INTRODUCTION: The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed "hypersexual disorder," "sexual addiction," "porn addiction," "sexual compulsivity," and "out-of-control sexual behavior." OBJECTIVES: To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them. METHODS: A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues. RESULTS: CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent "unhealthy" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed. CONCLUSIONS: Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related "out-of-control sexual behaviors" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
BACKGROUND AND AIMS: Despite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide standardized, state-of-the-art screening tools for research and clinical practice. METHOD: Using data from the International Sex Survey (N = 82,243; Mage = 32.39 years, SD = 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD. RESULTS: A total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were present in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability. DISCUSSION AND CONCLUSIONS: This study contributes to a better understanding of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive prevention and intervention strategies for CSBD that are currently missing from the literature.
- MeSH
- Antipsychotic Agents administration & dosage therapeutic use MeSH
- Adult MeSH
- Gender Dysphoria therapy MeSH
- Homosexuality psychology MeSH
- Gambling psychology therapy MeSH
- Borderline Personality Disorder diagnosis psychology therapy MeSH
- Disruptive, Impulse Control, and Conduct Disorders diagnosis etiology therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Munchausen Syndrome diagnosis etiology therapy MeSH
- Paraphilic Disorders diagnosis etiology psychology therapy MeSH
- Suicide, Attempted MeSH
- Personality Disorders * diagnosis etiology classification therapy MeSH
- Psychotherapy methods MeSH
- Self Mutilation psychology MeSH
- Sexual and Gender Disorders psychology therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Edice postgraduální medicíny
První vydání 215 stran : ilustrace, tabulky ; 24 cm
Kniha poskytuje informace o diagnóze a léčbě sexuálních dysfunkcí u mužů i žen, sexuálních onemocněních a některých sexuálně přenosných nemocech. Publikace je určena studentům lékařských fakult, připravujících se na atestaci ze sexuologie i praktickým lékařům z jiných oborů, kteří se ve své praxi s touto problematikou setkávají.; Publikace je určena mladým lékařům nejen před atestací ze sexuologie, ale také ambulantním i ústavním odborníkům, kteří chtějí získat přehled o problematice sexuologie v běžné klinické nebo ambulantní praxi.Kniha nabízí přehled současných diagnostických a terapeutických postupů ve vyšetřování mužské plodnosti a její léčby, v problematice mužských a ženských sexuálních dysfunkcí, věnuje se transsexualitě, zabývá se aktuálními postupy u diagnostiky sexuálních parafilií, falopletysmografickým vyšetřením nebo problematikou forenzní sexuologie s přihlédnutím na postupy u soudně znaleckých posudků v sexuologii. Opomíjena nezůstává ani sexuologická terapie zaměřená na onkologické pacienty v urologii, pohled na HIV pacienty nebo na gender problematiku.
- MeSH
- Paraphilic Disorders diagnosis therapy MeSH
- Sexually Transmitted Diseases MeSH
- Sexual Dysfunction, Physiological diagnosis therapy MeSH
- Conspectus
- Patologie. Klinická medicína
- NML Fields
- sexuologie
- NML Publication type
- kolektivní monografie
Penile plethysmography (PPG) is the primary physiologic assessment method used to gauge sexual responses in adult men. Depending on the country or jurisdiction of assessment, stimuli used to elicit arousal can include videos, still images, and audio materials. It can depict a variety consenting and non-consenting sexual scenarios as well as neutral, non-sexual scenarios. Models in visual stimuli can be clothed, semi-clothed, or nude. Variation in stimuli modality and the type of sexual interest being tested can have a large impact on PPG outcomes. This paper reviews research on types of PPG stimuli, the different sexual interests being assessed, reliability and validity, and the impact of anonymizing models depicted in assessment materials. Innovations in stimuli development in three labs located in Canada, the United States, and the Czech Republic are also discussed. The work done in these three labs and the broader range of research on assessment stimuli are presented to highlight the need for a unified, multi-site, standardized approach to assess problematic sexual interests and their change in response to treatment.
- MeSH
- Arousal physiology MeSH
- Adult MeSH
- Photography * MeSH
- Humans MeSH
- Paraphilic Disorders diagnosis psychology MeSH
- Penis blood supply MeSH
- Plethysmography standards MeSH
- Sexual Behavior physiology psychology MeSH
- Videotape Recording * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- Geographicals
- Czech Republic MeSH
- Canada MeSH
- United States MeSH
This article provides a comparison and comprehensive analysis of varied approaches to the assessment of sexual interest and behaviours at different international sexual behaviour assessment labs. The assessment protocols are described for four sexual behaviour laboratories: the Royal Ottawa Mental Health Centre's Sexual Behaviours Clinic in Canada; the Medical University of South Carolina's Sexual Behaviours Clinic and Laboratory in the US; the Laboratory of Evolutionary Sexology and Psychopathology in the Czech Republic; and the Laboratory of Forensic Sexology in Russia. An overview of examinee demographics and types of cases assessed is provided for each lab. Assessment protocols, including psychometric measures and objective measures of sexual interest and arousal, such as penile plethysmography or eye-tracking, are also reviewed. The differences across labs may lead to interesting and productive cross-cultural investigations and studies about the efficacy of specific assessment methods.
- MeSH
- Internationality * MeSH
- Humans MeSH
- Paraphilic Disorders diagnosis psychology MeSH
- Penis blood supply MeSH
- Plethysmography * MeSH
- Psychometrics MeSH
- Sexual Behavior psychology MeSH
- Forensic Psychiatry legislation & jurisprudence MeSH
- Cross-Cultural Comparison * MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- Geographicals
- Czech Republic MeSH
- Russia MeSH
- North America MeSH
- MeSH
- Aggression * psychology MeSH
- Exhibitionism MeSH
- Comorbidity MeSH
- Humans MeSH
- Paraphilic Disorders diagnosis therapy MeSH
- Psychotherapy MeSH
- Sexual Behavior * psychology MeSH
- Sex Offenses psychology MeSH
- Triptorelin Pamoate therapeutic use MeSH
- Residential Treatment methods legislation & jurisprudence MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Interview MeSH
- MeSH
- Homosexuality psychology MeSH
- Humans MeSH
- Paraphilic Disorders diagnosis psychology therapy MeSH
- Sexuality MeSH
- Sexual Behavior MeSH
- Sex Offenses classification prevention & control legislation & jurisprudence MeSH
- Sexual Dysfunctions, Psychological diagnosis rehabilitation MeSH
- Sexology MeSH
- Check Tag
- Humans MeSH
