaviors.
One of the fundamental hallmarks of compulsive sexual behavior is continued engagement in sexual activities despite the negative consequences created by these activities.
This is the same phenomenon seen in substance use and impulse control disorders. Psychologically, sexual behaviors serve to escape emotional or physical pain or are a way of dealing with life stressors.
Compulsive sexual behavior can be divided into paraphilic and non-paraphilic subtypes. Paraphilic behaviors refer to behaviors that are considered to be outside of the conventional range of sexual behaviors. These include the eight paraphilias recognized in the DSM-IV: Exhibitionism, voyeurism, pedophilia, sexual masochism, sexual sadism, transvestic fetishism, fetishism, and frotterurism.
A key clinical feature in diagnosing a paraphilic sexual behavior is that it must be distressing and cause significant impairment in one s life, with the exception of pedophilia and fetishism. The onset, clinical course, and male predominance are fairly similar to paraphilic disorders. This has the potential to confuse and cloud clinicians. Thus, asking about both paraphilic and non-paraphilic behaviors is critical in screening.
Identifying a compulsive sexual disorder is a challenge because of its sensitive and personal nature. Unless patients present specifically for treatment of this disorder, they are not likely to discuss it. Even signs of excessive sexual behaviors such as physical injury to the genital area or the presence of sexually transmitted diseases does not necessarily indicate compulsive sexual activity.
Their presence does signal the need to screen for those behaviors but one cannot assume a compulsive sexual disorder exists based on physical examination alone. Medically, patients are at a higher risk for sexually transmitted diseases STDs and for physical injuries due to repetitive sexual practices. Human immunodeficiency virus HIV , Hepatitis B and C, syphilis, and gonorrhea are particularly concerning consequences. Another significant consequence is the loss of time and productivity.
It is not uncommon for patients to spend large amounts of time viewing pornography or cruising also called mongering for sexual gratification. Financial losses can mount quickly, and patients can accumulate several thousands of dollars of debt in a short amount of time.
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The psychological consequences are numerous. Effects on the family and interpersonal relationships can be profound. Compulsive sexual behaviors can establish unhealthy and unrealistic expectations of what a satisfying sexual relationship should be. At the same time, the deception, secrecy, and violations of trust that occur with compulsive sexual behaviors may shatter intimacy and personal connections.
There are no substances of abuse to explain seemingly irrational behaviors. The stigma of not being able to control sexual impulses carries with it a connotation of depravity and moral selfishness. As a result, access to care and seeking care, even when one recognizes that sexual behaviors are out of control, is a decision faced with barriers and limitations.
Epidemiology There have been no national studies documenting the past-year or lifetime prevalence of compulsive sexual behaviors in the general population.
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Regional and local surveys suggest that approximately five percent of the general population may meet criteria for a compulsive sexual disorder using criteria that are similar to substance use disorders. One of the reasons why reliable epidemiological data are lacking is the inconsistency in defining criteria for compulsive sexual behaviors, lack of funding, and the lack of researchers committed to documenting the extent of this problem. Men appear to outnumber women with compulsive sexual behaviors.
Etiology As with impulse control and substance use disorders, no single biological cause has yet been identified to explain the origins and maintenance of compulsive sexual behaviors. Neuroscience research, which would be an excellent approach to understand basic brain differences between those with and without compulsive sexual behaviors, has rarely been applied to this population.
To date though, most of the neuroimaging work has been done with nonclinical populations and has examined the biology of sexual arousal in healthy subjects.
Neurotransmitter studies in compulsive sexual behaviors have focused on the monoamines, namely serotonin, dopamine, and norepinephrine. Normal sexual functioning involves all of these monoamines as evidenced by selective serotonin reuptake inhibitor SSRI -induced sexual dysfunction and the increased sexuality observed among those on stimulants. Beautiful girls with hairy pussy. Blowjob and squirt. Oral sex no condom hiv. Naked amateurs blog. Bally exercise strip.
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