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Internet Pornography: Addiction or Sexual Dysfunction?
Published in Philipa A Brough, Margaret Denman, Introduction to Psychosexual Medicine, 2019
Since then, the APA has recognised behavioural addiction related to the Internet, specifically the addictive potential of Internet Gaming Disorder (2013 DSM-5). The World Health Organization International Classification of Diseases (ICD-11) published in June 2018 has added Internet Gaming Disorder within the addictions section as anticipated and although it has also extended the sexual dysfunction categories to include C672: Compulsive Sexual behaviour disorder, it has not classified Sexual Addiction as a distinct condition. This has already attracted much comment prior to publication and will no doubt continue to do for the foreseeable future (55,56). Perhaps something to take into account is that particularly in the United States the naming of a condition has significant implications for the medical insurance companies and their obligation to fund therapy and so the cynics would suggest that this may carry some weight. However, they are still using ICD-10 and it is anticipated that they will not move to ICD-11 for many years. For this chapter however I prefer to look at the practicalities rather than become overly distracted by classification.
Effects of testosterone suppression on desire, hypersexuality, and sexual interest in children in men with pedophilic disorder
Published in The World Journal of Biological Psychiatry, 2022
Valdemar Landgren, Pontus Olsson, Peer Briken, Christoffer Rahm
Hypersexuality as defined by Kafka (Kafka 1997, 2010) is characterised by excessive and uncontrollable sexual fantasies, urges, and behaviours. Related terms for the same phenomena are sexual addiction (Carnes 1983) and most recently the ICD-11 diagnosis of Compulsive Sexual Behaviour Disorder (CSBD) (World Health Organization 2019, p. 11). The HBI measures three factors: control, consequences, and coping. The respondent rates whether the behaviour is uncontrollable, negative consequences from sexual behaviour, and whether sex is used to cope with negative emotions (Bőthe et al. 2019). An example item is ‘My sexual behaviour controls my life’ for which participants indicate their answers on a 5-point Likert scale ranging from 1 (= never) to 5 (= very often), yielding a total score of 19–95. A score ≥53 points is considered indicative of hypersexuality (Reid et al. 2011). A systematic review evaluating psychometric adequacy of the six most researched measurements of hypersexual disorder found the HBI to achieve excellent internal consistency (α>.90) and adequate test-retest validity (r > 0.70) together with good content and construct validity (Montgomery-Graham 2017).
Religiosity, Perceived Effects of Pornography Use on Personal Sex Life, and Moral Incongruence: Insights from the German Health and Sexuality Survey (GeSiD)
Published in The Journal of Sex Research, 2022
Aleksandar Štulhofer, Christian Wiessner, Goran Koletić, Laura Pietras, Peer Briken
The results of our study also indicate that MI is an important concept both for clinical assessment, as well as for counseling and therapy. Keeping in mind that we did not address problematic, compulsive, or dysregulated pornography use, possible distress linked to self-evaluation of pornography use and its perceived impact on personal sex life should be clinically approached in a differentiated way. If the experience of distress is mainly caused by an anti-sexual or, more specifically, an anti-pornography moral attitude, compulsive sexual behavior disorder should not be diagnosed. In such cases, sex-positive counseling with the aim of reducing MI should be offered. What is interesting and new about our study is that MI appears to be better predicted by religious upbringing and deeply rooted religious attitudes and beliefs (which may or may not be very explicit) than by current religious practice. Thus, it may make sense to focus on such attitudes in psychotherapy, but not in the context of sexual addiction or dysregulated sexuality interventions. It should also be noted that some therapeutic approaches, either individual- or couple-focused, might even increase MI by reinforcing moralistic, sex-negative attitudes. Instead, a sex-positive approach focused on resolving internalized sociocultural conflicts (Coleman et al., 2018), which utilizes techniques that bring balance between sexual inhibition and excitation and assists in improving the client’s understanding of his/her sexuality, is more promising (Briken, 2020).
Sexual Shame and Emotion Dysregulation: Key Roles in the Association between Internalized Homonegativity and Sexual Compulsivity
Published in The Journal of Sex Research, 2022
Jorge Cienfuegos-Szalay, Raymond L. Moody, Ali Talan, Christian Grov, H. Jonathon Rendina
Increased attempts have been made to understand what factors impact, maintain, or exacerbate sexual compulsivity among sexual minority men (SMM). In prior literature, sexual compulsivity has been broadly operationalized in terms of behavior, including excessive use of pornographic material, excessive masturbation, multiple sexual encounters with anonymous partners, and condomless sexual intercourse (Kafka, 2010; Satinsky et al., 2008). However, for the purpose of this study we defined sexual compulsivity as any sexual behaviors, urges or fantasies that are considered frequent, repetitive, and of an intensity to the point where they are considered hard to control, and consequently interfere with work, personal relationships and other vocational pursuits (Black, 2000; Parsons et al., 2017; Reid et al., 2009). This definition aligns with the previous proposed criteria for Hypersexual Disorder for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5; Kafka, 2010) as well as the International Classification of Diseases 11th Revision’s (ICD-11) definition of Compulsive Sexual Behavior Disorder (World Health Organization [WHO], 2018), with the noted exception that we did not include a time frame for which the individual must be experiencing said urges.