The "Msychology" of Hypersexuality: A 40-year-old Bisexual Man's Use of Online Chat, Pornography, Masturbation, and Extradyadic Sex

Sex addiction characterizes “a persistent pattern of failure to control intense [and] repetitive sexual impulses or urges, resulting in repetitive sexual behavior over an extended period that causes significant distress or impairment in personal, family, social, educational, occupational, or other important areas of functioning” (Kraus et al., 2018, p. 109). The condition is also described as hypersexuality, hypersexual behavior, sexual impulsivity, and compulsive sexual behavior (Cantor et al., 2013; Kafka, 2010). More recently, compulsive sexual behavior has been proposed as an impulse control disorder for inclusion in the International Classification of Diseases, 11th ed. (ICD-11), with Internet field trials and clinical studies planned to test its validity (Kraus et al., 2018; Walton & Bhullar, 2018). Hypersexuality is a complex and heterogeneous condition that involves various underlying mechanisms (e.g., high propensity for sexual arousal), subtypes of sexual interest/behavior (e.g., compulsive masturbation), and biopsychosocial factors (e.g., self-esteem) that differentially present among cases (Bőthe et al., 2018; Cantor et al., 2013; Kafka, 2010; Knight & Graham, 2018; Walton, Cantor, Bhullar, & Lykins, 2017a). Therefore, it is important that clinicians distinguish when hypersexuality indicates (1) potentially a distinct disorder (as yet unrecognized) for a nucleus of presentations, (2) a psychosexual behavior problem, (3) a symptom of an existing disorder or medical condition or subclinical presentation thereof, or (4) normophilic activity at the high end of sexual functioning about which some people are distressed (Braun-Harvey & Vigorito, 2016; Walton, Cantor, Bhullar, & Lykins, 2017b).