Hypersexuality

Hypersexuality

Hypersexuality is extremely frequent or suddenly increased sexual urges or sexual activity. Hypersexuality is typically associated with lowered sexual inhibitions. Although hypersexuality can be caused by some medical conditions or medications, in most cases the cause is unknown. Medical conditions such as bipolar disorders can give rise to hypersexuality,[1] and alcohol and some drugs can affect social and sexual inhibitions in some people. A number of theoretical models have been used to explain or treat hypersexuality. The most common one, especially in the popular media, is the sexual addiction approach, but sexologists have not reached any consensus. Alternative explanations for the condition include compulsive and impulsive behavioral models.

The International Classification of Diseases (ICD-10) of the World Health Organization includes “Excessive Sexual Drive” (coded F52.8),[2] which is divided into satyriasis for males and nymphomania for females, and “Excessive Masturbation” (coded F98.8).[3]

The American Psychiatric Association (APA) rejected a proposal to add sexual addiction to its official list of psychiatric disorders, the Diagnostic and Statistical Manual of Mental Disorders (DSM). A proposal to include Hypersexual Disorder, which is not Hypersexuality, simply describes the symptom without implying any specific theory, is under consideration for inclusion in the appendix of the DSM, but not in the main list of official diagnoses.[4]

Some authors have questioned whether it makes sense to discuss hypersexuality at all, arguing that extreme sexual urges merely stigmatize persons who do not conform to the norms of their culture or peer group.[5]

Contents

Epidemiology

The number of people who are hypersexual, or believe that they are hypersexual, is unknown. Although several estimates have been published, it is not clear on what basis they were made.[6] The estimates asserted are usually 3–6%.[6]

Many proposed definitions of hypersexuality are relative to cultural or peer group norms. Surveys of "convenience samples" suggest that 3–5% of high school or college age males masturbate on a daily basis.[7] In the Kinsey studies, 7.6% of males engaged in some sexual behavior leading to orgasm (masturbation, sexual intercourse, oral sex, etc.) on a daily basis or more.[8] In the Laumann study (a large-scale representative survey of sexual behavior),[9] 1.9% of men ages 18–59 masturbated daily, and 1.2% masturbated more than once per day.[10]

Models and labels

Sexologists have been describing cases of hypersexuality since the late 1800s.[10] In some cases, the hypersexuality was a symptom of another medical disease, such as Klüver-Bucy syndrome or bipolar disorder, or the side effect of a medication, such as the drugs used to treat Parkinson's disease. In other cases, the hypersexuality was reported to be the primary problem.

Sexologists have not reached a consensus over how best to describe when hypersexuality is the primary problem.[11][12][13] Some researchers assert that such situations represent a literal addiction;[14][15] other researchers assert that such situations represent a type of obsessive-compulsive disorder (OCD) or “OCD-spectrum disorder”; and other researchers assert that it is a disorder of impulsivity. Moreover, some authors assert that there is no such thing as hypersexuality at all[16] and that the condition merely reflects a cultural dislike of exceptional sexual behavior.[5][17]

Consistent with there not being any consensus over what causes hypersexuality,[10] 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 were studying. Contemporary names include compulsive masturbation, compulsive sexual behavior,[18][19] cybersex addiction, erotomania, “excessive sexual drive”,[20] hyperphilia,[21] hypersexuality,[22][23] hypersexual disorder,[24] problematic hypersexuality,[25] sexual addiction, sexual compulsivity,[26] sexual dependency,[17] sexual impulsivity,[27] “out of control sexual behavior”,[28] and paraphilia-related disorder.[29][30][31] Other, mostly historical, names include Don Juanism, the Messalina complex,[32] nymphomania,[33] and satyriasis.

Addiction model of hypersexuality

The most commonly discussed way of understanding hypersexuality is with an addiction model. The concept of hypersexuality as an addiction was started in the 1970s by former members of Alcoholics Anonymous who believed that their sexual behaviors meant the same thing as their alcohol use.[34][5] 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.

Compulsivity model of hypersexuality

Compulsions are behaviors a person performs in order to reduce feelings of anxiety or tension. According to this explanation of hypersexuality, persons engage in whatever sexual behavior in order to reduce feelings of tension, instead of to express sexual desire. Because engaging in the behavior can worsen the situation causing the tension, the person experiences a longer-term increase in tension, despite the shorter-term relief, resulting in a self-perpetuating cycle.[35][36]

Impulsivity model of hypersexuality

Barth and Kinder (1987) argued against classifying hypersexuality as an addiction or as a compulsion, arguing instead for classifying it as an impulsivity problem.[37] They argued that an addiction entails a substance and withdrawal states, whereas sexual behavior has neither, and that compulsive behaviors exclude intrinsically enjoyable activities, whereas sexual behavior is intrinsically enjoyable. Hypersexuality does, however, contain the essential elements of an impulsivity problem: (1) It pertains to the failure to resist an impulse, drive, or temptation. (2) There is an increasing sense of tension before the behavior. (3) There is an experience of either pleasure, gratification, or release at the time of committing the behavior.

