In recent years, people have blamed failed marriages, crumbling careers and shrinking bank accounts on sexual addiction – patterns of uncontrollable sexual behaviors that some say could stem from a person's brain chemistry. But a recent study from the University of California, Los Angeles challenges that idea, saying that there is no scientific evidence to classify such an addiction as a legitimate mental disorder.
Researchers monitored the brain activity of 52 people who reported "having problems controlling their viewing of sexual images," in order to determine if there is a link between sexual addiction, or hypersexuality, and the way their brains responded to the images. The participants were shown pictures of anything from dismembered bodies, to people skiing, to people having sex – images that were chosen to specifically elicit "pleasant or unpleasant" feelings.
For years most researchers believed that sex addicts have brain chemistry changes that resemble other addictions. If a person is addicted to sex, for example, their brain response to sexual stimuli would be higher than normal, similar to that of a drug addict to images of cocaine.
But when researchers monitored the participants' brain activity on sexual stimuli they found no connection between differences in brain responses and hypersexuality.
"Brain response was only related to the measure of sexual desire," said co-author Nicole Prause, in a statement. "In other words, hypersexuality does not appear to explain brain responses to sexual images any more than just having a high libido."
The Society for the Advancement of Sexual Health estimates that 3 to 5 percent of the American population, or more than 9 million people, meet the criteria for this condition, which is associated with people who persistently engage in certain sexual behaviors – such as masturbation, prostitution, cyber sex or multiple affairs – despite negative consequences.
But the issue still prompts significant debate. Though many believe hypersexuality is a mental disorder and hundreds of therapists offer treatment for the compulsive behavior, it failed to meet the criteria to be included in the most recent update of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5.
The manual, updated and released in May, is a publication from the American Psychiatric Association that sets the standards for classifying mental disorders. Rory Reid, a UCLA assistant professor of psychiatry, published a study last year that supported a set of criteria to diagnose "hypersexual disorder." The criteria, which were intended to advocate for the condition to be included in DSM-5, accurately classified 88 percent of the patients who were seeking help for uncontrollable sexual behavior.
The diagnosis relied on identifying a recurring pattern of "sexual fantasies, urges and behaviors" for six months or longer that were not caused by other issues or conditions, and patients must have been unsuccessful in attempting to stop the behaviors they believed were problematic.
Many clinicians who treat patients who have problems controlling sexual urges look for what impact a behavior has on that person's life, rather than neurological indicators.
Robert Weiss, a sex addiction clinician and author, told U.S. News that sexual addiction needs to be recognized as a real issue and that those who treat people with compulsive sexual behaviors should not define the condition quantitatively, but rather qualitatively.
"You can't define an addiction by what a person eats, what kind of alcohol they drink or whether they play blackjack or craps," Weiss says. "We look at their life and determine if a substance or behavior is negatively affecting the quality of their life to the point where they need help."
Weiss added that some clinicians may be reluctant to categorize hypersexuality as an addiction or a mental disorder because it could be used as an excuse for sex offenders, like Ariel Castro, who is accused of kidnapping and raping three women who he held captive and publicly claimed he was a sex addict.
Others worry there is a social stigma against characterizing certain sexual behaviors as mental disorders, especially acts that are consensual. Weiss says that while many people can have occasional, non-intimate sexual experiences without a problem, those with a sexual addiction just keep going.
"If a person is an alcoholic, that person may not act the same way around alcohol, just as a person who has a problem with sex might not act the same way about casual sex," Weiss says.
"Just because you can control it doesn't mean everyone else can," Weiss says.