Previously submitted to: JMIR Mental Health (no longer under consideration since Oct 16, 2024)
Date Submitted: Oct 15, 2024
Open Peer Review Period: Oct 16, 2024 - Oct 16, 2024
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Compulsive Sexual Behavior Disorder: A Mixed-Methods Study of Clinical Diagnosis and Demographic Trends
ABSTRACT
Background:
Compulsive Sexual Behavior Disorder (CSBD) is characterized by repetitive and intense sexual urges and behaviors that individuals find difficult to control, leading to significant distress and impairment in daily life. Although CSBD has been recognized in the ICD-11, there is ongoing debate regarding its classification, particularly whether it should be categorized as a behavioral addiction or an impulse control disorder. Additionally, questions about the neurobiological mechanisms involved in CSBD contribute to the complexity of diagnosis and treatment approaches.
Objective:
The objective of this study is to investigate the classification, diagnosis, and treatment efficacy of Compulsive Sexual Behavior Disorder (CSBD), focusing on its neurobiological underpinnings and the influence of cultural factors on diagnosis. The study also aims to provide a standardized diagnostic framework that can guide clinical and public health practices.
Methods:
This study employs a mixed-methods design, integrating both qualitative and quantitative approaches. We conducted semi-structured interviews with clinicians to gain insights into the diagnostic challenges and treatment practices for CSBD. We also reviewed existing literature on CSBD to contextualize the clinical findings, focusing on neurobiological mechanisms such as those identified through fMRI and EEG studies. Finally, a cross-sectional survey was performed to gather demographic and behavioral data from individuals diagnosed with CSBD.
Results:
The analysis suggests that CSBD aligns more closely with behavioral addiction, given its association with the brain's reward pathways, particularly dopamine dysregulation. Cultural factors emerged as a significant influence on the perception and diagnosis of CSBD, with clinicians reporting variability in how sexual behavior is judged across different populations. Moreover, a lack of long-term studies on treatment efficacy presents a gap in the current literature, making it difficult to determine the long-term success of therapeutic interventions such as Cognitive Behavioral Therapy (CBT) and pharmacological treatments (e.g., SSRIs).
Conclusions:
The findings underscore the need for a standardized diagnostic framework for CSBD, one that accounts for both neurobiological and cultural factors. Standardizing the diagnosis could lead to more consistent treatment approaches and influence both clinical practices and public health policies. To address current gaps in the literature, future research should prioritize longitudinal studies that assess the durability of various treatment interventions, with a focus on integrating neurobiological data to further refine diagnostic and treatment protocols. Clinical Trial: this study is not a clinical trial, thus does not require registration
Citation
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