Medical disorders and drugs causing hypersexuality

People who suffer from 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.

Several neurological conditions such as Alzheimer's disease,[38] various types of brain injury,[39] Klüver-Bucy syndrome,[40] Kleine-Levin syndrome,[41] and many more neuro-degenerative diseases can cause hypersexual behavior. Hypersexuality has also been reported to result as a side-effect of some medications used to treat Parkinson's disease.[42][43] Some street drugs, such as methamphetamine, may also contribute to hypersexual behavior.[44]

Official diagnostic status

The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA) includes 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.”[45] A proposal to add Hypersexual Disorder to the appendix (but not the main list of official diagnoses) of the DSM is currently under consideration by the APA.[4]

The International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization (WHO), includes two relevant entries: One is “Excessive Sexual Drive” (coded F52.8),[46] which is divided into satyriasis for males and nymphomania for females. The other is “Excessive Masturbation” or “Onanism (excessive)” (coded F98.8).[47]

A proposal to add Sexual Addiction to the DSM system has been rejected by the APA, as not enough evidence suggested to them that the condition is analogous to substance addictions, as that name would imply.[48][49][50]

Treatment

There does not yet exist any treatment approach uniformly endorsed by experts and/or community groups. Most clinical authors recommend a multifaceted or multimodal approach that includes a variety of treatments, including certain classes of anti-depressants (selective serotonin reuptake inhibitors, or SSRIs) that reduce sex drive in some people, motivational interviewing,[25] and individual, group, or couples' therapy (including cognitive-behavioral, psychodynamic, and relapse-prevention).[51][6]

Historical uses

Richard von Krafft-Ebing

Krafft-Ebing described several cases of extreme sexual behaviours in his seminal 1886 book, Psychopathia Sexualis.[52] Although he also used the term "hypersexuality" in that book, he was describing conditions that would now be called premature ejaculation.

Nymphomania in the Victorian age

Many Victorian era mental institutions treated nymphomania as an exclusively female mental illness. Women were classified as mentally ill for nymphomania if they were a victim of sexual assault, bore illegitimate children, "abused themselves" (i.e. masturbated), or were deemed promiscuous. Upon arrival at the asylum, doctors would give the woman a pelvic exam. If doctors felt that the woman had an enlarged clitoris, she would undergo treatments. These treatments included induced vomiting, bloodletting, leeches, restricted diet, douches to the head or breasts, and, at times, clitoridectomies.[53]

