Abstract
BACKGROUND: Compulsive sexual behavior disorder (CSBD) is characterized by extensive sexual behavior and unsuccessful efforts to control excessive sexual behavior. It is a pathological behavior that has compulsive, cognitive and emotional consequences. There is a controversy among researchers and clinicians whether to recognize sex addiction or compulsive sexual disorder and how to classify it. Although hyper-sexuality was proposed for the DSM-V (American Psychiatric Association, 2013), it was not included due to a lack of research into diagnostic criteria for compulsive sexual behavior. The International Classification of Diseases for Mortality and Morbidity Statistics (11th ed.; ICD-11; World Health Organization, 2018) has included CSBD as an impulse control disorder. Recent studies have shown an association between CSBD and impulsivity. AIMS AND OBJECTIVES: to describe our studies and review the evidence for an association of CSBD with impulsivity and to discuss its classification as an impulse control disorder. RESULTS: We have shown that impulsivity and problematic online use of pornography have been associated with sex addiction. In a further study, participants after 5 year treatment for CSBD, have shown higher ratings of sexual addiction and sexual obsessive-compulsivity than control participants. However, they have demonstrated reduced risk-taking behavior and no evidence for impulsivity indicated by performance on a computerized delay discounting task and the Balloon risk- taking computerized task. In both studies, the positive association between sex addiction, impulsivity and compulsivity supports the notion of an impulsivity-compulsivity spectrum is CSBD. There is contradicting evidence regarding the relationship between CSBD and motor impulsiveness and disinhibition. Individuals with CSBD report that their search after sexuality is often driven by negative emotionality. DISCUSSION AND CONCLUSIONS: there is contradicting evidence regarding the relationship between CSBD and impulsivity. Currently, there is not enough data supporting CSBD as a behavioral addiction. Further research has to be done, examining CSBD phenomenology as a whole construct and based on a homogeneous criterion. REFERENCES: Sassover, E., Weinstein, A. (2020). Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view. Journal of Behavioral Addictions, 11(2):166–79. doi: 10.1556/2006.2020.00055. Sassover Eli and Weinstein Aviv. Compulsive sexual behavior disorder and impulsivity In Moustafa Ph.D “The Psychology and Neuroscience of Impulsivity” Elsevier Masson Publishers. In press.