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Archive 1

Why this article is tagged as potentially inaccurate

I think there are a diversity of points of view on the subject:

  • Sex addiction is a clinically diagnosable mental illness.
  • Sex addiction is a problem some people have.
  • Sex addiction is a myth propagated by anti-sex advocates, usually for religious reasons.

Currently, the article seems to be arguing with itself, and its only references are to some web sites that are obviously biased on the issue. I've tagged this article as potentially inaccurate, until it becomes more coherent and multi-faceted. -- Beland 08:00, 19 July 2005 (UTC)

Inappropriate?

09:57, 25 Apr 2005 ---- deleted "Sexual addiction" (content was: '#REDIRECT hypersexuality' -- inappropriate redirect)

I am scratching my head trying to figure out why redirecting an extremely common (if non-medical) term to the article most closely describes that concept is "inappropriate". I am restoring the redirect; if you think it's inappropriate please explain your logic at WP:RfD. -- Antaeus Feldspar 22:39, 25 Apr 2005 (UTC)

I have unmerged this article from "hypersexuality", and moved it back here, for the good and simple reason that hypersexuality is not the same thing as "sex addiction". Blurring pop-psychology with medicine is not a good idea.
There is serious doubt as to whether "sex addiction" exists. Many people are convinced it does. (See the cites in the article). Many others doubt that is exists, or that it is even a meaningful concept. [1] [2] [3] (and I can supply more, if you'd like).
There is probably a good article to be written about this, but at the moment this isn't it; at the moment, this article is a great heap of POV, that represents only one side of this controversy.
However, hypersexuality, on the other hand, is an undoubted real medical phenomenon, and an observed symptom of several medical conditions, and is acknowledged as such in the medical literature. It can be observed in cases of mania, dementia, Kluver-Bucy syndrome, and even as a result of brain surgery. (Search PubMed for cites ad nauseam.) No-one seriously suggests that it does not exist.
Still, if we don't care about precision, wouldn't it be simpler to just merge most of the medical articles to collywobbles, lurgi, gippy tummy, something wrong down below or feeling a bit out of sorts, and be done with it. -- Karada 23:35, 18 Jun 2005 (UTC)
You know, I actually support your decision to separate "hypersexuality" and "sexual addiction" into different articles. Unfortunately, your apparent inability to deal with views other than your own in any other mode but patronizing the holders of those views means I can't support you as fully as I'd like. Perhaps next time your playground mockery can include snide and factless claims that I would support redirecting cooties to venereal disease, hmmmmm? After all, if one has chosen not to abide by the facts, one has a wide range of options for opponent-smearing.
The fact is that searching on "sexual addiction" brings up ten times the number of hits that hypersexuality does; if someone comes to Wikipedia and searches on "sexual addiction", they should get something. The quality and NPOVness of what they get will of course be determined by who's willing to put effort in, but they should not get nothing just because you don't believe any such thing exists, which is exactly the situation you created when sexual addiction only existed as a redirect and you deleted the redirect -- without going through RfD, which rather borders on abuse of administrator powers. -- Antaeus Feldspar 14:51, 19 Jun 2005 (UTC)
There is no correlation between the number of search engine hits on a phrase and the vigor of argument which supports the legitimacy of the phrase.
You're missing my point completely and entirely. My point is no matter what its state of existence or non-existence is, "sexual addiction" is a notable concept in the cultural landscape, and thus saying "there should be nothing on it because it doesn't actually exist" is completely misguided. Even if the notion of sexual addiction was a deliberate hoax, a quick look at Category:Hoaxes would show that that hardly disqualifies it from being discussed on Wikipedia. If you are still somehow managing to hallucinate that my argument was based on the "legitimacy of the phrase", I urge you to re-read and re-read and re-read until you stop seeing things that aren't there. My point was not that the number of search engine hits on a phrase supports "the legitimacy of the phrase" but that it supports the need to return a result for that phrase. I think I've made my point very clear and I'd appreciate if you'd stop interpolating things I didn't say. -- Antaeus Feldspar 23:21, 11 August 2005 (UTC)

Sexual addiction (SA) is very distinct from hypersexuality as noted.

From what I have seen, the notion of sex addiction is almost universally promulgated by those who have been indoctrinated or believe in the 12-step system. Patrick Carnes, who is mentioned as the most prolific proponent and writer of the notion of sex addiction, seems to be making a bundle off of it, also recommends 12-steps like SLAA. Certainly a lay group which depends on people buying into the notion of sex addiction cannot be looked to as authoritative. There is a growing body of evidence which reasonably identifies SLAA (Sex and Love Addicts Anonymous) and other 12-step groups as cults. So where did this renaming of behaviors previously described in the DSM to sex addiction come from? There is no sound clinical purpose in the grouping of behaviors ranging from serial one night stands, serial monogamy, compulsive masturbation, exhibitionism, frotteurism, all the way to rape, into a single vague term, sex addiction. It looks to me as though this redefinition serves the groups and practitioners patronized by this ever expanding clientele.

Small thing

From the article "Like a dog, he has returned to his vomit." - Piece of idiom I'm not familiar with, seems fairly loaded and subjective? 80.73.223.229 03:43, 24 December 2006 (UTC)

Adding my two cents

I think there is a better way to point out the disputed nature of sex addiction. I'll start by saying that I do believe sex addiction exists. I also understand why it is held in contention. I would like to make the argument that "addiction" is any repetitive and compulsive behaviour that endangers the person. Now, physiological addictions are much more easily to be accepted, since there is "proof". You can measure the addiction. It's the psychological addictions that are more difficult to analyze, and these include gambling and sex. One can argue that the repeated compulsive nature of these activities provides a physiological stimulus, but more down to the point, psychological addicts are still willing to bet their grandmother's last dollar, or have unprotected anal sex with a complete stranger because they need it. That's not mentally healthy. I would like to distinguish that motivation behind sex addiction differs from promiscuity in a number of ways. Many promiscuous people are open abot who they had sex with or are encouraged by their peers to go and have a good time. Sex addicts are often ashamed of their actions and will try to conceal their behaviour. They will stay up until 4am trying to figure out how they can obtain their next "fix" or sexual partner. If a promiscuous person doesn't pick up at a bar, then they go home cursing their bad luck and go to bed. Sex addicts lose their jobs, endanger their health with exposure to STI's and experience many of the same self-esteem issues as other addictions. Additionally to confirm my two cents, hypersexuality, nymphomania, sex addiction and promiscuity are all different things. I am going to rephrase certain areas of the article to encourage a more neutral tone. --Waterspyder 19:08, 24 October 2005 (UTC)

I've fleshed out the Controversy section a bit. Note that sexuality is important to life, just as eating and breathing are. Though, just as requirements for nutrition are not as immediate as requirements for oxygen, requirements for sexuality are not as immediate as requirements for food. Still, just as a person with breathing problems might become obsessive, or even desparing, about breathing the same can happen in other health related areas. Note also that I'm not even arguing that there is no such thing as sexual addiction -- just that there can be other valid causes which fit the same objective descriptions (that said, sexuality is self-limiting in scope see Human sexual response cycle as an example of this and the Westermarck effect as another). -- . RaulMiller 05:27, 25 October 2005 (UTC)

I think you did a very good job of articulating the concerns. I couldn't write on the topic since I myself am onlly well-read on one side of the issue. I'm wondering if we can remove the POV tag? As far as I can tell, the article now has a neutral POV. Expressing both sides of the issue in a factual sense is pretty well what that means. Now if someone will flesh out the intro...--Waterspyder 20:05, 25 October 2005 (UTC)
As stated above, it is an obsessive disorder. That obsessive disorders may have some commonality with addictions is clear, but that does not mean they are the same. Lets not let the addiction addicts cloud the issue. The American Psychiatric Association does not even officially use the term addiction anymore because it has been so watered down by the 12 step cults.

I am a final year psychology student and one of my modules this term is Addictive Behaviours. I've chosen to answer an exam question on sex addiction. My lecturer is one of the leading addiction psychologists in the country. He has stated in his lectures, that although focusing on behavioural rather than biological addictions, he finds the concept of sex addiction difficult. It is not that he is against sex addiction, more the mess the area is in. I have been doing research based on internet searches. I am trying to find out what sex addiction is and what it means to the people who suffer from it. One thing that has amazed me is the complete disagreement between different sites. Every web-site I have visited has a different definition. How can sex addiction exist when no-one knows what it really is? One thing my lecturer emphasised was the importance of context. He stated that everyone goes through stages in their lives when they could be diagnosed a sex addict, but that doesn't mean they are. I understand that sex addiction is very really to the people who claim to have it, and I am not denying they have a problem. I'm just finding the psychological literature to make so little sense, how can it exist? ----bex 22:22, 23 May 2006 (UTC)

I have a concern with the line "People selling spiritually-based methods of treatment claim to provide an effective treatment." under "Treatment". I detect something of an anti-12-step bias in some of the comments here. I've found 12-step programs helpful, and disagree strongly with calling them "cults".

I think a much more neutral and useful statement introducing the idea of 12-step groups under treatment would be something like this:

"A number of groups based on the 12-step model of Alcoholics Anonymous provide an avenue for affected people to learn to deal with their compulsive behavior. Many have found groups such as Sexaholics Anonymous, Sex Addicts Anonymous, Sex and Love Addicts Anonymous, and Sexual Compulsives Anonymous to be quite helpful in understanding and restricting their compulsive sexual behaviors." Robnorth 23:17, 21 June 2006 (UTC)

Controversy

I think the information on the page is well written. I removed that line reading "According to proponents of this concept," from the beginning of each paragraph since I think that it's not neutral for one. An example would be if someone wrote that for the article on Evolution or for Intelligent Design. Let's acknowledge that there is controversy, and I have included a section on Controversy within this article. Right now there is not much information in that section, so I invite people who believe that Sexual addiction is not real to please share their thoughts and reasons in this talk page and under that heading since it will help to elaborate on the larger picture without affecting the other information that people have spent time researching and verifying. Thanks --Waterspyder 19:29, 24 October 2005 (UTC)

Removal of the NPOV

Does everyone think the article is neutral enough to remove the tag? --Waterspyder 04:45, 26 October 2005 (UTC)

I'm not sure it's ready for that yet. There's some striking simularities between the concept of "people suffer from sexual addiction" and the teachings of past religious practices such as mortification or puritanism. I think there should be some up-front coverage of this issue, with some recognition of the potential positive and negative aspects. (Potential positives: people have thought this in the past and might have had a valid reason for that. Potential negative: these reasons might be as more political and/or social than altruistic.) Either that, or there should be much more specific diagnostic criteria -- criteria which are not so trivially satisfiable by people experiencing normal relationship woes. RaulMiller 01:47, 27 October 2005 (UTC)

I'm not sure I particularly agree with what you said for the reasons you said it (if that makes any sense). Neutral Point of View is a standpoint that presents information from a neutral stanpoint. Well, as neutral as humans can get. Not having a specific diagnostic criteria does not make the writing of the article any more or less neutral. I'm absolutely agreeing with you that your points have merit in regards to the controversial nature of the article, but is this controversial issue presented in a way that doesn't make either side grit their teeth in ire? If both sides can read this article and not completely disagree with the way the points are presented, then NPOV exists in the writing of this article. --Waterspyder 01:53, 1 November 2005 (UTC)
I agree with you about what NPoV means. I've fleshed out how each of the existing diagnostic criteria could be interpreted to refer to something which happens in normal relationship situations. My wording is a bit hasty, and could probably be done better -- I'd really like to emphasize that people classified as "sexual addicts" can have very real problems. But I've tried to cover the controversy in more detail. I'd really prefer for the diagnostic criteria themselves to be rephrased in a fashion which, as you say "doesn't make either side grit their teeth in ire", but I'm not sure how to do that. RaulMiller 21:59, 1 November 2005 (UTC)
What's funny about the diagnostic criteria is that many psychiatrists and psychologists rarely actually use the DSM IV to diagnose, and mainly it is there as a guideline, especially for family physicians. I'll take a look though the article when I have time/energy to do it properly. It can be tricky to navigate this topic. The way that the controversy section is shaping up, it may be useful to insert subheadings, but once I take a better look I'll be able to say for sure.--Waterspyder 04:30, 2 November 2005 (UTC)
Ok. Note also that the typical cycle described under Manifestation shares similar attributes. Preoccupation is characteristic of someone in the early stages of the human sexual response cycle. Much about sex and relationships gets ritualized; flirting, dating and marriage are some rather obvious classes of rituals but that's just scratching the surface. Compulsion is one way of describing the psychological changes when a person transitions to an adult and begins to be aware of their sexuality. Despair describes someone losing friends, failing in relationships and that sort of thing. All told, there's nothing there which is specific to addiction unless life itself is to be considered addictive. Perhaps I should delete from the controversy section most of the writeup on diagnostic issues and focus on these manifestation issues instead? RaulMiller 00:36, 3 November 2005 (UTC)
I think that might be better. I mean, it's factual that sex addiction isn't in the DSM and no one quite agrees on the specific diagnosis. The characteristic points of sex addiction are the real items that are disputed, basically as you've outlined. I can definitely see where your points are coming from. I do want to try and give you some perspective (mine). I guess this is the point where I out myself as a sex addict. I'm in a much better place right now than I was 18 months ago, so I can look back and remember certain emotions/behaviours. Preoccupation to me is more than just thinking about it often and wanting it. Yes, that did indeed form a component with daydreaming and the whole bit. Up to a point, I believe that is normal, especially in puberty and in sexually charged situations like bars or strip clubs. But there is a line that gets crossed, preoccupation then becomes disruptive. I stopped going to sleep because I wanted it. I would seduce people at work. It was stupid and potentially destructive behaviour. That is the line.
Ritual, i'll concede, getting gussied up to go to the bar every night is something a lot of people do, and while I might question anyone who does it every night, I think that one may be too vague to ever really draw a line. I would frequently engage in behaviours that resulted in sex, with great compulsion (surfing the web, etc.), but I'm not sure that made me any different than a lotto player.
Despair is when I hit rock bottom, was having unprotected sex with strangers, and the realization that this fucking sucked (pardon the colloquialism). At the same time, it was just depression, and just one of a million roads to get there. But yeah, the controversy is more in the symptoms than anything. "How is this different from being normal?"
Just because I started sharing. I should say that I'm not trying to change your mind on whether it exists. I believe it does though. In any case, the story continued with trying to get help from a 12-step program, but believe me, being a woman in an all-male group didn't fly well. I found out I was a lucky girl when all was said and done. I met my present partner, and for a long while I thought I was getting better, but honestly, I'm not, I'm just in a socially acceptable outlet for my behaviour. I mean, the goal of the 12-step program is to stop objectifying people and no masturbation (ever) or sex until marriage. I didn't last long enough to know if it worked, but from my POV the sex after marriage was somewhat masking the symptoms in a socially acceptable role, and the no masturbation ever was making a normal act into a taboo one. I know that said that marriage was acceptable because marriage is a union under god in which you show true love and bring children into the world. I'm still not sure how I feel about that one.
I don't think I'm ever going to be completely well in this regard, so I work hard in my relationship and with any luck I won't be single any time soon to see where I really am in my progress, because that frankly scares me. Anyhow, take it as you will, but I do think when behaviour crosses a line and works towards destroying your life, and you keep doing it and you're not sure if you can stop, then I call it addiction.--Waterspyder 01:03, 4 November 2005 (UTC)
Ok, that makes sense. I'll try and rework the controversy section -- hopefully in the next few weeks (unless someone else does it better, first). Just to clarify where I'm coming from: I recognize that when people talk about "Sexual Addiction", some of the people they're talking about have very real problems. But, personally, I'd classify these problems as problems relating to other people (or, more bluntly "not enough" of something which is sexual in character) rather than as problems because of their sexual drive (or, bluntly, "too much" sexual drive). Once again, I'm not disputing that people have relationship problems and I'm not really even disputing that the sorts of interaction with other people that go on during a "sexual addiction treatment program" can wind up being helpful. But I am claiming that there are at least some people with these kinds of problems where the basic approach -- treating their drives as "addiction" -- is more likely to make their situation worse than better. There are social ills here, as well as personal ills -- in much of our society, it's simply not polite to talk frankly about sexual issues, and people resort to evasion mechanisms rather than dealing with these issues positively. I see the concept of "sexual addiction" as an extension of this social flaw at least as much as it's an attempt to help those who have gotten themselves into a state they're unhappy about. Put differently, despair is awful and whatever you manage to do to get yourself above that is a positive thing, but it's probably a good idea to distinguish between "here's a label that seems to be associated with what worked for me" and "here's a concept which makes sense for people, in general". Put differently, there's nothing wrong with backing off and approaching things differently -- that's often a very good thing. But you don't need to classify the initial desire as addiction to do that. There's other concepts ("off balance", "out of tune", "unaware", "fearful", etc. etc., there's even some DSM criteria which might apply) which also can be used to describe the same issues. I wouldn't describe someone with an eating disorder as having a food addiction, and while I'll grant that eating disorders could be described as food addiction I don't think the usual concepts of addiction would really be appropriate for those contexts -- much more useful would be helping the person identify and address their real problems. Put differently, please don't consider this controversy about the concept of sexual addiction as a personal criticism of you or of any of the things you've done which help you live your life better. I'd much prefer you think of this as a debate about whether there's better ways to describe these things in a generally meaningful fashion. RaulMiller 20:12, 4 November 2005 (UTC)
Oh, no worries, I know this is not about "me". People have beliefs, sometimes they don't agree. Sometimes I just find it useful to give a firsthand account. I think that much of what you say has a great deal of validity. Some people will use "addiction" as a shield to never get better. I think personally that I can attribute a lot of my personal situation to loneliness and using sex to fix that. Whether this is something many people do, I can't say, I haven't seen research for it! As for open sexuality, I think that's also a geographical thing. Some areas and age groups are more open about discussing sexuality and sexual activity. It's when you start lying to close friends that you didn't have sex with someone, or having to lie because you failed to use protection when you knew damn well you should have that the concealment becomes a real problem. So whether it is an "addiction", or merely a destructive set of behaviours that people share to solve problems, I'm not sure... and I'm not sure that will be clear until we get a little further away from Victorian ethics.

