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Articles and topics related to compulsive sexual behavior.
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Brain Structure and Functional Connectivity Associated With Pornography Consumption

Brain Structure and Functional Connectivity Associated With Pornography Consumption | Sex  Addiction | Scoop.it

"The negative association of self-reported pornography consumption with the right striatum (caudate) volume, left striatum (putamen) activation during cue reactivity, and lower functional connectivity of the right caudate to the left dorsolateral prefrontal cortex could reflect change in neural plasticity as a consequence of an intense stimulation of the reward system, together with a lower top-down modulation of prefrontal cortical areas. Alternatively, it could be a precondition that makes pornography consumption more rewarding."

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Bill Herring LCSW, CSAT's insight:

 Curator comment: Note that although the researchers give support to the idea that frequent pornography consumption could structurally alter reward systems, this is not a longitudinal study, so these brain differences could have been present prior to the porn use.


This study is already making its way into the popular media, as in this article in the Daily Beast titled "Does Porn Cause Brain Shrinkage?"


Source:  JAMA Psychiatry. Published online May 28, 2014. doi:10.1001/jamapsychiatry.2014.93

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Dominique Strauss-Kahn to sue over 'sex addict' film

Dominique Strauss-Kahn to sue over 'sex addict' film | Sex  Addiction | Scoop.it

"Former IMF chief Dominique Strauss-Kahn has instructed lawyers to sue the makers of a movie in which veteran French star Gerard Depardieu plays a sex addict who commits a sexual assault on a hotel maid."


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With No Formal Diagnosis or Treatment Plans, How Can Sex Addiction Exist?

With No Formal Diagnosis or Treatment Plans, How Can Sex Addiction Exist? | Sex  Addiction | Scoop.it

"For the most part, those who believe that sexual addiction (also known as sexual compulsivity and hypersexuality disorder is simply a myth tend to offer some combination of the five challenges presented below. I thought it might be both interesting and useful to examine the validity/reality of these concerns here."

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Bill Herring LCSW, CSAT's insight:

Curator comment:  A useful summation

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Thirteen Dimensions of Sex Addiction-Induced Trauma (SAIT) among Partners and Spouses Impacted by Sex Addiction

Thirteen Dimensions of Sex Addiction-Induced Trauma (SAIT) among Partners and Spouses Impacted by Sex Addiction | Sex  Addiction | Scoop.it

Ego-reality fragmentation then becomes one of the critical injuries of (sex addiction-induced trauma) and from this many......symptoms and trauma-inducing dynamics evolve.  The metaphor of “the foundation of a house fragmenting, slowly or suddenly or both” applies in order to conceptualize ego destruction and damage.

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Bill Herring LCSW, CSAT's insight:

Curator comment:  The author presents a nuanced and comprehensive approach to conceptualizing the levels of damage that can occur to a person who learns that a supposedly monogamous partner has been engaging in a calculated pattern of sexual deception with attendant psychological manipulation

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BK's curator insight, April 24, 9:51 AM

"The induction of fear into the psychological and relational system is one of the specific traumatic symptom processes of discovery trauma.  A discovery does not in any way mean a full awareness of reality or the truth for the partner or spouse.  It means a degree of awareness that there is reality incongruence and the open possibilities of a deceptive, compartmentalized, sexual or relational system, with no ability to confirm the extent or nature.  This can often induce severe panic, terror, and intense fear, horror, or helplessness.  It opens up an entire world of actual possibility, with no reliable source of reality, as it has been systematically denied and withheld from the intimate partner, with intention."

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Selena Gomez believes Justin Bieber is a sex addict

Selena Gomez believes Justin Bieber is a sex addict | Sex  Addiction | Scoop.it


Selena Gomez fears that boyfriend teen idol Justin Bieber is a sex addict and that his womanizing ways will destroy their relationship soon.

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Bill Herring LCSW, CSAT's insight:

Curator comment: The stated commitment of this site is to curate "every conceivable source and perspective" about this wide topic, including how the phrase "sex addiction" is used in popular culture.  That's the reason for this otherwise throwaway entry as well as another in which somebody named Dean McDermott "hints he may be a sex addict".   

