Gender differences were smaller than previously theorized, with 10.3% of men and 7.0% of women endorsing clinically relevant levels of distress or impairment associated with difficulty controlling sexual feelings, urges, & behavior

Prevalence of Distress Associated With Difficulty Controlling Sexual Urges, Feelings, and Behaviors in the United States. Janna A. Dickenson et al. JAMA Netw Open. 2018;1(7):e184468. doi:10.1001/jamanetworkopen.2018.4468

Key Points

Question  What is the prevalence among US men and women of the primary feature of compulsive sexual behavior disorder, distress and impairment associated with having difficulty controlling one’s sexual feelings, urges, and behaviors?

Findings  In this survey study, we found that 8.6% of the nationally representative sample (7.0% of women and 10.3% of men) endorsed clinically relevant levels of distress and/or impairment associated with difficulty controlling sexual feelings, urges, and behaviors.

Meaning  The high prevalence of such symptoms has major public health relevance as a sociocultural problem and indicates a significant clinical problem that should be recognized by health care professionals.

Abstract

Importance  The veracity, nomenclature, and conceptualizations of sex addiction, out-of-control sexual behavior, hypersexual behavior, and impulsive or compulsive sexual behavior are widely debated. Despite such variation in conceptualization, all models concur on the prominent feature: failing to control one’s sexual feelings and behaviors in a way that causes substantial distress and/or impairment in functioning. However, the prevalence of the issue in the United States is unknown.

Objective  To assess the prevalence of distress and impairment associated with difficulty controlling sexual feelings, urges, and behaviors among a nationally representative sample in the United States.

Design, Setting, and Participants  This survey study used National Survey of Sexual Health and Behavior data to assess the prevalence of distress and impairment associated with difficulty controlling sexual feelings, urges, and behaviors and determined how prevalence varied across sociodemographic variables. Participants between the ages of 18 and 50 years were randomly sampled from all 50 US states in November 2016.

Main Outcomes and Measures  Distress and impairment associated with difficulty controlling sexual feelings, urges, and behavior were measured using the Compulsive Sexual Behavior Inventory–13. A score of 35 or higher on a scale of 0 to 65 indicated clinically relevant levels of distress and/or impairment.

Results  Of 2325 adults (1174 [50.5%] female; mean [SD] age, 34.0 [9.3] years), 201 [8.6%] met the clinical screen cut point of a score of 35 or higher on the Compulsive Sexual Behavior Inventory. Gender differences were smaller than previously theorized, with 10.3% of men and 7.0% of women endorsing clinically relevant levels of distress and/or impairment associated with difficulty controlling sexual feelings, urges, and behavior.

Conclusions and Relevance  The high prevalence of this prominent feature associated with compulsive sexual behavior disorder has important implications for health care professionals and society. Health care professionals should be alert to the high number of people who are distressed about their sexual behavior, carefully assess the nature of the problem within its sociocultural context, and find appropriate treatments for both men and women.