Wednesday, September 28, 2011

What is hypersexuality?

Hypersexuality is referred to as a sexual addiction disorder. It is a constant sexual urge, fantasies or behavior in which a person desires. Sexual addiction represents a life-threatening obsession-a pattern of out-of-control sexual behavior with serious physical, emotional and legal consequences (Cooper and Lebo, 2001). DSM-V diagnosis is often questioned whether it could be used to identify sexual addicts. Most treatments for sex addicts are formulated as a system. The major components of treatment: behavioural symptom management, individual psychotherapy, therapeutic group experience, and pharmacotherapy (Goodman, 1993).


Kafft-Ebbing, a western European sexologist in the 19th century, was the one who described the first case of abnormally increased sexual desire which he named ‘hyperesthesia sexual’, but it wasn’t until the mid-1970’s that the concept of sexual addiction was introduced by a member of Boston Alcoholics Anonymous group. Kinsey and his colleagues then developed the concept of total sexual outlet (TSO), the total number of orgasms achieved by any combination of sexual outlets (masturbation, sexual intercourse) per week. Kafka et al then proposed that hypersexual behavior could be characterized by TSOs of at least seven times a week (Garcia and Thibaut, 2010).
The first notion of excessive non-paraphlic sexual behavior as an addict was proposed by Orford, in 1978, describing it as "maladaptive pattern of use and impaired control over a behavior with associated adverse consequences" . This condition was popularized by Cain’s book ‘Out of the Shadows: Understanding Sexual Addiction’ as a psychopathological condition. Other authors have developed the sexual addiction concept but there is considerable controversy that surrounds the issue of how it should be classified. Even the Diagnostic and Statistical Manual of Mental Disorders (DSM) has changed and revised multiple times as to which section/definition best suits "sexual addiction" (Kafka, 2010).


The main cause for sexual addictions is dysfunctional family attachment. A dysfunctional attachment with the major caregiver during child-rearing is a characteristic for both substance and sexual addicts. Earle and Crow identified negative childhood experiences such as neglect, abuse or abandonment as probable related factors in sexual addiction, because with these experiences, the sex addicts fail to develop appropriate skills for communicating with others. A lack of intimacy or fear of it is often the result of dysfunctional role-modeling by parents or caregivers. Murry Bowen and social learning theorists assert that dysfunctional sexual attitudes and behaviors are learned in early family life.
Coleman-Kennedy and Padley (2002) adapted Kasl’s model to demonstrate that childhood victimization that occurs as a result of physical, emotional or sexual abuse/neglect, results in violations of one’s person-hood. Subsequently, a negative belief system develops in the child, which develops into a negative operational belief in adulthood. Operational beliefs lead to action such as codependency and sexual addiction, which provides an escape for negative core beliefs.

(Coleman-Kennedy and Padley, 2002).

Other causes for sexual addiction may be genes, sexual trauma or injury. Many sex addicts identify sex as a means to have power over another person. That is why people with sexual trauma/abuse would become an addict to feel as though they have power over others to give them the illusion that they would not get hurt (Garcia and Thibaut, 2010).


Hypersexual activity is associated with individuals who are experiencing an overpowering desire for a high or escape. Often the engagement in such activity provides satisfaction, however if this activity becomes excessive, the satisfaction of the experience diminishes. Often the individual will experience sexually arousing fantasies and urges which consume thought and seemingly regular sexual activity will increase in intensity and in duration over a period of 6 months. The individual may also find these obsessions interfere with normal social activities, avoiding and postponing commitments both at work and in their social lives. Hypersexual activity is often found in correlation with extensive drug addiction, and an individual’s inability to form intimate and loving relationships.
As of 2010 “there is no current specific, separate, named diagnosis for hypersexuality,” (Kaplan, 2010) however, a complete definition will be added to the DSM-V to be released in 2013. This definition will include:
Image:DSM_criteria.jpg (Kafka, 2009)

Sexual Addiction Screening Test

The Sexual Addiction Screening Test, or SAST, was developed in 1988 and was described as an assessment tool for clinicians who had patients that exerted sexually compulsive behaviours. It was comprised of 25 questions created to uncover any sexual maladies within men. Although quite valid and reliable for heterosexual men, it proved to be invalid and unreliable for women and homosexual men.
The SAST is now comprised of 45 questions and has since been revised to accommodate women as well as homosexual men (Carnes, Green, Carnes, 2010).