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A Sex Addiction Expert Diagnoses Lars Von Trier’s ‘Nymphomaniac’

A Sex Addiction Expert Diagnoses Lars Von Trier’s ‘Nymphomaniac’ | Sex  Addiction | Scoop.it

"What sex addicts want is an oxymoron: controllable intimacy, because they don’t want to allow themselves to be vulnerable in a healthy relationship. Sex addicts also choose intensity when what they really want is intimacy. They confuse the two. With Joe, von Trier has provided all the characteristics of a female sex addict and early trauma survivor—an underdeveloped sense of self, failure to thrive in life, and lack of empathy."

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Bill Herring LCSW, CSAT's insight:

Curator comment: Here's an interesting perspective on this controversial movie, which seems to provide some similar insight for female sex addiction as "Shame" did for did for men a couple of years back.

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The Emperor Has No Clothes: A Fractured Fairytale Posing As A Review

 "Ley et al. imply that concern about porn addiction is somehow proof of moralistic judgments calculated to suppress sexual expression and stigmatize sexual minorities. In fact, as the concept of porn addiction has gained currency, moral concerns about porn use, suppression of sexual expression and stigmatization of sexual minorities all seem to be declining sharply."

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Bill Herring LCSW, CSAT's insight:

Curator comment: This is a hard-hitting, lengthy, point-by-point rebuttal to a recent article that challenged almost every notion that pornography use can reach unhealthy levels for some people who find it difficult to stop or control despite negative consequences and a sincere desire. to do so.  It does not list authorship, which is unusual.  Unfortunately, the demeaning emotional tone it takes is likely to undercut its potent arguments.

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The relationship of “passionate attachment” for pornography with sexual compulsivity, frequency of use, and craving for pornography

The relationship of “passionate attachment” for pornography with sexual compulsivity, frequency of use, and craving for pornography | Sex  Addiction | Scoop.it

"(W)e administered a pornography-specific modification of the Passion Scale and other psychological measures to a sample of undergraduate males who used pornography regularly......As one would expect of a sample of young, non-clinical, regularporn ography users, our participants reported relatively low rates of obsessive passion for pornography indicating that most retained the flexibility to engage or disengage in this specific activity."

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Bill Herring LCSW, CSAT's insight:

Curator comment:  The authors have also recently published their findings related to the development of the Pornography Craving Questionnaire in the Archives of Sexual Behavior.


Available online 24 February 2014.  In Press, Corrected Proof.

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‘High desire’, or ‘merely’ an addiction? A response to Steele et al.

‘High desire’, or ‘merely’ an addiction? A response to Steele et al. | Sex  Addiction | Scoop.it

"To trivialize, minimize, and de-pathologize compulsive sexuality is to fail to understand the central biological role of sexuality in human motivation and evolution. It demonstrates a naiveté with regard to what is now an accepted understanding of current reward neuroscience, in that it pronounces sexual desire as inherent, immutable, and uniquely immune from the possibility of change either qualitatively or quantitatively......

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Bill Herring LCSW, CSAT's insight:

Curator comment: This is Donald Hilton's scathing response to a 2013 article in  Socioaffective Neuroscience and Psychology.  The details may seem arcane to a casual reader but the issues go to the heart of what neuroscience is attempting to discern about just what is meant by "desire" and its relation to the concept of addiction.  Other material referencing the original study can be found on this site by clicking this link.


Published 21 February 2014.

Socioaffective Neuroscience & Psychology 2014, 4: 23833 - http://dx.doi.org/10.3402/snp.v4.23833.  

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Treatment of Sexual Addiction Within the British National Health Service

Treatment of Sexual Addiction Within the British National Health Service | Sex  Addiction | Scoop.it

"This study investigated what treatment services were available within British Mental Health Trusts (MHTs) that are currently provided for those who experience compulsive and/or addictive sexual behaviours within the National Health Service (NHS) system.........Based on the responses provided, only five MHTs reported having had treated sexual addiction as a disorder that took primacy over the past 5 years. There was also some evidence to suggest that the NHS may potentially treat sexual addiction as a secondary disorder that is intrinsic and/or co-morbid to the initial referral......"

