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Mental health professionals’ pathologization of compulsive sexual behavior: Does clients’ gender and sexual orientation matter?
Abstract
It has recently been proposed that compulsive sexual behavior disorder should be included in the 11th version of the International Statistical Classification of Diseases and Related Health Problems. Concerns have been repeatedly expressed regarding the overpathologizing of sexual behaviors and the potential for false-positive results in clinical practice. Empirical evidence indicates that stereotypes related to gender and sexual orientation might influence therapists' assessments of clients. Those stereotypes are likely to be associated with different levels of pathologization and stigmatization of high levels of sexual interest and behavior. The aim of this study was to explore the possible connections between clients' gender and sexual orientation and mental health professionals' (MHP) pathologization of compulsive sexual behavior. A sample of MHPs (N = 546) were presented with a case vignette describing a client with compulsive sexual behavior. The information on the client varied by gender (male or female), sexual orientation (homosexual or heterosexual), and clinical condition (ambiguous diagnostic criteria and fulfilled compulsive sexual behavior disorder diagnostic criteria). After reading the vignette, the MHPs rated the client's mental health status and gave an opinion about causation (psychological vs. biological etiology) and stigmatization indicators (blaming the affected individual for their problems, desire for social distance, perception of dangerousness). The MHPs showed significantly fewer tendencies to pathologize when the client was a homosexual woman or man independent of their clinical condition. Mediation analyses revealed that the biological etiological model partly mediated the effects of reduced pathologization in homosexual clients. These results indicate that clinical decisions relating to compulsive sexual behavior are influenced by nosologically irrelevant beliefs about the biological causation of sexual behavior. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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A current study showed that homosexual women and men were less often diagnosed as having CSBD as compared to heterosexual women and men regardless of whether individuals fulfilled the criteria or not.
“For example, a current study showed that homosexual women and men were less often diagnosed as having CSBD as compared to heterosexual women and men regardless of whether individuals fulfilled the criteria or not (Klein, Briken, Schröder, & Fuss, 2019).”
From Treatments and interventions for compulsive sexual behavior disorder with a focus on problematic pornography use: A preregistered systematic review (2022) · cites this paper as Klein, Briken, Schröder, & Fuss, 2019
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“However, as previously alluded to, clinician judgment can be clouded by both personal and client individual differences (Droubay & Butters, 2019; Klein et al., 2019).”
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Metadata
- Authors
- Klein, V., Briken, P., Schröder, J., & Fuss, J.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Venue
- Journal of Abnormal Psychology
- Published
- 2019-07
- Volume
- 128
- Issue
- 5
- Pages
- 465-472
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- OpenAlex
- W2960744532
- Cited by
- 36
- References
- 1
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 2 · 2022: 5 · 2021: 6 · 2020: 8 · 2019: 1
- FWCI
- 5.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Abnormal Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Keywords
- compulsive sexual behavior disorder, pathologization, sexual orientation, gender, mental health professionals, diagnostic decision-making, biological etiology, sexual stereotypes, stigmatization, case vignettes, sexual interest
- MeSH terms
- Adult, Attitude of Health Personnel, Compulsive Behavior, Female, Homosexuality, Humans, Male, Middle Aged, Psychiatry, Psychology, Sexual Behavior
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