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UI psychiatry researcher studies compulsive sexual behavior
IOWA CITY, Iowa -- Try telling someone that you, or a person you know, have
a compulsive sexual behavior disorder, and your words might be met with an
unbelieving smirk and a wink.
But for the estimated three to five percent of Americans with compulsive
sexual behavior, it is a serious condition that can lead to personal or family
distress, problems at work, and legal or financial consequences. A University
of Iowa College of Medicine researcher has studied people with this condition
to better describe its features and understand any links to other behavioral
In an article published in the February issue of the American Journal of
Psychiatry, Dr. Donald Black, UI professor of psychiatry, and his colleagues
report that compulsive sexual behavior may be a clinically useful concept,
but it actually describes a diverse group of individuals with a range of behavioral
Although there is no universally accepted definition of compulsive sexual
behavior, the term is generally used to describe an excessive urge to engage
in sexual activities. It has been characterized as a failure to control one's
sexual behavior and the continuation of this behavior despite potentially
"The main thing is that compulsive sexual behavior exists. People describe
this behavior and it's quite problematic for them," Black says. "This
condition has received little attention in professional psychiatric literature,
although it is probably given a disproportionate amount of coverage in the
In the study, UI researchers interviewed 36 people (28 men and eight women)
who responded to advertisements for persons who have a problem with compulsive
sexual behavior. Participants completed psychiatric assessments for personality
and other behavioral disorders. The researchers found that the "typical"
person with compulsive sexual behavior is a 27-year-old male who has experienced
this condition for nearly nine years. "The behavior is essentially chronic
for a number of years," Black says. "It generally involves normal
sexual behavior that is taken to extremes."
The most often-reported compulsive sexual activities were "cruising,"
or seeking repeated sexual experience, and having multiple sexual partners.
Compulsive sex within a relationship and compulsive masturbation were also
frequently reported among study subjects.
Nearly two-thirds of the study participants met criteria for a current mental
disorder, most commonly substance abuse, anxiety disorder or mood disorder.
"There does seem to be some relationship between compulsive sexual behavior
and substance abuse," Black says. "Using drugs or alcohol may disinhibit
some of these people enough to carry out the behavior, or to numb their sense
He notes, however, that no good evidence exists to link compulsive sexual
behavior to other psychiatric conditions, such as obsessive-compulsive disorder
(OCD). "The main distinction is that OCD is characterized by repetitive
thoughts or behavior that the person intensely dislikes. Certainly with compulsive
sexual behavior there is a repetitive quality, but these are behaviors that
are generally viewed as pleasurable. These people like what they're doing
-- at least at first. After a while, they may start to feel remorse, because
it can lead to trouble at home or at work, but they still enjoy the behavior."
Although compulsive sexual behavior's relationship to other psychiatric disorders
is unclear, Black believes it is not a single phenomenon. "It probably
describes a heterogeneous group of disorders that have repetitive sexual behavior
in common. What links a pedophile who engages in such acts repeatedly and
someone who masturbates compulsively is that both behaviors are repetitive,
indulgent and each person enjoys doing it. But we're talking about two totally
different conditions, really. That's part of the problem with the term used
to describe this behavior. People read or hear about this and think it only
describes a specific set of individuals."
Treatment options for people with compulsive sexual behavior vary, although
few studies of the treatments' effectiveness have been conducted, Black says.
Some of the newer medications for psychiatric disorders or depression may
reduce sex drive and dampen this kind of behavior. For some individuals, psychotherapy
may be helpful. Counseling groups, 12-step programs and hospital inpatient
treatment programs also are available. "It is still unclear, however,
whether these treatments have any proven benefit," Black says.