Talk:Sexual addiction

Addicted to men

This seems like an absurd title for a redirect to this article. Does anyone know if this refers to something in particular? If not, I'm going to WP:RfD it. Seppi333 (Insert 2¢) 10:43, 21 April 2019 (UTC)

It is indeed a very silly redirect; it was a single link from the article Nurse 3D, which I have now removed from the article. Yes, please RfD it. -- The Anome (talk) 10:56, 21 April 2019 (UTC)

Listed at WP:RfD#Addicted to men. Seppi333 (Insert 2¢) 11:13, 21 April 2019 (UTC)

Move of the article

The Anome, regarding this and this, Mayo Clinic and mdedge.com are not ideal sources to use for medical topics; see the the archived discussions on Mayo Clinic at Wikipedia talk:Identifying reliable sources (medicine), including Wikipedia talk:Identifying reliable sources (medicine)/Archive 10#Mayo: how did this happen ?. Furthermore, "sexual addiction" is the WP:Common name for this topic. If we are going with a medical name per WP:NCMED, it's still the case that, per this 2017 "Routledge International Handbook of Sexual Addiction" source and sources like it, "sexual addiction" is the most common name and that the concept is not defined consistently in the literature. I've requested that your move be undone. I will alert WP:Med to this matter. Flyer22 Reborn (talk) 01:51, 22 April 2019 (UTC)

Try these:

• Fong, Timothy W. (2006). "Understanding and Managing Compulsive Sexual Behaviors". Psychiatry (Edgmont). 3 (11): 51–58. ISSN 1550-5952. PMC 2945841. PMID 20877518. Compulsive sexual behavior, otherwise known as sexual addiction, is an emerging psychiatric disorder that has significant medical and psychiatric consequences
• Derbyshire, Katherine L.; Grant, Jon E. (2015). "Compulsive Sexual Behavior: A Review of the Literature". Journal of Behavioral Addictions. 4 (2): 37–43. doi:10.1556/2006.4.2015.003. ISSN 2062-5871. PMC 4500883. PMID 26014671. Compulsive sexual behavior (CSB), also known as sex addiction, hypersexuality, excessive sexuality, or problematic sexual behavior, is characterized by repetitive and intense preoccupations with sexual fantasies, urges, and behaviors that are distressing to the individual and/or result in psychosocial impairment

-- The Anome (talk) 07:48, 22 April 2019 (UTC)

We don't seem to have an article about Compulsive sexual behavior disorder, which is an ICD-11 diagnostic code.[1] A quick look at some search results[2][3] suggests that there isn't a one-to-one correlation with sexual addiction, partly because "sex addiction" seems to be a code phrase for "I got caught cheating (or raping, or spending more time looking at porn than my mother approves of), and I don't want to take responsibility for my actions".

Like basically every ICD-listed diagnosis, CSBD is notable. Do you all think that it'd be better to handle CSBD separately, or as part of this larger subject? WhatamIdoing (talk) 17:52, 22 April 2019 (UTC)

As part of this larger subject. What I find remarkable is that the greater part of this article is about how "sex addiction" does not actually exist as an official clinical entity in any of the major diagnostic systems. The concept of sex addiction seems to me to be at once the product of moral panic and social conservatism that allows the thinking behind the War On Drugs to be expanded to the sexual sphere, providing yet another way to disparage un-approved-of sexual activity, and, as you say, an all-purpose excuse for sexual misbehavior that can be used to medicalize away responsibility. It's also created a whole specialist industry devoted to diagnosing and treating sex addiction. The only problem I can see with using the ICD-11 concept is that the ICD-11 is still being revised, and has not yet come into effect, but at least the CSBD definition actually exists. The neurochemical models being applied to behavior reinforcement and compulsivity are interesting, and they seem make a lot of sense here once you stop using the word "addiction". I would imagine that this reasoning was probably behind the ICD-11 decision to use the concept of compulsivity rather than addiction. -- The Anome (talk) 09:08, 23 April 2019 (UTC)

The Anome, those references don't change what the common name is. They also don't establish that "compulsive sexual behavior" is the most common clinical name for the topic.

As for "compulsive sexual behavior disorder," per WP:No page, I think it should definitely be regulated to this article for now. Like the Routledge source I cited above notes, there are a number of different terms for this topic and the concept isn't cleanly defined. Hypersexuality is currently its own Wikipedia article, but it is commonly seen as just another term/concept for sexual addiction (as noted by the aforementioned Routledge source).

As for the validity of sexual addiction and whether or not it is harmful, there are a lot of people who report it as having reduced their quality of life. This is related to pornography addiction, although obviously sex addiction is broader than that. Although sex addiction has conceptual issues and isn't an official diagnosis (if excluding the ICD-11 diagnostic code), many or most researchers who study it clearly believe it exists. It's just a matter of naming it and what criteria to use for it. Researchers know that humans can develop compulsive behaviors regarding a number of things, including video games. The human brain is like that. Some people may use their condition as an excuse, but it's more so a reality than an excuse. Compulsive behavior can be harmful, although not always. As for rape, WhatamIdoing... I haven't seen any researcher try to justify rape by stating "he has a sexual addiction." Flyer22 Reborn (talk) 00:51, 24 April 2019 (UTC)

I didn't say that respectable researchers say that sexual addiction is a justification for rape, or anything else. I said that the self-identified sex addicts (and their publicists and their lawyers) say that, and things like that. This is presumably why this page is linked to in so many BLPs.

On the general question, right now, it appears that any psychologist, not to mention any author who wants to make a fast buck, is free to make up his own mind about what constitutes "sex addiction", without regard to whether it's properly an addiction or anything else. So there appears to be quite a diversity of definitions, some of which have defined nearly half of adult men as "sex addicts". The ICD's notion of CSBD is probably at the other end of that continuum, with only about 1% of adults qualifying for a diagnosis. It isn't widely in current use, but ICD-11 was "released" last year and is supposed to be officially "endorsed" by WHO next month (each country decides when/whether to use it), so I think we'll see a lot more use of that language soon.

The question I'd like to ask, though, isn't really about the title. It's about whether we want to have one article about whatever sexual behavior somebody claimed was due to "addiction", and a different one about the scientifically researched subject of an impulsive behavior disorder, or whether we want to make the formal scientific subject be just one section in this article. WhatamIdoing (talk) 23:06, 24 April 2019 (UTC)

WhatamIdoing, I know that you didn't "say that respectable researchers say that sexual addiction is a justification for rape, or anything else." I just wanted to point out that I haven't seen any researchers arguing that. And if there are some that do, they are WP:Fringe. I also have not seen any sex addicts or their lawyers argue that, but maybe you saw something in the news that I didn't.

I don't know about "some of which have defined nearly half of adult men as 'sex addicts'." But it's certainly true that many men have high libidos, and typically have higher libidos than women. A high libido doesn't automatically mean "sex addict." So I see what you mean.

As for multiple articles, I still feel the way that I felt above. In other words, I'm going with WP:No page in this case. Having both this article and the Hypersexuality article is enough, at least for now. And there has been talk of merging the Hypersexuality article into this article. If done, of course unnecessary redundancy should be removed. The only reasons I've been hesitant to support merging these two articles is because of how hypersexuality has been notable in its own right (especially historically) and a source might use the term "hypersexuality" without meaning "sexual addiction." The Hypersexuality article is also currently being used in the "article about whatever sexual behavior somebody claimed was due to 'addiction'" way that you mentioned. See James Cantor's comment in the discussion about merging. He stated, "Because 'hypersexuality' is the most neutral of terms in wide-spread use, I believe it's the best place for an overview, with links to other pages where more detail is needed. That is, I'd return to the page the basic descriptions of the sex addiction model (and compulsion model, etc.) of hypersexuality and refer readers to the sex addiction articles (etc.) in the appropriate section headers." As noted in that discussion, we also have the Hypersexual disorder article, and more discussion took place at WP:Med. Having both a Hypersexuality article and a Hypersexual disorder article is similar to the suggestion of having both a Sexual addiction article and Compulsive sexual behavior disorder article, and it's too much. Best to consolidate this material, like the Hypersexuality article currently does. That stated, Cantor might think that using the "Compulsive sexual behavior" title is best for this article and that "Compulsive sexual behavior disorder" should be its own article linked within that one. Flyer22 Reborn (talk) 04:48, 26 April 2019 (UTC)

One of the DSM-related proposals for sex addiction gave ≥1 orgasm per day as a standard, until someone figured out that this meant 40% of adult men (probably "otherwise healthy adult men in some suitable age range", etc., but still: nearly half in a category that has more than a billion people in it). WhatamIdoing (talk) 15:57, 29 April 2019 (UTC)

For a similar example (regarding sexual addiction and compulsive sexual behavior disorder), the Gaming disorder article was recently merged into the Video game addiction article. Flyer22 Reborn (talk) 10:24, 26 April 2019 (UTC)

This article was a very interesting read. Frankly, I’ve had some pretty major qualms with the DSM-5 and ICD-11 diagnostic categories for drug addictions for a while; but, the focus of each diagnostic manual would seem to explain why the diagnostic criteria are a bit borked/conflated with drug dependence. In any event, that article mentions things about the diagnostic classification of compulsive sexual behavior that should be mentioned in this article; e.g., the ICD-11 working group recommending its inclusion in impulse control disorders, which is a diagnostic category composed of a weird amalgamation of behavioral addictions and others disorders unrelated to addiction.

It mentions other things about compulsive sexual behavior that might be worthwhile to cover as well, but the part about the ICD-11 recommendation is the most notable IMO. I don’t really like writing about the diagnosis of addiction for the aforementioned reason, so if someone else is willing to add that, I’d appreciate it. If not, I’ll probably begrudgingly do it at some point. Seppi333 (Insert 2¢) 00:09, 17 May 2019 (UTC)

@WAID: that DSM proposal involving ≥1 orgasm/day as a criterion for sex addiction is a case in point as to why the DSM-5’s approach to the diagnosis of addiction is stupid: the relative frequency of a behavior isn’t diagnostic for addiction. While it’s certainly true that addicts tend to excessively perform behaviors which mediate their addiction (e.g., use an addictive drug), this is not what distinguishes an addict from a non-addict (it'd probably be accurate to describe it as a non-specific behavioral symptom of addiction); e.g., addicts and non-addicts with low genetic loadings for addiction can perform behaviors that mediate an addiction at the same frequency. Moreover, “excessive behavior” in a drug context is equivalent to “overuse” of an addictive drug, but that’s an ill-defined and basically meaningless concept except in the case of prescription drugs, since the “baseline use” (against which “overuse” would be defined and measured) would be the prescribed daily dose. Hence, that proposal represents a divergent approach to diagnosing behavioral addictions. Nevermind, after looking at Substance use disorder#Diagnosis (NB: ignore criteria 10 and 11 since those pertain exclusively to dependence), the DSM-5 invented a rather derp way to measure overuse with criterion 1. I call that derp because a person may plan to use all of drug in their possession whenever they obtain it and desire to continue their drug use indefinitely.
In any event, including a criterion for the frequency of behaviors does not represent a divergent approach to diagnosing behavioral addictions because it's analogous to criterion 1 in the diagnosis of SUDs.

That said, the defining features of any addiction are an intense desire/wanting which is directed toward a stimulus (amplified incentive salience attribution) and an inability to stop oneself prior to or while in the process of exposing oneself to that stimulus (impaired inhibitory control). Consequently, if the questions “Do you experience strong or intense wanting or craving for X?” and “Can you stop yourself from engaging in obtaining X once you start and do something else?” (or something equivalent to these) are not considered in a proposed addiction diagnosis (or an established one in the DSM, ICD, etc. for that matter), then said diagnosis is not actually diagnostic of an addiction. Why? The first question asks in plain English whether or not the behavior in question is rewarding and the associated reward has been sensitized (re: amplified incentive salience). The second question asks in plain English whether or not the behavior is compulsive. Together, they ask whether or not a person is compulsively engaging in a rewarding stimulus: the defining characteristic of addiction. I really don’t see why it’s so hard to develop a set of diagnostic criteria centered around those two features; but, I have little to no interest in nosology, so meh. Seppi333 (Insert 2¢) 00:09, 17 May 2019 (UTC)

One reason I can think of is that when you ask such questions, you give the message that the patient is in control of his/her own diagnosis, not the psychiatrist. Tgeorgescu (talk) 00:47, 17 May 2019 (UTC)

I don't really see the difference between that and a doctor asking a patient if they're experiencing chest pain if they suspect a heart attack or if they occasionally experience headaches at the back of their head if they have high blood pressure. A doctor can't observe pain in a patient just like a psychiatrist can't observe an abnormal cognitive process in a patient. I realize that in both cases, these might be inferred through specific behaviors; but, doctors typically don't check to see if a patient is wincing, grimacing, grabbing their chest, etc. as a proxy for just asking the question. What makes psychiatry different? Seppi333 (Insert 2¢) 01:46, 17 May 2019 (UTC)

Yes, psychiatrists have to question their patients, but they never imply that they take the self-diagnosis of the patient at face value. The questions you suggested boil down to "Do you give yourself the diagnosis of addiction?" Tgeorgescu (talk) 01:54, 17 May 2019 (UTC)

Assuming that a patient correctly identifies that those questions pertain to how an addiction is characterized and knows which responses (i.e., yes/no) would be consistent with that characterization, I'd agree with you. That said, mental health disorders are definitely screened for by asking patients questions. E.g., I recently switched my PCP and was asked a battery of questions pertaining to major depressive disorder. If, for whatever reason, I wanted to game the questionnaire and walk out of my doctor's office with an SSRI prescription, I could've done so fairly easily.