There are multiple kinds of treatment that are implemented on hypersexuality patients. The most common treatments used are psychodynamic/cognitive therapy, self-help program and therapeutic group experience. These treatments comply with the same twelve step process that is also similar to Alcoholics Anonymous. The International Service Organization of SAA, Inc. (2007) lists the twelve steps from Sex Addicts Anonymous:
  1. We admitted we were powerless over addictive sexual behavior - that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood God.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked God to remove our shortcomings.
  8. Made a list of all persons we had harmed and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory and when we were wrong promptly admitted it.
  11. Sought through prayer and meditation to improve our conscious contact with God as we understood God, praying only for :knowledge of God's will for us and the power to carry that out.
  12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to other sex addicts and to practice these principles in our lives.

The difference is in Step One: the sexual addict admits powerlessness over sexual addiction, instead of alcohol. Relapse prevention is implemented during the treatment process. Patients need to recognize their arousal triggers and implement three primary prevention components: risk-recognition, urge-coping, and slip-handling. Risk-recognition teaches sex addicts to be aware of their arousal behavior and to recognize them before they are not able to manage their urges. Self-monitoring helps sex addicts manage their urges by, for example, keeping a daily dairy. Critical component of risk recognition is identification of early warning signs . Urge coping uses consistent behavioural and cognitive strategies to help the sex addict manage their urges without lapsing(Goodman, 1993).
Behavioural strategies include:
  1. Avoidance of identified risk factors
  2. Specific protective responses when exposed to risk factors

These strategies are most effective when planned ahead of time.

Cognitive strategies include:
  1. Acceptance of urges and fantasies of engaging in the behavior as natural accompaniments of recovery
  2. Recognition that urges are feelings that will pass
  3. Review of the benefits of abstinence and the potential negative consequences of engaging in symptomatic behavior

These strategies are most effective when verbalized. Slip handling skills are taught to sex addicts to help prevent relapse once a slip has occurred. A slip represents a risk situation for which the individual had not yet developed an appropriate coping strategy . It is an opportunity to learn and to improve therapeutic programing. The sooner an intervention is applied onto the slip, the less likely a relapse occurs (Goodman, 1993).


Carnes, Patrick, Green, Bradley and Carnes, Stefanie (2010). The Same Yet Different: Refocusing the Sexual Addiction Screening Test (SAST) to Reflect Orientation and Gender. Sexual Addiction & Compulsivity, 17, 7-30. Retrieved March 5, 2011, from the PsychINFO database.
Carnes, Green and Carnes' journal The Same Yet Different: Refocusing the Sexual Addiction Screening Test (SAST) to Reflect Orientation and Gender gives the reader insight on how sexual addictions and hypersexuality is currently diagnosed. It allows the reader to formulate an idea of what the SAST was in its primal stages and how it has developed into a system of diagnosis used by medical practitioners. The criteria of questions in reflected in the appendix of the journal, as well as the results of questions answered.

Coleman-Kennedy, Carol and Pendley, Amanda (2002) Assessment and Diagnosis of Sexual Addiction. Journal of the American Psychiatric Nurses Association, 8(5), 143-151. Retrieved March 1 2011, from the PsychInfo database.
Carol Coleman-Kennedy, RN, CS, PMH-NP, MSN is an advanced practice nurse at Dignity Geropsychiatry, Inc, and a clinical instructor at the University of Arkansas for Medical Sciences- School of nursing in Little Rock, Arkansas. Amanda Pendley, RN, CS, PMH-NP, MSN, is an advanced practice nurst at Trover Foundation Center for Behavioural Health in Madisonville, Kentucky, and a clinical instructor at Vanderbilt University School of Nursing in Nashville, Tennessee. This article is intended for nurses working in psychiatric hospitals and what they will need to understand about the sex addicts that enter the institution. This article was intended for an understanding of how sexual addiction is identified and treated. This work compared to the other work cited has a more in-depth analysis on the vary of causes to sexual addiction. This work conveys the importance of how most sex addicts are results of childhood experiences.

