Hypersexuality

Hypersexuality
SpecialtyPsychiatry

Hypersexuality is a proposed medical condition said to cause unwanted or excessive sexual arousal, causing people to engage in or think about sexual activity to a point of distress or impairment. Whether it should be a clinical diagnosis used by mental healthcare professionals is controversial. The terms nymphomania and satyriasis have historically been used to describe this condition in women and men, respectively.

Hypersexuality may be a primary condition, or the symptom of other medical conditions, such as Klüver–Bucy syndrome, post-traumatic stress disorder, bipolar disorder, brain injury, and dementia. Hypersexuality may also be a side effect of medication, such as dopaminergic drugs used to treat Parkinson's disease. Frontal lesions caused by brain injury, strokes, and frontal lobotomy are thought to cause hypersexuality in individuals who have suffered these events. Clinicians have yet to reach a consensus over how best to describe hypersexuality as a primary condition, or the suitability of describing such behaviors and impulses as a separate pathology.

Hypersexual behaviors are viewed by clinicians and therapists as a type of obsessive–compulsive disorder (OCD) or obsessive–compulsive spectrum disorder, an addiction, or an impulse-control disorder. A number of authors do not acknowledge such a pathology, and instead assert that the condition merely reflects a cultural dislike of exceptional sexual behavior.

Consistent with having no consensus over what causes hypersexuality, authors have used many different labels to refer to it, sometimes interchangeably, but often depending on which theory they favor or which specific behavior they have studied or researched; related or obsolete terms include compulsive masturbation, compulsive sexual behavior, cybersex addiction, erotomania, excessive sexual drive, hyperphilia, hypersexual disorder, problematic hypersexuality, sexual addiction, sexual compulsivity, sexual dependency, sexual impulsivity, and paraphilia-related disorder.

Due to the controversy surrounding the diagnosis of hypersexuality, there is no generally accepted definition and measurement for hypersexuality, making it difficult to determine its prevalence. Thus, prevalence can vary depending on how it is defined and measured. Overall, hypersexuality is estimated to affect 2–6% of the population, and may be higher in certain populations, like men, those who have been traumatized, and sex offenders.

Causes

There is little consensus among experts as to the causes of hypersexuality. Some research suggests that some cases can be linked to biochemical or physiological changes that accompany dementia, as dementia can lead to disinhibition. Psychological needs also complicate the biological explanation, which identifies the temporal and frontal lobes of the brain as the areas for regulating libido. Injuries to this part of the brain increase the risk of aggressive behavior and other behavioral problems, including personality changes and sexual behavior, such as hypersexuality or pedophilia. The same symptom can occur after unilateral temporal lobotomy. There are other biological factors that are associated with hypersexuality, such as premenstrual changes, and the exposure to virilizing hormones in childhood or in utero.

Physiology

In research involving the use of antiandrogens to reduce undesirable sexual behavior such as hypersexuality, testosterone has been found to be necessary, but not sufficient, for sexual drive. A lack of physical closeness and forgetfulness of the recent past were proposed as other potential factors (specifically in the context of hypersexual behavior exhibited by people suffering from dementia).

Pathogenic overactivity of the dopaminergic mesolimbic pathway in the brain—forming either psychiatrically, during mania, or pharmacologically, as a side effect of dopamine agonists, specifically D3-preferring agonists—is associated with various addictions and has been shown to result among some in overindulgent, sometimes hypersexual, behavior. HPA axis dysregulation has been associated with hypersexual disorder.

The American Association for Sex Addiction Therapy acknowledges biological factors as contributing causes of sex addiction. Other associated factors include psychological components (which affect mood and motivation as well as psychomotor and cognitive functions), spiritual control, mood disorders, sexual trauma, and sexual anorexia as causes or types of sex addiction.[better source needed]

Multiple studies link hypersexuality and ADHD. Like other related conditions, ADHD is heavily related to dopamine levels and pathways.

As a symptom

Hypersexuality is known to present itself as a symptom in connection to a number of mental and neurological disorders. Some people with borderline personality disorder (sometimes referred to as BPD) can be markedly impulsive, seductive, and extremely sexual. Sexual promiscuity, sexual obsessions, and hypersexuality are very common symptoms for both men and women with BPD. On occasion for some there can be extreme forms of paraphilic drives and desires. "Borderline" patients, due in the opinion of some to the use of splitting, experience love and sexuality in unstable ways.

