What should be included in the criteria for compulsive sexual behavior disorder?

Abstract

Compulsive sexual behavior disorder (CSBD) is currently defined in the eleventh revision of the International Classification of Diseases (ICD-11) as an impulse control disorder. Criteria for hypersexual disorder (HD) had been proposed in 2010 for the fifth revision of Diagnostic and Statistical Manual (DSM-5). In this article, we compare differences between HD and CSBD and discuss their relevance.Significant differences between HD and CSBD criteria include: (1) the role of sexual behavior as a maladaptive coping and emotion regulation strategy listed in criteria for HD but not in those for CSBD; (2) different exclusionary criteria including bipolar and substance use disorders in HD but not in CSBD, and (3) inclusion of new considerations in CSBD, such as moral incongruence (as an exclusion criterion), and diminished pleasure from sexual activity. Each of these aspects has clinical and research-related implications. The inclusion of CSBD in the ICD-11 will have a significant impact on clinical practice and research. Researchers should continue to investigate core and related features of CSBD, inlcuding those not included in the current criteria, in order to provide additional insight into the disorder and to help promote clinical advances.

Frequency of use, moral incongruence and religiosity and their relationships with self‐perceived addiction to pornography, internet use, social networking and online gaming

“…2 Based on available evidence, we hypothesized that moral incongruence and religiosity would have a potential role in non-pornography behavioral addictions, although existing studies of these constructs in other behavioral addictions either do not exist or are limited [57,58]. As recently noted [53], a potential role for moral incongruence in other behavioral addictions should be investigated and discussed in light of diagnostic criteria adopted for these disorders (e.g. should distress that is entirely related to moral incongruence for internet or gaming addiction also be considered as a candidate for an exclusion criterion, as it is for CSBD?).…”

“…consider viewing of child sexual abuse imagery, a.k.a, child pornography, which may relate to moral incongruence as well as legal, relational and other problems) [39]. Further, moral incongruence may also relate importantly to other potentially addictive behaviors and disorders [53]. For example, use of illicit drugs may conflict with one's moral beliefs, as might gambling, especially in jurisdictions or cultures where gambling is illegal or considered as an inappropriate behavior.…”

“…The goals of the present article can be summarized in four main points: Because the potential relevance of moral incongruence and religiosity to pornography viewing and CSBD has been considered [16,52], it is important to investigate directly in a preregistered, independent study, originating from a separate laboratory and population of subjects. Based on available evidence, we hypothesized that moral incongruence and religiosity would have a potential role in non‐pornography behavioral addictions, although existing studies of these constructs in other behavioral addictions either do not exist or are limited [57,58]. As recently noted [53], a potential role for moral incongruence in other behavioral addictions should be investigated and discussed in light of diagnostic criteria adopted for these disorders (e.g. should distress that is entirely related to moral incongruence for internet or gaming addiction also be considered as a candidate for an exclusion criterion, as it is for CSBD?…”

Problematic Pornography Use in Japan: A Preliminary Study Among University Students

“…The most predominant behavior reported among men seeking treatment for hypersexuality is pornography consumption (Reid et al, 2012a,b). Thus, although the diagnosis does not explicitly state that the problematic pornography use is a subtype of compulsive sexual behavior disorder (Gola et al, 2020), in line consistent with previous research, problematic pornography use may be considered a prominent behavioral manifestations of compulsive sexual behavior disorder (Brand et al, 2019a). Moreover, the high number of users with impaired control suggests the possibility that a large number of people have tendencies related to problematic pornography use in Japan.…”

“…Given that problematic pornography use is considered a part of compulsive sexual behavior disorder under impulse-control disorders in the International Classification of Diseases 11th Revision (World Health Organization, 2018;Brand et al, 2019a), related research has received considerable attention in recent years (e.g., Kraus et al, 2020). Although not explicitly stated in the diagnosis, other sexual behaviors considered to be compulsive sexual behavior might include masturbation, telephone sex, cybersex, strip clubs, and sexual acts with consenting adults (Kafka, 2010;Gola et al, 2020). These sexual behaviors can be divided into two categories: individual-based, which do not require the involvement of a partner (e.g., masturbation); and partnered-based, which do require the involvement of a partner (e.g., repeated infidelity) (Efrati and Mikulincer, 2018).…”