--User:Waterspyder November 5, 2004


Caution on criticism

I did clean up the criticism, and I hope that while I was removing the POV that I didn't swing it too far in the opposite direction. I would like to caution other writers on the use of original source material, usually expressing an idea that has not been previously published in the news or journals. I realize this is a tricky topic to avoid doing so, but it is a public encycolpedia and not a forum for our respective speculations on various topics. In any case, good work so far.--Waterspyder 21:24, 10 November 2005 (UTC)

Been There

This is my 1st contribuition here, so I aploigize up front if I am way out of line. This is probably not of much use, but I thought I would share some of my experience. First to the suggestion: I suggest you replace "Feelings" with emotions as there is a Wikipedia article on emotions. I find the model proposed by Parrott, W. (2001), Emotions in Social Psychology, Psychology Press, Philadelphia and shown at http://changingminds.org/explanations/emotions/basic%20emotions.htm to be helpful when looking at an emotional basis for obsessive compulsive behaviors. I will also mention that model to the editor of the emotions article.

As someone who once considered them self a sex addict and did the 12 Step route for over five years, may I suggest (with all due respect to the 12 Step movement and addiction in general) that obsessive compulsive behaviors are not exactly the same as substance abuse, and trying to apply the same criteria and cure is incorrect.

Example: If a person is a compulsive hand washer, a behavior, and wants to change, they would still be encouraged to wash their hands after relieving them self. But because sex is "pleasurable" and of course the source of much moralizing over the ages there is often a desire to treat it differently. Indeed in the Sexaholics Anonymous fellowship for partners SA-Anon, there is a saying "Sex is optional."

In each individual, the effects of nature and nurturing (or the lack there of) I find truly amazing. But what I have found is that the "Acting out" of painful emotions is pretty close to what the original Alcoholics Anonymous "Big Book" identified: Fear, anger, shame. To which I add loneliness, boredom and depression. I have found that many times the sex addiction masks depression. Not vice versa as the colloquial would suggest.

Sex addiction is for most behavior,and I have found that behaviors can be changed and the "Addiction" either arrested or removed. Thus the difference between sex addiction and say an alcoholic who is one of the 15% of the population who has a physiology that reacts to alcohol differently then the other 85% of the population.

I find it interesting to note that crack cocaine comes very close to replicating the "high" produced in an orgasm.

It is also my opinion based on others research and my own personal observations that many become "sex addicts" in adolescence when they discover masturbation and porn and then use sex as a counter for painful emotions. Then rather work through these painful emotions in adolescence they get a "fix" through sex and don't develop the ability to manage their emotions except through relief via sex. And have difficulty with the secondary and tertiary emotions Parrott postulates. It is well accepted that sexual abuse can have a tremendous effect on a person. Pat Carnes in the Betrayal Bond also shows that sex addiction can demonstrate the effects of PTSD from non sexual abuse.

So if one is willing to do a bit of a paradigm shift, here is one way of looking at it:

If a 12 year old, new to the city, in their inexperience stepped in front of a bus, or was pushed by others who are ill, few would blame the victim. Few would deny the victim medical care, and no one would be surprised if even after a couple of years of treatment the adult was incapable of running a marathon. But if the effects are from an emotional blast the child can't handle, or from a series of small blasts, like a small car driving repeatedly over the same leg, so many are willing to say "Just get over it." Or you don't really have a problem.

Jon Marsh at http://www.recoverynation.com provides a non-12 Step model for changing sex and relationship addictions. One that is based on dealing with emotions from more of a scientific rather then "spiritual" basis. But one that is still based on the need to change one's belief system. Not unlike Martin Seligman teaches in Learned Optimism : How to Change Your Mind and Your Life.

Shiseiji 22:00, 17 March 2006 (UTC)

Is sexual addiction real?

>>>There is no sound clinical purpose in the grouping of behaviors ranging from serial one night stands, serial monogamy, compulsive masturbation, exhibitionism, frotteurism, all the way to rape, into a single vague term, sex addiction.<<<

I hate to disagree with Robnorth, but I'm afraid he's wrong on this. Sexual addition is not determined by the specific act that the addict performs (i.e.: serial one night stands, serial monogamy, compulsive masturbation, exhibitionism, frotteurism, rape), but rather by what is causing it. The addiction is really a symptom of something else, such as childhood traumas or past experiences, just as in the case of drug addiction. What makes it an addiction is not the act itself, which as you say covers a wide gamut of activities, but rather the compulsion that causes it.

For example, we cannot say that a drug addict who has been clean of drugs for 5 years and then returns to his habit is doing so because of the addictiveness of the drug: the drug has been out of his system for years. Something else is driving him to the addiction, a compulsion to get high. Once an addict, always an addict, even if the addict never uses his drug again. The compulsion to use the drug is always there, regardless of whether it is indulged or not.

You're correct that addiction is not determined by the specific act, but not correct in saying that it's determined by past experiences and such... That's as if to say that we're not in control of our own lives, and that our futures are all firmly mapped out as a projection based on our past. The reality of it is that sexual addiction is not determined by the act, or as you say by what causes it, but it's by what the act causes. More on this is soon to be added below.
As for the drug relapse analogy, actually the opposite is true. It is because of the addictiveness of the drug. Sure, you could argue that particular life experiences can have a very significant effect on events in the matter, but it's in no way shape or form a requirement; just merely factors on a purely individual basis.
You see, drugs are broken down in the liver to what we call metabolites, and though much of these metabolites are purged from the body, a certain percentage is trapped within the fatty tissues of the body. Because the fatty tissues in our bodies turn over so slowly, these metabolites can be stored away for years. Eventually they are released back into the bloodstream, reaching the brain, and even in minuscule amounts can cause effects comparable to a full dose once again. That's a relapse. See: http://www.drug-effects.com/drug-facts.htm
Beyond this point I would agree with you fully. :)Moosa17 03:09, 20 March 2007 (UTC)


Similarly, the sex addict is driven by a compulsion to act out sexually, whether that is with masturbation, voyeurism, exhibitionism, promiscuous behaviors, fetishism, fantasy/euphoric recall, etc. That compulsion is in turn caused by something experiential and emotional, and the compulsion really reveals a need to escape that experience or emotion. Some resort to alcohol to escape, others to drugs. And some resort to sexual behaviors that cause a high that is as measurable as the high from drugs or alcohol. It is the compulsion, not the way the compulsion is acted upon, that determines the addiction. And by that standard, sexual addiction is an addiction just like any other.

The sex addict who is acting out has been found to exhibit increased serotonin levels that create a euphoric state in the addict. Much like drug addiction, the sex addict becomes inured to the effects of that serotonin high, and so needs a bigger jolt to attain the same high. This results in the addict looking for riskier behaviors which create the increase in serotonin levels necessary to attain the high. That is how the disease of sexual addiction grows and progresses in the same way that drug or alcohol addiction do.

And similar to the way that the advent of crack-cocaine heralded an increase in drug use and addiction, due to the ease and accessibility of obtaining crack-cocaine, the advent of the internet had a similar effect on sexual addiction. Prior to the advent of the internet, sex addicts had to leave their homes and go to very dangerous places and do dangerous things in order to feed their addictions. But with the advent of cheap internet accessibility, people were able to get their high in the comfort of their own home or office, without much fuss and at low cost. And because of that, sexual addiction became much more prevalent.

So addiction follows many, if not most, of the same patterns as any form of substance addiction. This in turn lends credence to its voracity as its own form of addiction.

These facts have all been quantified and reviewed in various case studies, many of which are cited by Dr. Carnes. They are indeed measurable. The fact that the DSM IV hasn't yet caught up to the knowledge that is available about sexual addiction is not reason enough to dismiss the disease as nonsense. And doing so is detrimental to those who could be helped if they simply knew where to look. Your ready dismissal of sexual addiction as a disease is, in my opinion, irresponsible. —The preceding unsigned comment was added by 192.216.142.1 (talk • contribs) .

First off, thanks for your time! This isn't a warning or anything, just something to hopefully help you out. I've little or no history with the article here, but I will just point out that your arguments will be significantly bolstered if you can cite reliable sources to back them up; this helps us to be sure of the encyclopedia's factual accuracy and neutral point of view. Because it's unfortunately difficult or impossible for us to prove our credentials in any given subject, Wikipedia generally disallows original research -- per WP:V, "the standard of Wikipedia is not truth, but verifiability. Hope that makes sense. Again, thanks. Luna Santin 21:09, 11 July 2006 (UTC)

Wikipedia addiction

I don't know, editing wikipedia articles, I have stayed up all night, and messed up my sleep. Does that mean wikipedia is a disorder? — —The preceding unsigned comment was added by 71.117.93.160 (talk • contribs) 12:25, 7 August 2007.

Proposed links:

A suggestion

I'll start by stating that I believe the concept of "sexual addiction" to be erroneous at best and, as often used by proponents of the concept, sheer nonsense. Further, I consider Carnes to be an ideologue more than a scientist. My biases aside, however, the fact is that the larger psychiatric/clinical community does not accept the concept of "sexual addiction", nor does the sexology community. The reason for this is pretty simple: there is no evidence such a disorder exists.

There is a certain degree of merit to, and evidence for, considering compulsive sexual behavior to be a legitimate clinical condition. The fact is, one can already assign a diagnosis covering this concept within the current, accepted DSM-IV-TR criteria (the correct diagnosis would be 302.9, Sexual Disorder Not Otherwise Specified). But, while there is no real question that compulsive sexual behavior can be a problem, it isn't an addiction.


Who are any of you to say that this is not an addiction? Are you a psychiatrist or someone that has vast knowledge in this area? Because I have a sexual addiction, knowing for a fact that it exists and you're not qualified to tell me that it doesn't. Matter of fact, unless a person has this condition, they are only speculating or relying on testimony from the FEW people, that they've questioned.Hotchina 21:12, 1 June 2007 (UTC)


Anyhow, my suggestion...

Given that the diagnosis of "sexual addiction" does not currently exist as a recognized psychiatric diagnosis, and that there is a great deal of controversy over the concept, the text of the main article should be edited in a manner which reflects the theoretical (and rather dubious) nature of the concept, emphasizing that this concept is not an accepted diagnosis. Consider this example, from the existing text in the article: "Sexual addicts may enjoy frequent sexual intercourse and other sexual activities, but the key to this addiction is more the enjoyment of the journey rather than the destination. That is, sexual addicts do not require an orgasmic event in order to feel accomplished in the pursuit of their addiction."

This might be edited as such: "[i]According to Carnes[/i], sexual addicts may enjoy frequent sexual intercourse and other sexual activities, but the key to this supposed addiction is more the enjoyment of the journey rather than the destination. That is, [i]supposed[/i] sexual addicts do not require an orgasmic event in order to feel accomplished in the pursuit of their addiction."

There is already some language more or less of this sort in the article, and I think it would be better to edit the text so that such qualifying statements are employed throughout the statement, both for reasons of consistency and, again, to reflect the fact that the concept of sexual addiction is at this point theoretical, largely the work of one rather controversial figure and not a recognized diagnostic category. JeffreyWKramer 01:49, 1 October 2006 (UTC)JeffreyWKramer

Quick Review / NPOV

I reviewed this article with an eye towards NPOV.

It seems to me that relative to many other articles on wikipedia this article is already relatively NPOV, especially given the controversy these types of topics usually generate.

I think the article is clearly qualified, and would hate to see every sentence turned into allegedly and supposedly. "Proponents of sexual addiction theorize" is clear. No one is going to mistake this as a clinical diagnosis.

I would support removing the NPOV tag, but continuing what seems a good and civil discussion.

Augustz 07:10, 14 October 2006 (UTC)

If there is no objection I will remove the NPOV tag in the next few days. This doesn't mean the article can't continue to be edited of course. Augustz 08:17, 13 November 2006 (UTC)
I think the NPOV tag should remain. A large proportion of the article is written as though it is a real, validated diagnosis. Rosemary Amey 06:01, 16 November 2006 (UTC)
If one displays any of the behaviors mentioned in this article, then one needs to recuse oneself - not support an NPOV tag. --Haizum 07:39, 30 November 2006 (UTC)
I've taken some time too look this area up, and it seems within the mental health community there is large agreement that this type of behavior occurs, but controversy around the classification / designation of the behavior. It seems clear to me that the article is not making claims of a real, validated diagnosis. But it captures interesting information and does what seems to me a fair job of presenting it. Can you be more specific about the claims of a "real, validated diagnosis"? Perhaps then those can be edited accordingly. Augustz 19:22, 8 December 2006 (UTC)

definitions of sexual addiction

from the MAIN article on Addiction.

-Addiction is a mental or physical disorder proposed to be precipitated by a combination of genetic, biological/pharmacological and social factors. Addiction is characterized by the repeated use of substances or behaviors despite clear evidence of morbidity secondary to such use.

From Merriam Websters online dictionary definition of Addiction.

1 : the quality or state of being addicted <addiction to reading> 2 : compulsive need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal; broadly : persistent compulsive use of a substance known by the user to be harmful

NOW. IS masturbation ALWAYS harmful?, IS prostitution ALWAYS HARMFUL?, IS PORNOGRAPHY HARMFUL?, and IS THERE CLEAR EVIDENCE OF THE DANGER OF THESE ACTIVITIES???.

If anyone answered NO to any of these questions then this subject IS up for debate, i've got TWO good sources and I can come up with numerous other definityions of addiction.

Sexual Addiction as people put it. Is nothing more then a supposed addiction of a sexual nature. So. THUS the standard definition of addiction fits in quite well i should say.

And.. based on this... I am going to be editing the article accordingly... (Especially the first few sentences) Nateland 10:09, 7 January 2007 (UTC)

Well, as of late the article seems in decent shape.

Before it was FILLED with religious and/or extensive POV statements and scantily (at best) backed up claims. And it seems to me that with the addition of my definition of addiction things have cleared up a bit. I DO however think that there might be more room for fixing up, and this article seems to be in better health then before wiki wise.

Yet it seems that some groups of well hidden weasel words still remain, although I think that the NPOV tag should be removed and IF this case changes then it be immediately put back up. And... if revert wars escalate like they have with me and a bunch of other people in the article on adolescence (currently i've managed to get a NPOV conforming purely scientific definition on teen sex in their for at least half an hour, although this is of little importance to the article.. just making an example)

We can call in an administrator. I think the next section that will need extensive rewords is the pornography addiction section if it's the same as when I checked it yesterday, plus the article on adolescent psychology could use with an expert other then 'leonard sax'. But all in all, things seem to be going pretty well with this article, anyone else have thoughts they want to share? Nateland 20:39, 7 January 2007 (UTC)

But it is in DSM

according to volume IV of the Diagnostic and Statistical Manual of Psychiatric Disorders, sex addiction involves 'compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships or compulsive sexuality in a relationship. 86.29.248.60 02:00, 25 January 2007 (UTC) Remember, unless you want to feel the ban hammer, unsigned does not mean auto revert!

Stick to the facts

Please stick to the facts and delete assumptions and opinions of those that are not qualified to give them. Unless you are quoting factual statements from qualified psychologists, psychiatrists, neurologists, etc. or have a sexual addiction, as I do, you are unable to accurately explain or accurately analyze this subject.

I fully disagree with many of the statements here regarding sexual addiction, because generalizations and blanket statements are being used to describe a disease that's experienced differently in each person.

Sexual addiction does not always involve negative consequences other than the fact that the person constantly thinks about sex and can't seem to stop. Depression, self-loathing, despair, etc. may be suffered by some, but definitely not by me. Therefore, to say that sex addicts suffer from these feelings and I do not, would mean that sex addicts don't all suffer from these feelings. Nor do they all utilize prostitutes and have sex with hundreds of people. You can have a sexual addiction and only be involved faithfully, with one person.

I am also a woman and unfortunately, accurate studies have not been done, as they should be, about this topic in relation to women.

Therefore, Patrick Carnes and many like him, are generalizing and probably doing so just to sell books and make money.

Hotchina 15:34, 1 June 2007 (UTC)

There are page numbers throughout the article, as if this were lifted from a book. —Preceding unsigned comment added by F13nd (talk • contribs) 20:35, 18 June 2007

Added unsigned template and moved section to bottom of talk page.
These page numbers are all in parenthetical citations. Not the preferred method on Wikipedia, but certainly not copyright infringement. Putting them all into <ref></ref> tags would be a great idea. By the way, a note to the administrator who handles this: is it acceptable for a non-admin to remove the tag in cases like this? Ichibani utc 00:53, 19 June 2007 (UTC)
Harvard references ≠ copyvio. As for a non-admin removing the tag, common sense is common sense so I don't think there's any problem here, but as copyright violations are treated very, very seriously, I'd recommend asking for immediate admin assistance instead (WP:AN/I might not be a bad place to go). By the way, F13nd, {{cv-unsure}} is more appropriate for when a copyvio is suspected, but a certain source cannot be found. Fvasconcellos (t·c) 04:01, 23 June 2007 (UTC)

Author of "Copyright Infringement"

I am the author of the supposedly "stolen" material at the top of the page and under the symptoms section. I did not infringe any copyrights. I properly referenced my sources using the APA format. If you consult the APA website you'll see that pages numbers are included in the reference. That is why page numbers come after the statements. (In response to the above woman's concern) In addition to properly referencing my sources, I rewrote the author's ideas in my own way without consulting the author's actual wording. That hardly meets the definition of copyright infringement.

