Should compulsive sexual behavior be considered an addiction?

Abstract

Aims: To review the evidence base for classifying compulsive sexual behavior (CSB) as a non-substance or 'behavioral' addiction.

Methods: Data from multiple domains (e.g. epidemiological, phenomenological, clinical, biological) are reviewed and considered with respect to data from substance and gambling addictions.

Results: Overlapping features exist between CSB and substance use disorders. Common neurotransmitter systems may contribute to CSB and substance use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases. Similar pharmacological and psychotherapeutic treatments may be applicable to CSB and substance addictions, although considerable gaps in knowledge currently exist.

Conclusions: Despite the growing body of research linking compulsive sexual behavior (CSB) to substance addictions, significant gaps in understanding continue to complicate classification of CSB as an addiction.

Keywords: Addiction; behavioral addictions; compulsive sexual behavior; hypersexuality; neurobiology; psychiatric disorder; sexual behavior; sexual compulsivity.

Figure 1

Number of publications in Google Scholar using key terms related to compulsive sexual behavior (CSB) or problem gambling Note. On December 3, 2015, we entered the following key words into Google Scholar: “compulsive sexual behavior” OR “hypersexual disorder” OR “sexual addiction” OR “sexual compulsivity”; for problematic gambling, we entered the following words into Google Scholar: “gambling disorder” OR “pathological gambling” OR “disordered gambling” OR “problem gambling”.