Should compulsive sexual behavior be considered an addiction?
Open accessAbstract
Aims: To review the evidence base for classifying compulsive sexual behavior (CSB) as a non‐substance or ‘behavioral’ addiction. Methods: Data from multiple domains (e.g. epidemiological, phenomenological, clinical, biological) are reviewed and considered with respect to data from substance and gambling addictions. Results: Overlapping features exist between CSB and substance use disorders. Common neurotransmitter systems may contribute to CSB and substance use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases. Similar pharmacological and psychotherapeutic treatments may be applicable to CSB and substance addictions, although considerable gaps in knowledge currently exist. Conclusions: Despite the growing body of research linking compulsive sexual behavior (CSB) to substance addictions, significant gaps in understanding continue to complicate classification of CSB as an addiction.
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Men with problematic pornography use show relatively high reaction to sexual cues.
“The notion is also applicable to sexuality, i.e. a relatively high reaction to sexual cues, as shown, for example, by men with a problematic use of pornography (Kraus et al., 2016;Voon et al., 2014).”
From A motivation model of sex addiction – Relevance to the controversy over the concept (2022) · cites this paper as Kraus et al., 2016
The Neurobiological Basis of CSB section reports greater brain activation and attentional bias to pornographic cues in men with compulsive sexual behavior than in men without it. But it also reports lower responses to pornographic photos among some people reporting problematic pornography use without CSB. The claim is supported for the CSB group, not for men with problematic pornography use generally. (LLM, conf=0.84)
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“…together with substance-use disorders as addictive behaviors (cf. Chamberlain et al., 2015; Derbyshire and Grant, 2015; Fauth-Bühler and Mann, 2015; Fauth-Bühler et al., 2016; Grant et al., 2006, 2010; Grant and Chamberlain, 2015; Kraus et al., 2016; Potenza, 2006; Robbins and Clark, 2015).”
Self-citationBrand, M., Wegmann, E., Stark, R., Müller, A., Wölfling, K., Robbins, T. W., & Potenza, M. N. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.06.032 · Cited by 2,126 · see citing works
“…also exist neuroimaging studies of compulsive sexual behaviors, including problematic pornography use (e.g., Brand et al., 2016a; Gola et al., 2017; Klucken et al., 2016; Schmidt et al., 2017; Voon et al., 2014), which have been examined in recent reviews (Kraus et al., 2016; Stark et al., 2018).”
Self-citationCompulsive sexual behaviour disorder in the ICD‐11
Kraus, S. W., Krueger, R. B., Briken, P., First, M. B., Stein, D. J., Kaplan, M. S., Voon, V., Abdo, C. H. N., Grant, J. E., Atalla, E., et al. (2018) · World Psychiatry · doi:10.1002/wps.20499 · Cited by 511 · see citing works
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Brand, M., Rumpf, H.-J., Demetrovics, Z., MÜller, A., Stark, R., King, D. L., Goudriaan, A. E., Mann, K., Trotzke, P., Fineberg, N. A., et al. (2020) · Journal of Behavioral Addictions · doi:10.1556/2006.2020.00035 · Cited by 398 · see citing works
Self-citationCan Pornography be Addictive? An fMRI Study of Men Seeking Treatment for Problematic Pornography Use
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Self-citationHigh-frequency pornography use may not always be problematic
Bőthe, B., Tóth-Király, I., Potenza, M. N., Orosz, G., & Demetrovics, Z. (2020) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2020.01.007 · Cited by 242 · see citing works
Self-citationRevisiting the role of impulsivity and compulsivity in problematic sexual behaviors
Bőthe, B., Tóth-Király, I., Potenza, M. N., Griffiths, M. D., Orosz, G., & Demetrovics, Z. (2019) · The Journal of Sex Research · doi:10.1080/00224499.2018.1480744 · Cited by 220 · see citing works
Self-citationHypersexuality: A Critical Review and Introduction to the “Sexhavior Cycle”
Walton, M. T., Cantor, J. M., Bhullar, N., & Lykins, A. D. (2017) · Archives of Sexual Behavior · doi:10.1007/s10508-017-0991-8 · Cited by 192 · see citing works
Is internet pornography causing sexual dysfunctions? A review with clinical reports
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Self-citationImpulsivity traits and addiction-related behaviors in youth
Rømer Thomsen, K., Callesen, M. B., Hesse, M., Kvamme, T. L., Pedersen, M. M., Pedersen, M. U., & Voon, V. (2018) · Journal of Behavioral Addictions · doi:10.1556/2006.7.2018.22 · Cited by 173 · see citing works
Self-citationCompulsive sexual behavior and dysregulation of emotion
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Self-citationParoxetine Treatment of Problematic Pornography Use: A Case Series
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What should be included in the criteria for compulsive sexual behavior disorder
Gola, M., Lewczuk, K., Potenza, M. N., Kingston, D. A., Grubbs, J. B., Stark, R., & Reid, R. C. (2022) · Journal of Behavioral Addictions · doi:10.1556/2006.2020.00090 · Cited by 134 · see citing works
Self-citationPsychometric instruments for problematic pornography use: A systematic review
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Neurocognitive mechanisms in compulsive sexual behavior disorder
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Self-citationChild sexual abuse and compulsive sexual behavior: a systematic literature review
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Self-citationProfiles of cyberpornography use and sexual well-being in adults
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Psychiatric comorbidity in compulsive sexual behavior disorder (CSBD)
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An integrated model to assess and treat compulsive sexual behaviour disorder
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The association between the quantity and severity of pornography use: a meta-analysis
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Compulsive sexual behavior: A twelve-step therapeutic approach
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Self-citationA network approach to hypersexuality: insights and clinical implications
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Controversies and clinical recommendations for the treatment of compulsive sexual behavior disorder
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“The notion is also applicable to sexuality, i.e. a relatively high reaction to sexual cues, as shown, for example, by men with a problematic use of pornography (Kraus et al., 2016; Voon et al., 2014).”
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- Authors
- Kraus, S. W., Voon, V., & Potenza, M. N.
- Affiliations
- Yale University (US)
- University of Cambridge (GB)
- Corresponding author
- Kraus, Shane W.
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2016-02-18
- Volume
- 111
- Issue
- 12
- Pages
- 2097-2106
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC4990495
- OpenAlex
- W2276653618
- Cited by
- 402
- References
- 98
- Citations by year
- 2026: 39 · 2025: 23 · 2024: 20 · 2023: 35 · 2022: 38 · 2021: 50 · 2020: 89 · 2019: 30 · 2018: 38 · 2017: 22 · 2016: 17 · 2015: 1
- FWCI
- 5.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Responsible Gaming
- NIH Clinical Center
- Topics
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- compulsive sexual behavior, behavioral addiction, addiction classification, substance use disorders, neurotransmitter systems, craving, attentional bias, pharmacotherapy, psychotherapy, gambling addiction
- MeSH terms
- Compulsive Behavior, Erotica, Female, Humans, Impulsive Behavior, Libido, Male, Reward, Sexual Behavior, Behavior, Addictive, Unsafe Sex, Craving
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