The woman above me said that Patrick Carnes is researching and writing about sexual addiction because he wants to make money. I don't believe people work for a PhD to make money. For that you go for an MBA.

The material I added to the page is clearly not breaking any copyright laws. I would like the copyright infringement tag to be removed as soon as possible. Thank You.

Stanleymilgram 02:42, 23 June 2007 (UTC)

I removed the tag, as there is absolutely no evidence of a problem. A citation is of course not copyright infringement. Ichibani utc 03:16, 23 June 2007 (UTC)

Thank you so much :D

Stanleymilgram 13:03, 23 June 2007 (UTC)

Still NPOV troubled.

Though this article has come a long way toward NPOV, there's still room to improve. Much of it reads as real, validated diagnosis (as mentioned in the Quick Review / NPOV above) and does not sufficiently indicate the controversiality of the controversial statements. It probably just needs one good edit to fix this up and then it'll be ready to lose the tag. I will hopefully start adding improvements myself soon. Things to fix (feel free to add to the list):

  • Introduction: "numerous critics and evidence on both sides of the debate". What debate? It hardly seems like a two sided argument. Whatever it is, the core disagreements should be briefly explained in the introduction.
  • Diagnosis: Is it DSM now? (above talk post says yes) Can't find it in DSM IV.
  • Manifestation: There's a lot here that seems controversial. Really, an expert review would be the best solution here. In an article flooded with references yet scarce of citations it'll take a complete rewrite to figure out what's accurate or not.
  • Treatment: This twelve step plan stuff can't be neutral. However, it should still be mentioned without all the weasel words and boons.
  • More to come...

Ichibani 06:35, 20 March 2007 (UTC)

I returned the NPOV tag, because the above problems are still there and frankly I don't see an easy way to fix them. Ichibani 17:23, 29 April 2007 (UTC)

At present, the NPOV tag should still be up. I also noticed that there is no mention of medication in the treatment section, but I've run across a few sources concluding that medication can be an effective treatment for sexual addiction. Chupper 23:35, 19 September 2007 (UTC)

Intro has more alcoholism then sex

Hi, i just came in here and the first paragraph i thought was horrible. It only had the first sentence dedicated to explaining sexual addiction, 2 sentences explaining alcoholism, and the rest comparing them. Shouldn't the focus primarly be on sexual addiction? It felt like views were being shoved down my throat --206.116.159.199 (talk) 00:36, 26 November 2007 (UTC)

You can change it. :) -- Craigtalbert (talk) 01:58, 26 November 2007 (UTC)

Manifestation - masturbation

This section doesn't follow from the rest of the information in the article, and doesn't sound encyclopedic; further, it's also uncited. I'm taking it out until someone can put in a cited source and write it in a professional tone.

: According to proponents of the sexual addiction concept, the addict's obsessive / compulsive tendencies can also be seen by the frequency with which they use masturbation for stimulation. Quite often they will perform this activity to the point of injury or to where it interferes significantly with ordinary life. For some addicts, it can even reach a point where the masturbatory activities replace their desire for sexual interactions with others. When a sexual addict does feel comfortable enough to involve other people, quite often they seek out strangers for anonymous sex or look for 'new love' through infidelity. Prostitutes are also employed because of their anonymity and non-judgmental willingness to engage in the sometimes unconventional sexual requests of sex addicts. The varying nature of a sexual addict's activities are in sharp contrast to individuals who commonly prefer more narrowly focused sexual activities such as those engaging in fetishism. But this is not to say that sex addicts cannot be found pursuing fetishes.

68.42.17.202 (talk) 07:26, 15 December 2007 (UTC)

My Goodness

Sex Addiction is much different from Hypersexuality. In fact, a person in treatment for sexual addiction may not exhibit an unusually voracious sexual appetite. Like a food addiction, which does not always exhibit as hyperphagia, it is the way the behaviors affect the individual's quality of life, how it affects others around him/her, and if there is difficulty in stopping the behavior in spite of attempts to do so. A good abstract on the problem of the DSM IV's failure to include sexual compulsive behavior is outlined here: "Differential Diagnosis of Addictive Sexual Disorders Using the DSM-IV"

Sexual Addiction & Compulsivity 1996, Volume 3, pp 7-21, 1996.

by Richard Irons, M. D. and Jennifer P. Schneider, M.D., Ph.D.

ABSTRACT The current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) describes certain sexual disorders which are characterized by, or include among their features, excessive and/or unusual sexual urges or behaviors. Common disorders in the differential diagnosis include paraphilias, impulse disorder not otherwise specified (NOS), sexual disorder NOS, bipolar affective disorder, cyclothymic disorder, post-traumatic stress disorder, and adjustment disorder. Infrequent disorders in the differential diagnosis consist of substance-induced anxiety disorder, substance-induced mood disorder, dissociative disorder, delusional disorder (erotomania), obsessive-compulsive disorder, gender identity disorder, and delirium, dementia, or other cognitive disorder. Addictive sexual disorders which do not fit into standard DSM-IV categories can best be diagnosed using an adaptation of the DSM-IV criteria for substance dependence.

I am too tired tonight to elaborate any more on this subject, but if I told my clients that they suffered from "hypersexuality", they'd laugh themselves silly.

Agree - the section about compulsive masturbation doesn't make sense, given the rest of the description of the disorder. It also reads as something childish and apocryphal. —Preceding unsigned comment added by 68.42.17.202 (talk) 07:16, 15 December 2007 (UTC)

REHABILITATION FOR ADDICTION

If you think you are moving on a road where there is only the deep abyss of addiction looming large in front of you, it is time you got yourself enrolled into a drug abuse or an alcohol abuse treatment center. Even if it is not you but someone you care for who is addicted, it is important that you intervene constructively when there is still time and get them enrolled.

Most people wonder why they should enter into a treatment center when they can try to overcome the addiction by themselves. There are many reasons why you should not think much about overcoming your addiction yourself. Firstly, you might end up doing it the wrong way, which can have more serious repercussions on your health than your addiction itself. Secondly, addiction treatment is never too effective if you are doing it yourself. That’s because there is no one to monitor you. You might think it is all right to go overboard with your addiction sometimes even when you are trying to come out of the addiction.

However, drug and alcohol rehab centers can help you in great measure. They will use the medication and the treatment programs that are needed to bring you or your loved one out of the addiction. But, most importantly, they are quite equipped to deal with the withdrawal symptoms that will occur and which can sometimes get to be too violent. They will use the personal approach to deal with their addicts and treat them on a one-to-one basis. This helps them in strengthening their resolve. Rehab centers use aggressive methods with great delicateness. This makes the person come out of the addiction without suffering too much, or going astray on the path to deaddiction.

Visit our site: [[ http://www.drugrehab-center.com | Drug Rehab Center ]] —Preceding unsigned comment added by 121.1.43.58 (talk) 07:11, 18 June 2008 (UTC)

Bias?

While this article was quite informative and seems factual, I cannot really vouch for it in earnest due to the very biased tone. —Preceding unsigned comment added by 71.142.110.114 (talk) 07:13, 26 August 2008 (UTC)

Consequences of Addiction section

The article as a whole and this section in particular is very biased. Specifically, this section presents rape and child molestation as consequences of an uncontrollable addiction. This idea is an extreme minority view. I have redrafted this section to remove this inference.

The text of this section gives a strong sense that the legal consequences of sex crimes are unfair consequences a sex addict may incur due to their medical disorder. There was also criticism (which I have now removed) of professional institutions and the clergy for implementing sanctions against staff for sexual misconduct and sex crimes.

This "appologist" view for sex criminals pervades much of this article- including the "controversy" section, where the view that sex addiction is not a real disorder is presented in a way that reveals the writer's opposition to this view-point- an encyclopedia should not be drafted in this way. The view point that sex addiction is a real phenomenon but does not excuse sex crimes is not made anywhere and no distinction is made between sex addicts who manage their addiction within the law (masterbation, promiscuity etc) and those who choose to violate the law by committing sex crimes such as rape.

00:21, 30 August 2008 (UTC)Dr V. Jones

replaced "nonintimate" with "intimate"

In the definition it said "highly impersonal nonintimate behaviors", which I changed to "highly impersonal INTIMATE behaviors. Nonintimate implies platonic, whereas I think sex addiction means the opposite. Does this contradict the intended meaning? highly impersonal nonintimate behaviors could mean anything. Please comment/correct/clarify as needed. —Preceding unsigned comment added by Elleng (talk • contribs) 12:25, 29 August 2008 (UTC)

Questioning the term

word for word reverts??

Can some editor pls explain this revert through a wikipedia guideline? Several valuable references were added, how can they be removed?? Removal of well cited is nothing but Vandalism. Moreover, the "citation needed" tags were address with reliable sources, how can this be deleted, show me the wikipedia guideline for this? "The idea of "sexual addiction" is not universally accepted[1] and is not recognized either by the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association or by the International Classification of Diseases of the World Health Organization." — This is Original Research, where is the citation for this? In fact the edits before this correct this factual accuracy. Now coming to another statement in the intro, "Sexual addiction is a controversial term used to describe.." — The term "controversial" is Original Research and not based on any reliable sources, where is the citation from reliable sources for the term "controversial". However I do agree, the word "debatable" can be used, for which a reliable sources exists from the book Clinical Management of Sex Addiction, which was reverted :) I am going to restore the contents from reliable source I added., and let the facts speak for themselves. Also coming to the edit summary, "again, one paper doesn't define the topic" is misleading, there isn't one paper, there are at least 4-5 reliable sources. Bluptr (talk) 14:09, 9 October 2008 (UTC)

New section on "Definition"

Dear Editors, I have added a new section on definition by material from the lead, neutral usage of words have been taken care, see, Wikipedia:WTA#Synonyms_for_say and the let the facts speak for themselves. Bluptr (talk) 14:50, 9 October 2008 (UTC)

As per WP:LEAD, the citations should be provided in detail later, the introduction must provide pointers. thanks. Bluptr (talk) 14:59, 9 October 2008 (UTC)

The intro, "Sexual addiction is sometimes used to describe sexual behaviour", is a weasel word and not backed by a reliable source, a more generic and neutral term would be "arguably defined", as per WP:WTA -- Bluptr (talk) 06:01, 11 October 2008 (UTC)

I appreciate Bluptr's point that "some" is usually a weasle word. However, I also dislike "arguably defined," for two reasons: First, that which is 'arguably anything' is in the mind of the editor. A WP entry needs not to refer to the mind of the editor. Second, there is no consensus among experts whether sexual addiction exists, never mind what its definition might be. So, we need a lead sentence that simultaneously describes for readers what people mean when they use the phrase "sexual addiction," but that provides no implications beyond that. Personally, I think that "some" accomplishes that, even though WP frowns on it in most circumstances. I am not wed to the word "some" and would welcome other suggestions for how to solve the above.
— James Cantor (talk) 12:19, 11 October 2008 (UTC)

Dear James, thanks for your views, I basically used "arguably" because, this is a very standard and generic term used by International Journals, Authors, when no consensus exits., ( In journals the way researchers write is, "I have argued..." ) and the word "argue" as such means — "To debate, disagree, or discuss opposing or differing viewpoints."[4] and this is what the therapists, experts related to "sexual addiction" are doing....and Wikipedia's NPOV tutorial also prescribes the usage of the word "argue". However, I am also OK with the word controversy because this also captures the idea well — "A controversy or dispute is a commencement of a conflict between statements of accepted fact and a new or unaccepted proposal that disagrees with, argues against, or debates the accepted knowledge or opinion. Controversies can range in scope from private disputes between two individuals to large-scale disagreements between societies." Thank you. Bluptr (talk) 07:39, 12 October 2008 (UTC)

Lack of neutrality?

An editor added the non-neutrality tag to the main page without comment. It is not at all clear, at least to me, what is non-neutral about the article. The article is grossly under-sourced and requires substantial editing, but I personally don't see any obvious lack of neutrality. In fact, I am not sure exactly which side the article is being perceived as biased towards.
— James Cantor (talk) 22:32, 17 October 2008 (UTC)

Agree with you. Before adding the neutrality tag, it should be discussed. Bluptr (talk) 08:23, 18 October 2008 (UTC)

Proposal to merge sexual addiction and hypersexuality

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.
The result was merge -- — James Cantor (talk) 14:35, 28 January 2009 (UTC)

These two pages are essentially redundant in their content. They differ only in the actual term, which can be resolved by having a terminology section in the article kept. Because hypersexuality is a stub and "sexual addiction" (and its cognates) are the more commonly used term, I proposed that the smaller article be moved into the larger. Although I was tempted to be bold and just to do the merge, sexuality article are frequently controversial, so I have opted to enter this as the proposal first.
— James Cantor (talk) 23:59, 24 January 2009 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Addiction?

This 'sexual addiction' only seems to be a real addiction in some parts of the article, because it generally does not interfere in a bad way with the normal life of the person. —Preceding unsigned comment added by Xilliah (talk • contribs) 11:13, 22 January 2009 (UTC)

That is part of why the phenomenon and the name "sexual addiction" for it are both controversial.
— James Cantor (talk) 13:33, 22 January 2009 (UTC)
It might be a wise idea to change the title from "sexual addiction" to a less controversial one, particularly since the apparent result has been a bias towards not only the existence of the phenomenon but of it being an addiction in nature. At the moment, there is a gross lack of information both from the critics of the phenomenon and of this explanation for the phenomenon. The bulk of the article uncritically accepts both the phenomenon and the belief that it is a true addiction and does not merely have behaviours in common.71.76.225.98 (talk) 06:48, 1 March 2009 (UTC)

The article says : In The L Word, the lesbian character Bette Porter, (is a sex addict).

No way. I've seen the show and they never state she is an addict. Hence the above statement would be original research. The characater never displays any of the behaviour of an addict nor does she appear to have any sexual dysfunction. I'll leave it to someone with decent writing skills to remove the original research in this article.

Have cut out part of section and wd move towards A - Z by topic though this will need more time and effort.----Felix Folio Secundus (talk) 10:36, 31 March 2009 (UTC)

Non 12-step therapy

"Research about recovery from sexual addiction has indicated that 12-step meetings are important for success. Those who do not attend 12-step meetings have a much more difficult time recovering, if they do at all."

It,s only an author's personal opinion. Notice that Carnes' researches include only 12-steps meetings members, so they were all convinced, that if they don't attend meetings they will fail. Carnes didn't consider those, who choose other therapy methods (eg cognitive-behavioral therapy), or those who overcame addiction on their own.

No, actually the study pooled and did outcome surveys with three sub-groups; those who participated in therapy only, those who participated in 12-step only and those who did a combination of both therapy and 12-step. True, it was a limited study in that it did not include other theoretically available and theoretically widely practiced methods for arresting addictive sexual complaints. The results of the study (I don't recall the numbers but they are available from SASH)were that the best outcomes were found among those who did therapy and 12-step combined.

I am submitting the above paragraph for consideration to use instead of the original senstence quoted above.

Why would you include biased, 12 step propaganda into the article? the 12 steps are nothing but religion which has never been proven to "treat" anything well. —Preceding unsigned comment added by 199.233.178.254 (talk) 20:32, 25 August 2009 (UTC)

Conflation of sexual addiction with hypersexuality

The current version of this article conflates sexual addiction with hypersexuality. As can be shown by the references given in this article, sexual addiction is a controversial concept, the existence of which is still a matter of debate.

Hypersexuality, on the other hand, is an uncontroversial clinical concept, which can be observed as a symptom of a number of conditions such as bipolar disorder, Parkinson's disease, dementia, Kluver-Bucy syndrome, or many other disorders (see, for example, this unusual report of hypersexuality as a symptom of multiple sclerosis[5]).

Accordingly, I've restored the previous hypersexuality article to its previous state. -- The Anome (talk) 08:02, 29 July 2009 (UTC)

I don't see the basis on which can say that. At least, in my own reading of this literature, none of the terms or concepts is any less controversial than is any other. It isn't that "hypersexuality" is a different entity from "sexual addiction" or "sexual compulsivity," etc.; rather, authors simply adopt whichever terms best suits their own theories of what causes the problem. That is, addictions people call it "sexual addiction," whereas OCD researchers call it "sexual compulsivity," etc. There is no good basis for saying that these terms actually represent different things, however.
— James Cantor (talk) 12:40, 29 July 2009 (UTC)
This article isn't called "sexual compulsivity", it's called "sexual addiction", and characterising hypersexuality as an addiction is controversial to say the least. Addiction implies a reward feedback loop, yet hypersexuality can in some cases come on suddenly without any sexual stimulus to start the process; for example in the case of brain injury or stroke, or hypomania with rapid onset.
"Sexual addiction" is a diagnosis with a built-in theory. Hypersexuality is merely an observation of behavior, and is exceedingly well documented to be associated with numerous distinct medical conditions, with as-yet-unknown causal mechanisms. In this way, it resembles other easily defined clinically observable phenomena like "rash" or "fever". Conflating the two is in effect asserting that sexual addiction theory not only has the status of universally agreed truth, but that all hypersexuality is sexual addiction, either which goes against NPOV. -- The Anome (talk) 00:25, 30 July 2009 (UTC)
Actually, I agree with you. I, personally, don't find the term "sexual addiction" very useful, and I agree that "hypersexuality" is much less theory-laden. Unfortunately, this belief that you and I share is irrelevant. The contents of RS's on the topic(s) are highly inconsistent. There is no consensus in the field about the term(s), so there is way to achieve one on the mainpage here. All we can do is document the varying, overlapping terms and definitions and to remember whose definitions apply to which claims.
— James Cantor (talk) 01:12, 30 July 2009 (UTC)
I think that's fine, providing they remain in separate articles until or unless there is some kind of general consensus that the two are synonymous, which seems to me to be unlikely to happen for a long time, if ever. -- The Anome (talk) 14:26, 30 July 2009 (UTC)

NPOV?