People with bipolar disorder may often display tremendous swings in sex drive depending on their mood. As defined in the DSM-IV-TR, hypersexuality can be a symptom of hypomania or mania in bipolar disorder or schizoaffective disorder. Pick's disease causes damage to the temporal/frontal lobe of the brain; people with Pick's disease show a range of socially inappropriate behaviors.

Several neurological conditions such as Alzheimer's disease, autism, various types of brain injury, Klüver–Bucy syndrome, Kleine–Levin syndrome, epilepsy and many neurodegenerative diseases can cause hypersexual behavior. Sexually inappropriate behavior has been shown to occur in 7–8% of Alzheimer's patients living at home, at a care facility or in a hospital setting. Hypersexuality has also been reported to result as a side-effect of some medications used to treat Parkinson's disease. Some recreationally used drugs, such as methamphetamine, may also contribute to hypersexual behavior.

A positive link between the severity of dementia and occurrence of hypersexual behavior has also been found. Hypersexuality can be caused by dementia in a number of ways, including disinhibition due to organic disease, misreading of social cues, understimulation, the persistence of learned sexual behavior after other behaviours have been lost, and the side-effects of the drugs used to treat dementia. Other possible causes of dementia-related hypersexuality include an inappropriately expressed psychological need for intimacy and forgetfulness of the recent past. As this illness progresses, increasing hypersexuality has been theorized to sometimes compensate for declining self-esteem and cognitive function.

Symptoms of hypersexuality are also similar to those of sexual addiction in that they embody similar traits. These symptoms include the inability to be intimate (intimacy anorexia), depression and bipolar disorders. The resulting hypersexuality may have an impact in the person's social and occupational domains if the underlying symptoms have a large enough systemic influence.

As a disorder

In 2010, a proposal to add Sexual Addiction to the Diagnostic and Statistical Manual of Mental Disorders (DSM) system failed to get support from the American Psychiatric Association (APA). The DSM does include an entry called Sexual Disorder Not Otherwise Specified (Sexual Disorder NOS) to apply to, among other conditions, "distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used". As of December 2024, the DSM-5-TR does not recognize a diagnosis of sexual addiction.

The International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization (WHO), included two relevant entries. One is "Excessive Sexual Drive" (coded F52.7), which is divided into satyriasis for males and nymphomania for females. The other is "Excessive Masturbation" or "Onanism (excessive)" (coded F98.8).

In 1988, Levine and Troiden questioned whether it makes sense to discuss hypersexuality at all, arguing that labeling sexual urges "extreme" merely stigmatizes people "who do not conform to the norms of their culture or peer group", and that sexual compulsivity was a myth. However, and in contrast to this view, 30 years later in 2018, the ICD-11 created a new classification, compulsive sexual behavior disorder, to cover a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour. It classifies failure to control as an abnormal mental health condition.

Risks

Individuals with hypersexuality are at a higher risk for various negative consequences, such as contracting STIs, committing sexual abuse, damaging relationships, and developing other addictions. 27.5% of affected individuals contracted an STI on at least one occasion as a result of their hypersexual behavior, and 12% of affected individuals engage in excessive, unprotected sex with multiple anonymous partners. Additionally, an overwhelming 89% affected individuals admit to engaging in sexual activities outside of their primary relationship. This can negatively affect one's interpersonal and sexual relationships. In fact, 22.8% of sex addicts have had a relationship end due to their behaviors.

Furthermore, those with hypersexuality are more likely to have had or acquire another addiction. Multiple addictions are also prevalent amongst affected individuals. Common co-occurring disorders and addictions hypersexual individuals include eating disorders, compulsive spending, chemical dependency, and uncontrollable gambling.

Assessment

Those seeking treatment for hypersexual behavior are a heterogeneous group, thus a thorough assessment is required to evaluate what kinds of behaviors and conditions need to be addressed and treated. It is essential for clinicians to conduct a comprehensive clinical interview with the patient, in which they address the history of their presenting problems, psychological history, sexual history, psychiatric history, mental health history, substance use history, and medical history. Understanding these facets of an individual exhibiting hypersexual behavior is crucial due to the diverse array of comorbid conditions potentially linked to hypersexuality. The presence of ongoing treatment for any coexisting conditions in the individual can also have an impact on their symptoms and subsequent therapeutic interventions. Supplemental information from a spouse or family member could also be used during assessments.

In addition to this, various questionnaires and instruments may be used to further assess various aspects of an individual's behaviors and symptoms. Some common questionnaires that are used in assessments are the Sexual Inhibition/Sexual Excitation Scale, Intensity of Sexual Desire and Symptoms Scale, Compulsive Sexual Behavior Inventory, Sexual Compulsivity Scale, and the Sexual Addiction Screening Test amongst others. Different instruments can also be used in assessments, including but not limited to the Clinical Global Impression Scale, Timeline Followback, Minnesota Multiphase Personality Inventory II, and the Millon Inventory.

