Jury’s Still Out On “Sex Addiction”

Sexual addiction–if dinner parties had trending topics, this would rank first this holiday season.

We told you about Dr. Drew’s new show Sex Rehab, about eight people dealing with issues stemming from their addiction to sex, last month and just recently one of our writers wrote a scathing critique of the classification of Tiger Woods’ multiple affairs as sexual addiction.

Everyone seems to be talking about this new pandemic, but some experts are not so sure this ailment is legit.

A piece in Forbes recently explored the matter:

No such diagnosis is even recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), psychiatry’s Bible. The DSM-IV assiduously avoids the word “addiction,” preferring to talk about dependence, withdrawal and compulsion. A new condition, called hypersexuality, might be something close, but some psychiatrists bristle at the idea of talking about human sexuality as an addictive force unto itself.

Craig Fabrikant, a clinical psychologist at Hackensack University Medical Center, says that he doesn’t believe that sex addiction exists in the same way that alcohol or cocaine addiction does. Real disorders, however, might cause behavior that is interpreted as sex addiction. For example, someone in the manic phase of bipolar disorder can be overly sexual, and a person with obsessive compulsive disorder might look at pornography frequently.

The idea of sex addiction, however, got a big boost in 1983 with the publication of a book called Out of the Shadows by Patrick Carnes, Ph.D., who has treated patients with the disorder at several clinics. The idea is that because sex releases dopamine in the brain and provides a momentary high just as many drugs do, problematic sexual behavior could be understood as being very much like a chemical dependency.

But is compulsive sexuality really similar to pathological gambling or even compulsive shopping? One small brain-imaging study says maybe not. Researchers at the University of Minnesota compared eight people who had been diagnosed with hypersexuality with others who had been diagnosed with impulse-control disorders like gambling or attention deficit disorder. There was also a control group.

The subjects were asked to look at a flashing letter on a screen, and quickly press a button if they saw any letter other than “X.” Patients who have impulse disorders usually press the button more often; this held true for both the patients who had traditional problems as well as the sexually compulsive people.

Things changed, however, when the researchers had their subjects do this task inside an MRI machine. People with impulse disorders had reduced activity in the bottom front of the brain (as seen in previous experiments), but the people with sexual disorders had reduced activity at the top front of the brain, indicating that something different was going on.

Michael H. Miner, one of the University of Minnesota researchers, cautions that his study is too small to draw any firm conclusions.

“There’s a lot of conceptual writing, there’s a lot of theoretical writing, there’s not a great deal of empirical data,” Miner says. “If this is a disorder, what is it? Is this really a disorder at all, or is it a series of symptoms that are part of something else?”

The truth is we don’t know.

Read the entire article at Forbes.