In the diagnosis of an SUD, a clinician asks a patient questions pertaining to those 11 diagnostic criteria. If you read through each of them, you'd notice that criteria 2 and 4 reflect my second and first questions above, respectively. Therefore, I don't think that the DSM-5's SUD diagnosis is woefully borked, but it does conflate 2 disorders by grouping criteria 2 and 4 with criteria 10 and 11 under a single diagnosis.

In any event, I don't really see where you're going with this since what I said really has nothing to do with a self-diagnosis. Even if it did, one could just as easily self-diagnose an addiction from the 2 defining features I mentioned as from the set of 11 (again, technically 9, since 2 reflect a distinct disorder) SUD diagnostic criteria. Seppi333 (Insert 2¢) 03:53, 17 May 2019 (UTC)

Pinging WhatamIdoing since Seppi replied to her. Flyer22 Reborn (talk) 04:37, 18 May 2019 (UTC)

Confusion in the Section on ICD

Hello, the sub-section referring to ICD in the part talking about "classification" is confusing as it refers to both ICD-10 and ICD-11 as "The most recent version of that document". These statements can not both be true can they? It may be worth clarifying what is meant here. — Preceding unsigned comment added by Pwatts2 (talk • contribs) 17:34, 10 June 2019 (UTC)

@Pwatts2: Changed. Tgeorgescu (talk) 20:05, 10 June 2019 (UTC)

In the news

“Historically the term ‘sex addiction’ has been used by white males to absolve themselves from personal and legal responsibility for their behaviors,” one expert said. “It is often used as an excuse to pathologize misogyny.”

— NBC News, 'Sex addiction' isn't an actual disorder, but white men often get excused by using it, experts say

Quoted by Tgeorgescu (talk) 16:35, 21 March 2021 (UTC)

@Hotpine: Regarding Apryl Alexander, an associate professor at the University of Denver, provides no primary source information, therefore it cannot be verified, that's not what WP:VER means. We do not have to second guess associate professors. tgeorgescu (talk) 20:48, 18 December 2021 (UTC)

@Tgeorgescu: I wasn't referring to WP:VER. I was referring to the fact that it's a bad source. You can't just write whatever you want, and then pat yourself on the back because it appears in a (bad) secondary source somewhere. The source shows clear bias, and my point was that the source doesn't provide any primary sources to demonstrate that it's correct despite the appearance of bias. In the absence of any information from sources biased in other directions, the reader isn't being provided a balanced and neutral POV, and so it wouldn't serve their interests to leave the article as-is. — Preceding unsigned comment added by Hotpine (talk • contribs)

Right, we are not "unbiased", but we have a WP:GOODBIAS. tgeorgescu (talk) 06:30, 24 December 2021 (UTC)

Thanks for spamming my talk page, I guess. According to the "yes, we are biased" content you posted there, sources should essentially be scientific. One biased scientist talking out of their butt, and being quoted in a biased article, is not a reputable scientific source. If you can find a scientific journal dumb enough to publish their words verbatim, then great, we can quote and cite that instead. Until then, this is biased, pure and simple, and not in the WP:GOODBIAS way. It's just as bad as homeopathy and the other pseudosciences listed there. Hotpine (talk) 01:45, 22 January 2022 (UTC)

What are negative effects of sexual addiction? — Preceding unsigned comment added by Seriousnes (talk • contribs) 22:03, 17 June 2022 (UTC)

We don't know if sexual addiction even exists. tgeorgescu (talk) 07:59, 14 October 2023 (UTC)

Dr. Donald Hilton

Can we include dr Hilton here Jm33746 (talk) 15:53, 8 October 2023 (UTC)

AFAIK he is a neurosurgeon. His area of expertise does not include sexual "addiction". You are gently reminded to obey WP:MEDRS. tgeorgescu (talk) 17:12, 8 October 2023 (UTC)

And Hilton is an anti-pornography activist, i.e. he wants to ban all pornography, even when consumed with moderation. tgeorgescu (talk) 07:57, 14 October 2023 (UTC)