National Post (National Edition) - - NEWS - sharon KirKEy

Asig­nif­i­cant pro­por­tion of the pop­u­la­tion is grap­pling with a new and con­tro­ver­sial dis­or­der: com­pul­sive sex­ual be­hav­iour, a new study has found. And it’s not just men, as a sur­pris­ing num­ber of women say they have trou­ble con­trol­ling their sex­ual urges.

Of 2,325 U.S. adults sur­veyed, 10 per cent of men and seven per cent of women met the clin­i­cal cut-off point for “com­pul­sive sex­ual be­hav­iour dis­or­der,” a newly named cat­e­gory of sex­ual pathol­ogy that in­volves a per­sis­tent in­abil­ity to con­trol in­tense, repet­i­tive urges and feel­ings, re­sult­ing in repet­i­tive sex­ual be­hav­iour “that causes marked dis­tress or so­cial im­pair­ment.”

Un­til now, rough es­ti­mates pegged the con­di­tion’s preva­lence at some­where be­tween one and six per cent of the pop­u­la­tion, with men as­sumed to be be­tween two and five times more likely to suf­fer from the dis­or­der than women.

The re­searchers hy­poth­e­sized 20 to 30 per cent of those who met the clin­i­cal cut-off point would be women. But the new study, pub­lished in JAMA Net­work Open, found women ac­counted for 41 per cent of those who qual­i­fied for a CSBD di­ag­no­sis.

The men and women ex­hib­ited the en­tire range of sex­ual symp­toms, from “prob­lem­atic” but non­clin­i­cal out-of-con­trol sex­ual be­hav­iour — mean­ing it doesn’t meet the stan­dard for a for­mal di­ag­no­sis — to a cer­ti­fi­able psy­chi­atric dis­or­der.

But the di­ag­no­sis it­self — of­fi­cially added this year to the World Health Or­ga­ni­za­tion’s In­ter­na­tional Clas­si­fi­ca­tion of Dis­eases — is con­tro­ver­sial.

When do sex­ual urges, feel­ings and be­hav­iours cross the line from nor­mal, to com­pul­sive, a patho­log­i­cal brain dis­or­der? As psy­chol­o­gist David J. Ley wrote this year, the of­fi­cial di­ag­no­sis “doesn’t in­di­cate a ‘right’ amount, or kind, of sex.”

WHO de­fines com­pul­sive sex­ual be­hav­iour dis­or­der as an im­pulse con­trol dis­or­der. Symp­toms, which must per­sist for six months or more, can in­clude “repet­i­tive sex­ual ac­tiv­i­ties be­com­ing a cen­tral fo­cus of the per­son’s life,” nu­mer­ous un­suc­cess­ful at­tempts to re­duce the be­hav­iour, and “con­tin­ued repet­i­tive sex­ual be­hav­iour de­spite ad­verse con­se­quences.”

“Dis­tress that is en­tirely re­lated to mo­ral judg­ments and dis­ap­proval about sex­ual im­pulses, urges or be­hav­iours is not suf­fi­cient to meet this re­quire­ment,” the def­i­ni­tion reads.

Psy­chi­a­try has had a long, dodgy and con­tro­ver­sial his­tory of de­ter­min­ing how to de­fine “out of the norm” sex­ual be­hav­iour, or even what to call it — hy­per­sex­u­al­ity, sex­ual ad­dic­tion or some­thing else.

“From Tiger Woods to Har­vey We­in­stein, news ar­ti­cles have con­jec­tured that ‘sex ad­dic­tion’ is a grow­ing and hereto­fore un­rec­og­nized ‘epi­demic,’ while the sci­en­tific com­mu­nity de­bates whether such a prob­lem even ex­ists,” the au­thors write.

“There is a lot of con­tro­versy here, but we wanted to as­sess the one thing that is com­mon in all th­ese dif­fer­ent con­cep­tu­al­iza­tions — the dif­fi­culty in con­trol­ling sex­ual urges and be­hav­iour,” said first author Janna Dick­en­son, a post-doc­toral fel­low in hu­man sex­u­al­ity at the Univer­sity of Min­nesota.

Dick­en­son and her co-au­thors ad­min­is­tered a 13-item screen­ing tool to iden­tify those among their sam­ple (adults aged 18 to 50) who met the cri­te­ria for a prob­a­ble di­ag­no­sis of com­pul­sive sex­ual be­hav­iour. Ques­tions in­cluded how of­ten (never, to very fre­quently) peo­ple felt un­able to con­trol their sex­ual feel­ings and urges, how of­ten they’ve con­cealed or hid­den their be­hav­iour from oth­ers and how of­ten they used ex­cuses to jus­tify their be­hav­iour.

Dick­en­son said one pos­si­ble ex­pla­na­tion for the smaller-than-ex­pected gen­der dif­fer­ences might mean com­pul­sive, dis­tress­ful sex­ual be­hav­iour is in­creas­ing among women in the wake of a cul­tural shift to­ward more “per­mis­sive fe­male sex­ual ex­pres­sion,” and the pro­lif­er­a­tion of on­line sex­ual im­agery and ca­sual sex. The in­ter­net has cre­ated once unimag­in­able ac­cess to sex­u­al­ity, anonymity and re­la­tion­ships — or at least to the il­lu­sion of re­la­tion­ships.

Dr. Lori Brotto, di­rec­tor of the Univer­sity of Bri­tish Columbia’s sex­ual health lab­o­ra­tory, said it’s plau­si­ble, but she’s not en­tirely con­vinced eas­ier ac­cess to pornog­ra­phy and in­creas­ing per­mis­sive­ness around women’s sex­u­al­ity would trans­late into more com­pul­sive be­hav­iours.

It’s pos­si­ble women were more likely than men to en­dorse items on the screen­ing tool, such as feel­ing guilty or shame­ful about sex and feel­ing emo­tion­ally dis­tant en­gag­ing in sex.

The few times she has seen it in her own prac­tice, com­pul­sive sex­ual be­hav­iour in women doesn’t look all that dif­fer­ent from men.

“It’s in­ter­fer­ing in the woman’s life, she’s pay­ing for ser­vices, she feels a sense of it be­ing out of con­trol," she said. “In the cases I’ve seen there was a very kind of ob­ses­sional com­po­nent to it, an anx­i­ety-re­liev­ing com­po­nent to it."

Other re­searchers have found that dif­fi­cul­ties with in­ti­macy and at­tach­ment are re­lated to com­pul­sive sex­ual be­hav­iour.


“From Tiger Woods to Har­vey We­in­stein, news ar­ti­cles have con­jec­tured that ‘sex ad­dic­tion’ is a grow­ing ... ‘epi­demic,’ ” say the au­thors of a study on sex­ual com­pul­sion.

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