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Bill Herring LCSW, CSAT's insight:

International Journal of Mental Health and Addiction.

February 2014


Abstract only.

DOI 10.1007/s11469-014-9485-2

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The Pornography Craving Questionnaire: Psychometric Properties

The Pornography Craving Questionnaire: Psychometric Properties | Sex  Addiction | Scoop.it

"Despite the prevalence of pornography use, and recent conceptualization of problematic use as an addiction, we could find no published scale to measure craving for pornography. Therefore, we conducted three studies employing young male pornography users to develop and evaluate such a questionnaire. This questionnaire could be applied in clinical settings to plan and evaluate therapy for problematic users of pornography and as a research tool to assess the prevalence and contextual triggers of craving among different types of pornography users."

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Bill Herring LCSW, CSAT's insight:

Curator comment: The authors designed the instrument to measure several possible dimensions of craving for pornography: desire,

intention, physiological arousal, and anticipated difficulty restraining
use.


Arch Sex Behav
DOI 10.1007/s10508-013-0229-3


Published online 28 January 2014.

Abstract only.


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Calming the tempest, bridging the gorge: healing in couples ruptured by “sex addiction”

Calming the tempest, bridging the gorge: healing in couples ruptured by “sex addiction” | Sex  Addiction | Scoop.it

"The current paper proposes precise definition and diagnostic language regarding a range of compulsive sexual behaviors. It maps a model for understanding and treating compulsive sexual activity in marital therapy in a stepwise sequence, beginning with careful history taking and diagnostics of both partners, identification of the mutually reinforcing relationship dynamics keeping destructive behaviors in play, processing of underlying psychological and developmental roots of such behaviors, cultivation of empathy and trust, and revitalizing of the couple's sexual relationship."

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Bill Herring LCSW, CSAT's insight:

(2014). Calming the tempest, bridging the gorge: healing in couples ruptured by “sex addiction”. Sexual and Relationship Therapy: Vol. 29, pp. 76-86. doi: 10.1080/14681994.2013.869314


Abstract only.

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Mental Health and Clinical Correlates in Lesbian, Gay, Bisexual, and Queer Young Adults

Mental Health and Clinical Correlates in Lesbian, Gay, Bisexual, and Queer Young Adults | Sex  Addiction | Scoop.it

"LGBQ students were significantly more likely to report histories of affective, substance use, and certain anxiety disorders as well as compulsive sexual behavior....."

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Bill Herring LCSW, CSAT's insight:

Curator comment: One of the authors has previously been referenced on this site for a 2001 case report examining the  use of naltrexone in the treatment of compulsive sexual behavior.  



(2014). Mental Health and Clinical Correlates in Lesbian, Gay, Bisexual, and Queer Young Adults. Journal of American College Health: Vol. 62, No. 1, pp. 75-78. doi: 10.1080/07448481.2013.844697


Abstract only.

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Psychopathological Predictors Characterizing Sexual Compulsivity in a Non-Clinical Sample of Women

Psychopathological Predictors Characterizing Sexual Compulsivity in a Non-Clinical Sample of Women | Sex  Addiction | Scoop.it

"(T)here is missing evidence on the relationship between psychological factors and sexual compulsivity in the absence of significant psychiatric disturbance...... Against this background, this study used a non-pathological frame to explore this relationship......Data suggested that when sexual compulsivity is measured as a continuous construct in a community sample of women, only some factors seem common to those found in severe forms of hypersexuality."

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Bill Herring LCSW, CSAT's insight:

Curator comment: Only the abstract is currently available online, so it's a bit unclear just what the findings are indicating.


Published online 16 May 2014.