Cooper, M., and Lebo, R. A. (2001). Assessment and Treatment of Sexual Compulsivity. Journal of Social Work Practice in the Addictions, 1 (2), 61 - 74. Retrieved March 5, 2011, from the PsychINFO database.
The author Marlene Cooper is a PhD Associate Professor from Forham University and Graduate School of Social Service. Robert A. Lebo is a researcher for the Covenant House. The authors strongly based this article towards social workers that work with clients who compulsively act-out sexually. This work provides a valuable concept of the disorder and provides useful form's of treatment for sex addicts.

Garcia, Frederico Duarte and Thibaut, Florence ( 2010). Sexual Addictions. The American Journal of Drug and Alcohol Abuse, 36(5), 254-260. Retrieved March 1 2011, from the PsychInfo database.
Frederico Duarte Garcia is from the Rouen University Hospital and Biomedical Research Institute with a MD. Florence Thibaut is from the Rouen University Hospital and is a psychiatric researcher with a M.D. and Ph.D. This article is intended to define sexual addiction, where the roots of it came from, and how it has evolved overtime. This article also contains the treatment and possible definitions of sexual addiction. "Sexual Addictions" focuses on the history as well as possible treatments and definition, unlike the other sources that were used.

Goodman, A. (1993). Diagnosis and treatment of sexual addiction. Journal of Sex & Martial Therapy, 19 (3), 225-251. Retrieved March 5, 2011, from the PsychINFO database.
The author is a director of the Minnesota Institute of Psychiatry. The intended audience are for people who are interested in Sex and Marital Therapy. This work is similar to M.Cooper and R.A Lebo, "Assessment and Treatment of Sexual Compulsivity" article because it states the assessment and treatment process for hypersexuality disorder. The article provides diagnoses and treatments of sexual addiction by defining the term "sexual addiction" and treatments that are implemented towards the patients.

International Service Organization of SAA, Inc. (2007). Sex Addicts Anonymous. (International Service Organization of SAA, Inc.) Retrieved March 30, 2011, from

Kafka, Martin P. (2009). Hypersexual Disorder: A Proposed Diagnosis for DSM-V. Archives of Sexual Behavior, 39, 377-400. Retrieved March 23, 2011, from PsychInfo database.
This journal by Martin P. Kafka introduces the idea of Hypersexual Disorder being proposed as a new psychiatric disorder for consideration in the Sexual Disorders section of the DSM-V. Kafka describes the diagnosis criteria for Hypersexual Disorder as well as empirical evidence obtained in non-clinical samples. The journal also describes in detail what behaviours (or DSM specifiers) are exactly affected when it comes to Hypersexual Disorder. This journal introduces the reader to many new and common terms in the field of research on Hypersexual Disorder. Kafka states historical discourses in regards to hypersexual disorder and how exactly they aid in the justification of adding hypersexual disorder to the DSM-V.

Kafka, Martin P.( 2010). "What is Sexual Addiction?" A response to Stephen Levine. Journal of Sex & Marital Therapy, 36:3, 276-281. Retrieved March 1 2011, from the PsychInfo database.
Martin P. Kafka is from the Department of Psychiatry from the Harvard Medical school in Boston , USA, his focus of this article is towards Dr. Levine who promoted the question ' What is sexual addiction?'. The article compared to the other ones focused solely on the symptoms of sexual addiction providing a brief history as to when the reported case of sexual addiction. Kafka's article helped to reinforce the accuracy towards the history of sexual addiction.

Kaplan, M. S., and Krueger, R. B. (2010). Diagnosis, Assessment, and Treatment of Hypersexuality. Journal of Sex Research, 47(2/3), 181-198. Retrieved March 5, 2011, from the PsychINFO database
Published in the Journal of Sex Research, The Society for the Scientific Study of Sexuality, this article seeks to review the current methods and treatment for assessing Hypersexuality. Meg S. Kaplan and Richard B. Krueger from the New York State Psychiatric Institute work to outline the current evidence to support Hypersexuality as an addiction and provide analysis of studies and research in the field. Previously, Hypersexuality has been defined as a “sexual disorder not otherwise specified (NOS).” Given within the article is the proposed revisal to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and dialogue around the controversy of adding this article in the DSM to be released in 2013.

