Compulsive Sexual Behavior as an Impulse Control Disorder: Awaiting Field Studies Data

Abstract

This is a response to Gola and Potenza's (2018) Letter to the Editor regarding Walton, Cantor, Bhullar, and Lykins' (2017a, b) review of hypersexuality. In their Letter, Gola and Potenza referred to problematic hypersexuality as compulsive sexual behavior (CSB), although such behavior has also been variously described as hypersexual behavior, sexual impulsivity, sexual compulsivity, and sex addiction (Cantor et al., 2013; Kafka, 2010). Inherent to these varied theoretical conceptualizations exists the premise that some people experience their sexual behavior as recurrent, uncontrollable, and distressing. Walton et al. (2017a, b) suggested that hypersexuality may be a distinct disorder for a nucleus of presentations, although the condition is likely to often indicate a heterogeneous psychosexual behavioral problem or clinical or subclinical symptom of an existing psychological disorder or medical condition. Further research is needed, however, as there is still a debate whether CSB can be considered a clinical condition and, to date, only a small number of studies have investigated the neuroscience related to CSB. Gola and Potenza (2018) identifed that further data are required, involving representative samples and longitudinal studies, to inform various conceptualizations of CSB and to better evaluate clinical and subclinical populations. Indeed, recruitment of representative samples for investigating CSB may assist health professionals to understand its prevalence, diferences related to groups (e.g., age, gender, sexual orientation, culture), subtypes of sexual interest and behavior (e.g., pornography use), and risk factors (e.g., moral beliefs). Gola and Potenza also cited additional neuroscientifc research to Walton et al. (2017a). This research suggested that CSB may be associated with increased reactivity to sexual stimuli related to the anterior cingulate, ventral striatum, and amygdala regions of the brain.