Compulsive sexual behavior disorder (CSBD) is currently defined as an impulse control disorder and “characterized by a persistent pattern of failure to control intense, repetitive sexual urges and behaviors” where an individual (1) devotes excessive time to sexual activities to the point of neglecting health, personal care, interests, and responsibilities, (2) experiences diminished control manifest by multiple unsuccessful efforts to reduce sexual behavior, (3) continues sexual activity despite adverse consequences, (4) continues engagement in sexual behavior even when little or no satisfaction is derived, and (5) experiences significant distress or impairment across life domains or important areas of functioning. The classification also cautions, “Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviors is not sufficient to meet this requirement.” Additionally, paraphilic disorders are exclusionary.
Compulsive sexual behavior disorder proposed for ICD-11
1. Repetitive sexual activities become a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities
2. A person makes numerous unsuccessful efforts to significantly reduce repetitive sexual behavior
3. The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behavior causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.
4. A person continues the engagement in repetitive sexual behavior despite adverse consequences.
5. A person continues the engagement in repetitive sexual behavior despite deriving little or no satisfaction from it.
Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviors is not sufficient for a CSBD diagnosis.
Hypersexual disorder proposed for DSM-5
A1. Time consumed by sexual fantasies, urges or behaviors repetitively interferes with other important (non-sexual) goals, activities and obligations.
A2. Repetitively engaging in sexual fantasies, urges or behaviors in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability).
A3. Repetitively engaging in sexual fantasies, urges or behaviors in response to stressful life events.
A4. Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges or behaviors.
A5. Repetitively engaging in sexual behaviors while disregarding the risk for physical or emotional harm to self or others.
B. There is clinically significant personal distress or impairment in social, occupational or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges or behaviors.
C. These sexual fantasies, urges or behaviors are not due to the direct physiological effect of an exogenous substance (e.g., a drug of abuse or a medication).
Exclusion criterion: CSBD episodes directly due to exogenous substances
- Gola M, Lewczuk K, Potenza MN, Kingston DA, Grubbs JB, Stark R, Reid RC. What should be included in the criteria for compulsive sexual behavior disorder? J Behav Addict. 2020 Nov 25;11(2):160–5. [Medline]
- Lew-Starowicz M, Coleman E. Mental and sexual health perspectives of the International Classification of Diseases (ICD-11) Compulsive Sexual Behavior Disorder • J Behav Addict. 2022 Jul 13;11(2):226-229. [Medline]
Created Aug 18, 2022.