I'm concerned that this entry lacks neutrality. It seems to privilege proponents of 'sexual addiction' through listing their aetiological theories about the debatable phenomenon in question, while little corresponding space is given to the sceptics and their objections to classification of 'sexual addiction' as a distinct 'disorder.' This entry needs compensatory expansion to deal with critics of the diagnosis and its claimed aetiology. Calibanu (talk) 03:39, 3 March 2010 (UTC)User Calibanu

The reality of sexual addiction

I am a therapist that deals with sexual addiction. I have been frustrated by the DSM IV's lack of comment on this topic, which I hope will be addressed in DSM V. So far, for insurance purposes, I have had to classify this as a 309.28 adjustment disorder with mixed depression and anxiety. This does not mean that the addiction is not present, however, in diagnoses. As a reminder for those familiar with the DSM, PTSD was not at first classified as a traumatic stress disorder, but as a depressive or anxiety disorder, which it includes, but does not fully satisfy the symptomology of the disease. When dealing with clients, I do not dismiss the patient choice in the matter to recover as it is a crucial component of recovery. The work of recovery is a long and painful process for the sexual addict which involves insight into unsuccessful beliefs and restructuring into new life beliefs that deliver the addict from the physical and emotional damage present in their life. ---- G. Nutter —Preceding unsigned comment added by 174.16.55.10 (talk) 14:07, 11 May 2010 (UTC)

United States only?

I have a strong hunch that this is an United States only phenomenon. (Defining someone as a "sexual addict.") A some sort of international aspect would be interesting. Does anyone know any studies or statistics? Thanks! -- 88.194.188.158 (talk) 20:52, 16 May 2010 (UTC)

Citation Needed 11

I have deleted the following sentence in the main intro para

Skeptics believe that it is a myth that the phenomenon exists as a disease or disorder at all and is instead a by-product of cultural and other influences.{{Citation needed|date=April 2010}}
Thanks!

Arman Cagle (Contact me EMail Me Contribs) 18:16, 15 July 2010 (UTC)

No critical section ?

Am I the only to believe that this so-called phenomenon is nothing but a way for the therapists to line their pockets ?
Seriously...
The only pathology, in my opinion, is that some people want to believe they are sick. And some people are more than willing to make them think they are. —Preceding unsigned comment added by 86.210.13.245 (talk) 17:40, 6 September 2010 (UTC)

Disclosure.

I have added to the mainpage an EL to an interview regarding sex addiction. Because I am the subject of that interview, I am indicating it here, so that other editors may decide whether the EL informative appropriate to the page content.
— James Cantor (talk) 00:11, 11 September 2010 (UTC)

US only?

Isn't this modern version of sexual addiciton a United States only definition that is at least partly influenced by Christianity and "one partner only" policy? I think in Europe there is no such thing as too much sex. Healthy libido is a sign of healthy body. [6] -- 93.106.242.104 (talk) —Preceding undated comment added 13:56, 22 September 2010 (UTC).

Controversy

I think there should be a "Controversy" section. Some experts believe that sex addiction isn't real. For example, sex addiction is not listed in the current version of the DSM-IV. Here's a source to prove my point: http://www.cbsnews.com/stories/2009/06/04/health/cbsdoc/main5062828.shtml

Voz7 (talk) 02:41, 2 February 2011 (UTC)

I have added the controversy section, as well as some reliable sources.

Voz7 (talk) 03:24, 2 February 2011 (UTC)

Debate over Status

This section is in need of expansion (and perhaps re-naming to "Criticisms" or "Controversy" or the like). There is much controversy over the existence, nature, diagnosis, nomenclature, treatment, etiology, etc. -- not only from a scientific/medical/psychological perspective, but also a social science perspective. Discussion of the various social science critiques of this phenomenon might present a more well-rounded or balanced picture of the kinds of debates that are happening. Christina1001 (talk) 02:28, 17 September 2011 (UTC)

I suggest that it needs to be expanded further, and merged into the rest of the article, which (except for one sentence in the lead) seems to assume that sexual addiction (or at least compulsivity) actually exists and is actually a problem (as opposed to the problem being personal/societal discomfort with one's sexual urges). (Forgot to sign - sorry - Allens (talk) 00:34, 28 January 2012 (UTC))
Call me cynical, but a lot of people appear to make a living from treating sex addiction. It seems to me that they would, for professional reasons, be likely to want to edit this article, and also, for self-esteem reasons, be somewhat unlikely to have much time for the idea that they may be spending their lives treating a non-condition. -- The Anome (talk) 00:13, 28 January 2012 (UTC)
And, of course, most of those who do "addiction medicine" are hardly likely to reject the opportunity to extend their reach to people not (allegedly) suffering from chemical dependencies... Allens (talk) 00:23, 28 January 2012 (UTC)
Indeed. The same goes for the opinions of medical doctors about physical sickness, electricians about electricity, yoga teachers about yoga, homeopaths about homeopathy, or professional psychics about fortune telling. Or priests about God. The above is an observation on human behavior, not an observation on the actual reality or otherwise of sex addiction, something on which I have no definite view one way or the other. -- The Anome (talk) 00:50, 28 January 2012 (UTC)
Understand. Biased != always incorrect; Pasteur's history shows that, among others, from what I've read about him... Allens (talk) 01:01, 28 January 2012 (UTC)

Requested move

The following discussion is an archived discussion of the proposal. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

No consensus to move. Vegaswikian (talk) 06:59, 10 January 2012 (UTC)

Sexual addiction → Sexual intercourse addiction – the title is more fitting as the article as is is about addiction to sexual intercourse rather then addictions of a sexual nature, which should be reserved for another article which would include subjects like cyber sex addiction, pornography addiction etc. could also be called just plain sex addiction though that would be less precise. Hoginford (talk) 01:49, 2 January 2012 (UTC)

  • But the article doesn't even mention the word intercourse. It's about various "sexual urges, behaviors, or thoughts". Station1 (talk) 00:55, 3 January 2012 (UTC)
  • Comment - wouldn't Sex addiction be the better title, as it is an addiction to sex? – ukexpat (talk) 16:00, 3 January 2012 (UTC)
  • Oppose I hear the terms "sex addiction" and sexual addiction" used in media, by therapists like Dr. Drew Pinsky and others all the time, and know exactly what they are. I have never heard any of the say "sexual intercourse addiction." Besides, the current term is more broad, and deals with addictions to pornography, etc, which are all related, but might not involve actual intercourse.Mmyers1976 (talk) 16:18, 9 January 2012 (UTC)
The above discussion is preserved as an archive of the proposal. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

Criticism?

While this entry refers to the concept of 'sex addiction,' it does not refer to criticism of this concept from medical practitioners and researchers. Unintentionally, there may be an NPOV involved in the formation of this entry. Calibanu (talk) 23:27, 7 June 2012 (UTC)User Calibanu

Cleanup

I removed a few sentences from the lead of this article. The lead was clearly disproportionally long. It contained various sentences which were too general or simply didn't fit into a lead. Debresser (talk) 08:42, 24 June 2012 (UTC)

NPOV issues with article

I tagged this article as having NPOV. Sex addiction as a psychological disorder is currently a controversial issue but this article as it stands does a poor job of addressing the controversy. The intro completely ignores the controversy and while there is one section that does address it then rest of the article seems to be written as if there is no controversy . Another problem is that the article refer in parts to hypersexuallity as if it is a synonym for sexual addiction when the former can simply refer to someone who's sex drive is much stronger then average, without there being an addiction. --67.101.218.192 (talk) 23:09, 26 October 2012 (UTC)

Please visit the history for this talk page. This has been discussed. The article is about sex addiction, not solely about the controversy surrounding sex addiction. It is appropriate for the bulk of this wiki article to focus on information about sex addiction, as is the case for similar subjects like historical people and institutions where there is controversy. A sub-category focusing on the controversy would be appropriate here, but there is no precedent of Wikipedia to include mention of the controversy throughout the article. Perhaps a separate page focusing solely on Sex Addiction Controversy might be in order. TBliss (talk) 19:04, 15 November 2012 (UTC)
I think your misunderstanding the POV issues the above contributor expressed concern over. I've gone over the article myself and agree with what the NPOV concerns expressed above. Like the above person says, the intro did not mention the concept of sex addiction as being controversial, which I corrected. Second, the problem with the rest of the article is not that it does not focus mostly on the fact that this is a controversial concept but that certain sections present certain aspects of this conceptual model as if they are generally accepted when significant debate still exists over them in the medical & psychological community. I a few places there needs to be a slight rewording so as to make it clear that what is being discussed is a proposed conceptual model and that the info represent the views of those that believe sexual addiction to be a valid conceptual model. If you look at the article on Pornography addiction, you can see what I believe to be a more NPOV way to write about controversial conceptual models like this one. In that article, statements like "Pornography addiction is defined, by those who argue that it exists,..." and "Psychologists who see pornography as addictive may consider..." make it clear that the concept is controversial. Thus we need to go through the sections of this article and add similar clarifications that make it clear that the concept or some cases aspects of it are controversial. Basically we don't need to focus the whole article on the controversy just change the wording some places so it's clear the statements reflect the views of those who believe in the sex addiction and not currently generally accepted facts or views on the concept. Finely, you mention that NPOV issue has been discussed before but went through the archives and don;t feel the wording issue was properly discussed. If you believe the wording is fine as is then please why you don't feel it needs to changed here. --67.101.218.25 (talk) 16:46, 15 January 2013 (UTC)

Borderline Personality Disorder section

This section doesn't seem to be integrated into the rest of the article and barely refers to sexual addiction -- I'm not sure why it's included in this article. BPD is already mentioned in the Causes section.TBliss (talk) 19:11, 4 July 2014 (UTC)

DSM-5 quote

The general background info is: DSM-5 states the medical consensus in US psychiatry. I offered a direct quote from DSM-5, now it passes very well WP:VER. So, both parts of the claim are thoroughly supported. Tgeorgescu (talk) 01:12, 6 July 2014 (UTC)

DSM-5 is the US medical consensus, as far as sex addiction is concerned. Tgeorgescu (talk) 01:41, 6 July 2014 (UTC)

Your latest edit is obviously different from your first edit, which basically stated that the medical consensus disproved sex addiction. That the DSM5 found insufficient peer-reviewed evidence is the reason it wasn't included, and sounds more like a quote from that document. It also doesn't invalidate the theory of sex addiction -- just there isn't enough evidence yet. I think it might be noted that "medical consensus represented by DSM5" tho.TBliss (talk) 06:43, 6 July 2014 (UTC)
According to WP:BALL, there is now no way to know the medical consensus from 2023 or 2033, we just know the US medical consensus from 2013. That the DSM-5 is the Bible of psychiatry (in US and some EU countries) is already sourced inside the article. And sex addiction would be treated by psychiatrists, if it were acknowledged as a real addiction. Tgeorgescu (talk) 15:56, 6 July 2014 (UTC)
I am not implying that it could not be treated by psychologists, it is just that most psychologists aren't MDs, so the term medical consensus does not apply for them. Tgeorgescu (talk) 15:58, 6 July 2014 (UTC)
You're parsing words. Why not just state "medical consensus represented by the DSM-5" - ? - that's the first mention of DSM-5 in the article. The idea is to provide accurate encyclopedic information to the public. The burden is now on the reader to ferret out the truth of this information because you are obscuring it. And most readers aren't familiar with the DSM-5. BTW anyone can currently treat sex addiction -- psychiatrists, psychologists, therapists, life coaches, sexologists -- there is little regulation or requirements. Inclusion in the DSM-5 chiefly means insurance would cover it. You really need to provide a page number for the DSM-5 where the quote comes from and format the citation correctly for such a document. I'm surprised you haven't done so since you're such a prolific editor who cites rules at the drop of a hat. Is that only when it suits your agenda?TBliss (talk) 17:59, 6 July 2014 (UTC)
Hilarious! Page numbers are provided in the reference. It's editing 101. Tgeorgescu (talk) 19:05, 6 July 2014 (UTC)
For the record, I have no radical agenda in respect to this article. I don't have a dog in this fight. I am only a supporter of medical orthodoxy. If sex addiction will become part of medical orthodoxy, I will support its labeling as an addiction inside this article. But not before it belongs to orthodoxy. Now it is just a contested, purported addiction, as far as the APA is concerned. Tgeorgescu (talk) 00:55, 8 July 2014 (UTC)
Well this isn't the encyclopedia of APA terms, is it? Or the encyclopedia of your personal version of orthodoxy. There's more to sex addiction than the one paragraph in the DSM-5 as numerous citations here affirm. And misquoting the DSM-5 to say it disproved sex addiction doesn't do anyone any favors, least of all the public. I'm still surprised your pointing fingers at me, trying to have me banned no less, without manning up and admitting your own mistake.TBliss (talk) 04:14, 8 July 2014 (UTC)
DSM-5 and APA are representative for the medical consensus in this matter from a large part of the world (US and some EU countries which abide by the DSM, perhaps some other regions, too). And practically every significant piece of medical research is published in English, so APA is aware of all research that matters. The difference between [7] and [8] is so subtle that it practically means nothing, since there is no essential epistemic difference between them. That's why I got the impression that you would be trolling and believe me, it is frustrating to see one's good faith contributions getting trolled. Tgeorgescu (talk) 20:12, 8 July 2014 (UTC)
Science customarily rejects hypotheses for which there is no convincing evidence, so I don't see the big difference with [9] either. Splitting hairs, there could technically be a difference between unproven and rejected, but as far as the scientific method is concerned, they mean the same thing. Tgeorgescu (talk) 22:12, 8 July 2014 (UTC)
I disagree. Moving on -- What do you think of moving the Borderline Personality Disorder section from Medical Models to a subsection under Causes? Maybe cutting half of the first paragraph -- the part which focuses on different manuals' language for BPD which is out of place in a sex addiction article, and maybe including the last half of that paragraph. Then also deleting the last paragraph focusing on famous people with BPD and their paraphilias, as sex addiction and paraphilias are different topics even though they may interrelate. Also I wonder if there should be a new section to talk about all the recent neurological studies that are finding evidence in support of brain addiction to sexual behavior -- there's a big one coming out on Friday.TBliss (talk) 00:23, 10 July 2014 (UTC)

Sex addiction is not an accepted diagnosis.

This article fails to acknowledge that regardless on how strongly the authors believe in sex addiction, sex addiction is not a scientific term nor is it a diagnosis that has been accepted by the American Psychological Association or the American Psychiatric Association. It perpetuates the myth that sex addiction is a recognized diagnosis within the scientific community. Although recognized as such by almost every other civilized country on earth, the APA is still studying the matter at present.— Preceding unsigned comment added by 24.98.126.97 (talk)

See ΔFosB for a summary of the state of biomedical research on addiction to drugs and natural rewards. There's actually a very large body of research supporting reinforcement effects in sexual reward/addiction; that single transcription factor plays a crucial role in its development. Seppi333 (Insert 2¢ | Maintained) 13:43, 18 June 2014 (UTC)
Given that there's a mountain of neuroscientific research on drug and natural reward addiction and how they're mediated through ΔFosB, I felt it prudent to update this article. The signaling cascades between chronic amphetamine use and excessive sexual reward are apparently very similar, but not identical. Seppi333 (Insert 2¢ | Maintained) 22:18, 17 July 2014 (UTC)

"Pathophysiology" section

The "Pathophysiology" of this article talks about sexual addiction as if it was a real thing, with real biochemical pathophysiology. However, both of these are things that are far from universally agreed by practitioners: there are multiple theories about what might or might not be the cause of sex addiction, and moreover, serious doubt as to whether sex addiction exists at all.

