Debating the Conceptualization of Sex as an Addictive Disorder

Three predominant pathophysiological models have been applied to hypersexuality, which were developed based on observed similarities with obsessive-compulsive disorders, impulse-control disorders, and addictions. Each model was intended to elucidate etiological mechanisms and symptom profile, and facilitate effective treatment. Unfortunately, there are a number of conceptual problems inherent in these models, and clinicians and researchers have typically adopted one descriptive model and have applied it to all individuals presenting with hypersexuality. In this paper, I review the utility and applicability of the sexual addiction conceptualization, arguably the most common model used in both academia and popular media in describing this behavior. Emphasis is placed on the similarities and differences between hypersexuality and addictions, including clinical characteristics, neurobiological underpinnings, diagnostic co-morbidity, and treatment response.