See also

References

  1. ^ About.com Bipolar Disorders
  2. ^ http://www.icd10data.com/ICD10CM/Codes/F01-F99/F50-F59/F52-/F52.8
  3. ^ http://www.icd10data.com/ICD10CM/Codes/F01-F99/F90-F98/F98-/F98.8
  4. ^ a b DSM-5 Development Page for Sexual Dysfunctions.
  5. ^ a b c Levine, M. P; Troiden, R. R. (1988). "The Myth of Sexual Compulsivity". Journal of Sex Research 25 (3): 347–363. doi:10.1080/00224498809551467. 
  6. ^ a b c Kaplan, M. S.; Krueger, R. B. (2010). "Diagnosis, Assessment, and Treatment of Hypersexuality". Journal of Sex Research 47 (2–3): 181–198. doi:10.1080/00224491003592863. PMID 20358460. 
  7. ^ Atwood, J. D.; Gagnon, J. (1987). "Masturbatory Behavior in College Youth". Journal of Sex Education and Therapy 13: 35–42. 
  8. ^ Kinsey, A. C.; Pomeroy, W. B.; Martin, C. E. (1948). Sexual behavior in the human male. Philadelphia: W. B. Saunders. 
  9. ^ Laumann, E. O.; Gagnon, J. H.; Michael, R. T.; Michaels, S. (1994). The social Organization of Sexuality: Sexual Practices in the United States. Chicago: University of Chicago Press. ISBN 0226469573. 
  10. ^ a b c Kafka, M. P. (2010). Hypersexual Disorder: A proposed diagnosis for DSM-V. Archives of Sexual Behavior, 39, 377–400.
  11. ^ Stein, D. J. (2008). Classifying hypersexual disorders: Compulsive, impulsive, and addictive models. Psychiatric Clinics of North America, 31, 587–592.
  12. ^ Bancroft, J., & Vukadinovic, Z. (2004). Sexual addiction, sexual compulsivity, sexual impulsivity or what? Toward a theoretical model. Journal of Sex Research, 41, 225–234.
  13. ^ Coleman, E. (1986, July). Sexual compulsion vs. sexual addiction: The debate continues. SIECUS Report (pp. 7–11).
  14. ^ Orford, J. (1985). Excessive appetites: A psychological view of the addictions. Chichester, England: John Wiley & Sons.
  15. ^ Carnes, P. (1983). Out of the shadows: Understanding sexual addiction. Minneapolis, MN: CompCare.
  16. ^ Levine, S. B. (2010). What is sexual addiction? Journal of Sex & Marital Therapy, 36, 261–275.
  17. ^ a b Rinehart, N. J., & McCabe, M. P. (1997). Hypersexuality: Psychopathology or normal variant of sexuality? Sexual and Marital Therapy, 12, 45–60.
  18. ^ Quadland, M. C. (1985). Compulsive sexual behavior: Definition of a problem and an approach to treatment. Journal of Sex and Marital Therapy, 11, 121–132.
  19. ^ Coleman, E. (1990). The obsessive–compulsive model for describing compulsive sexual behavior. American Journal of Preventive Psychiatry & Neurology, 2, 9–14.
  20. ^ ICD-10 entry for "Excessive sexual drive."
  21. ^ Money, J. (1980). Love and love sickness. The science of sex, gender difference, and pair bonding. Baltimore, MD: Johns Hopkins University Press.
  22. ^ Miller, B. L., Cummings, J. L., & McIntyre, H. (1986). Hypersexuality and altered sexual preferences following brain injury. Journal of Neurology, Neurosurgery and Psychiatry, 49, 867–873.
  23. ^ Orford, J. (1978). Hypersexuality: Implications for a theory of dependence. British Journal of Addiction, 73, 299–310.
  24. ^ Krueger, R. B., & Kaplan, M. S. (2001). The paraphilic and hypersexual disorders. Journal of Psychiatric Practice, 7, 391–403.
  25. ^ a b Kingston, D. A., & Firestone, P. (2008). Problematic hypersexuality: Review of conceptualization and diagnosis. Sexual Addiction and Compulsivity, 15, 284–310.
  26. ^ Dodge, B., Reece, M., Cole, S. L., & Sandfort, T. G. M. (2004). Sexual compulsivity among heterosexual college students. Journal of Sex Research, 41, 343–350.
  27. ^ Kafka, M. P. (1995b). Sexual impulsivity. In E. Hollander & D. J. Stein (Eds.), Impulsivity and aggression (pp. 201–228). Chichester, England: John Wiley.
  28. ^ Bancroft, J. (2008). Sexual behavior that is "out of control": A theoretical conceptual approach. Psychiatric Clinics of North America, 31, 593-601.
  29. ^ Kafka, M. P. (1994). Paraphilia-related disorders: Common, neglected, and misunderstood. Harvard Review of Psychiatry, 2, 39–40.
  30. ^ Kafka, M. P. (2000). The paraphilia-related disorders: Nonparaphilic hypersexuality and sexual compulsivity/addiction. In S. R. Leiblum & R. C. Rosen (Eds.), Principles and practice of sex therapy (3rd ed., pp. 471–503). New York: Guilford Press.
  31. ^ Kafka, M. P. (2001). The paraphilia-related disorders: A proposal for a unified classification of nonparaphilic hypersexuality disorders. Sexual Addiction &Compulsivity, 8, 227–239.
  32. ^ Orford, J. (1978). Hypersexuality: Implications for a theory of dependence. British Journal of Addiction, 73, 299-320.
  33. ^ Ellis, A., & Sagarin, E. (1965). Nymphomania: A Study of oversexed women. London: Ortolan.
  34. ^ Goleman, D. (1984, October 16). addiction&st=nyt&pagewanted=2 Some sexual behavior viewed as an addiction. New York Times, pp. Cl, C9.
  35. ^ Assalian, P., & Ravart, M. (1993). Compulsive sexual behaviour: Etiology, clinical manifestations & pharmacological treatment. The Canadian Journal of Human Sexuality, 2, 221-226.
  36. ^ Coleman, E. (1992). Is your patient suffering from compulsive sexual behavior? Psychiatric Annals, 22, 320–325.
  37. ^ Barth, R. J., & Kinder, B. N. (1987). The mislabeling of sexual impulsivity. Journal of Sex & Marital Therapy, 13, 15-23.
  38. ^ 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. 
  39. ^ Miller BL, Cummings JL, McIntyre H, Ebers G, Grode M (August 1986). "Hypersexuality or altered sexual preference following brain injury". J. Neurol. Neurosurg. Psychiatr. 49 (8): 867–73. doi:10.1136/jnnp.49.8.867. PMC 1028946. PMID 3746322. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1028946. 
  40. ^ National Institute of Neurological Disorders and Stroke. "NINDS Klüver-Bucy Syndrome Information Page". http://www.ninds.nih.gov/disorders/kluver_bucy/kluver_bucy.htm. Retrieved 2009-10-10. 
  41. ^ 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. 
  42. ^ Vogel, H. P., & Schiffter, R. (1983). Hypersexuality: A complication of dopaminergic therapy in Parkinson's disease. Pharmacopsychiatria, 16, 107-110.
  43. ^ Uitti, R. J., Tanner, C. M., & Rajput, A. H. (1989). Hypersexuality with antiparkinsonian therapy. Clinical Neuropharmacology, 12, 375-383.
  44. ^ Mansergh, G., Purcell, D. W., Stall, R., McFarlane, M., Semaan, S., Valentine, J., et al. (2006). CDC consultation on methamphetamine use and sexual risk behavior for HIV/STD infection: Summary and suggestions. Public Health Reports, 121, 127-132.
  45. ^ American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
  46. ^ http://www.icd10data.com/ICD10CM/Codes/F01-F99/F50-F59/F52-/F52.8
  47. ^ http://www.icd10data.com/ICD10CM/Codes/F01-F99/F90-F98/F98-/F98.8
  48. ^ Rubin, Rita (2010-02-09). "Psychiatry's bible: Autism, binge-eating updates proposed for 'DSM'". USA Today. http://www.usatoday.com/news/health/2010-02-10-dsm10_ST_N.htm. 
  49. ^ Daily News (New York). http://articles.nydailynews.com/2010-02-10/entertainment/27055937_1_autism-mental-disorders-mental-illness. 
  50. ^ http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2010/02/10/new-diagnostic-guidelines-for-mental-illnesses-proposed
  51. ^ Kafka, M. P. (2007). Paraphilia-related disorders: The evalution and treatment of nonparaphilic hypersexuality. In S. R. Leiblum (Ed.), Principles and practice of sex therapy (4th ed.) (pp. 442-476). New York: Guilford.
  52. ^ Krafft-Ebing, R. von (1886/1965). Psychopathia sexualis: A medico–forensic study (H. E. Wedeck, Trans.). New York: Putnam.
  53. ^ Goldberg, Ann. Sex, Religion, and the Making of Modern Madness New York: Oxford University Press, 1999. ref in [1]