It's find to talk about the FOSB stuff in the context of it being a theory of how sex addiction might be a real phenomenon, but the views in the section need to be attributed to individual authors who propose those theories, in order to meet WP:NPOV, and they must be explicitly tied to those authors framing those theories in terms of sex addiction, and not just an analysis of sexual reward systems without describing it as sex addiction. To blend together material from sources that do not talk directly about sex addiction risks WP:SYNTH. -- The Anome (talk) 23:01, 9 September 2014 (UTC)

Update: I've now removed the section altogether. Renaming it "Biomolecular mechanism", and moving it up the article, makes things worse, not better. There is no consensus that sex addiction exists, and no consensus about what, if anything its cause might be if it does exist. The theory you outline looks quite plausible, but it must be described as a theory, along with all the others, until there is medical consensus as to the existence and nature (if any) of sex addiction
Do you have any named medical researchers who this theory can be attributed to? The nearest medical source I can find from a quick web search on "sexual addiction fosb" is this article, and that's (a) talking about pornography addiction, and (b) doesn't, as far as I can see, quite say it outright. This PMC search doesn't seem to give anything else that directly makes the statement, either. -- The Anome (talk) 23:07, 9 September 2014 (UTC)
@The Anome: The current lack of diagnostic criteria by practicioners isn't remotely relevant to the existence of behavioral addictions, it merely affects the status of the addiction as being termed a disorder. These facts aren't relevant to the inclusion of the content in this article though.
I'm going to reply with these four points:
  1. Every source except one unnecessary source which I marked in the source code meets every requirement listed in WP:MEDRS. Ie., they are ALL very high quality medical secondary sources.
  2. This is not a theoretical framework. This evidence is experimentally established via viral vector gene transfer experiments. Read the reviews if you want to know more.
  3. There isn't a single sentence that could qualify as WP:SYNTH, because every statement is independently fully supported by each citation. You can delete any source you want until there's only 1 left per sentence, and each sentence will still fully satisfy WP:V. Feel free to check any/every statement for verifiability.
  4. Take note of WP:3RR.
To answer your question about researchers, Eric J. Nestler hypothesized that the factor caused addiction over a decade ago. He and many others later demonstrated the role that gene transcription and ΔFosB in particular play in addiction; you could just check FOSB or pubmed if you'd like a partial list of authors publishing literature on it. Publications on the signal transduction pathways and participation of gene transcription factors in human addictions are also hosted on KEGG - they're linked at the bottom of FOSB. Google isn't a suitable search engine for medical sources - WP:MEDRS lists suitable literature search tools if you'd like to use others.
Also, once again, this isn't a theory. Seppi333 (Insert 2¢ | Maintained) 23:44, 9 September 2014 (UTC)
It's a theory. Please read the scientific theory article for illumination.
Just to take the [ttp://www.ncbi.nlm.nih.gov/pubmed/25083822 top hit on your PubMed search], the author of the top hit "Molecular neurobiology of addiction: what's all the (Δ)FosB about?" has this to say on the matter:
The transcription factor ΔFosB is upregulated in numerous brain regions following repeated drug exposure. This induction is likely to, at least in part, be responsible for the mechanisms underlying addiction, a disorder in which the regulation of gene expression is thought to be essential.
"May be." "Likely to." "At least in part." "is thought to be." That's four cautious qualifications in one sentence, from a serious researcher who is clearly an advocate of the FOSB connection.
As far as I can see from your userpage, your academic background is in mathematics, statistics, finance, and economics. and you make no claim to be a physician or a biomedical researcher: can you tell me your qualifications on this matter? -- The Anome (talk) 23:50, 9 September 2014 (UTC)
Asking a user for personal information violates WP:TPG. My userpage indicates I'm a doctoral student in statistics. That's all I'm willing to say on wikipedia. Neither my personal qualifications or your views on the current status of the evidence are relevant to whether or not this goes in the article though. I've made the point about adherence to wikipedia policies being the only relevant criteria twice now; simply because I don't want to, I'm not going to reply to any further comments/questions that have nothing to do with the this section and a particular WP policy. Seppi333 (Insert 2¢ | Maintained) 00:01, 10 September 2014 (UTC)
Note: I've alerted WP:Med to this discussion. Flyer22 (talk) 00:05, 10 September 2014 (UTC)
I'm not asking you your name, age, sex or other personal details. I'm simply asking if you have any relevant qualification in the area. I, for example, have none. My qualifications are in mathematics, physics and computer science. But I don't make ex cathedra statements about what is or isn't medical fact, either. I leave that to WP:MEDRS, and defer to actual medics about the interpretation of that. Therefore, I see no reason to take your assertions on this matter with any more weight than that of any other Wikipedia editor.
Regarding policy: your insertion of this material in this matter is against WP:NPOV, as it describes the FOSB hypothesis as "the" cause of addiction, and indeed also the cause of sex addiction, the existence of which is something doctors can't agree among themselves about, without either stating it as being just a hypothesis, or stating who the proponents of the hypothesis are. Moreover, putting this material into the article like this is WP:SYNTH: it uses the well-attributed material in that section to give a misleading impression. -- The Anome (talk) 00:15, 10 September 2014 (UTC)
This information clearly belongs somewhere in the article -- perhaps rephrased so it underscores the fact that is a theory. Albeit a theory backed by scientific evidence. Anome, you talk about material in this article giving a misleading impression -- how about all the scientific studies under the so-called controversy section. It's wrong that this sex addiction article is being defined by its controversies. There should be a separate article that focuses on controversies, and definitely a reference on this page but it's ridiculous that some people want every fact to be seen through the lens of controversy. There is plenty of strong evidence emerging that supports a biological basis for an out-of-control sexual problem that is popularly referred to as sex addiction. Plus these two scientific studies -- the UCLA study and the religious study -- are totally misleading. That anyone would look at these two studies and suggest they have anything concrete to say about sex addiction is all a marketing scam. They don't! And they shouldn't even be in this article. The problem is a lot of Wiki editor nerds are porn addicts and they're freaked out someone's going to take their porn away -- or worse, point out that their sexuality is unhealthy. There's a lot of Wiki article subjects that don't have consensus, but that doesn't mean all the different points of view are equally worthy. This page has been hijacked by the sex addiction deniers long enough.TBliss (talk) 06:20, 10 September 2014 (UTC)
Read WP:NPA and WP:Advocacy. Sex addition is not part of medical orthodoxy and we cannot know now if it will ever be. Tgeorgescu (talk) 14:19, 10 September 2014 (UTC)
Pornography addiction is a construct advanced in order to help those who experience problems due to porn use, it wasn't meant to pathologize porn users who don't experience problems due to porn use.

Other behaviours such as drinking alcohol or gambling are addictive to only a small minority of the people who engage in them—between one and 10 per cent, Krueger says. “I would argue for the same sort of hit rate with exposure to Internet pornography, that most people would do it and it won’t become a problem.”

— Tamsin McMahon, Will quitting porn improve your life?
Quoted by Tgeorgescu (talk) 16:11, 10 September 2014 (UTC)
Wikipedia isn't a battleground between porn advocates and moral crusaders against porn. Conflating a way to help people overcome their problems with a moral condemnation of porn in general makes me doubt that you realized this. Tgeorgescu (talk) 17:01, 10 September 2014 (UTC)
Wikipedia describes facts and facts about opinions, and the question is always "Is there good evidence for this fact?" not "Which viewpoints do Wikipedia editors prefer to support?" Tgeorgescu (talk) 17:55, 10 September 2014 (UTC)
Didn't say porn is bad. I'm perfectly fine with porn. The problem is porn addicts or people who rely on porn as a substitute for relationship who get easily threatened by the concept of sex addiction. The cited religious study listed here was a study of a small number of people who identified as religious which asked if they felt religious guilt over using porn. Predictably, many did. That's it -- that's the study. No control group. Then it's reported that porn addiction might actually be more of a religious moral issue than an addiction -- there's no way that result should be extrapolated from such a study, yet it is. Same with the UCLA study, which has been cited to prove that sex addiction doesn't exist. Why would people crusade against the diagnosis of sex addiction unless they were in denial about the behavior. We're talking people who spend their savings on porn and sex lines, people who masturbate in public or until they're bleeding, people who break up marriage after marriage because they literally cannot stop cheating. To be in denial that those behaviors are problematic suggests certain issues at play within the individual. And the DSM-V only said there wasn't enough evidence yet for inclusion, which they've done with other conditions many times. The lack of inclusion in the DSM-V cannot be pointed to as evidence that sex addiction doesn't exist.TBliss (talk) 16:03, 11 September 2014 (UTC)
DSM-5 did not say that sex addiction would not exist, it said there is insufficient evidence in order to accept it as a valid diagnosis. Tgeorgescu (talk) 16:13, 11 September 2014 (UTC)
Not that it could be answered by original research, but you beg the question, since we don't speak of hand-washing addiction or bathtub scrubbing addiction. Tgeorgescu (talk) 19:56, 11 September 2014 (UTC)

Speaking of good evidence... most of the citations on this page actually fail WP:MEDRS, so I'm probably going to go through and update what I can with current medical reviews and delete what I can't.

In any event, after doing a WP:V check of what I wrote yesterday, I can safely say I did screw up the text-source integrity that was cited adequately before. In the original section, I've added the reference quotes for cited statements to every reference quote parameter. In other words, the section is now referenced by just the text in the quote parameters. The quotes include passages that don't cite anything, but which I left in simply for context. If somehow it isn't obvious which passage in the cited ref quotes corresponds to a specific clause in the text, I'll point it out for you. I'm also putting a tweaked table back in; the size isn't an issue anymore.

As for the MEDRS problems, the causes section has WP:MEDDATE issues and a WP:MEDPRI issue with the journal ref, so it needs to be updated or deleted if there's no reviews on this. Controvery has a lot of primary sources that really should just be a single recent medical review. It probably won't be hard to find something suitable as a replacement source for this section. Seppi333 (Insert 2¢ | Maintained) 08:06, 11 September 2014 (UTC)

Some aspects of the Criticism section (which cover whatever is controversial about this topic) don't need to adhere to WP:MEDRS. WP:MEDRS-compliant sources are not needed to state that a controversy exists on this topic; it would be fine to use a news source to report on that matter, for example (not that news articles are prohibited by WP:MEDRS; it's rather that they generally should not be used for medical content). And a researcher's statement (opinion or otherwise), such as Marty Klein's, does not necessarily need to be a WP:MEDRS-compliant issue. Flyer22 (talk) 14:43, 11 September 2014 (UTC)
Ah, that's fine then. I figured I'd be able to find a review on this considering how many pubmed articles of that type I've seen on other topics. I hadn't checked yet, but that leaves a lot less article work to do. Seppi333 (Insert 2¢ | Maintained) 15:06, 11 September 2014 (UTC)
I don't discourage reviews being used for any of the material that would be suited for it. Reviews are obviously better than a news source for it; well, generally anyway. I simply wanted to note that we don't have to be too strict with the sourcing when it comes to reporting on the fact that the sexual addiction debate exists. For some topics, it would be necessary to produce WP:MEDRS-quality sources to show that there is a medical debate. But for this topic, the debate is already clear by some WP:Primary and WP:Secondary sources in the article. Flyer22 (talk) 15:15, 11 September 2014 (UTC)
I'm going to do a lit search this evening when I get home to determine if I can cite anything in the causes section. I'll look into controversies to see if there are any reviews when I do. Even if I can't find anything for the theories, I'll probably just post any current reviews that include sexual addiction in the title/abstract to this page so others can expand it later. Seppi333 (Insert 2¢ | Maintained) 19:07, 13 September 2014 (UTC)
Seppi333, you just reverted my entire recent chain of edits, because the resulting text said "ΔFosB is the most significant gene transcription factor involved in altered gene expression" -- which you challenged, because you say it fails to meet WP:V -- back to an earlier edit, which says... exactly the same thing. Almost as if you didn't actually read what you were editing before hitting the "revert" button. If a statement does not meet WP:V, please remove it, editing on top of other editors' work.
And again, you've moved the material up to the top level of the article. Since there is no consensus among clinicians that sexual addiction is actually a real clinical entity, you can't describe it as having a biochemical mechanism. You can say that some neuroscientists / molecular biologists believe this, but you can't describe it as uncontroversial truth, because it conflicts with other experts' opinions. To do so would be to impose your personal opinion (ie your original research) on the article that one set of scientists have the WP:TRUTH, and others do not, which, as you've stated on the medical project talk page, is not something you're qualified to do. Where experts differ, Wikipedia articles must use WP:NPOV to state those . -- The Anome (talk) 16:59, 13 September 2014 (UTC)
There is no diagnostic criteria or good way to describe sex addiction within the pharmacological framework; like some addictive drugs and several other seemingly addictive behaviors, it has no withdrawal syndrome, which means there's no clear "dependence", and tolerance doesn't even make sense in this context. Unless there's blatant compulsive behavior, the DSM provides no guidance as to how to diagnose something under those circumstances.
Sexual addiction fits the criteria of an addiction within the reward-reinforcement framework of addiction quite well though. This does not conflict with the problem of a lack of diagnosis because the model can't be used for diagnostics (e.g., it requires self administration). Unless you find an expert disputing FOSB genes and addiction, you can't write your own doubt into this text. The language medical reviews use is the way this is to be phrased, not your own biased interpretation. Seppi333 (Insert 2¢ | Maintained) 18:27, 13 September 2014 (UTC)
Frankly, it's quite obvious you don't know much about addiction given your response; WT:MED#Term definitions infobox/template (permalink) - this thread may help enlighten you. It was you who I had in mind as "the minority of people" when I wrote that thread.
The DSM isn't an expert body on medicine. They refer to experts like people who wrote these reviews to develop means of diagnosing mental disorders. It is completely backwards to argue that there needs to be a clinical means of diagnosis for this to be valid. You are evaluating this research with a very clear bias, and it shows in your last reply. Seppi333 (Insert 2¢ | Maintained) 18:30, 13 September 2014 (UTC)

I've rolled back your most recent edits to my proposed NPOV version. Please see my comments on your talk page, and the Medicine WikiProject talk page, for my rationale for this. To summarize: some legitimate researchers say sexual addiction does not exist, others say it does, they can't both be right, therefore WP:NPOV applies, and statements must be attributed, not reported as uncontroversial statements of absolute truth. Other policies also apply, but that's the primary issue here. -- The Anome (talk) 21:48, 13 September 2014 (UTC)

Regarding your other point: No-one is claiming that this is a pharmacological addiction, so there's no need to refute that claim.

A serious question: if there is no objective means of diagnosis for sexual addiction, how do scientists study it as an objective phenomenon? If diagnosis requires self-diagnosis by introspection, that's quite a hard entity to pin down: for example, a surprisingly large number of people believe they have been abducted by aliens, yet others believe that they have been possessed by demons or by the Holy Spirit.

For example, can you tell me in what way sexual addiction differs in kind from, say, electrosensitivity, hysteria, or morgellons disease? Have there, for example, been any statistically significant double-blind investigations of people claiming, and not claiming, to be sex addicts, and measurements of their brain anatomy and FOSB metabolism that meet the standards set by the evidence-based medicine community, to show that this is a real correlation? If not, it's difficult to see how the FOSB/sex addiction link can be regarded as settled fact. Consider, for example, the large amount of research put into the serotonin hypothesis for depression, and the lack of clarity on that matter. -- The Anome (talk) 22:02, 13 September 2014 (UTC)

Delta FosB research is done by autopsy. You cannot do it with living human subjects. So, in respect to humans, it is unfalsifiable. All you could do is study Delta FosB in animals by killing them. And, in respect to pornography addiction, animals aren't generally aroused by porn. Tgeorgescu (talk) 22:30, 13 September 2014 (UTC)
I agree entirely. I can't see any literature that performed direct studies on human beings, either. If it's unfalsifiable in humans, it's essentially impossible to make firm conclusions about it in people, particularly when it's a self-reported condition with no direct animal equivalent. What we can say at the moment is that animal models strongly suggest that sexual addiction (whatever that is) depends on FOSB. And then we have to go back to the experts, who clearly still divide up into multiple camps on this. -- The Anome (talk) 22:43, 13 September 2014 (UTC)
@Tgeorgescu: Your statement about being unassociated with humans due to autopsies is both non-sequitur and wrong. For one, there are neuroimaging methods to examine the functional and structural brain development (forms of MRI) and the ΔFosB phosphorylation by phosphorimaging, as an example, in living organisms. If you had actually read studies about ΔFosB or just the Fos family, you might have known this. For another, it's been detected in humans and its clinical relevance has been discussed in reviews since then. So, your asinine assertion that it's unfalsifiable and therefore over a decade of research on this topic is therefore moot is just that: asinine... and laughably wrong. You're not an authority, but none of our opinions matter anyway; you clearly barely have an understanding of this field to boot. This also has nothing to do with porn. I'm going to ignore any subsequent statements like this since it's not my job to educate you. Seppi333 (Insert 2¢ | Maintained) 23:33, 13 September 2014 (UTC)
@The Anome: Read what I wrote on my talkpage. I'll continue my discussion with you there since this thread is examining research itself, which is outside the scope of wikipedia's citation policy: WP:MEDASSESS. Seppi333 (Insert 2¢ | Maintained) 23:33, 13 September 2014 (UTC)
OK: I've just posted there with what I believe to be the key insight about why we're having problems with achieving consensus on this article: it's not the quality of the sources, it's that different groups of people have different conceptual models, and there's thus no one mutually-understood thing called "sexual addiction" that consensus can be reached on. We need to distinguish the different meanings of the term used by different groups of players: reward-reinforcement neuroscientists, psychologists, psychiatrists, anti-sex moralists, and the popular press all understand the same term to mean quite different things, the last two of which are not even the subject of valid medical attention. -- The Anome (talk) 23:44, 13 September 2014 (UTC)

The cohort was composed of 37 male and three female subjects, ranging in age between 15 and 66 years. All subjects died suddenly without a prolonged agonal state or protracted medical illness.... The control group comprised 20 subjects with no history of cocaine dependence and no major psychiatric diagnoses. All subjects died suddenly from causes that had no direct influence on brain tissue.

— Alfred J. Robison, Vincent Vialou, Michelle Mazei-Robison, Jian Feng, Saïd Kourrich, Miles Collins, Sunmee Wee, George Koob, Gustavo Turecki, Rachael Neve, Mark Thomas, and Eric J. Nestler, "Behavioral and Structural Responses to Chronic Cocaine Require a Feedforward Loop Involving FosB and Calcium/Calmodulin-Dependent Protein Kinase II in the Nucleus Accumbens Shell"
Not exactly in contradiction to what I've said. Let's see: find enough subjects who are sex addicted and a control group of not sexually addicted people, wait till they die, hope that senescence does not blur the data and you can do research on sexual addiction and Delta FosB (apparently no one did it with MRI). Tgeorgescu (talk) 00:04, 14 September 2014 (UTC)
@Seppi333 and Tgeorgescu: -- for those not reading the discussions elsewhere, I think Seppi333 and I have now reached agreement about a way forward on this. See Seppi333's talk page for the details. -- The Anome (talk) 00:25, 14 September 2014 (UTC)

Resourcing the article

I'm just making a new thread on this topic because the previous one has three tangential subthreads.