Treatment

The first step to treat hypersexual behavior is to help the individual stop or control their urges. There are a multitude of different treatment options for those experiencing hypersexual behaviors, and many clinicians recommend a multifaceted approach. Treatment plans are created after assessing the individual, so treatment methods can vary depending on an individual's history, current symptoms, and any comorbid conditions they may have. Common treatment methods include cognitive-behavioral therapy, relapse-prevention therapy, psychodynamic psychosocial therapy, and psychopharmacological treatment, which can be implemented through individual therapy, couple's therapy, and/or group therapy.

The concept of hypersexuality as an addiction was started in the 1970s by former members of Alcoholics Anonymous who felt they experienced a similar lack of control and compulsivity with sexual behaviors as with alcohol. Multiple 12-step style self-help groups now exist for people who identify as sex addicts, including Sex Addicts Anonymous, Sexaholics Anonymous, Sex and Love Addicts Anonymous, and Sexual Compulsives Anonymous. Some hypersexual men may treat their condition with the usage of medication (such as cyproterone acetate) or consuming foods considered to be anaphrodisiacs. Other hypersexuals may choose a route of consultation, such as psychotherapy, self-help groups or counselling.

Terminology

Sexologists have been using the term hypersexuality since the late 1800s, when Krafft-Ebing described several cases of extreme sexual behaviors in his seminal 1886 book, Psychopathia Sexualis. The author used the term hypersexuality to describe conditions that would now be termed premature ejaculation. Terms to describe males with the condition include donjuanist, satyromaniac, satyriac and satyriasist, for women clitoromaniac, nympho and nymphomaniac, for teleiophilic (attracted to adults) heterosexual women andromaniac, while hypersexualist, sexaholic, onanist, hyperphiliac and erotomaniac are gender-neutral terms.

Other, mostly historical, names are the Messalina complex, sexaholism, hyperlibido and furor uterinus. John Wilmot, 2nd Earl of Rochester, described hypersexuality in some of his literature.

