Problematic Hypersexuality: A Review of Conceptualization and Diagnosis

Abstract

There has been considerable debate regarding the conceptualization and diagnosis of individuals exhibiting problematic hypersexuality. Various terms such as sexual addiction, sexual compulsivity, and sexual impulsivity have been applied based predominantly on the perceived psychopathological mechanisms guiding the behavior. Unfortunately, such descriptive diversity has inhibited adequate conceptualization and current diagnostic practices, which in turn, have negatively impacted treatment design. This paper critically reviews the extant literature regarding the conceptualization and diagnosis of problematic hypersexuality. Additionally, this review highlights the utility of a relatively new conceptualization of problematic hypersexuality, the Sexual Desire Disorders model, which accounts for many of the limitations inherent in previous explanatory models. Finally, diagnostic, conceptual, and treatment implications are discussed.

We would like to thank Elke Reissing and Pamela M. Yates for their very helpful comments on an earlier draft of this paper.

This paper was funded, in part, by a Social Sciences and Humanities Research Council of Canada Doctoral Fellowship and Ontario Graduate Scholarship awarded to the first author.

Notes

¹Substance dependence is the descriptor used in the DSM-IV-TR to describe addiction but the two terms are, at least in this context, synonymous (APA, 2000; O'Brien, Volkow, & Li, 2006).

²Despite the nosological categorization of pathological gambling (PG) as an ICD, the predominant features have been equated with addiction (see Schneider & Irons, 1996). Certain elements of addiction (e.g., preoccupation and tolerance) can be applied to several criteria for PG.