Impact of drugs on hypersexuality

The relationship between cocaine and amphetamine drug use and sexual activity has been studied in individuals and in the gay and homeless communities. These drugs are seen to enhance sexual experience and increase an individual’s perception of themselves. For these reasons, often hypersexual activity is seen as a result of such drug dependence.
A woman is shown with cocaine
A woman is shown with cocaine

Reasons for Drug Use

Individuals subject to highly traumatic events throughout their lives will often experience a sense of loss of personal control and the ability to trust people in their lives. As a result of such life experience, these individuals use drugs in order to gain self-esteem, mask internal feelings of guilt and shame and an overall feeling of helplessness. Through the use of drugs a certain buffer is established between the individual’s point of view and the real world, and they are able to engage in sexual activity with immense amount of courage and without notice of the societal and cultural hindrances that may otherwise exist.

Cocaine/Crack Cocaine

Cocaine is a drug which produces alertness and a heightened sense of well-being. Individuals using the drug have more energy and experience a surge of positive emotion that is best experienced through the interaction of other people. Anxiety of social obligation and interaction is also lowered. For these reasons, the use of cocaine in correlation with hypersexual activity is very common as individuals can engage in sexual acts without feelings of guilt or shame, while improving their “high” through the sexual experience.

Crystal Methamphetamine

Crystal Methamphetamine (a.k.a. Meth) is a drug which increases sensory feeling and energy, lowering a need for sleep. Individuals using methamphetamine feel an immense amount of confidence and euphoria which elevates sex drive and mood. Use of crystal methamphetamine often decreases boredom and feelings of loneliness. The use of crystal Methamphetamine promotes hypersexual activity as individuals who lack sexual confidence or esteem are able to engage in sexual acts without bounds, their sexual experience is also greatly enhanced.

Correlation of Drug Addiction and Hypersexual Activity

An individual who is addicted to drugs such as crack cocaine and methamphetamine is often subject to a culture and environment which promotes sexual activity, leading to hypersexual behaviour. The individuals who engage in such a lifestyle are often using drugs to combat intense feelings of worthlessness and self loathing. It is found that the correlation between drugs and hypersexual activity is dependent on drug use as “It cannot be predicted that sexually compulsive behaviour will persist in the context of abstinence from drugs – it often does not.” (Guss and Drescher, 2000). As an individual removes his drug use from his lifestyle, the engagement in such hypersexual behaviour is often extinguished as well. However, it is seen that when an individual works towards toward sobriety from drug use, he must also remain abstinent. Jeffrey R. Guss describes this as “in early sobriety sexual behaviour can sometimes trigger intense craving [for the drug]” (Guss and Drescher, 2000). Although drug use and sexuality are seemingly separate, their correlation in managing addiction is quite evident.


Guss, Jeffrey R., Drescher, Jack (2000). Sex Like You Can't Even Imagine: "Crystal," Crack and Gay Men. Addictions in the gay and lesbian community., 3, 105-122. Retrieved March 23, 2011, from the PsychInfo database.
Dr. Jeffrey Gus is an academic from New York University and is a candidate to become a Clinical Assistant professor at New York University and runs his own private practice. He has completed this research study to understand sex addiction and the relation to drug use after observing many patients spending excessive amounts of money on sexual endeavours. He provides an assessment and analysis of the proposed correlation between both drug use and Hypersexuality and describes treatment methods. Although this study pertains to the gay community, much of the information is highly relatable to the general population as he describes sexual tendency and drug use through the sub culture.

McGill, Ken (2003). The development of an integrated treatment program for the sexually addicted homeless population in rescue missions. Dissertation Abstracts International: Section B: The Sciences and Engineering, 64(6-B), 2929. Retrieved March 29, 2011, from the PsychInfo database
This paper has been written for use in requirements of Ken McGill and his pursuit of his Doctor of Psychology. Ken McGill became heavily involved in this research with great concern for individuals in rescue missions. This thesis seeks to review the relationship between homelessness, cocaine addiction and sexual activity. McGill acknowledges that ‘sex addictions’ has not yet been defined wholly in the psychological community, but uses the basic understanding of sex addiction in application through his research. The thesis outlines the reasons for cocaine use throughout the homeless community, attributing general availability of the drug to its widespread use. Additionally, the thesis examine the resultant issues of hypersexual activity such as the spread of sexually transmitted diseases and the ongoing trauma these individuals face.