See also

References

  1. 1 2 "hypersexuality"., according to the website of Psychology Today, 2021.
  2. ↑ van Tuijl, Piet; Tamminga, Aerjen; Meerkerk, Gert-Jan; Verboon, Peter; Leontjevas, Ruslan; van Lankveld, Jacques (21 September 2020). "Three Diagnoses for Problematic Hypersexuality; Which Criteria Predict Help-Seeking Behavior?". International Journal of Environmental Research and Public Health. 17 (18): 6907. Bibcode:2020IJERP..17.6907V. doi:10.3390/ijerph17186907. PMC 7559359. PMID 32967307.
  3. 1 2 3 4 5 Kaplan, Meg S.; Krueger, Richard B. (24 March 2010). "Diagnosis, Assessment, and Treatment of Hypersexuality". The Journal of Sex Research. 47 (2–3): 181–198. doi:10.1080/00224491003592863. PMID 20358460.
  4. ↑ Nakum, Shivanee; Cavanna, Andrea E. (April 2016). "The prevalence and clinical characteristics of hypersexuality in patients with Parkinson's disease following dopaminergic therapy: A systematic literature review". Parkinsonism & Related Disorders. 25: 10–16. doi:10.1016/j.parkreldis.2016.02.017. PMID 26923525.
  5. ↑ Stein, Dan J. (December 2008). "Classifying Hypersexual Disorders: Compulsive, Impulsive, and Addictive Models". Psychiatric Clinics of North America. 31 (4): 587–591. doi:10.1016/j.psc.2008.06.007. PMID 18996299.
  6. ↑ Bancroft, John; Vukadinovic, Zoran (August 2004). "Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model". The Journal of Sex Research. 41 (3): 225–234. doi:10.1080/00224490409552230. PMID 15497051.
  7. ↑ Coleman, E. (July 1986). "Sexual Compulsion vs. Sexual Addiction: The Debate Continues" (PDF). SIECUS Report. 14 (6): 7–11. Retrieved 2012-10-15.
  8. ↑ Orford, Jim (1985). Excessive Appetites: A Psychological View of Addictions. Wiley. ISBN 978-0-471-10301-1.[page needed]
  9. ↑ Douglas, Weiss (1998). The Final Freedom: Pioneering Sexual Addiction Recovery. Fort Worth, Tex.: Discovery Press. pp. 13–14. ISBN 978-1-881292-37-1. OCLC 38983487.[page needed]
  10. ↑ Carnes, Patrick (1983). Out of the Shadows: Understanding Sexual Addiction. CompCare Publications. ISBN 978-0-89638-086-8.[page needed]
  11. ↑ Levine, Stephen B. (30 April 2010). "What is Sexual Addiction?". Journal of Sex & Marital Therapy. 36 (3): 261–275. doi:10.1080/00926231003719681. PMID 20432125.
  12. 1 2 3 Levine, Martin P.; Troiden, Richard R. (August 1988). "The myth of sexual compulsivity". Journal of Sex Research. 25 (3): 347–363. doi:10.1080/00224498809551467. JSTOR 3812739.
  13. 1 2 Rinehart, Nicole J.; McCabe, Marita P. (February 1997). "Hypersexuality: Psychopathology or normal variant of sexuality?". Sexual and Marital Therapy. 12 (1): 45–60. doi:10.1080/02674659708408201.
  14. 1 2 Kafka, Martin P. (April 2010). "Hypersexual Disorder: A Proposed Diagnosis for DSM-V". Archives of Sexual Behavior. 39 (2): 377–400. doi:10.1007/s10508-009-9574-7. PMID 19937105.
  15. ↑ Quadland, Michael C. (1985). "Compulsive Sexual Behavior: Definition of a Problem and an Approach to Treatment". Journal of Sex & Marital Therapy. 11 (2): 121–132. doi:10.1080/00926238508406078. PMID 4009729.
  16. ↑ Coleman, E. (1990). "The obsessive–compulsive model for describing compulsive sexual behavior" (PDF). American Journal of Preventive Psychiatry & Neurology. 2: 9–14. Archived from the original (PDF) on 2019-01-08. Retrieved 2019-01-08.
  17. ↑ "ICD-10 entry for "Excessive sexual drive"". Apps.who.int. Retrieved 2012-06-22.
  18. ↑ Money, John (1980). Love and Love Sickness. Johns Hopkins University Press. ISBN 978-0-8018-2317-6.[page needed]
  19. ↑ Krueger, Richard B.; Kaplan, Meg S. (2001). "The Paraphilic and Hypersexual Disorders: An Overview". Journal of Psychiatric Practice. 7 (6): 391–403. doi:10.1097/00131746-200111000-00005. PMID 15990552.
  20. ↑ Kingston, Drew A.; Firestone, Philip (21 November 2008). "Problematic Hypersexuality: A Review of Conceptualization and Diagnosis". Sexual Addiction & Compulsivity. 15 (4): 284–310. doi:10.1080/10720160802289249.