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Gender-related differences in the associations between sexual impulsivity and psychiatric disorders

Gender-related differences in the associations between sexual impulsivity and psychiatric disorders | Sex  Addiction | Scoop.it

"The robust associations between sexual impulsivity (SI) and psychopathology across genders suggest the need for screening and interventions related to SI for individuals with psychiatric concerns. The stronger associations between SI and psychopathology among women as compared to men emphasize the importance of a gender-oriented perspective in targeting SI. Longitudinal studies are needed to determine the extent to SI predates, postdates or co-occurs with specific psychiatric conditions."

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Bill Herring LCSW, CSAT's insight:

Curator comment: This is the abstract only, so it's not clear what the authors are defining as "sexual impulsivity".   The NESARC, which appears to be the primary source for the data used for this analysis, can be reviewed at this site.


Published online 5 May 2014.

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Understanding service users’ and therapists’ experiences of pharmacological treatment for sexual preoccupation and/or hypersexuality in incarcerated sex offenders

Understanding service users’ and therapists’ experiences of pharmacological treatment for sexual preoccupation and/or hypersexuality in incarcerated sex offenders | Sex  Addiction | Scoop.it

"This research comprises two qualitative studies understanding the experiences of (1) convicted sex offenders voluntarily receiving pharmacological treatment to reduce sexual preoccupation and (2) therapists working with these offenders. Understanding service users’ and therapists’ experiences of pharmacological treatment for sexual preoccupation and/or hypersexuality in incarcerated sex offenders."

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Bill Herring LCSW, CSAT's insight:

Curator comment:  The relationship between sexual offending and sexually addictive/compulsive behavior is murky and contentious.  The two constructs are distinct but often overlapping.  In general the sexual offender research and treatment community is not especially supportive of concept of sex addiction, in large measure out of concern that it mediates against accountability.    The term sexual preoccupation is sometimes used instead, as in this study.  A companion piece was published along with this one, "Preliminary evaluation of the use of pharmacological treatment with convicted sexual offenders experiencing high levels of sexual preoccupation, hypersexuality and/or sexual compulsivity.  Both are available online only in abstract form.

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4 Ways to Tell the Person You’re Dating You’re a Sex Addict

4 Ways to Tell the Person You’re Dating You’re a Sex Addict | Sex  Addiction | Scoop.it

"Dating is a way to weed out who’s right for you and who’s not. The person you’re seeing should be understanding and supportive of you, and even if they don’t respond well right away, if they really like you they’ll come around and be that understanding and supportive person you need. They won’t shame you for your past and guilt you in your present. And if they do, you’ll know they aren’t the person you should be with."

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Bill Herring LCSW, CSAT's insight:

Curator comment: Many people who struggle with their sexual behavior find it difficult to tell this part of their history with another person they are starting to date.  This writer advises an approach that is simple and direct.

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Is This the Golden Age of Sex Addiction Films?

Is This the Golden Age of Sex Addiction Films? | Sex  Addiction | Scoop.it

"The reason why sex-addiction films have been trending as of late has felt a bit cultural: after all, the first generation of kids to grow up with porn just one click away are coming into their own as of late, and that creates a whole new cohort of people who have invented their own definitions of sexuality. And with that new round of kids comes a new round of art that wants to look at and detail the pains and frustrations that come along when people have all the options in the world and end up dealing with the corrosive effects of sex addiction."

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Bill Herring LCSW, CSAT's insight:

Curator comment: This is an interesting, enjoyable and insightful essay

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Compulsive Use of Internet-based Sexually Explicit Media: Adaptation and Validation of the Compulsive Internet Use Scale (CIUS)

Compulsive Use of Internet-based Sexually Explicit Media: Adaptation and Validation of the Compulsive Internet Use Scale (CIUS) | Sex  Addiction | Scoop.it


"This report investigates the psychometric properties of the 14-item Compulsive Internet Use Scale.......adapted to assess the severity of compulsive Internet (sexually explicit media) SEM use........The results offer preliminary evidence for the reliability and validity of using an adapted version of the CIUS to understand compulsive Internet SEM use......"