Here's the current reviews on this topic that I found:

  • PMID 24001295
  • PMID 19937105
  • PMID 20432124
  • PMID 24693342 (this one is free)
  • PMID 22641964 (this one is free and partially used in the article)

I'll download the first three and upload them for anyone interested to download... should have that done over the next day or two. Been a bit busy the last two days, so I didn't have a chance to finish this. I didn't find anything on the topics in the causes section in relation to sex addictions, so that will need to be rewritten with the content of these reviews (assuming there is anything on causes). Seppi333 (Insert 2¢ | Maintained) 07:08, 16 September 2014 (UTC)

Model-specific organization of the article

@The Anome: I just finished doing a lot of editing to try to clarify that there are two frameworks of addiction covered in this article as well as indicate which framework is used in model-specific sections of the article.

Let me know what you think. I'm open to revising it; I feel like it could use additional copyediting, mainly because there was a large amount of text that I added/changed. Seppi333 (Insert 2¢ | Maintained) 21:38, 7 October 2014 (UTC)

This article is much improved by your edits. I think the current article better serves anyone from the general public coming to this page now for information to write a report or learn about sex addiction. I would suggest a section about sex addiction in popular entertainment citing recent films like Shame, Thanks for Sharing, etc. Also it seems a section about Patrick Carnes' book Out of the Shadows would be appropriate in the history section because this was the first public mention and exploration of the concept of sex addiction as it is currently known. In general, it would be helpful for the casual reader to get a sense of how the concept of sex addiction has evolved since the publication of that book. But great work cleaning up a difficult subject!TBliss (talk) 18:39, 9 October 2014 (UTC)

Making the article more friendly to laypeople

Dear @Seppi333:

Regarding your recent revert:

1. True, WP:MEDORDER is part of a guideline, but so is WP:UPFRONT. In this unusual case, the "Biomolecular mechanisms" section is unusually technical, even for a medical article. It's perhaps even too technical for certain clinicians, and certainly too technical for the lay public. In this extra-special case, I think UPFRONT should take precedence over MEDORDER.

2. Even if sex addiction is a disease, we can still try to remove as much medical jargon as possible from the article — at least from the first sentence or two of the lead section. (See WP:EXPLAINLEAD.) We don't want to scare them away just as they start reading. It is crucial that we allow people who arrive here (maybe via an internal link from another article) to at least get an idea of whether or not they likely suffer from sex addiction; if they do, they can then visit a family doctor or psychiatrist and get help. We have articles with leads which are far simpler, such as the featured article "Influenza".

Dear readers: Thoughts?

TealHill (talk) 23:12, 22 May 2015 (UTC)

I haven't updated the language or the evidence on addiction in this article for several months, so there's actually a little more to the mechanisms of addiction in general.
The most accessible content on a particular addiction is under Amphetamine#Addiction. If that's fairly understandable, it would be worth using the language from that page in the model description here.
In any event, all addictions are, at their core, equivalent to a common state of ΔFOSB overexpression and stimulus-specific epigenetic mechanism differences accounting for the variability between different drugs and behaviors. ΔFOSB has a pathological gene expression threshold at which point it starts to bring about further increases in its expression through its effect on behavior. The intensity of the behavioral effects associated with ΔFOSB expression vary positively with its expression level.
The only real sign/symptom of an addiction follows from the definition of the general concepts in operant conditioning: compulsive engagement in rewarding stimuli (sexual activity), despite adverse consequences
  1. compulsive engagement...The behavior or drug use is compulsive (another way of saying that is it's "pathologically reinforced" without specifying the reinforcement subtype - the meaning of pathological in this context is covered in the #3 clause)
  2. ...in rewarding stimuli (sexual activity), ...The associated stimulus is rewarding (it's something a person perceives as being positive, approachable, or otherwise desirable); with the previous criteria, it means something is positively reinforcing - so experiencing it makes an individual want to experience it again because they like it.
  3. ... despite adverse consequences An individual can't make themselves stop regardless of the severity of consequences associated with continued use. It's analogous to the idea that one attempts, but fails (not for lack of trying), to exert inhibitory control over their behavior. The exact ΔFOSB expression level at which "inhibitory control" starts to fail is also analogous to the overexpression threshold.
The most plain English way to express those 3 points is just:
  1. When you experience it, you want more
  2. You like or want the experience because it feels good.
  3. You can't stop yourself from continuing once you've begun to perform the behavior or use a drug.
This framework charaterizes the addict's perception of an addiction and the definition of addictive stimuli in an identical manner.
Seppi333 (Insert 2¢) 00:37, 23 May 2015 (UTC)
@Seppi333:
Fair enough. I am a layperson, and I didn't understand most of what you wrote above, but I don't disagree with any of it. And I do like the plain-English explanation you added towards the end. :)
Regarding the article's section ordering: The "Biomolecular mechanisms" section, as currently written, is too technical. I think that, per my arguments above, we should move it to the bottom of the article — for now. If someone edits it to make it layperson-friendly, we can move it back to the top.
Also, I think we should tag the article with {{technical}} for now. The article is about sexual addiction. It's possible to explain sexual addiction in plain language that any layperson can understand. MedicineNet has done so in this article — their article (targeted to laypeople) about sexual addiction. If we put in sufficient effort, we too can do so. Tagging the article may help to alert interested WikiProject members, as well as editors in general, that the article still needs work.
Dear Seppi, and dear readers: Agree? Disagree? Thoughts?
TealHill (talk) 03:55, 27 May 2015 (UTC)
That's fine. I'll try to make it more understandable at some point in the next month or two, assuming no one else does it in the intervening period. Seppi333 (Insert 2¢) 14:46, 3 June 2015 (UTC)

Section ordering

Dear @Seppi333:

There are two competing Wikipedia guidelines which each seem to apply to this article. WP:MEDORDER says that the article's "Mechanisms" section should be first. But WP:UPFRONT says that the article's "Mechanisms" section should actually not be first.

Which guideline should win? I vote for WP:UPFRONT.

Regards, TealHill (talk) 04:06, 5 August 2015 (UTC)

There's no reason for this article to deviate from its parent article - addiction - in layout. Seppi333 (Insert 2¢) 18:53, 7 August 2015 (UTC)
Dear @Seppi333: Well, perhaps the layout of _that_ article should also be rearranged in order to comply with WP:UPFRONT? TealHill (talk) 20:21, 7 August 2015 (UTC)

POV-pushing

There is massive POV-pushing in this article towards sexual addiction somehow being a recognized medical condition, and in particular for this article to map onto an ICD-10 categorization in the infobox. It does not. ICD-10 recognizes "excessive sexual drive" aka. satyriasis/nymphomania. These are not the same thing as sexual addiction. The proponents of the addiction model theorize them to be the same. And they might even be right. But the medical authorities who write the medical categorizations do not -- at least as yet.

Please, please, please stop the POV-pushing. Regardless of the validity or otherwise of this model, medical consensus does not yet consider these equivalent. Moreover, there is more than one possible cause of hypersexuality; consider, for example, sexual behavior from disinhibition in dementia, or hypersexuality from mania in bipolar disorder.

If you want to change medical consensus on these issues, Wikipedia is not the place to do it. Wikipedia reports consensus, it does not make it. -- The Anome (talk) 12:48, 25 October 2015 (UTC)

The proponents of the addiction model - who?
It's entirely irrelevant whether or not this is considered a "clinical entity" because no form of addiction is clinically treatable effectively at the moment. People will just end up suffering through them just like drug addictions. It makes no sense to push that POV in light of that.
FWIW, accusing me of POV-pushing is a bit retarded when you are the only one who only edits the niche of addiction articles related to sexual behavior. Seppi333 (Insert 2¢) 15:21, 25 October 2015 (UTC)

Interesting

This looks interesting: http://www.huffingtonpost.com/jesse-jackman/utahs-new-antiporn-law-_b_9741310.html , and specifically this:

Prause, Nicole; Steele, Vaughn R.; Staley, Cameron; Sabatinelli, Dean; Hajcake, Greg (July 2015). "Modulation of late positive potentials by sexual images in problem users and controls inconsistent with "porn addiction"". Biological Psychiatry. 109: 192–199. doi:10.1016/j.biopsycho.2015.06.005.

which seems to make the FOSB hypothesis look rather more tentative. I've therefore removed the "Mechanism" section. -- The Anome (talk) 11:37, 23 April 2016 (UTC)

ΔFosB is a biomarker for addiction; hence, content on ΔFosB should be included in every addiction-related article for which there's a review that covers the relationship between it and the article topic. This isn't the pornography addiction article. If it were, I wouldn't have a problem with omitting content on mechanisms. Many research papers operationally define a porn addiction as compulsive porn viewing. Visual stimuli aren't capable of inducing an addiction though. In contrast, a sex addiction involves compulsive intercourse, so there's little in common between the two addiction models. Seppi333 (Insert 2¢) 13:23, 23 April 2016 (UTC)
@The Anome: I have to agree with @Seppi333: While there is debate about it, removing the entire section seems excessive. - Scarpy (talk) 16:25, 25 April 2016 (UTC)
@The Anome: I agree with @Seppi333: and @Scarpy:, and I would vote against the removal of this section. Note that Nicole Prause and David Ley, the main sources in the article, collude and campaign against sex addiction, and profit from these point of views. They hardly represent scientific fact and a simple Google search will show their work has been much derided and debunked. TBliss (talk) 02:45, 27 April 2016 (UTC)

Wiki used to promote business

This Wiki is being used to promote a group of profiteering therapists and is continually updated to include their specific group whenever it is (appropriately) removed. CSAT has no basis in science and is under investigation by a number of bodies for practitioners attacking scientists and promoting anti-sex and anti-LGBT training and treatment. There is no reason to have a referece to them in this article except for their practitioners adding it themselves to promote profits. — Preceding unsigned comment added by 80.175.11.52 (talk) 17:09, 30 October 2016 (UTC)

Review to add later

PMID 26623203 Seppi333 (Insert 2¢) 19:12, 3 October 2016 (UTC)

The authors of that paper hold patents on the substances they are recommending clinicians prescribe in the paper...not worth adding. The journal it appears in is a known predatory journal with no impact factor. — Preceding unsigned comment added by 80.175.11.52 (talk) 17:11, 30 October 2016 (UTC)

AASECT section

The section below was recently added into a section covering the diagnosis of sexual addiction. AASECT is obviously an organization, like the WHO or APA. The WHO and APA publish the ICD-10 and DSM-5 respectively. That being said, it seems acceptable to add this content into the article and place it in the context of the diagnostic manual that the AASECT publishes, assuming that it actually publishes one. If it doesn't, this position statement has basically the same weight as any pubmed-indexed review on sexual addiction diagnosis, which we don't cover here.

If we start adding position statements from various organizations and review articles on diagnostic criteria, then I suppose we could add this back in under a new subsection under diagnosis; however, this needs to be revised to provide a representative summary of opinions for and against a diagnostic classification (under a specific diagnostic classification system) before being added back in.

Personally, I don't really have a preference for either option, but simply omitting it would be less work. Seppi333 (Insert 2¢) 03:48, 14 May 2017 (UTC) 

=== AASECT ===
In November 2016, the American Association of Sexuality Educators, Counselors and Therapists (AASECT), the official body for sex and relationship therapy in the United States, issued a position statement on Sex Addiction which states that AASECT "does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy."<ref>https://www.aasect.org/position-sex-addiction</ref>

AASECT are THE official registration body for sex and relationship therapy and sexual health in the United States. It is entirely relevant that this position statement is included as it illustrates the controversial nature of this topic. Otherwise it just reads as an entirely POV advertorial for sex addiction theories. — Preceding unsigned comment added by Cogsci101 (talk • contribs) 04:06, 14 May 2017 (UTC)

I've never heard of AASECT or a diagnostic classification system associated with it, but that's not really relevant. We don't give special weight to medical organizations above and beyond current medical reviews (WP:MEDRS). E.g., USFDA and USCDC publications are not inherently better than medical literature reviews, and they're certainly not better than Cochrane reviews per MEDRS.
So, to address the POV issue I pointed out, I'm just going to copy/paste content from Addiction directly into this article and juxtapose it with that content to balance out the POV problem. The issue with putting it in the diagnosis section next to diagnostic manuals is simply the fact that it makes no sense to place it there. AASECT is not a diagnostic classification system like the DSM and ICD are. Seppi333 (Insert 2¢) 04:26, 14 May 2017 (UTC)

I take your point on diagnosis.. Though technically ALL of the classifications listed under Diagnosis are not actually for sex addiction at all but associated disorders. It looks like an attempt to conflate two things as a rhetorical device WP:NPOV I think the name of the section needs thinking about. The extra FOSB stuff is unnecessary There is already loads on that (almost a third of the page) and we are supposed to be making this accessible for non technical readers. FOSB has it's own page I have a NPOV on this subject but the current article fails to give any indication of the fact this is a contentious topic. — Preceding unsigned comment added by 82.23.5.199 (talk) 04:43, 14 May 2017 (UTC)