  21. ↑ Dodge, Brian; Reece, Michael; Cole, Sara L.; Sandfort, Theo G. M. (November 2004). "Sexual compulsivity among heterosexual college students". Journal of Sex Research. 41 (4): 343–350. doi:10.1080/00224490409552241. PMC 3331786. PMID 15765274.
  22. ↑ Kafka, M. P. (1995b). "Sexual impulsivity". In Hollander, E.; Stein, D. J. (eds.). Impulsivity and aggression. Chichester, England: John Wiley. pp. 201–228.[ISBN missing]
  23. ↑ Kafka, Martin P. (May 1994). "Paraphilia-Related Disorders—Common, Neglected, and Misunderstood". Harvard Review of Psychiatry. 2 (1): 39–40. doi:10.3109/10673229409017112. PMID 9384878.
  24. ↑ Kafka, M. P. (2000). "The paraphilia-related disorders: Nonparaphilic hypersexuality and sexual compulsivity/addiction". In Leiblum, S. R.; Rosen, R. C. (eds.). Principles and practice of sex therapy (3rd ed.). New York: Guilford Press. pp. 471–503.[ISBN missing]
  25. ↑ Kafka, Martin P. (July 2001). "The Paraphilia-Related Disorders: A Proposal for a Unified Classification of Nonparaphilic Hypersexuality Disorders". Sexual Addiction & Compulsivity. 8 (3–4): 227–239. doi:10.1080/107201601753459937.
  26. ↑ Walton, Michael T.; Cantor, James M.; Bhullar, Navjot; Lykins, Amy D. (November 2017). "Hypersexuality: A Critical Review and Introduction to the 'Sexhavior Cycle'". Archives of Sexual Behavior. 46 (8): 2231–2251. doi:10.1007/s10508-017-0991-8. PMID 28687897.
  27. ↑ Bőthe, Beáta; Bartók, Réka; Tóth-Király, István; Reid, Rory C.; Griffiths, Mark D.; Demetrovics, Zsolt; Orosz, Gábor (November 2018). "Hypersexuality, Gender, and Sexual Orientation: A Large-Scale Psychometric Survey Study". Archives of Sexual Behavior. 47 (8): 2265–2276. doi:10.1007/s10508-018-1201-z. PMID 29926261.
  28. ↑ Cipriani, Gabriele; Ulivi, Martina; Danti, Sabrina; Lucetti, Claudio; Nuti, Angelo (March 2016). "Sexual disinhibition and dementia". Psychogeriatrics. 16 (2): 145–153. doi:10.1111/psyg.12143. PMID 26215977.
  29. 1 2 3 4 Robinson, Karen M. (January 2003). "Understanding Hypersexuality: A Behavioral Disorder of Dementia". Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional. 21 (1): 43–47. doi:10.1097/00004045-200301000-00010. PMID 12544463.
  30. ↑ Devinsky, Julie; Sacks, Oliver; Devinsky, Orrin (19 March 2010). "Klüver–Bucy syndrome, hypersexuality, and the law". Neurocase. 16 (2): 140–145. doi:10.1080/13554790903329182. PMID 19927260.
  31. 1 2 Catalan, Jose; Singh, Ashok (1995). "Hypersexuality revisited". The Journal of Forensic Psychiatry. 6 (2): 255–258. doi:10.1080/09585189508409891.
  32. 1 2 Silverstone, Trevor (May 1985). "Dopamine in manic depressive illness". Journal of Affective Disorders. 8 (3): 225–231. doi:10.1016/0165-0327(85)90020-5. PMID 2862169.
  33. 1 2 "MedlinePlus Drug Information: Pramipexole (Systemic)". United States National Library of Medicine. Archived from the original on 2006-09-26. Retrieved 2006-09-27.
  34. 1 2 Boyd, Alan (March 1995). "Bromocriptine and psychosis: A literature review". Psychiatric Quarterly. 66 (1): 87–95. doi:10.1007/BF02238717. PMID 7701022.
  35. ↑ Arias-Carrión O, Pöppel E (2007). "Dopamine, learning and reward-seeking behavior". Acta Neurobiol Exp. 67 (4): 481–488. doi:10.55782/ane-2007-1664. PMID 18320725.
  36. ↑ Nestler, Eric J (November 2005). "Is there a common molecular pathway for addiction?". Nature Neuroscience. 8 (11): 1445–1449. doi:10.1038/nn1578. PMID 16251986.
  37. ↑ Chatzittofis, Andreas; Arver, Stefan; Öberg, Katarina; Hallberg, Jonas; Nordström, Peter; Jokinen, Jussi (January 2016). "HPA axis dysregulation in men with hypersexual disorder". Psychoneuroendocrinology. 63: 247–253. doi:10.1016/j.psyneuen.2015.10.002. hdl:10616/45066. PMID 26519779.
  38. ↑ "Psychological components". Mobility and transport – European Commission. 2016-10-17. Retrieved 2018-06-18.
