Current Perspectives on Hypersexuality and Compulsive Sexual Behavior Disorder  

Presenter: Drew Kingston, PhD, ATSAF 

Course description: Hypersexuality is defined as a stronger than usual urge to have sexual activity. Researchers and clinicians remain largely divided on whether hypersexuality is a central feature of a distinct diagnostic disorder or whether it simply reflects normative, albeit high, sexual drive. The proposed disorder underscores a number of features, such as non-paraphilic hypersexuality, loss of control over sexual behavior, the use of sex in response to dysphoric mood, and the continuation of sexual behavior despite adverse consequences. Although Hypersexual Disorder was rejected for inclusion in DSM-5, Compulsive Sexual Behavior Disorder was incorporated as an impulse-control disorder in ICD-11. This has important clinical implications as ICD is the most widely used classification system of mental disorders in the world and the diagnostic codes are mandated for use in many countries.  

Despite the continued controversy, non-paraphilic hypersexual behavior continues to be an important clinical construct. Indeed, hypersexuality in some form has been embedded in etiological models of sexually aggressive behavior (Knight & Sims-Knight, 2003; Seto, 2019) and it has also been found to covary with recidivism among those who have committed sexual offenses (Hanson & Morton-Bourgon, 2004; Kingston & Bradford, 2013).  Consequently, it has become an important target for assessment and treatment among individuals convicted of sexual aggression (Marshall & Marshall, 2006). 

In this presentation, I discuss the overarching construct of hypersexuality and Compulsive Sexual Behavior Disorder, it’s place in current nosology, as well as specified problems, ranging from global issues about its core theoretical conceptualization to specific issues about the content and structure of the scales used to measure it. Recent research will be presented that underscore these aforementioned issues particularly around assessment and measurement. Implications pertaining to the treatment of individuals presenting with hypersexuality will be discussed including the identification of specified treatment targets among other pertinent issues related to effective intervention.