Creating a Definition for Sex Addiction That Will Withstand Scrutiny
Addiction Basics
Addiction is a mental and physical process that begins when the brain stops treating a substance or behavior as unusual and instead starts treating that substance or behavior as a necessary given for its “normal” daily function. Patterns of life-disrupting behavior reinforce this physical dependence and signal the true onset of addiction by orienting an affected person’s life toward the fulfillment of the brain’s ongoing cravings for its new norm. The most clear scientific evidence for the development of addiction has been established for a variety of substances known to affect the brain’s pleasure centers, including legal and illegal opioid drugs (narcotics), cocaine and other legal or illegal stimulants, nicotine, alcohol and marijuana. However, a growing body of evidence has firmly established that behaviors can also affect the brain’s pleasure centers in the absence of drugs or alcohol, and thereby can trigger patterns of addiction. The terms commonly used to describe these non-substance-based behavioral patterns are behavioral addiction and process addiction.
Sex Addiction
Sex addiction is a proposed process addiction centered on dysfunctional patterns of sex-oriented thinking and feeling, as well as sex-oriented behavior. However, the condition does not have the recognition of the American Psychiatric Association (APA), which (among other things) formulates the basic terms for diagnosable substance and process addictions in the U.S. This means that doctors have no single frame of reference for deciding what constitutes sex addiction and what doesn’t. In 2009, a mental health professional from a well-regarded U.S. institution proposed a definition for the condition under the title hypersexual disorder (HD). However, in 2013, the APA decided not to use this definition, and sex addiction still has no official status equal to that of substance addiction or the sole recognized process addiction, gambling disorder.
Toward a Workable Definition
In the study review published in Sexual Addiction & Compulsivity, researchers from the University of North Texas, Georgia State University and the University of Virginia looked at the accumulated body of evidence regarding sex addiction and attempted to assess how this evidence might contribute to a workable definition for a diagnosable disorder. Specifically, they looked at three separate lines of potential evidence: self-reports of hypersexual thoughts and behaviors from various study participants, self-reported harmful outcomes of those thoughts and behaviors, and interview sessions conducted by doctors under controlled circumstances.
After completing their review, the researchers found that there is considerable evidence to support the existence of harmful, dysfunctional patterns of sexual behavior among certain adults. However, they also found that, since previous efforts in the field relied on a wide range of techniques to detect the presence of sex addiction, there is no way of reconciling all of the available information into a single framework that mental health professionals can use for a consistent, logical, meaningful diagnosis. One specific area of hindrance is prior researchers’ tendency to use of a large number of non-universal, non-equivalent terms to describe the presence of an observed or reported addictive relationship toward sex.
The American Psychiatric Association rejected the proposed definition for hypersexual disorder for a number of reasons, including a lack of the ability to consistently use the definition to tell the difference between sexually addicted patterns of thought and behavior and the normal (and widely varying) patterns of sex-related thought and behavior found in the vast majority of adult human beings. However, the authors of the study published in Sexual Addiction & Compulsivity note, the development of the basic terms for hypersexual disorder still represents a clear advance in the attempt to define a condition that could withstand the APA’s scrutiny. They also believe that, over time, the establishment of hypersexual disorder’s terms will further focus the efforts of future researchers and gradually provide an increasingly mutual frame of reference for identifying dysfunctional, compulsive sexual thoughts and actions. In turn, this mutual framework may finally produce a compelling, coherent definition that leads to the official recognition of sex addiction.