  39. ↑ "American Association For Sex Addiction Therapy". aasat.org. Retrieved 2018-06-18.
  40. ↑ Doroldi, Davide; Jannini, Tommaso B.; Tafà, Mimma; Del Casale, Antonio; Ciocca, Giacomo (April 2024). "ADHD and hypersexual behaviors: The role of impulsivity, depressive feelings, hypomaniacal symptoms and psychotic prodromes". Journal of Affective Disorders Reports. 16 100730. doi:10.1016/j.jadr.2024.100730. hdl:11573/1699877.
  41. ↑ Mitchell, Stephen (1995). Freud and Beyond: A History of Modern Psychoanalytic Thought. New York: Basic Books. ISBN 978-0-465-01405-7.
  42. ↑ Flanigan, Robin L. (2021-06-02). "Help for Hypersexuality—When Impulsive Behavior Becomes a Problem". bpHope.com. Retrieved 2024-03-19.
  43. ↑ Kopeykina, Irina; Kim, Hae-Joon; Khatun, Tasnia; Boland, Jennifer; Haeri, Sophia; Cohen, Lisa J.; Galynker, Igor I. (May 2016). "Hypersexuality and couple relationships in bipolar disorder: A review". Journal of Affective Disorders. 195: 1–14. doi:10.1016/j.jad.2016.01.035. PMID 26851616.
  44. ↑ Cummings, J. L. Dementia: A clinical approach (2nd ed.). Boston: Butterworth-Heinemann.[date missing][ISBN missing][page needed]
  45. ↑ Jones, M. C.; Okere, K. (2008). "Treatment of Hypersexual Behavior with Oral Estrogen in an Autistic Male". Southern Medical Journal. 101 (9): 959–960. doi:10.1097/SMJ.0b013e318180b3de. PMID 18708975.
  46. ↑ Dhikav V, Anand K, Aggarwal N (April 2007). "Grossly disinhibited sexual behavior in dementia of Alzheimer's type". Arch Sex Behav. 36 (2): 133–4. doi:10.1007/s10508-006-9144-1. PMID 17308974.
  47. ↑ Miller BL, Cummings JL, McIntyre H, Ebers G, Grode M (August 1986). "Hypersexuality or altered sexual preference following brain injury". J. Neurol. Neurosurg. Psychiatry. 49 (8): 867–73. doi:10.1136/jnnp.49.8.867. PMC 1028946. PMID 3746322.
  48. ↑ National Institute of Neurological Disorders and Stroke. "NINDS Klüver–Bucy Syndrome Information Page". Archived from the original on 2017-01-04. Retrieved 2009-10-10.
  49. ↑ Arnulf I, Zeitzer JM, File J, Farber N, Mignot E (December 2005). "Kleine–Levin syndrome: a systematic review of 186 cases in the literature". Brain. 128 (Pt 12): 2763–76. doi:10.1093/brain/awh620. PMID 16230322.
  50. ↑ Rees, Peter M; Fowler, Clare J; Maas, Cornelis P (February 2007). "Sexual function in men and women with neurological disorders". The Lancet. 369 (9560): 512–525. doi:10.1016/S0140-6736(07)60238-4. PMID 17292771.
  51. ↑ Vogel, H. P.; Schiffter, R. (1983). "Hypersexuality: A complication of dopaminergic therapy in Parkinson's disease". Pharmacopsychiatria. 16 (4): 107–110. doi:10.1055/s-2007-1017459. PMID 6685318.
  52. ↑ Uitti, Ryan J.; Tanner, C. M.; Rajput, A. H.; Goetz, C. G.; Klawans, H. L.; Thiessen, B. (1989). "Hypersexuality with antiparkinsonian therapy". Clinical Neuropharmacology. 12 (5): 375–383. doi:10.1097/00002826-198910000-00002. PMID 2575449.
  53. ↑ Mansergh, G.; Purcell, D. W.; Stall, R.; McFarlane, M.; Semaan, S.; Valentine, J.; Valdiserri, R. (2006). "CDC Consultation on Methamphetamine Use and Sexual Risk Behavior for HIV/STD Infection: Summary and Suggestions". Public Health Reports. 121 (2): 127–132. doi:10.1177/003335490612100205. PMC 1525267. PMID 16528944.
  54. ↑ Burns, Alastair; Jacoby, Robin; Levy, Raymond (July 1990). "Psychiatric Phenomena in Alzheimer's Disease. IV: Disorders of Behaviour". British Journal of Psychiatry. 157 (1): 86–94. doi:10.1192/bjp.157.1.86. PMID 2397368.
  55. ↑ Series, H.; Dégano, P. (2005). "Hypersexuality in dementia". Advances in Psychiatric Treatment. 11 (6): 424. doi:10.1192/apt.11.6.424.
  56. ↑ Douglas., Weiss (1998). The Final Freedom: Pioneering Sexual Addiction Recovery. Fort Worth, Tex.: Discovery Press. pp. 31–34. ISBN 978-1-881292-37-1. OCLC 38983487.
  57. ↑ Douglas., Weiss (1998). The Final Freedom: Pioneering Sexual Addiction Recovery. Fort Worth, Tex.: Discovery Press. pp. 87–88, 92–93. ISBN 978-1-881292-37-1. OCLC 38983487.