Wikimedia Foundation. 2010.

Игры ⚽ Нужно сделать НИР?

Look at other dictionaries:

  • hypersexuality — noun see hypersexual …   New Collegiate Dictionary

  • hypersexuality — See hypersexual. * * * …   Universalium

  • hypersexuality — noun The desire for human sexual behavior at levels high enough to be considered clinically significant …   Wiktionary

  • hypersexuality — hy·per·sex·u·al·i·ty (hi″pər sek″shoo alґĭ te) abnormally increased sexual desire or activity; see nymphomania and satyriasis …   Medical dictionary

  • hypersexuality — n. affected by an overly strong sexual instinct …   English contemporary dictionary

  • hypersexuality — hy·per·sexuality …   English syllables

  • hypersexuality — noun see hypersexual …   Useful english dictionary

  • hypersexual — hypersexuality, n. hypersexually, adv. /huy peuhr sek shooh euhl/ or, esp. Brit., / seks yooh /, adj. 1. unusually or excessively active in or concerned with sexual matters. n. 2. a person who is hypersexual. [1940 45; HYPER + SEXUAL] * * * …   Universalium

  • Dopamine dysregulation syndrome — Three dimensional model of the structure of a dopamine molecule. Dopamine is at the origin of DDS. Dopamine dysregulation syndrome (DDS), sometimes known as hedonistic homeostatic dysregulation in Parkinson s disease, is a dysfunction of the… …   Wikipedia

  • Stereotypes of East Asians in the Western world — This article focuses primarily on Western stereotypes of East Asians, though certain parts are applicable to other groups. For other Asians, please see Stereotypes of South Asians or Western stereotypes of West and Central Asians Stereotypes of… …   Wikipedia

Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”