One in 10 Americans Suffers Distress From Uncontrollable Sexual Urges

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Stock image of two young people in bed. iStock

Large numbers of Americans have such difficulty controlling their sexual feelings, urges and behaviors that it causes them significant levels of distress, according to a study published in JAMA Network Open.

It would appear from even a fleeting glance at the media that “sex addiction” is a growing epidemic. However, the scientific community has long debated whether such a problem even exists—i.e. does it represent a true psychiatric disorder or is it simply indicative of a larger sociocultural problem?

“There have been decades of debate about whether compulsive sexual behavior represents a clinical diagnosis, and, if so, how it should be defined, what the specific symptoms are, and what it should be named,” Janna Dickenson, lead author of the study from the Department of Family Medicine at the University of Minnesota Medical School, told Newsweek.

“In the literature, terms have included impulsive/compulsive sexual behavior, out-of-control sexual behavior, hypersexual behavior, sexual compulsivity, and the often-refuted term of sex addiction,” she said. “We wanted to assess a feature that was shared across the various conceptualizations: having difficulty controlling sexual feelings, urges, and behaviors that significantly interferes with one's life.”

These key features form the basis of a new classification—compulsive sexual behavior disorder (CSBD)—which for the first time has gained recognition as a formal disorder in the International Classification of Diseases, Eleventh Revision (ICD-11).

“The ICD-11 characterizes compulsive sexual behavior disorder as a persistent pattern that involves failing to control intense, repetitive sexual urges, resulting in repetitive sexual behavior,” Dickenson said.

Understanding how many people could be experiencing difficulty controlling their sexual urges and behaviors in a way that interferes with their lives can give us some insight into the sexual health of Americans. However, the prevalence of distress linked to difficulty controlling sexual behaviors in the United States is largely unknown due to a lack of research on the issue.

To address this gap in our knowledge, Dickenson and her colleagues examined data from the National Survey of Sexual Health and Behavior, which they used to randomly sample a total of 2,325 adults between the ages of 18 and 50 from all 50 U.S. states.

GettyImages-825911256 (1) Stock image of two young people in bed. iStock

The participants were rated using a scale known as the Compulsive Sexual Behavior Inventory (CSBI) to identify clinically relevant levels of stress and/or social impairment.

The researchers found that overall, 8.6 percent of participants (10.3 percent of men and 7 percent of women) met the clinical threshold of the CSBI.

“The fact that 8.6 percent of our nationally representative sample met the clinical threshold of our screening tool suggests that a substantial number of people are feeling significantly distressed and/or are impaired by their difficulty controlling their sexual behavior,” Dickenson said. “CSBD is clearly an important sexual health concern that needs greater attention.”

“Although men made up the majority of people who show clinically relevant levels of distress controlling sexual feelings, urges, and behaviors, 40 percent of them are women,” she added. “These results prompt us to thoughtfully consider our assumptions and biases about gender and sexuality and how they can contribute to sexual health concerns. More research needs to be done to determine whether women’s distress about their sexual urges and behaviors is comparable to the distress that men feel about their sexual urges and behaviors.”

It's important to note that the study has certain limitations. For example, the behavior screening tool that was used may not always be accurate and the survey didn’t assess any other potential causes of distress linked to the participants’ sexual behavior.

Another drawback was the study’s idea of gender as a binary construct, according to Dickenson.

“In order to understand the factors that lead to the gender differences in CSBD, it would be necessary to include a broader range of gender diversity,” she said. “This means not only including individuals who identify as cisgender women in future studies of CSBD, but to also include transgender and gender non-conforming people.”

Furthermore, more work needs to be done to clarify the factors that contribute to the development of CSBD. Currently, scientists think that a variety of biological, psychological and social factors play a role.

Nevertheless, the findings of the latest study have important implications for health care professionals and society, according to the authors.

“Health care professionals should be alert to the high number of people who are distressed about their sexual behavior, carefully assess the nature of the problem within its sociocultural context, and find appropriate treatments for both men and women,” they wrote.

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