  58. ↑ Weiss, Douglas (2007). Sex Addiction: 6 Types and Treatment. Fort Worth, Texas: Discovery Press. p. 33. ISBN 978-1-881292-36-4.
  59. ↑ Rubin, Rita (2010-02-09). "Psychiatry's bible: Autism, binge-eating updates proposed for 'DSM'". USA Today.
  60. ↑ "Black Friday deals for Target, H&M, Forever21, Old Navy, Radio Shack and more". Daily News. New York. 2010-02-10. Archived from the original on July 27, 2011.
  61. ↑ "New Diagnostic Guidelines for Mental Illnesses Proposed". Health.usnews.com. 2010-02-10. Retrieved 2012-06-22.
  62. ↑ Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®. American Psychiatric Association. 2000. doi:10.1176/appi.books.9780890420249.dsm-iv-tr. ISBN 978-0-89042-024-9.[page needed]
  63. ↑ Martinez-Gilliard, Erin (2023). Sex, Social Justice, and Intimacy in Mental Health Practice: Incorporating Sexual Health in Approaches to Wellness. Taylor & Francis. p. unpaginated. ISBN 978-1-000-84578-5. Retrieved 5 March 2023. 'Sex addiction' is also referred to as a diagnosis or presenting problem. Sex addiction is not a diagnosis in the DSM-5-TR and identified as Compulsive Sexual Behavior in the ICD-11 rather than an issue of addiction.
  64. ↑ "2012 ICD-10 Diagnosis Code F52.7: Excessive sexual drive". Retrieved 2013-02-22.
  65. ↑ "2012 ICD-10-CM Diagnosis Code F98.8: Other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence". Icd10data.com. Retrieved 2012-06-22.
  66. ↑ Christensen, Jen. "WHO classifies compulsive sexual behavior as mental health condition". CNN. Retrieved 2018-11-26.
  67. ↑ "ICD-11 - Mortality and Morbidity Statistics". icd.who.int. Retrieved 2018-11-26.
  68. 1 2 3 4 "Sexual Addictions Statistics [2023]: Impacts & Treatments". 2023-02-08. Archived from the original on 29 November 2022. Retrieved 2023-11-30.
  69. ↑ Koós, Mónika; Bőthe, Beáta; Orosz, Gábor; Potenza, Marc N.; Reid, Rory C.; Demetrovics, Zsolt (June 2021). "The negative consequences of hypersexuality: Revisiting the factor structure of the Hypersexual Behavior Consequences Scale and its correlates in a large, non-clinical sample". Addictive Behaviors Reports. 13 100321. doi:10.1016/j.abrep.2020.100321. PMC 7750154. PMID 33364331.
  70. ↑ Elrafei, Heba; Jamali, Qutub (May 2022). "Assessment and treatment of hypersexuality: a review". BJPsych Advances. 28 (3): 198–205. doi:10.1192/bja.2021.68.
  71. ↑ Janssen, Erick; Vorst, Harrie; Finn, Peter; Bancroft, John (1 May 2002). "The sexual inhibition (SIS) and sexual excitation (SES) scales: II. Predicting psychophysiological response patterns". The Journal of Sex Research. 39 (2): 127–132. doi:10.1080/00224490209552131. PMID 12476244.
  72. ↑ Rösler, Ariel; Witztum, Eliezer (1998-02-12). "Treatment of Men with Paraphilia with a Long-Acting Analogue of Gonadotropin-Releasing Hormone". New England Journal of Medicine. 338 (7): 416–422. doi:10.1056/nejm199802123380702. PMID 9459644.
  73. ↑ Coleman, Michael Miner, Fred Ohlerk, Eli (July 2001). "Compulsive Sexual Behavior Inventory: A Preliminary Study of Reliability and Validity". Journal of Sex & Marital Therapy. 27 (4): 325–332. doi:10.1080/009262301317081070. PMID 11441516.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  74. ↑ Marchetti, Igor (2023). "The Structure of Compulsive Sexual Behavior: A Network Analysis Study". Archives of Sexual Behavior. 52 (3): 1271–1284. doi:10.1007/s10508-023-02549-y. PMC 10102046. PMID 36735169.
  75. ↑ Kalichman, Seth C.; Rompa, David (June 2001). "The Sexual Compulsivity Scale: Further Development and Use With HIV-Positive Persons". Journal of Personality Assessment. 76 (3): 379–395. doi:10.1207/s15327752jpa7603_02. PMID 11499453.
  76. ↑ Carnes, Patrick; Green, Bradley; Carnes, Stefanie (2021). "Sexual Addiction Screening Test--Revised Version". PsycTESTS Dataset. doi:10.1037/t75674-000.