Bill Herring LCSW, CSAT's insight:

Curator comment:  The study is based on an online survey of 265 men who have sex with men (MSM).  The idea that viewing sexually explicit media may contribute to, rather than be a correlate of, greater numbers of sexual partners, sexual risk-taking, etc. is not without controversy. 

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The Role of Maladaptive Cognitions in Hypersexuality Among Highly Sexually Active Gay and Bisexual Men

The Role of Maladaptive Cognitions in Hypersexuality Among Highly Sexually Active Gay and Bisexual Men | Sex  Addiction | Scoop.it

"(W)e validated a measure of maladaptive cognitions about sex and examined its unique ability to predict hypersexuality…….(M)agnifying the necessity of sex and disqualifying the benefits of sex partially predicted minimized self-efficacy for controlling one’s sexual behavior, all of which predicted problematic hypersexuality……  Results suggest the utility of a cognitive approach for better understanding hypersexuality and the importance of developing treatment approaches that encourage adaptive appraisals regarding the outcomes of sex and one’s ability to control his sexual behavior."

Bill Herring LCSW, CSAT's insight:

Curator comment:The findings of this article raise some valuable questions regarding the nature of cognitions that seem to co-exist with hypersexual behavior among certain populations.  


The authors define maladaptive cognitions as "inaccurate appraisals of the meaning of situations, the consequences of one’s behavior, or one’s ability to exert control over life circumstances or personal behavior."  The three primary maladaptive cognitions explored in this study include

  1. magnifying the necessity of sex, 
  2. disqualifying the benefits of sex, and 
  3. minimizing one’s self-efficacy for controlling sexual thoughts and behaviors.  


The authors suggest that "treatment approaches that induce negative attitudes toward sexuality, fail to highlight the benefits of sex, and encourage the belief that one is not in control of his sexual behavior may unintentionally serve to perpetuate, rather than reduce, hypersexuality." The authors caution treatment providers against perpetuating "self-regulation fallacies" and note "the particularly central role of only perceiving harm, not benefit, from sex". The authors conclude that their findings about the importance of maladaptive cognitions offer "a more complete picture of hypersexuality than previously offered".


This study seems to suggest that many people who present for symptoms of hypersexuality are more capable of self-control than is generally assumed by classic "addiction" models of hypersexuality.  It also suggests the value of highlighting rather than "disqualifying" the positive benefits of sex.  The key disclaimer in all this is the recognition of "the possibility that maladaptive cognitions might follow problematic behavior or that an unmeasured third variable might explain the relationship between cognition and behavior." As is so often the case, the distinction between correlation and causation is of paramount importance.


While only the abstract is readily available online, this article is well worth reading in its entirety.  


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Pachankis, J. E., Rendina, H. J., Ventuneac, A., Grov, C., & Parsons, J. T. (2014). The Role of Maladaptive Cognitions in Hypersexuality Among Highly Sexually Active Gay and Bisexual Men. Archives of sexual behavior, 1-15.


Abstract only.

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Addicted to Brain Scans

Addicted to Brain Scans | Sex  Addiction | Scoop.it

"The debate about the nature of hypersexuality exemplifies a broader cultural confusion about addiction, a concept that has been medicalized to the point that people think it means both less and more than it really does."

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Bill Herring LCSW, CSAT's insight:

Curator comment: Stanton Peele fleshes out a position he originally expressed in a blog post last year in reaction to the  2013 UCLA study that has garnered so much attention in the field since its initial publication. He remains wholly unimpressed by attempts to isolate the nature of addiction via brain scans and continues to advocate for a subjective, experiential definition of addiction.


Source: Reason.com: "Free minds and free markets." March 2014.

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The Emperor Has No Clothes: A Review of the ‘Pornography Addiction’ Model

The Emperor Has No Clothes: A Review of the ‘Pornography Addiction’ Model | Sex  Addiction | Scoop.it

"The theory and research behind ‘pornography addiction’ is hindered by poor experimental designs, limited methodological rigor, and lack of model specification.......Individuals reporting ‘addictive’ use of VSS could be better conceptualized by considering issues such as gender, sexual orientation, libido, desire for sensation, with internal and external conflicts influenced by religiosity and desire discrepancy.......When faced with such complaints, clinicians are encouraged to address behaviors without conjuring addiction labels."

