Managing hypersexual disorders in brain-injured clients

Zencius, Arnie H.; Wesolowski, Michael D.; Burke, W. H.; Hough, Sigmund

doi:10.3109/02699059009026163

Cited by 60 publications

(16 citation statements)

References 5 publications

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“…The term ''hypersexuality'' has also been utilized to describe acute changes in sexual behavior, usually induced by a neuropsychiatric illness (Blumer, 1970;Huws, Shubsachs, & Taylor, 1991;Jensen, 1989;Krueger & Kaplan, 2000;Tosto, Talarico, Lenzi, & Bruno, 2008;Van Reeth, Dierkins, & Luminet, 1958), brain injury (Epstein, 1973;Miller, Cummings, & McIntyre, 1986;Monga, Monga, Raina, & Hardjasudarma, 1986;Zencius, Wesolowski, Burke, & Hough, 1990), or a medication effect typically induced by dopaminergic agonists (Bilgiç, Gürkan, & Türkoglu, 2007;Boffum, Moser, & Smith, 1988;Uitti, Tanner, & Rajput, 1989;Vogel & Schiffter, 1983). In these circumstances, it is not unusual for disinhibited hypersexual behaviors to be an admixture of normophilic and paraphilic-like sexual behaviors (e.g., inappropriate touching and exposing one's genitals but not to strangers).…”

Section: Hypersexual Disorder Associated With Neuropsychiatric Illnesmentioning

confidence: 99%

Hypersexual Disorder: A Proposed Diagnosis for DSM-V

2009

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Hypersexual Disorder is proposed as a new psychiatric disorder for consideration in the Sexual Disorders section for DSM-V. Historical precedents describing hypersexual behaviors as well as the antecedent representations and proposals for inclusion of such a condition in the previous DSM manuals are reviewed. Epidemiological as well as clinical evidence is presented suggesting that non-paraphilic "excesses" of sexual behavior (i.e., hypersexual behaviors and disorders) can be accompanied by both clinically significant personal distress and social and medical morbidity. The research literature describing comorbid Axis I and Axis II psychiatric disorders and a purported relationship between Axis I disorders and Hypersexual Disorder is discussed. Based on an extensive review of the literature, Hypersexual Disorder is conceptualized as primarily a nonparaphilic sexual desire disorder with an impulsivity component. Specific polythetic diagnostic criteria, as well as behavioral specifiers, are proposed, intended to integrate empirically based contributions from various putative pathophysiological perspectives, including dysregulation of sexual arousal and desire, sexual impulsivity, sexual addiction, and sexual compulsivity.

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Section: Hypersexual Disorder Associated With Neuropsychiatric Illnesmentioning

confidence: 99%

Hypersexual Disorder: A Proposed Diagnosis for DSM-V

2009

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“…Almost all respondents agreed that training should focus specifically on dealing with resident sexual expression. Overall, the sample reported generally positive attitudes towards resident sexuality and sexual expression [75].…”

Section: Health Professionals' Perceptions and Responsesmentioning

confidence: 92%

The Complex Nature of Inappropriate Sexual Behaviors in Patients with Dementia: Can We Put it into a Frame?

et al. 2010

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Sexuality constitutes an inseparable aspect of human life, strongly influenced and affected by the social environment. Similarly, it plays a crucial role on how people assess themselves and relate to others. Elderly sexual needs are similar to those of younger people, but may vary in frequency, intensity and expression. Sexual activity may show fluctuations across lifespan, gradually declining with age; however, it is not uncommon for a significant percent of elderly to remain sexually active. As for patients with dementia, there is either an increase or even a decline in sexual desire, which means less sexual activity especially in cases of severe cognitive dysfunction. Often sexuality in patients with dementia may arise as Inappropriate Sexual Behavior (ISB) due to behavioral disinhibition which is a common pattern of the disease. The present review examines sexual function and behavior in patients with dementia considering a number of aspects including but not limited to possible causes and interpretations, its associated anatomy, neurochemistry, pathophysiology and treatment.Keywords Sexuality Á Elderly Á Inappropriate sexual behavior Á Greece Sexuality can be regarded as a core element of human life, influencing and being affected by interpersonal experiences. The way people face their sexuality has been shown to play a

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“…Existing treatment approaches include pharmacotherapy (e.g., [11]), or more commonly, behavioral interventions such as scheduled feedback [12][13][14][15] and differential reinforcement of low rates of behavior [16,17]. Evidence supporting the efficacy of the behavioral interventions, however, has not been conclusive, with only one of the cases reporting extinction of the target ISBs [12].…”

mentioning

confidence: 99%

“…Evidence supporting the efficacy of the behavioral interventions, however, has not been conclusive, with only one of the cases reporting extinction of the target ISBs [12]. Also, methodological shortcomings in the behavioral studies [12][13][14][15][16][17] mean that caution is required in attributing causality to the interventions in achieving the ISB reductions.…”

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confidence: 99%

Remediating Serious Inappropriate Sexual Behavior in a Male with Severe Acquired Brain Injury

Kelly¹,

Simpson

2011

Sex Disabil

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Inappropriate sexual behaviors such as sexual talk, non-genital and genital touching (non-consensual), exhibitionism and coercive sexual behavior are consistently reported sequelae of severe Acquired Brain Injury (ABI). A single-case experimental design was employed to evaluate the relative effectiveness of environmental controls and facilitated access to a sex worker in the management of inappropriate sexual behavior displayed by a male with ABI. Environmental controls comprised behavioral strategies commonly employed to manage disinhibited behavior secondary to ABI such as redirection, cueing appropriate behavior, and verbal feedback. An additional component, facilitated visits to a sex worker, provided a comparison treatment. The introduction of a sex worker contributed to the reduction and eventual extinction of inappropriate behaviors. Improvements were maintained at follow-up probes 1 and 2 years later. The social validity of the intervention is evaluated, and the legal, safety and ethical issues raised by facilitating access to a sex worker are carefully addressed.

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Managing hypersexual disorders in brain-injured clients

Cited by 60 publications

References 5 publications

Hypersexual Disorder: A Proposed Diagnosis for DSM-V

Hypersexual Disorder: A Proposed Diagnosis for DSM-V

The Complex Nature of Inappropriate Sexual Behaviors in Patients with Dementia: Can We Put it into a Frame?

Remediating Serious Inappropriate Sexual Behavior in a Male with Severe Acquired Brain Injury

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