  77. ↑ Fletcher, Kenneth E. (November 2008). "Handbook of Psychiatric Measures, 2nd Editionedited by A. John Rush, Jr., M.D., Michael B. First, M.D., and Deborah Blacker, M.D., Sc.D.; Washington, D.C., American Psychiatric Publishing, Inc., 2008, 828 pages, $195, CD-ROM included". Psychiatric Services. 59 (11): 1351. doi:10.1176/ps.2008.59.11.1351.
  78. ↑ Trevin, A.; Carter Sobell, L.; Sobell, M. (November 2012). "PRM124 Translation of the Alcohol Timeline Followback (TLFB) in 4 Languages". Value in Health. 15 (7): A483. doi:10.1016/j.jval.2012.08.1587.
  79. ↑ Butcher, James N.; Dahlstrom, W. Grant; Graham, John R.; Tellegen, Auke; Kaemmer, Beverly (2001). "Minnesota Multiphasic Personality Inventory-2". PsycTESTS Dataset. doi:10.1037/t15120-000.
  80. ↑ "The Millon Clinical Multiaxial Inventory–III (MCMI–III)". Encyclopedia of Psychology and Law. Thousand Oaks California: SAGE Publications. 2008. doi:10.4135/9781412959537.n196. ISBN 978-1-4129-5189-0.
  81. ↑ Goleman, Daniel (October 16, 1984). "Some Sexual Behavior Viewed as an Addiction". New York Times: Cl, C9. Retrieved 2012-10-15.
  82. ↑ "Aphrodisiacs, Fertility and Medicine in Early Modern England by Jennifer Evans (review)". Parergon. 32 (2): 293–294. 2015. doi:10.1353/pgn.2015.0119.
  83. ↑ Griffiths, Mark D.; Dhuffar, Manpreet K. (October 2014). "Treatment of Sexual Addiction Within the British National Health Service". International Journal of Mental Health and Addiction. 12 (5): 561–571. doi:10.1007/s11469-014-9485-2.
  84. ↑ von Krafft-Ebing, R. (1965) [1886]. Psychopathia sexualis: A medico–forensic study (H. E. Wedeck, Trans. ed.). New York: Putnam.
  85. ↑ Sifuentes-Jáuregui, B (2002). Transvestism, Masculinity, and Latin American Literature: Genders Share Flesh. Springer. p. 207. ISBN 978-0-230-10728-1.
  86. ↑ Scruton, Roger (2015). Sexual Desire: A Philosophical Investigation. Bloomsbury. p. 168. ISBN 978-1-4729-2784-2.
  87. ↑ Eghigian, Greg (August 2012). "Hypersexual disorder: an encounter with Don Juan in the archives". Psychiatric Times. 29 (8): 18. Gale A301776602.
  88. ↑ Spooner, Henry (1918). American Journal of Urology and Sexology. p. 565.
  89. ↑ Plummer, Kenneth (2002). "A sociological perspective". Sexualities: Difference and the diversity of sexualities. Taylor & Francis. p. 43. ISBN 978-0-415-21275-5.
  90. ↑ Craigshead, W. Edward; Nemeroff, Charles, eds. (2004). The Concise Corsini Encyclopedia of Psychology and Behavioral Science (3rd ed.). Wiley. p. 630.[ISBN missing]
  91. ↑ Trout, Steven (1997). "Decadence & Modernism". English Literature in Transition. 40 (2): 210–214.
  92. ↑ Gozzi, Jr., Raymond (Spring 1995). "Confessions of a metaphoraholic". ETC.: A Review of General Semantics. 52 (1): 51–55. doi:10.66774/etc_5201_051. Gale A16744693.
  93. ↑ Coleman, Eli (12 June 1991). "Compulsive Sexual Behavior: New concepts and Treatments". Journal of Psychology & Human Sexuality. 4 (2): 37–52. doi:10.1300/J056v04n02_04.
  94. ↑ "Jen Gerson: Feel free to opt for the epidural sans guilt, new moms". 8 April 2016.
  95. ↑ Orford, Jim (March 1978). "Hypersexuality: Implications for a Theory of Dependence". British Journal of Addiction to Alcohol & Other Drugs. 73 (3): 299–310. doi:10.1111/j.1360-0443.1978.tb00157.x. PMID 280354.
  96. ↑ Longo-Disse, Samadhi Carol (January 2006). "Sexaholism: A Perspective". Sexual Addiction & Compulsivity. 13 (1): 69–94. doi:10.1080/10720160500529292.
  97. ↑ Coleman, Eli (1992). "Is Your Patient Suffering from Compulsive Sexual Behavior?". Psychiatric Annals. 22 (6): 320–325. doi:10.3928/0048-5713-19920601-09.
  98. ↑ Groneman, Carol (1994). "Nymphomania: The Historical Construction of Female Sexuality". Signs. 19 (2): 337–367. doi:10.1086/494887. JSTOR 3174802.
  99. ↑ Davies, M.; Owens, W.R. (2018). The Oxford Handbook of John Bunyan. Oxford Handbooks. OUP Oxford. p. 125. ISBN 978-0-19-164944-8. Retrieved 2023-06-18.