Is sexual addiction a recognized clinical disorder? A Clinical Psychologist weighs in.

In the fall of 2009, people around the world became transfixed by world-renowned golf champion Tiger Woods, for reasons other than his golfing prowess, when his extramarital affairs became publicly known. Experts and laypersons alike quickly speculated that Tiger was a ‘sex addict’ as alleged details of his sexual endeavors were exposed for public consumption. Many of us read the headlines and watched the news clips with mixed emotion as he and his family struggled to cope with this difficult time. Some of us may have even scrutinized people in our own lives, wondering “could he or she be a sex addict too?” But truthfully, how many of us are actually familiar with the clinical definition of a sex addict? This article serves to clarify sexual addiction as defined by experts in the field of clinical psychology.


Is sexual addiction a recognized clinical disorder?


The American Psychiatric Association (APA) does not currently recognize sex addiction as a mental illness in the Diagnostic Statistical Manual (DSM IV-TR), which provides a common language and standard criteria for the classification of mental disorders. Therefore, no official diagnostic criteria exists for sex addiction.

However, the APA has created classifications that are helpful for understanding specific sexual behavior disorders. These disorders are called paraphilias. The most common include:

* Pedophilia — an adult’s sexual attraction toward children
* Exhibitionism — sexual excitement from exposing one’s genitals in public
* Voyeurism — sexual excitement from watching an unsuspecting person
* Sexual masochism — sexual excitement from being the recipient of inflicted or threatened pain
* Sexual sadism — sexual excitement from threatening or administering pain
* Transvestic fetishism — sexual excitement from wearing the clothing of the opposite sex
* Frotteurism — sexual excitement from touching or fondling an unsuspecting person

All of these disorders are characterized by recurrent, intense, sexually arousing fantasies, sexual urges or behaviors involving:

* Non-human objects
* The suffering or humiliation of oneself or one’s partner, children or other nonconsenting persons
* Clinically significant distress in social, occupational or other important areas of functioning caused by the behavior, sexual urges or fantasies.

The broad term of sexual addiction may include some of the obsessions and behaviors caused by these disorders. However, sexual addiction typically involves conventional, or nonparaphiliac, sexual behaviors that when taken to an extreme, like alcohol or any other vice, can interfere with daily functioning and produce guilt, shame and recurrent harm to oneself or others.

Symptoms of sexual addiction

While there is no official diagnosis for sex addiction, researchers and clinicians have attempted to define the disorder using criteria based on chemical dependency literature (see CAGE, or DAST both screening tests commonly used by clinicians). They include:

* Frequently engaging in more sex and with more partners than originally intended.
* Being preoccupied with or persistently craving sex; wanting to cut down and/or unsuccessfully attempting to limit sexual activity.
* Thinking of sex to the detriment of other activities such as work, or family or friends, or continually engaging in excessive sexual acts despite a desire to stop.
* Spending considerable time engaging in sexual activities such as searching for partners, viewing pornographic materials, or visiting pornographic web sites.
* Continually engaging in the sexual behavior despite negative consequences, such as failing relationships, unmet work obligations, or potential health risks.
* Escalating scope or frequency of sexual activity to achieve the desired ‘high’, such as increased number or variety of sexual partners, or more time spent at places such as strip clubs, or swingers bars.
* Feeling irritable or depressed when unable to engage in the desired sexual behavior.

You may have a sex addiction problem if you identify with three or more of the above criteria.

Experts in the field describe sex addicts as tending to organize their world around sex in the same way that heroin addicts organize theirs around heroin. Very often, the goal of people with a sexual addiction in social situations is obtaining sexual pleasure.