Recognizable behavior patterns which indicate the presence of sexual addiction.
Diagnosis needs to done by a mental health professional trained in sexual addiction.
The Sexual Addiction Screening Test (http://www.sexhelp.com/sast.cfm) is designed to assist in the assessment of sexually compulsive or addictive behavior. Helps to discriminate between addictive and nonaddictive behavior.
1. Were you sexually abused as a child or adolescent?
2. Do you regularly purchase romance novels or sexually explicit magazines?
3. Have you stayed in romantic relationships after they become emotionally or physically abusive?4. Do you often find yourself preoccupied with sexual thoughts or romantic day dreams?
5. Do you feel that your sexual behavior is not normal?6. Does your spouse (or significant other(s)) ever worry or complain about your sexual behavior?
7. Do you have trouble stopping your sexual behavior when you know it is inappropriate?8. Do you ever feel bad about your sexual behavior?
9. Has your sexual behavior ever created problems for you and your family?10. Have you ever sought help for sexual behavior you did not like?
11. Have you ever worried about people finding out about your sexual activities?12. Has anyone been hurt emotionally because of your sexual behavior?
13. Have you ever participated in sexual activity in exchange for money or gifts?14. Do you have times when you act out sexually followed by periods of celibacy (no sex at all)?
15. Have you made efforts to quit a type of sexual activity and failed?16. Do you hide some of your sexual behavior from others?
17. Do you find yourself having multiple romantic relationships at the same time?18. Have you ever felt degraded by your sexual behavior?
19. Has sex or romantic fantasies been a way for you to escape your problems?20. When you have sex, do you feel depressed afterwards?
21. Do you regularly engage in sado-masochistic behavior?22. Has your sexual activity interfered with your family life?
23. Have you been sexual with minors?24. Do you feel controlled by your sexual desire or fantasies of romance?
25. Do you ever think your sexual desire is stronger than you are?
While the assessment and diagnosis of sex addiction might seem straightforward, much of the diagnosis is dependent upon the individual’s willingness to disclose the details of their acting out behavior, or their willingness to face the consequences.
Denial of the existence of a problem is prevalent in most addictive disorders, regardless of the nature of the addiction - sex addiction is no different.
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Based on "The Challenge of Treating Compulsive Sex" (By David L. Delmonico, PhD and Elizabeth Griffin, MA, LMFT)
A mistake often made during the assessment phase is the assumption that the problem is easily isolated and identified. Sexual compulsivity rarely, if ever, stands alone (see cross-addictions).
Other potential issues:
Sexual health and deviance are defined culturally and individually.
Therefore, one purpose of an initial screening is to help determine if further assessment and intervention is warranted. For example, clients often present for treatment because they have guilt about the frequency of their masturbatory behavior.
Other common presenting problems include the spouse who believes his or her partner is sexually compulsive because he or she had an affair, or wishes to engage in an unusual sexual practice. Pornography is mentioned quite often when individuals are concerned about a sexual fantasy, feeling, or behavior. None of these examples alone indicate sexual compulsivity, however, each must be considered in the context of other information gathered during the initial screening. An initial interview should be objective, non-judgmental, and include questions that help gather the data necessary to distinguish between sexual concerns and sexual compulsivity.
Such questions may include:
"Have you made efforts to stop the sexual behavior?"
"What consequences have you experienced as a result of your sexual behavior?"
The initial screening process should include questions that evaluate whether other behaviors or substances are problematic for the individual.
Schneider (1994) suggested that counselors examine the history, frequency, sense of loss of control, obsession, and consequences to help ascertain if the behavior has become problematic.
The following instruments and interview instructions may be helpful in determining if sexual compulsivity is an issue:
The sexual interview should address any sexual issues that surfaced during other testing or assessment procedures. Often, questions from various instruments can serve to stimulate dialogue between the interviewer and interviewee.
The interviewer should review all pertinent and available data prior to starting the interview process. The sexual interview questions should seek to gather relevant sexual information and fill in gaps that are missing from other areas.
It is useful to ask clients to complete a structured, written sexual history that includes a detailed account of all sexual behaviors since early childhood. This history can assist in determining the questions to ask during the interview.
Questions to determine how the family of origin dealt with issues of sexuality are a critical part of the sexual interview.
Perhaps the most difficult aspect of the interview is to ask personal, intimate, and sometimes uncomfortable questions. However, it is imperative to address issues such as fetishes, inappropriate sexual arousal, sexual offense behavior, cybersex usage, and unusual sexual practices.
Test from http://www.way2hope.org/signs_of_sexual_addiction.htm :
1. Do you imagine sexual body parts or activities more than a few times
a week?
2. When these imaginations occur, do you find yourself dwelling on these
thoughts?
3. Do you view nude images in books or on the Internet?
4. Do you view images of sexual body parts?
5. When you see underwear ads or commercials, do you think about sex?
6. When viewing sexually suggestive TV programming, do you pause or replay
the images?
7. When making love with your spouse, do you find yourself thinking of
other people?
8. When you see people of the opposite sex, do you find yourself looking at
their sexual body parts?
9. Do you view pornographic materials featuring children or young teens?
10. Do you have sexual thoughts about children or young teens?
11. Have you thought about how you could seduce a particular child or young
teen?
1. Do you masturbate while imagining sexual images, viewing explicit
materials or remembering people you've seen?
2. Have you ever masturbated to the point of not being sexually interested
in you spouse?
3. Do you attend "adult" theaters or drive-ins?
4. Do you visit nude (partially or totally) night clubs or strip clubs?
5. Do you engage in cyber-sex or phone sex?
6. Do you visit peep shows, where people display their sexual organs?
7. Do you engage in spouse swapping or orgy type behavior?
8. Do you ever pressure your spouse for sex when they don't feel like it?
9. Do you ever pressure your spouse to engage in sexual behavior they're
uncomfortable with?
10. Do you use prostitutes?
11. Do you masturbate while thinking about children or young teens?
12. Do you masturbate while viewing pornographic images of children or
young teens?
13. Do you think about children or young teens while making love with your
spouse?
14. Do you masturbate often while thinking about a particular child or
young teen?