A team of researchers from the University of California-Los Angeles have tested proposed criteria for diagnosing “hypersexual disorder” — more commonly called sexual addiction — as a new mental health condition. The researchers found the new criteria to do a good job in discriminating between those who have sex addiction and those who don’t.
While sexual addiction is often fodder for talk shows and comedians, researchers say it is no laughing matter as relationships are destroyed, jobs are lost, and lives are ruined.
Even with these dire consequences, psychiatrists have been reluctant to accept the idea of out-of-control sexual behavior as a mental health disorder because of the lack of scientific evidence, the researchers said.
Rory Reid, Ph.D., a research psychologist and assistant professor of psychiatry at the Semel Institute of Neuroscience and Human Behavior at UCLA, led a team of psychiatrists, psychologists, social workers, and marriage and family therapists who found the proposed criteria to be reliable and valid in helping mental health professionals accurately diagnose hypersexual disorder.
The results of the study, reported in the Journal of Sexual Medicine, will be a factor in whether hypersexual disorder should be included in the forthcoming revised fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the primary diagnostic reference book for psychiatry, the researchers noted.
“The criteria for hypersexual disorder that have been proposed, and now tested, will allow researchers and clinicians to study, treat and develop prevention strategies for individuals at risk for developing hypersexual behavior,” he said.
The criteria, developed by a DSM-5 sexual and gender identity disorders work group for the revised manual, establish a number of symptoms that must be present in order for the diagnosis to be made.
The symptoms for sex addiction include a recurring pattern of sexual fantasies, urges and behaviors lasting six months or longer that are not caused by other issues, such as substance abuse, another medical condition or manic episodes associated with bipolar disorder.
Also, an individual must show a pattern of sexual activity in response to unpleasant mood states, such as feeling depressed, or a pattern of repeatedly using sex as a way of coping with stress.
The criteria also states that individuals must be unsuccessful in their attempts to reduce or stop sexual activities they believe are problematic.
“As with many other mental health disorders, there must also be evidence of personal distress caused by the sexual behaviors that interfere with relationships, work or other important aspects of life,” Reid said.
To test the criteria, Reid and his colleagues conducted psychological testing and interviews with 207 patients in several mental health clinics around the country. All of the patients were seeking help for out-of-control sexual behavior, a substance-abuse disorder or another psychiatric condition, such as depression or anxiety.
The researchers found that the proposed criteria for hypersexual disorder accurately classified 88 percent of hypersexual patients as having the disorder.
The criteria were also accurate in identifying negative results 93 percent of the time.
In other words, the criteria appear to do a good job of discriminating between patients who experience hypersexual behavior and those who don’t, such as patients seeking help for other mental health conditions like anxiety, depression or substance abuse.
“The results lead us to believe that the proposed criteria tend not to identify patients who don’t have problems with their sexual behavior,” Reid said. “This is a significant finding, since many had expressed concerns that the proposal would falsely classify individuals.”
Another finding of the study was that patients who met the criteria for hypersexual disorder experienced significantly greater consequences for their sexual activities, compared with individuals with a substance-abuse diagnosis or a general medical condition, according to Reid. Of the 207 patients they examined, 17 percent had lost a job at least once, 39 percent had a relationship end, 28 percent contracted a sexually transmitted disease, and 78 percent had interference with healthy sex.
“Our study showed increased hypersexual behavior was related to greater emotional disturbance, impulsivity and an inability to manage stress,” he said.
Another interesting finding, according to Reid, was that 54 percent of the hypersexual patients felt their sexual behavior began to be a problem before the age of 18. Another 30 percent reported that it began to be problematic during their college-aged years, from 18 to 25.
“This appears to be a disorder that emerges in adolescence and young adulthood, which has ramifications for early intervention and prevention strategies,” Reid said.
The study also examined the types of sexual behavior that hypersexual patients reported. The most common included masturbation and excessive use of pornography, followed by sex with another consenting adult and cybersex. The study noted that hypersexual patients had sex with commercial sex workers, had repeated affairs or multiple anonymous partners, amounting to an average of 15 sex partners in the previous 12-month period.
“It’s not that a lot of people don’t take sexual risks from time to time or use sex on occasion to cope with stress or just escape, but for these patients, it’s a constant pattern that escalates until their desire for sex is controlling every aspect of their lives and they feel powerless in their efforts to change,” Reid noted.