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Bill Herring LCSW, CSAT's insight:

Curator comment:  This site is committed to curating all perspectives about this complex topic, including those that are controversial or critical.  Note that this is a 'review' article, not a research article, which makes it more susceptible to the bias of its authors.  Along with their blanket dismissal of thousands of professionals who utilize various components of addiction theory to help people with out-of-control use of visual sexual stimuli, Ley and Prause never-the-less raise some arguments that require thoughtful discussion.  


Based on the abstract and the accompanying press release from Springer, it appears that the authors enthusiastically praise the positive benefits of pornography.  They seem to only very grudgingly admit that some people "struggle" regulating their use.  The relative reluctance to acknowledge problematic use of pornography, especially by David Ley, is evident, and the contention that unrestricted access to porn actually reduces rates of child molestation is surprising. Prause seems much more willing to acknowledge the legitimacy of the phenomena of dysregulated sexual behavior.  Her article in Socioaffective Neuroscience and Psychology in the summer of 2013 garnered a lot of attention among people interested in this topic. 


It's unclear whether the authors were attempting to be wry by using the phrase "no clothes" in an article about visual sexual stimuli.
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Transgression as Addiction: Religiosity and Moral Disapproval as Predictors of Perceived Addiction to Pornography

Transgression as Addiction: Religiosity and Moral Disapproval as Predictors of Perceived Addiction to Pornography | Sex  Addiction | Scoop.it



"(T)he present study indicated that religiosity and moral disapproval of pornography use were robust predictors of perceived addiction to Internet pornography while being unrelated to actual levels of use among pornography consumers."

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Bill Herring LCSW, CSAT's insight:

Curator comment:  This article supports the idea that some people who perceive themselves to be addicted to pornography are experiencing psychological distress in large part because it conflicts with their religious beliefs.  On the one hand this makes intuitive sense: people who have a strong sense of what they "should" and "shouldn't" do are more likely to be distressed by their behavior than people who don't give a rip. Articles like this are a reminder of the importance of carefully negotiating the addiction narrative with people who perceive themselves to have a problem because of their strong moral convictions around matters of sexuality in the absence of harm to others.


See also the accompanying  press release from Case Western Reserve University concerning this article.


Arch Sex Behav. 2014 Feb 12. [Epub ahead of print]
Abstract only.
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“I’m Married to a Sex Addict… But That’s Okay”

“I’m Married to a Sex Addict… But That’s Okay” | Sex  Addiction | Scoop.it
It made one woman’s marriage stronger, but her route was anything but traditional.

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Bill Herring LCSW, CSAT's insight:

Curator comment:  There are many paths to healing for couples, and the work "codependency", which is used here, divides many of them. 

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BK's curator insight, February 11, 11:39 AM

"Then, four years later, everything shattered. I was at a family party at his parents’ place when I needed to make a call. Rather than hunt for my phone, I grabbed my husband’s—when a text from my best friend flashed up on the screen. It was immediately clear that they were having an affair."

Read more: Sex Addiction - Married to a Sex Addict - Redbook 
Follow us: @redbookmag on Twitter | REDBOOK on Facebook 
Visit us at Redbook.com

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Characteristics of men who have sex with men (MSM) who attend sex parties: results from a national online sample in the USA

Characteristics of men who have sex with men (MSM) who attend sex parties: results from a national online sample in the USA | Sex  Addiction | Scoop.it


 "A significantly higher proportion of (men who have sex with men who attended a sex party in the past year)....... demonstrated sexual compulsivity symptomology (39.2%)......"

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Bill Herring LCSW, CSAT's insight:


Curator comment: They were also more likely to be HIV-positive, to have recently used drugs, and to have had the greatest number of sexual partners and  instances of unprotected anal intercourse.


Sex Transm Infect 2014;90:26-32 doi:10.1136/sextrans-2013-051094


Abstract only

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