We should simply say that it is a contentious topic in the lead and cover this more in the body. It's worth pointing out that diagnostic manuals do a really shitty job at distinguishing between addiction and dependence in their diagnosis labels for drug addiction/dependence, so I don't expect them to a decent job with classifying compulsive behaviors. They conflate drug addiction and drug dependence as a "substance use disorder", which is a diagnostic label/diagnosis for those two distinct brain diseases that can, but sometimes don't, co-occur (e.g., you can be dependent upon, but not addicted to, a drug; caffeine and clonidine are good examples of drugs that cause dependence but not addiction).
FWIW, this article isn't so much about whether or not sexual addiction "exists" so much as it is about whether or not compulsive sexual behavior constitutes an addiction.
An addiction is a compulsion toward a rewarding stimulus that arises from pathological dysregulation of the reward system, leading to excessively amplified incentive salience for a specific rewarding stimulus (NB: this amplification is caused by ΔFosB when its expression increases), a persistent impairment in inhibitory control, and the establishment of conditioned reinforcers (i.e., drug cues, in the context of drugs) that promote engagement in the aforementioned rewarding stimulus: when the three of those occur together, it produces fairly severe compulsive behavior directed toward the aforementioned rewarding stimulus (e.g., an addictive drug). Compulsive behaviors are readily observable phenomena; however, not all compulsions are addictions (NB: a very simplistic definition of compulsive behavior is a behavior that one performs regularly and can't effectively stop themselves from doing despite their best efforts - in the case of addictions, the compulsive behavior is often performed excessively and one is unable to effectively stop themselves from continuing to engage in it). Compulsive sexual behavior has been pretty well documented in medical literature, so the issue here is about whether or not that compulsive behavior is due to dysregulated reward cognition and, related to that point, whether or not it should be classified as an addiction. Seppi333 (Insert 2¢) 23:26, 14 May 2017 (UTC)
I agree that the diagnostic frameworks do a shoddy job on addiction full stop but including paragraphs about sexual dysfunctions which are not addictions is unhelpful as it can mislead users by conflating the two in their mind.
I question your assumption that this article is not about whether sexual addiction exists. The science is conflicting and far from settled.
It's obvious you are very knowledgeable about the neuroscience theories of addiction. However, addiction and mental health generally have social and cultural models as well as biological. The title is Sex Addiction not Biological Theories of Sex Addiction. If the social and cultural models were to be left out it would be like writing a page on gender whilst only referring to chromosomes.
To make this article more readable for its intended audience. I propose that we distill the biological content into its own section on biological models / theories and add a section on social and cultural models
In terms of the biological section, there has been considerable critiques within peer reviews, journals etc but there is no referrence to any of these in the page.
OVERALL.. we really need to work on the use of jargon and verbose technical language. Wikipedia is an encyclopedia for everyone - not just us scientists. Cogsci101 (talk) 01:34, 15 May 2017 (UTC)
@Cogsci101: "DESPITE THE IMPORTANCE OF NUMEROUS PSYCHOSOCIAL FACTORS, AT ITS CORE, DRUG ADDICTION INVOLVES A BIOLOGICAL PROCESS [no emphasis was added - this was written in all caps in the abstract]" – PMID 24459410. Psychosocial factors do indeed affect the severity/development of addictions, but they're not what drive the development and maintenance of an addiction, biological factors are (specifically, gene transcription factors like ΔFosB+NF-κB and epigenetic proteins like HDAC1+G9a). Addictions in lab animals have been experimentally induced and even prevented from developing altogether in molecular biology labs via the use of viral vectors that directly increase or inhibit the expression of some of the proteins that I just mentioned.
With that in mind, I'm not opposed to covering psychosocial factors since they are indeed important; however, they're not a competing theory or model in relation to biological ones, they're simply auxiliary/modulating factors that affect the potential for developing and rate of development and maintenance of an addiction. In the addiction article, psychosocial factors are covered in the Addiction#Risk factors section; it would probably be worth doing something similar here under that heading if you think it's worth covering that. Seppi333 (Insert 2¢) 02:03, 15 May 2017 (UTC)
Just to clarify, when I say that the article is less about whether or not sexual addiction "exists", I'm really just saying it's not about an "addiction" label. The article is about compulsive sexual behavior involving intercourse; the fact that the behavior is compulsive is what makes such behavior a disease/disorder; diseases don't come into being when a diagnosis is established (i.e., a diagnostic label and its associated criteria are added to a diagnostic manual). Consequently, this article is primarily about whether or not compulsive sexual behavior has consistent pathophysiology with an addiction. To rephrase what I said about it existing earlier: I'm basically saying that compulsive sexual behavior either is or is not an addiction; compulsive sexual behavior exists, but it's not clear if it constitutes an addiction at this point in time. Current evidence from molecular neuroscience and neuropsychology research does suggest that it constitutes an addiction due to its consistency with evidence obtained from drug addiction research though. Seppi333 (Insert 2¢) 02:12, 15 May 2017 (UTC)
I completely agree with you about the jargon in this article, but addictions are very complex phenomena that involve changes at the molecular and system level in the brain. Systems neuroscience is pretty easy to describe in layman's terms, but molecular neuroscience is not. Consequently, I've found it pretty difficult to simplify a lot of this material in several different articles.
Lastly, I have not read a single contradictory statement about the significant of ΔFosB as the core driver of an addiction in any academic journal article; at this point, I've probably read over 100 reviews and primary sources on the transcriptional and epigenetic mechanisms of addiction. Nonetheless, if you know of any article that makes a contradictory claim about this, I'm very interested in reading it. Seppi333 (Insert 2¢) 02:25, 15 May 2017 (UTC)
Edit: what I said about a contradictory statement relating to ΔFosB isn't completely true: I just remembered reading a critique on a paper about pornography addiction and the effect of sexual intercourse on ΔFosB; the critique focused on the fact that pornography and sexual intercourse are not the same stimulus, so the effect of intercourse on ΔFosB expression doesn't reflect upon the effect of pornography on ΔFosB expression. I don't remember the title of the article I read that in though. Seppi333 (Insert 2¢) 03:02, 15 May 2017 (UTC)
I think the study you have in mind was fMRI observation of users viewing pornography or having sex (though exactly what sex you can do in a scanner is mystifying). Anyway this study saw brain activity associated with tool use amomgst male porn viewers but not females.
The key debate is not whetner FOSB is involved in substance addiction - it is the fact that it is also involved in reinforcement of totally non addictive behaviours as well as addictive behaviours that we may not readily associate with addictions. Romantic love for example has almost identical FOSB mediated processes in the nucleus accumbens but we never see Romantic love presented that way, only sex. This is where the social aspect becomes critical. It is social stigma about sex which makes us regard reinforcement processes as intrinsically negative in the case of sex but fine for romantic attachment. So we may be seeing a real biological phenomena but our interpretation of that is massively influenced by social norms.
Few people debate the FOSB and addiction link.. but applying that to so called behaviourial addiction is contentious - and where non-harmful behaviours such as sex are concerned, even more so.
There are a whole host of compulsive sexual behaviours - but whether they are pathologies and if so driven by addiction processes is the key debate in this field. Cogsci101 (talk) 03:30, 15 May 2017 (UTC)
I agree with Seppi on the AASECT piece; it certainly should not have its own section. It is not nearly as authoritative as the DSM or ICD-10, if authoritative at all. Flyer22 Reborn (talk) 04:49, 15 May 2017 (UTC)
ΔFosB accumulation from excessive drug use
ΔFosB accumulation graph
Top: this depicts the initial effects of high dose exposure to an addictive drug on gene expression in the nucleus accumbens for various genes in the Fos family.
Bottom: this illustrates the progressive increase in ΔFosB expression in the nucleus accumbens following repeated twice daily drug binges, where these phosphorylated (35–37 kD) ΔFosB isoforms persist in the D1-type medium spiny neurons of the nucleus accumbens for up to 2 months.[1][2]
Romantic love is not actually a stimulus; it's a concept that relates to a variety of rewarding stimuli (some of those are natural/intrinsic rewards, others are conditioned /extrinsic rewards); e.g., the sight of one’s partner (extrinsic), physical contact (intrinsic), sexual intercourse (intrinsic), etc.. Anyway, this is sort of pedantic, but it's worth mentioning: the full length FosB protein ("FosB") has been shown to have absolutely no role in addiction whatsoever; only that particular truncated splice variant ("ΔFosB") is involved.
ΔFosB in D1-type NAcc MSNs regulates incentive salience (i.e., reward-related desire/motivation); it does not regulate inhibitory control (those neurons have no role in that process) and it only indirectly facilitates the establishment of conditioned reinforcers via the effect that incentive salience has on conditioned reinforcement. Nonetheless, of those three processes, the amplification of incentive salience is what actually drives addiction-related behaviors (e.g., drug seeking and compulsive drug use). Low levels of ΔFosB expression occur in D1-type NAcc MSNs at all times in healthy individuals and this is necessary for healthy cognitive (motivational salience) function. However, overexpression (i.e., an abnormal and excessively high level of expression that produces a pronounced gene-related phenotype) of ΔFosB in that set of neurons has been demonstrated to cause the vast majority of addiction-related behavioral and neural plasticity (again, this was demonstrated via viral vector-mediated gene transfer of ΔFosB and ΔJunD in lab animals) and, consistent with this, ΔFosB overexpression in those neurons has been detected in deceased human cocaine addicts.
With that said, if ΔFosB overexpression in the D1-type neurons were actually identified in excessively mated lab animals but not controls, compulsive sexual behavior would unequivocally constitute an addiction (this is because the behavioral phenotype of ΔFosB overexpression in those neurons is the addiction phenotype). That has not been shown in any studies to date. While it has been shown that sexual intercourse in mated lab animals induces ΔFosB expression in the NAcc through the same two mechanisms that amphetamine does[3][4] (i.e., via DRD1 and NMDAR: illustrated here), it is conceivable that it also acts on other mechanisms that ultimately prevent ΔFosB overexpression from occurring. Consequently, it may or may not progressively increase ΔFosB expression as the amount of exposure to sexual intercourse is sustained at an excessive level analogous to how it occurs when one regularly/frequently takes an excessive amount of amphetamine.
If we can find a review that covers psychosocial factors that are implicated in compulsive sexual behavior, I feel that this would be very worthwhile to cover in this article. However, again, I should emphasize that this is not something that runs in contradiction to biological evidence but something that acts in parallel to biological factors to modify cognition and behavior. In an addiction, literally all relevant psychosocial factors interact with disease-related biological ones to regulate the course and nature of addiction-related behavior: this occurs through activity-dependent neuroplasticity (i.e., physical and psychosocial stimuli that one perceives are transduced into biological signals that affect brain structure and function). Seppi333 (Insert 2¢) 20:45, 17 May 2017 (UTC)


Section reflist

References

  1. ^ Nestler EJ (December 2012). "Transcriptional mechanisms of drug addiction". Clin. Psychopharmacol. Neurosci. 10 (3): 136–143. doi:10.9758/cpn.2012.10.3.136. PMC 3569166. PMID 23430970. The 35-37 kD ΔFosB isoforms accumulate with chronic drug exposure due to their extraordinarily long half-lives. ... As a result of its stability, the ΔFosB protein persists in neurons for at least several weeks after cessation of drug exposure. ... ΔFosB overexpression in nucleus accumbens induces NFκB ... In contrast, the ability of ΔFosB to repress the c-Fos gene occurs in concert with the recruitment of a histone deacetylase and presumably several other repressive proteins such as a repressive histone methyltransferase
  2. ^ Nestler EJ, Barrot M, Self DW (September 2001). "DeltaFosB: a sustained molecular switch for addiction". Proc. Natl. Acad. Sci. U.S.A. 98 (20): 11042–11046. doi:10.1073/pnas.191352698. PMC 58680. PMID 11572966. Although the ΔFosB signal is relatively long-lived, it is not permanent. ΔFosB degrades gradually and can no longer be detected in brain after 1–2 months of drug withdrawal ... Indeed, ΔFosB is the longest-lived adaptation known to occur in adult brain, not only in response to drugs of abuse, but to any other perturbation (that doesn't involve lesions) as well.
  3. ^ Pitchers KK, Vialou V, Nestler EJ, Laviolette SR, Lehman MN, Coolen LM (February 2013). "Natural and drug rewards act on common neural plasticity mechanisms with ΔFosB as a key mediator". The Journal of Neuroscience. 33 (8): 3434–3442. doi:10.1523/JNEUROSCI.4881-12.2013. PMC 3865508. PMID 23426671. Drugs of abuse induce neuroplasticity in the natural reward pathway, specifically the nucleus accumbens (NAc), thereby causing development and expression of addictive behavior. ... Together, these findings demonstrate that drugs of abuse and natural reward behaviors act on common molecular and cellular mechanisms of plasticity that control vulnerability to drug addiction, and that this increased vulnerability is mediated by ΔFosB and its downstream transcriptional targets. ... Sexual behavior is highly rewarding (Tenk et al., 2009), and sexual experience causes sensitized drug-related behaviors, including cross-sensitization to amphetamine (Amph)-induced locomotor activity (Bradley and Meisel, 2001; Pitchers et al., 2010a) and enhanced Amph reward (Pitchers et al., 2010a). Moreover, sexual experience induces neural plasticity in the NAc similar to that induced by psychostimulant exposure, including increased dendritic spine density (Meisel and Mullins, 2006; Pitchers et al., 2010a), altered glutamate receptor trafficking, and decreased synaptic strength in prefrontal cortex-responding NAc shell neurons (Pitchers et al., 2012). Finally, periods of abstinence from sexual experience were found to be critical for enhanced Amph reward, NAc spinogenesis (Pitchers et al., 2010a), and glutamate receptor trafficking (Pitchers et al., 2012). These findings suggest that natural and drug reward experiences share common mechanisms of neural plasticity
  4. ^ Beloate LN, Weems PW, Casey GR, Webb IC, Coolen LM (February 2016). "Nucleus accumbens NMDA receptor activation regulates amphetamine cross-sensitization and deltaFosB expression following sexual experience in male rats". Neuropharmacology. 101: 154–164. doi:10.1016/j.neuropharm.2015.09.023. PMID 26391065.

Too much technical jargon / related theories with their own page

There is a lot of detail about the FOSB theories.. It would be good to have a summary and key themes and then link to the FOSB page Similarly, the table on addiction related plasticity is too much detail for non technical users and in the most part off topic — Preceding unsigned comment added by 82.23.5.199 (talk) 03:11, 14 May 2017 (UTC)

The table on addiction-related plasticity is transcluded in every article that is linked in the column header, and then some. Why exclude it from this article? An entire column of entries is relevant to this page; moreover, the main benefit of having that table here is to illustrate how the known neuroplastic effects of excessive sexual activity compare to the neuroplastic effects of excessive drug use, excessive fat/sugar intake, physical exercise, and environmental enrichment. Seppi333 (Insert 2¢) 02:28, 26 May 2017 (UTC)
Edit: the table could be collapsed if you think it takes up too much space, but again I don't think removing it would be beneficial for our readers. Seppi333 (Insert 2¢) 02:33, 26 May 2017 (UTC)
I think the table is very good - it's just in the wrong article. FOSB relates to so many other topics, we can't really transclude it in every page - we'll end up with massive duplication not to mention completely putting off non technical readers. Your paragraphs above the table summarise the FOSB stuff really well. A collapsible table would be better but this really is the kind of thing that should be spun off. Just to be clear, I merely want the page to have a suitable level of detail and to stay on topic. You are right there is a similar problem on other pages.. Once we have made this page more accessible, then we can look at those. — Preceding unsigned comment added by Cogsci101 (talk • contribs) 18:26, 26 May 2017 (UTC)
Seppi... just one other thing... if you want to modify an edit I have done, could you please just revert the INDIVIDUAL change and not ALL of my work. Thanks — Preceding unsigned comment added by Cogsci101 (talk • contribs) 18:39, 26 May 2017 (UTC)
I've collapsed the table. Seppi333 (Insert 2¢) 00:57, 27 May 2017 (UTC)

@Seppi333... Thanks for collapsing the table. I think this is a good compromise.Cogsci101 (talk) 11:51, 30 May 2017 (UTC)

NPOV

This article has a number of POV issues which need to be considered. I have flagged this on the NPOV Noticeboard and welcome third party input. I am particularly concerned that the page creates the impression there is widespread consensus where, as of yet, little exists. The current 'state of science' is in its infancy and this article should reflect that fact. It is not the role of wikipedia to push for wider acceptance of theory. We should try to accurately reflect current status in the academic and related communities.

Of particular concern, is the unrelated conditions in the Diagnosis section which creates the impression that their existence in the framework implies acceptance of sex addiction as a diagnosis. Sex addiction is NOT accepted by ANY of the diagnostic committees of the WHO, APA, BPS or others. 1. Sex addiction has been considered separately by the ICD and DSM committees and explicitly and repeatedly rejected from their diagnostic frameworks. 2. Excessive masturbation and excess sexual drive (both referred to in the diagnosis section) are NOT addictions. It is misleading to present them as such 3. Deliberately conflating differentiated conditions which share a single property (sex/sexuality) is a use of association fallacy which is counter to WP:NPOV and WP:VALID

Suggested Solution 1. Remove reference to unrelated conditions/diagnosis from the diagnosis section 2. Retain the history of consideration about their inclusion and any subsequent decisions / changes 3. Create a section on 'Associated Conditions / Misdiagnosis' and include reference to paraphilias, excess drive etc 4. Avoid implying that these sexual dysfunctions / behaviours are classified as addiction. 5. Merge the Borderline Personality Disorder into this section

Suggestions/feedback welcome Cogsci101 (talk) 12:19, 30 May 2017 (UTC)

Mechanisms

There was an extensive section on delta fos B in mechanisms, arguing that this was evidence for sex addiction. This has never been shown in any human model or study. It is the pet-theory of an activist in this area, so its inclusion likely reflects activism. None of the citations provided had anything to do with human sexuality, nor could they. Of all the possible mechanisms, it has by far the least support (i.e., none) and is better excluded unless such evidence is ever published. — Preceding unsigned comment added by Neuro1973 (talk) 01:58, 26 November 2017 (UTC)Neuro1973 (talk • contribs) 01:55, 26 November 2017 (UTC)

Diagnosis

After careful consideration and showing this content to other editors, I have come to the conclusion that the section on Diagnosis is potentially misleading. Let's be absolutely clear, NONE of the diagnostic frameworks list sex addiction as a diagnosis. There is no ambiguity about this. Recent reviews have even strengthened this position. However, the diagnosis section of this page lists numerous unrelated conditions (such as compulsive behaviour or 'sexual disorders not elsewhere classified') none of which are addictions. This page is about sex addiction not general sexual dysfunction or psychosexual disorders. Conflating the two confuses the issue and looks very much like an attempt to suggest acceptance of sex addiction as a diagnosis in the frameworks which simply does not exist. — Preceding unsigned comment added by Cogsci101 (talk • contribs)

If you want to clarify this, make it clear by adding to the section or revising what is stated for greater clarity. Don't simply delete what you don't agree with unless you gain WP:consensus first; that will inevitably be reverted due to the NPOV issues that it creates. Seppi333 (Insert 2¢) 02:26, 26 May 2017 (UTC)

It is misleading to include non related diagnosis in this section. It's like listing endless studies on nanotechnology on a page on homeopathy to try to get the reader to infer the the two are related. I believe their inclusion seriously harms NPOV. Should we raise a dispute? — Preceding unsigned comment added by Cogsci101 (talk • contribs) 18:56, 26 May 2017 (UTC)

I reverted, per Seppi. Cogsci101, do not WP:Edit war over this. Flyer22 Reborn (talk) 19:22, 26 May 2017 (UTC)
The material in the diagnosis section about drug-induced compulsive sexual behavior (i.e., the stuff about a dopamine dysregulation syndrome) is on-topic because there is a clinical diagnosis for it. I don't know why you would've removed it; that material doesn't contradict the fact that "sexual addiction" isn't included in any diagnostic classification system.
The material about compulsive sexual behavior and sexual disorders NOS is relevant to this article because that's how compulsive sexual behaviors are diagnosed in practice: they're not diagnosed as a "sexual addiction". Seppi333 (Insert 2¢) 00:55, 27 May 2017 (UTC)

@Seppi333 - Your comment on dopamine dysregulation is noted. Yes, this is an accepted diagnosis but this is not the same thing as sex addiction. However, I agree there is a margin of appreciation on this one, so I will leave it in. Where compulsive behaviours are concerned, I feel this is FAR more contentious and potentially misleading, so I suggest we leave this out until we achieve consensus via third parties.

