Is Sexual Addiction a Recognized Disorder?
The American Psychiatric Association does not currently recognize sex addiction as a mental illness. Therefore, no official diagnostic criteria exist for sex addiction. The APA does, however, have classifications that are helpful for understanding sexual behavior disorders. These disorders are called paraphilias.
Not everyone agrees that hypersexual behavior is indicative of a clinically significant disorder. The Diagnostic and Statistical Manual (DSM-IV 2001) of the American Psychiatric Association does not specifically list sex addiction, or compulsive sexual behavior, as a clinically significant disorder.
Some sexual disorders are listed in the DSM-IV, but they are few. Most are paraphelic disorders, or disorders that involve behavior that is deemed socially deviant in nature.
The DSM-IV-TR (APA, 2001) lists several paraphelic disorders, such as exhibitionism (302.4), fetishism (302.81), pedophilia (302.2), transvestic fetishism (302.3), and voyeurism (302.82).
Other sex related disorders include the restrictive sexual disorders, such as hypoactive sexual desire disorder (302.71), and sexual aversion disorder (302.79). One thing to note is that while the DSM-IV does not specifically list sexual addiction as a disorder, sex addiction often involves the behaviors, including the hypoactive sexual behaviors, which are indeed listed.
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The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR; American Psychiatric Association [APA], 2000) classifies sexual disorders as paraphilias.
According to the DSM-IV-TR, paraphilias "are recurrent intense sexually arousing fantasies, sexual urges, or behaviors generally involving (a) nonhuman objects, (b) the suffering or humiliation of oneself or one's partner, or (c) children or other nonconsenting persons" (p. 566) and includes exhibitionism, fetishism, frotteurism, pedophilia, sexual masochism and sadism, transvestic fetishism, and voyeurism.
Exhibitionism is defined as revealing one's genitalia to strangers in order to surprise or shock the victim(s) and, in turn, to sexually arouse the offender. Fetishism refers to the use of nonliving objects to produce or enhance sexual arousal.
Frotteurism is touching and rubbing against a nonconsenting person.
Pedophilia is an attraction or strong sexual preference for children and sexual activities that focus on prepubescent children.
The sexual activities can be fantasy or actual events. Sexual masochism refers to receiving humiliation or suffering. In contrast, sexual sadism is inflicting humiliation or suffering. Transvestic fetishism pertains to cross-dressing;
Sex addiction has all the symptoms of dependence:
Why sexual addiction is not in the DSM? Probably because it is hard for empirical evidence to support such a diagnostic criteria (sexual addiction is still very secretive and shameful in our society).
Unless and until sexually compulsive behavior disorders are listed in the DSM, it will be difficult at best to induce insurance companies to pay for treatment and recovery services.
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Sexual addiction can be classified into one of three major DSM-IV categories:
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Sexual addiction does not have a distinct code in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision, (DSM-IV-TR) but can be classified as:
The unconventional sexual type of behavior is classified as a paraphilia. Paraphilias are marked by an obsessive preoccupation with a socially unconventional sexual behavior that involves nonhuman objects, children or other non-consenting persons, or the suffering or humiliation of oneself or one’s partner.
The term impulsive-compulsive sexual behavior is used because an impulsive component (pleasure, arousal, or gratification) is involved in initiating the cycle, and a compulsive component is involved in the persistence of the behavior.
The classification of impulsive-compulsive sexual behavior in DSM-IV-TR is less well defined than paraphilia and it may be changing in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V).
In the DSM-IV-TR, paraphilic disorders have their own distinct category and impulsive-compulsive sexual behavior is classified as an impulsive-compulsive disorder not otherwise specified (NOS) or as a sexual disorder NOS.
Impulsive-compulsive sexual behavior may be classified in DSM-V in a new category of disorders named behavioral and substance addictions. This tentative category might include substance-related disorders and several impulse-control disorders (pathological gambling, pyromania, and kleptomania), as well as others currently in the category of impulse control disorders not otherwise specified (impulsive-compulsive sexual behavior, Internet addiction, and compulsive buying).
See also: