Internet Sex Addiction

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Internet sexual addiction, also called internet sex addiction, is really a state characterized by compulsive participation or engagement in sex, especially intercourse, despite negative consequences. Proponents of the diagnostic model for internet sexual addiction consider this truly is one of several sex-related disorders within hypersexual disorder. The expression sexual dependence is also used to refer to folks that report being unable to control their sexual urges, behaviors, or thoughts. Related or synonymous variations of pathological sexual behavior include hypersexuality, nymphomania, satyriasis, erotomania also paraphilia-related disorders.

There is considerable debate among psychiatrists, psychologists, sexologists and other specialists if sexual behavior constitutes an addiction, and therefore its classification and potential diagnosis. Animal research has established that compulsive sexual behavior arises from the same transcriptional and epigenetic mechanisms that mediate drug addiction in laboratory creatures. However as of 2018, internet sexual addiction is not a clinical diagnosis in either the DSM or ICD medical classifications of diseases and medical disorders.

Some contend that applying such concepts into normal behaviors such as gender, can be problematic and indicate that applying medical designs such as addiction to human sexuality can serve to pathologize ordinary behavior and cause injury. The ICD-11 created a new condition classification, insatiable sexual behavior, to cover a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior. None of the official diagnostic classification frameworks list internet sexual addiction as a distinct disorder.

The American Psychiatric Association (APA) publishes and periodically updates the Diagnostic and Statistical Manual of Mental Disorders (DSM), a broadly recognized compendium of mental health diagnostics. The version published in 1987 (DSM-III-R), known to distress about a pattern of repeated sexual conquests or other forms of nonparaphilic internet sexual addiction; involving a succession of individuals that exist only as things to be used. The reference to sexual addiction had been subsequently eliminated. Even the DSM-IV-TR, published in 2000 did not include sexual addiction as a mental disorder.

Some authors suggested that internet sexual addiction ought to really be re-introduced into the DSM system; however, internet sexual addiction was rejected for inclusion in the DSM-V, which was published in 2013. Darrel Regier, vice-chair of the DSM-V process team stated, “Even though ‘hypersexuality’ is a proposed new addition, the phenomenon was not at the point at which we now were ready to call it an addiction. The suggested diagnosis will not make the cut as an official diagnosis due to a deficiency of research into analytical criteria for compulsive behavior, according to the APA.

The World Health Organization creates the International Classification of Diseases (ICD), which is not limited to mental disorders. The most recent accepted version of that document, ICD-10, includes “excessive sexual drive” as a diagnosis (code F52.7), subdividing it into satyriasis for men and nymphomania for females. However, the ICD categorizes these diagnoses as behaviors or impulse control disorders and not addiction. The most recent but unapproved version of that document, the ICD-11 includes “compulsive sexual behavior disorder” because of diagnosis (code 6C72), it will not use the addiction model.

The Chinese culture of Psychiatry creates the Chinese Classification of Mental Disorders (CCMD), which is now in its 3rd edition (the CCMD-3) does not include internet sexual addiction for being a diagnosis. Mental health providers have proposed many requirements for diagnosing internet sexual addiction, including Patrick Carnes, and Aviel Goodman. Carnes authored the earliest clinical book about sex addiction in 1983 based on his own research. Carnes diagnostic version is nonetheless largely utilized from a large number of licensed sex addiction therapists (CSAT’s) trained by the organization he founded. No suggestion for internet sexual addiction was embraced into any official government diagnostic guide.

During the update of the DSM-5, the APA rejected two independent suggestions for inclusion. In 2011, the American Society of Addiction Medicine (ASAM), the biggest medical consensus of physicians dedicated to treating and preventing addiction re-defined addiction because of chronic brain disorder, which for the first time increased the definition of addiction from substances to include addictive behaviors and reward-seeking, such as gambling and sex.

The ICD, DSM along with CCMD list promiscuity because of widespread and problematic symptoms for Borderline Personality Disorder and/or BiPolar disorder. Individuals with this diagnosis sometimes engage in sexual behaviors that can appear out of control, distressing the individual or attracting negative reactions from others. There is therefore a risk that a person presenting with internet sex addiction can in truth be suffering from BiPolar and/or Borderline Personality Disorder. This might result in inappropriate or incomplete treatment.

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 stance on Internet Sex Addiction that states that AASECT does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction due to being 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 spiritual knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts, or behaviors to some addiction process cannot be conducted by AASECT as a regular norm of training for sexuality education delivery, counseling, or therapy.

In 2017, a few sexual health organizations found no aid for the idea that sex or adult films were addictive in their statement. In November that same year, the Association for the Treatment of Sexual Abusers (ATSA) published a position against sending sex offenders into internet sex addiction treatment facilities. Those centers claimed that illegal behaviors were indications of internet sex addiction, which ATSA challenged there was no scientific evidence to support such a claim.

Bestial research involving rats that exhibit compulsive sexual behavior has recognized that this behavior is mediated through the same molecular mechanisms in the brain that mediate drug addiction. Sexual activity is an intrinsic reward that was shown to behave as a positive reinforcer, strongly activate the benefit system, also induce the accumulation of ΔFosB in a member of the striatum (specifically, the nucleus accumbens). Chronic and excessive activation of certain pathways within the benefit system along with the accumulation of ΔFosB in a particular group of neurons within the nucleus accumbens has been directly implicated in the development of this compulsive behavior that characterizes addiction.

In individuals, a dopamine dysregulation syndrome, characterized by drug-induced cerebral engagement in sex or gambling, has also been detected in some individuals taking dopaminergic medications. Latest experimental models of addiction to natural rewards and drug reward demonstrate common alterations in gene expression in the mesocorticolimbic projection. ΔFosB is actually the most significant gene transcription factor involved in addiction, since it is viral or genetic over-expression in the nucleus accumbens is essential and adequate for most of the neural adaptations along with plasticity that occurs.

ΔFosB has been implicated in addictions for alcohol, cannabinoids, cocaine, nicotine, opioids, phenylcyclidineaccumbens, and substituted amphetamines. ΔJunD is the transcription factor that directly opposes ΔFosB. Increases in nucleus accumbens ΔJunD expression can decrease or, with a substantial increase, actually block the majority of these neurological alterations seen in chronic drug abuse that is; the alterations mediated by ΔFosB. ΔFosB also plays a significant function in regulating behavioral responses to natural rewards, such as palatable meals, sexual activity and exercise. Natural benefits, for example drugs of abuse; induce ΔFosB in the nucleus accumbens, and chronic acquisition of these benefits can result in an identical pathological addictive state.

Thus ΔFosB is also the primary transcription factor involved in addictions to natural rewards. Internet sexual addictions in specific since ΔFosB in the nucleus accumbens is essential for the reinforcing effects of sexual reward. Research on the interaction between natural and drug benefits suggests that psychostimulants and sexual benefits of cross-sensitization effects behave on common biomolecular mechanisms of addiction-related neuroplasticity; which are mediated through ΔFosB.

Since 2017, none of the official regulatory bodies for psychosexual counseling or sex and relationship therapy have confessed internet sexual addiction being a distinct entity with associated treatment protocols. Indeed, some practitioners regard internet sex addiction as being a potentially destructive diagnosis and draw on parallels with homosexual conversion therapy. As a result, treatment for internet sex addiction is much more often provided by addiction professionals compared to psychosexual specialists. Cognitive behavioral therapy is a common form of behavioral treatment for addictions and maladaptive behaviors. Behavior therapy has been shown to improve treatment outcomes as well.

Accredited Sex Addiction Therapists (CSAT); a group of sexual addiction therapists accredited by the International Institute for Trauma and Addiction Professionals offer specialized behavioral therapy designed specifically for internet sexual addiction. Their treatments have to be more subject into peer-review, so it is unclear should they help or harm the client base.

NoFap is an online community founded in 2011. It functions as a help group for those who wish to avert the use of porn, masturbation and/or intercourse. In-person service groups are available in many of the developed environment. Currently there is no proof to show whether or not they truly are helpful, therefore attendees do so at their own risk.

There are also a number of various self help groups aside from NoFap. Here is a list of the more popular groups:

Sex Addicts Anonymous: For people that wish to reduce or eliminate their use of pornography, masturbation or undesired sexual activity.

Sex and Love Addicts Anonymous: For people that wish to reduce or eliminate their use of pornography, masturbation or undesired sexual activity.

Sexaholics Anonymous: For those that want to eliminate the use of porn, masturbation, unwanted intercourse, and/or sex outside of marriage. This group has a stricter definition of sexual stimulation.

SMART Recovery: This group utilizes psycho-education and steers away from the mandate of needing a higher power to recover.

In places in which none of the aforementioned are open, open meetings of Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) might be considered a second-best option. At open AA and NA meetings, non-alcoholics/non-addicts are welcome to watch but not participate.

Internet sex addiction as a word first emerged in the mid-1970s when various members of Alcoholics Anonymous sought to use the principles of 12-steps toward sexual recovery from serial infidelity along with other unmanageable same-sex sexual behaviors that were similar into the powerlessness and un-manageability they experienced with alcoholism. Numerous 12-step type self-help groups exist for individuals who identify themselves as internet sex addicts, including sexual intercourse Addicts Anonymous, Sexaholics Anonymous, Sex and Love Addicts Anonymous, and Sexual Compulsives Anonymous.

Support groups are useful for uninsured or under-insured individuals. They might be useful as an adjunct to professional treatment as well. In addition, they may be useful in places in which professional practices are not accepting new patients, rare, or nonexistent or at which such practices have waiting lists. Finally, they may be useful for clients who are unable to spend money on professional treatment; especially since insurance won’t cover an issue that can not be diagnosed.

According to a systematic review from 2014; observed prevalence rates of internet sexual addiction and/or hypersexual disorder vary from 3% to 6%. Some research implies that internet sex addicts are disproportionately men at the rate of 80%.

Nonconsensual sex is sexual abuse. Treatment for internet sexual addiction generally will not handle the facets that cause people to sexually abuse others. The controversy surrounding internet sexual addiction is centered around its identification, via a diagnostic model; in a clinical setting. As noted in recent medical literature reviews, compulsive sexual behavior has been discovered in people; drug-induced compulsive behavior continues to be noted clinically in some individuals taking dopaminergic drugs. Moreover, some research indicates compulsive engagement in sexual behavior despite negative consequences.

Since the latest diagnostic units use drug-related concepts as diagnostic criteria for addictions, all these are ill-suited for modeling unfortunate behaviors in a clinical setting. Consequently, diagnostic classification systems, such as the DSM; do not include internet sexual addiction for being a diagnosis because there is currently insufficient peer-reviewed evidence to establish the diagnostic standards and course descriptions needed to recognize these behaviors as mental disorders. A 2014 systematic review on internet sexual addiction indicated that the lack of empirical proof on sexual addiction is the result of the disease’s complete lack from versions of this Diagnostic and Statistical Manual of Mental Disorders.

There has already been past debates for years regarding the definition and existence of internet sexual addictions, as the issue had been covered in a 1994 journal article. The Mayo Clinic considers internet sexual addiction as a form of obsessive compulsive disorder and refers to it because of sexual compulsivity (note that by definition, an addiction is a compulsion towards rewarding stimulation). A newspaper dating back to 1988 along with a journal comment letter published in 2006 asserted that sex addiction is a myth, a by-product of ethnic and other influences. The 1988 newspaper claimed that the condition is instead a means of projecting social stigma onto clientele.

A study from 2003 stated that the concept of internet sex addiction provides an outstanding case of being politically disastrous. The study singled out a range of features that considered crucial limitations of the internet sex addiction model. It also stated that the analytical criteria for sexual addiction is easy to find on the internet. Drawing on the Sexual Addiction Screening Test, the study stated that the sexual addiction diagnostic requirements make problems of non-problematic experiences; also being a result of pathologizing most people today.

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– BENJAMIN JONES, LCSW

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