@FlyerTalk and Seppi.. To summarise. I believe this section is misleading as:- 1. Sex addiction has been considered separately by the ICD and DSM committees and explicitly and deliberately rejected 2. Excessive masturbation and excess sexual drive are NOT addictions. It is misleading to present them as such 3. Deliberately conflating differentiated conditions which share a single property (sex/sexuality) is a use of association fallacy which is counter to WP:NPOV and WP:VALID To move this forward, I have flagged this on the NPOV noticeboard so that we may gain independent input. Until we reach consensus please do not mass revert.Cogsci101 (talk) 11:46, 30 May 2017 (UTC)

@Cogsci101: I don't have any objections to the current revision of the diagnosis section (i.e., the revision as of your most recent edits to the article). It seems fine to me. If you're happy with it as is, then are there any other issues you wish to address? Seppi333 (Insert 2¢) 00:41, 3 June 2017 (UTC)
@Cogsci101: There are now five sexual health organizations who published sex/porn science cannot be characterized as addictive and that doing so is harmful to patients. Someone added "addiction" back into this wiki again last week. It is clearly an activist reposting pet theories. Can this be frozen to avoid this intentional deception by activists? [10][11][12] — Preceding unsigned comment added by 209.194.90.6 (talk) 13:20, 20 November 2017 (UTC)
@Cogsci101 and Flyer22 Reborn: The first sentence should probably acknowledge that the idea that this is an addiction is not accepted. As-is, the wiki is presented to describe a thing "sex addiction" that exists. There is an easy resource to cite to show that the science does not support sex as addicting by neuroscientists who specialize in this exact topic Lancet Psychiatry peer-reviewed article among many others.Neuro1973 (talk) 02:05, 26 November 2017 (UTC)

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Transclusion

The single paragraph transcluded from Behavioral addiction is so small that I'm not sure it warrants the direct transclusion. Why not copy the text over (with attribution) and recast the whole section as specific to sexual addiction? (Better than using the multiple short headers, anyway) (not watching, please {{ping}}) czar 11:11, 7 February 2018 (UTC)

@Czar: The benefit of a transclusion is that when content is added to that section of the behavioral addiction article, it's added to this one as well. Seppi333 (Insert 2¢) 07:23, 9 February 2018 (UTC)
But the negatives outweigh the positives in this case. In the case of a table common to multiple articles, the transclusion would make sense. In the case of this short paragraph, the parent section should really be re-written specific to this subject with a hatnote to relevant sections. If the material were expected to change often, the benefits of direct transclusion would be more apparent, but in this case, they're not. Chances are stronger that something will change in the transcluded section that doesn't belong in this article, or otherwise the structure of the Medications section will remain as is rather than receiving the holistic rewrite it warrants. czar 19:16, 11 February 2018 (UTC)

Recent changes

As seen here, new account Suuperon, which is now indefinitely blocked for WP:Socking (no surprise there), made drastic changes to the article. Seppi333, since some or a lot of it has to do with changes you made to the article, you might want to review the changes. I have my plate full with other matters. One thing is very clear: Per WP:Lead, the lead should begin with the term "sexual addiction" in bold and define what it means. Flyer22 Reborn (talk) 20:51, 26 May 2018 (UTC)

Socking was a bad choice for him/her, he/she could have reached his/her purpose if it were not for socking. Anyway, I don't disagree with removing speculation-only information from the article. And, yes, in order to research DeltaFosB, one needs a postmortem study. Tgeorgescu (talk) 22:38, 26 May 2018 (UTC)
User was removed after providing accurate information following article vandalism? The inset quote is from a person whose 100% profit depends on defining sex as addictive and FOS is now misrepresented as having a human sexual role (paragraph beginning "ΔFosB also plays an important role"), so there remain gross inaccuracies. Maybe don't punt those improving the article accuracy? 185.51.228.243 (talk) 22:20, 27 May 2018 (UTC)
Every single suggested reading was by IITAP/CSAT therapists. Diverse and scientific books not represented at all. This article is compromised by bias. Watch for paid editors from IITAP/CSAT. 185.51.228.243 (talk) 22:33, 27 May 2018 (UTC)
Read WP:Vandalism. Reverting you was not vandalism. And since you apparently don't understand that a WP:Block is a block on you, not just your account, I will go ahead and have this article WP:Semi-protected. Stop socking. Flyer22 Reborn (talk) 05:25, 29 May 2018 (UTC)
Was out of town. Restored the neutrality in the revised content. Seppi333 (Insert 2¢) 20:34, 30 May 2018 (UTC)
Feel free to revise further; I'm assuming the blocked editor made most of those revisions. Seppi333 (Insert 2¢) 20:34, 30 May 2018 (UTC)
Regarding this revert, I think the lead sentence I used was fine and is perhaps a better lead sentence, given the sources. I mean, look at the source I used for that sentence. Sources (including the one I added) are also clear that "related models of pathological sexual behaviors" such as hypersexuality are not simply related models; they've been considered the same thing as sexual addiction, which is why I'd changed "related models to "related or synonymous models." Flyer22 Reborn (talk) 07:24, 31 May 2018 (UTC)
That revision seems fine to me. I was mainly referring to the first lead sentence and the coverage of different viewpoints. Seppi333 (Insert 2¢) 08:03, 31 May 2018 (UTC)
Thanks for restoring that piece. The first lead sentence is what I mean as well. Per WP:Lead sentence, it's what is meant when Wikipedia says "lead sentence." Given the sources, I'm just not seeing an issue with the lead sentence I used (other than that the shortened "sex addiction" was missing), but I don't feel strongly enough about it to debate it. Flyer22 Reborn (talk) 08:20, 31 May 2018 (UTC)

The current sentence is the definition of an addiction to a sexual stimulus. Seppi333 (Insert 2¢) 22:55, 1 June 2018 (UTC)

The World Health Organization that issues the International Classification of Disorders has just issued guidance on sex addiction. From Dr. Geoffrey M. Reed the ICD "specifically avoid using the addiction terms" and their media office is to "point out to journalists that we are not using it". He further stated that "We do not consider that there is sufficient evidence to conceptualize this as an addiction". The ICD section should be updated to reflect that WHO has clearly rejected "sex addiction". [13] 62.128.217.93 (talk) 16:15, 13 July 2018 (UTC)

Medicine vs. neurobiology

I understand that there is a quite plausible model for neuroplasticity-driven compulsive sexual behavior, albeit one that is defined by extrapolation from animal models. However, there is no consensus among the medical profession that this is actually a medical condition among human beings, and as such, they have consistently refused to codify it as such in the evidence-based diagnostic criteria; and on medical articles (which, if "sexual addiction" is a real medical condition, this is) we must rely on medical, not general scientific sources.

Let's by all means refer to the neurobiological model, but it is not the be-all and end-all of the discussion, and doesn't trump official consensus among practitioners of evidence-based medicine, no matter how plausible the science, or how many people earn their living from defining and treating "sex addiction", or whether certain political interests would like to pathologise people who like to have a lot of sex.

Note also that even if highly compulsive sexual behavior is explained by addiction-like neuroplasticity effects, it's still not necessarily a disease unless it causes suffering: see for example, the recent changes in the diagnostic literature regarding sadomasochism. Indeed, it could be argued that these changes are actually adaptive, since something has to drive human sexuality in order to continue human existence, and the only question then is how much is enough? Which is a massively political social-political question, a bit like the current culture war on what constitutes an acceptable level of food intake. Which for good and proper reasons, none of which is for Wikipedia to resolve; instead, we must rely on reliable sources, and in the case of a purported disease, these should be medical resources that meet WP:MEDRS.

What would change my opinion on this matter? Simple: (a) either the DSM or ICD adding "sexual addiction" as a diagnostic category, and (b) multiple, peer-reviewed, statistically valid human studies supporting the neuroplasticity hypothesis of sex addiction meeting the standards of evidence-based medicine. -- The Anome (talk) 16:56, 8 June 2018 (UTC)

I have absolutely no interest in editing the diagnostics-related content in this article. Making it crystal clear that there is no diagnosis for sexual addiction in humans is absolutely necessary. The same is true for animal research on the neuropathophysiology of compulsive sexual behavior. The lack of a diagnosis should not be conveyed in a way that downplays that research, nor should that research be used to suggest that sexual addiction is a clinical diagnosis. Simply put, it needs to be compartmentalized in this article.
Also, please don't link to addiction-related structural neuroplasticity in this article; it's such an abhorrently shitty article. Almost every sub/child-article of addiction is either incomplete or rife with inaccurate and/or off-topic information. Seppi333 (Insert 2¢) 03:38, 20 June 2018 (UTC)
I think the current version is fine. Seppi333 (Insert 2¢) 03:50, 20 June 2018 (UTC)
I think that the "proposed" wording The Anome added on to "state" should be removed. Researches are clear that the state exists, whether it's called sexual addiction, hypersexuality, or by some other name, or not. And on that note, editors can refer to sources like this one I added to the lead when attempting to clean it up back in May. Flyer22 Reborn (talk) 05:30, 14 July 2018 (UTC)
Changed to "characterized as." This is wording I also used at the G-spot article, given that the existence of the G-spot, at least as a distinct structure, is disputed. Flyer22 Reborn (talk) 07:44, 28 July 2018 (UTC)

Reducing bias

There is a large anti-porn lobby in the United States that appears to be repeatedly modifying this article. The hallmark is discussions of FOSB. That group consistently claims FOSB has some role in a proposed "sex addiction", yet it cannot be studied in living humans (and has not been in cadavers). They include long paragraphs that actually are about animal research on cocaine addiction and similar that are speculative, unpublished, and unlikely to be true. Thus, my changes reflect thoughtful corrections to activism on the page.Suuperon (talk) 19:55, 25 May 2018 (UTC)

Agree, purely speculative approaches should not be presented as evidence-based. Tgeorgescu (talk) 22:19, 25 May 2018 (UTC)
Since these comments, a huge section on delta fos-B has been added back. There is no evidence for this link in humans, and none is cited. It should be removed. — Preceding unsigned comment added by 198.184.147.58 (talk) 14:44, 29 August 2018 (UTC)

Semi-protected edit request on 5 June 2018

Add first line to "is a proposed model" or "is an hypothesized model". "Addiction" is a scientific model that has not been agreed on by any scientific body, so presenting "sex addiction" as "a state" misrepresents the state of the science, which largely has rejected this model (relative to, for example, impulsivity model, high drive model, social shame model, etc.). 71.196.154.4 (talk) 15:33, 5 June 2018 (UTC)

 Not done

The wiki is full of the overwhelming rejection of the "addiction" model by scientific and professional bodies. All are linked to verifiable sources. Troll account. — Preceding unsigned comment added by 198.184.147.58 (talk) 14:46, 29 August 2018 (UTC)

Semi-protected edit request on 26 November 2018

Information about the ICD-11 draft was added, but did not include that (1) The ICD cannot be accepted as a diagnosis anywhere yet, and the earliest in the USA is 2022 and (2) the World Health Organization specifically stated that they did not find evidence that sex was addictive. Given that this article is "sex addiction", that must be included for this to be accurate, otherwise it is misleading to people who do not know the differences between a compulsion and an addiction (there are many). "But the UN health body stops short of lumping the condition together with addictive behaviours like substance abuse or gambling, insisting more research is needed before describing the disorder as an addiction." Dr. Geoffrey Reed, WHO [1] TestAccount2018abc (talk) 20:44, 26 November 2018 (UTC)

Sexual addiction is an umbrella concept, which people use in different meanings. The point you're making is explained under Sexual addiction#ICD. Tgeorgescu (talk) 21:16, 26 November 2018 (UTC)
Addiction is not an "umbrella" concept. The article quote shows the head of the World Health Organization disagreeing with you too. Here neuroscientists describe the differences neurologically (https://onlinelibrary.wiley.com/doi/abs/10.1111/add.13297) and here by symptom (https://link.springer.com/article/10.1007/s10508-017-0991-8). You are an anti-sex activist who should not be editing this page, there is literally no science supporting your claim. Addiction and compulsivity are different models, and sex addiction appears nowhere in the ICD-11 intentionally, by WHO's own statement. — Preceding unsigned comment added by TestAccount2018abc (talk • contribs) 23:50, 26 November 2018 (UTC)
Cool down buddy, I'm not an anti-sex activist, through my edits I have decidedly opposed sexual pseudoscience, but I am also prepared to give the other side the benefit of the doubt when the matters aren't settled yet. You have read too few of what I wrote inside Wikipedia and you're jumping to conclusions. If that's the way to treat your allies I wonder how you treat your enemies.
So, yeah, I know that compulsion is different from addiction. However, this article is not only about sexual addiction, but about a lot of stuff. Instead of having ten different articles with roughly the same content, we have one article which covers them all. This is not hard to get from reading it. Tgeorgescu (talk) 17:01, 28 November 2018 (UTC)
This impression was based on a review of your bio, which has extensive commentary about your biblical beliefs, not your scientific background in this area. So the critique of the article and the likely source of the bias seems fair. The article already states in one place exactly what I suggest, your addition reverts back to mischaracterize again. I did not request a separate entry at any time, only that this entry be scientifically accurate. With your last addition, it is no longer scientifically accurate by my, or the World Health Organization's, estimation. — Preceding unsigned comment added by 209.194.90.6 (talk) 17:12, 28 November 2018 (UTC)
First, Wikipedia does not require editors to be experts/scientists, that's a thing for Citizendium. Wikipedia requires editors to WP:CITE WP:SOURCES, that's all: you have sources, you have everything, don't have sources, don't have anything. Second, editing Wikipedia is a cooperative enterprise. If I were the only one to write this article, I would write it differently, but since everybody can edit, I have to make allowance for their doubt. Third, the matter of sexual addiction vs. CSBD is not settled yet: ICD is not a diagnosis manual, it is a manual of codes, so that a French MD understands the diagnosis of a Mexican MD. There has been a discussion about adding TCM codes to ICD, but in fact WHO does not say that a specific code is a thing, so if TCM would be included in the ICD it would not mean that TCM got scientifically validated. Fourth, I have quoted a source (Ley), which says that ICD does not include sexual addiction, and I tried to briefly explain his point. Perhaps you might try to suggest a different wording, I'm all ears. Fifth, don't cast aspersions based on insufficient data. More precisely, you did not bother to read my opinions, e.g. that in respect to mental health insurance money, DSM is king, not ICD, and since addictions got purged out of DSM there is unlikely to be a diagnosis of porn addiction (or sex addiction, for that matter). Tgeorgescu (talk) 21:10, 28 November 2018 (UTC)

TestAccount2018abc/IP, see this 2017 "Sexual addiction: Terminology, definitions and conceptualisation" source, from Routledge, which states that "clinical sexologists have been unable to reach consensus on what to call or how to treat [compulsive sexual behavior]." The terminology, conceptualization and theory varies. Sexual behaviors such as hypersexuality have been considered the same thing as sexual addiction. The source is clear about that. And we address that aspect in the lead.

Since the final version of the ICD-11 has not yet been released, it is probably best that it's not included in the lead. That the concept of sex addiction lacks consensus is already made clear in the article; the "compulsion vs. addiction" aspect is also there, in the ICD section of the article. But as for consensus, the book source I cited notes that while there is a lack of consensus regarding the terminology, definition and conceptualization of sex addiction, "there is no dispute among therapists, researchers and society in general about the reality of the phenomenon, that is, there are individuals who are distressed because they perceive they have a lack of control over their sexual behavior."

As for Tgeorgescu, I assure you that he is not anti-sex. His contributions demonstrate the opposite. Flyer22 Reborn (talk) 22:12, 28 November 2018 (UTC)

Yes, what we cannot do is:
  • pretend that it is settled, when it is not settled;
  • if not settled, we cannot listen to only one POV. This cannot be fixed inside Wikipedia, it has to be fixed in the outside world. Tgeorgescu (talk) 14:02, 29 November 2018 (UTC)

Section reflist

References

  1. ^ https://medicalxpress.com/news/2018-07-recognises-compulsive-sexual-behaviour-mental.html

Addiction glossary template

The article currently contains the {{Addiction glossary}} template at the top of the article. Since almost the entirety of the rest of the article is about how the concept of "sex addiction" is not recognized by the majority of the medical profession as an addictive disorder, and that the position that it is an addictive disorder is a minority view, it seems unreasonable to make this pretty much the first thing the reader sees, creating the impression that this article is one of a family of articles about addictive disorders.

@Seppi333: I'm going to remove it again in a moment; if you feel this should be kept, please discuss this here before restoring it. -- The Anome (talk) 09:20, 21 April 2019 (UTC)

The whole point of a glossary is to provide a list of definitions for clarification. I don't see how the presence of the glossary implies that the article it's placed in is a diagnosable condition or not. As it is important to make a distinction between concepts like addiction and dependence, I am going to restore the glossary. Seppi333 (Insert 2¢) 09:26, 21 April 2019 (UTC)
Putting it there puts "addiction" front and centre at the top of the article, which is quite misleading since consensus is that this is not addiction. If it is to be there at all, I suggest moving it down to the section where the addiction model is discussed. By the way, I think the main problem here is the word "addiction", with its overtones of moral panic; the word "compulsion/compulsive" is much more realistic, and fits the proposed ICD-11 categorization of this as "compulsive sexual behavior". -- The Anome (talk) 09:37, 21 April 2019 (UTC)
I've now moved the {{Addiction glossary}} down to the "Mechanisms" section, where technical details of the addiction model are discussed. -- The Anome (talk) 09:45, 21 April 2019 (UTC)
An addiction is a compulsion. You seem to misunderstand the point of this glossary though. It was not created for this article. It was created for all articles on addiction, dependence, or substance use disorder to clarify these terms. Removing it from the article does not have any bearing on what the readers think about the article's topic. Nor does adding it. All that glossary does is clarify what those terms mean. That said, it should not be any further down in the article than the first section, otherwise it loses its utility. If you want to move it to another section, move that section to the very top of the article. Seppi333 (Insert 2¢) 09:46, 21 April 2019 (UTC)
Actually, nevermind. All of the sections are currently in the order specified by MOS:MED#Diseases or disorders or syndromes, so it doesn't matter. Seppi333 (Insert 2¢) 09:52, 21 April 2019 (UTC)
Please do not change the order of sections to suit a point of view. MOS:MED is quite clear on the order of sections in an article and the names of those sections. Seppi333 (Insert 2¢) 10:00, 21 April 2019 (UTC)
Per MOS:MED#Diseases or disorders or syndromes, "Classification" comes before "Mechanisms". I've just moved the classification section, which was previously mis-labeled as "Diagnosis" (which is clearly wrong, since (a) it's entirely about the various classification systems and (b) most of it consists of statements that there is nothing to diagnose), up the article to reflect this. -- The Anome (talk) 10:02, 21 April 2019 (UTC)
My bad; I didn't notice you retitled it as such. It looks fine now. Seppi333 (Insert 2¢) 10:04, 21 April 2019 (UTC)
@The Anome: Next time you move an article with a blocked target, use this script. I had to manually move the talk page subpages because you neglected to do so. That script would've moved them for you as well as obviated the need to delete the article page and talk page that you were moving it to (see WP:ROBIN). Seppi333 (Insert 2¢) 10:15, 21 April 2019 (UTC)
Thank you! Sorry for creating work for you, and thanks for fixing it. I think this article is now converging on something we can both be happy with as a proper WP:NPOV treatment of the subject. -- The Anome (talk) 10:18, 21 April 2019 (UTC)

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:

-- 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.[14] A quick look at some search results[15][16] 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)
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