Samenow, Charles P. and Finlayson, A. J. Reid (2010). A Psychiatrist's Approach to a Case of Problematic Sexual Behavior, Sexual Addiction & Compulsivity, 17:3, 173 - 184. Retrieved March 23, 2011, from PsychInfo database
Charles P. Samenow of Washington University and A.J. Reid Finlayson of Vanderbilt University are psychiatrists trying to uncover the causes of ‘problematic sexual behaviour’ through a case study of a man titled ‘Glen”. This editorial reviews the lifestyle and personal events in Glen’s life to uncover the causes of his hypersexual behaviour accompanied by his various drug addictions and severe depression. Glen’s history of alcohol and drug abuse and Axis I mood disorder are described as important factors in his hypersexual behaviour. However, the editorial also describes the sexual abuse Glen suffered as a child from trusted individuals. The editorial postulates that Glen is trying to overcome is previous traumas through drug use and the enactment of the various acts that were wrongfully done to him in the past. Through Glen’s example, the authors’ purpose is to demonstrate clinical procedure and practice for assessing hypersexual behaviour.

Hypersexuality in the media

Celebrity cases

In recent years, many celebrities in the forefront of society have come out and admitted to sexual addiction/hypersexuality, most notably Tiger Woods and Jesse James.
Tiger Woods & Elin Nordegren
Tiger Woods & Elin Nordegren

Tiger Woods

In 2009, Tiger Woods was exposed of his marital infidelities in a very public way. Woods fled his Orlando home after his wife Elin Nordegren found out about his adultery and ended up getting into an accident which badly damaged his car, his body, and his career. It was later found out that Woods was not faithful to his wife and multiple women came forth and discussed their affairs with the golfer. It was later found out that Woods was suffering from multiple addictions including drug and sexual addictions. In order to better himself, his marriage and as well as his public image, Woods checked into Sexual Rehabilitation in order to regain his control and be able to function in society without the use of drugs/sex (CBS, 2009).

Jesse James & Sandra Bullock
Jesse James & Sandra Bullock

Jesse James

In 2010, scandal broke of Jesse James and his infidelities to actress Sandra Bullock. Multiple women came out detailing their affairs with James, crushing Bullock. After James' multiple attempts to reconcile the marriage, Bullock filed for divorce. James immediately entered a centre for sexual rehabilitation much like Woods, to reconstruct his public image and deal with the addictions he felt needed to be removed from his life (ABC News, 2010).

Criminal cases

Over the past 20 years, there have been many police cases that have involved sex addicts and rapists, however, two cases in particular stand above them all. The cases of Paul Bernardo and Jeffrey Dahmer are both all extremely horrendous and immoral stories, but are appropriate to show, in order to explain how sex addicts can elevate from simple fantasies to murder.
Paul Bernardo
Paul Bernardo

Paul Bernardo

Paul Bernardo was born August 27, 1964 in Toronto, Ontario as a result of an affair his mother was currently in. His childhood seemed normal until 1975 when his dad, Kenneth Bernardo was charged with child molestation (Stone, 2010). He managed to continue through elementary and secondary school and ended up at University of Toronto, Scarborough. According to Stephen Williams (1998), it was during the time he attended University of Toronto that he developed “dark sexual fantasies” which eventually led him to compile his long list of rapes and murders. In 1987, he met Karla Holmolka a woman who not only became his wife (in 1991) but also became his accomplice in the sexual assaults and murders of three teenage girls. One of the girls was Karla’s little sister Tammy (Pardue, 2007). Paul Bernardo was known to stalk young women either at bus stops or departing from the bus late at night. He would then follow them and sexually assault them. He used this method from his start in 1987 to when he was arrested in 1993. After being arrested he was not put on trial until 1995 for the murders of the other two teenage girls: Kirsten French and Leslie Mahaffy. On September 1, 1995 Bernardo was convicted of two first degree murders and two aggravated sexual assaults sentencing him to 25 years in prison (Williams, 1998). Paul Bernardo also admitted to raping an additional 10 women on top of the 15 the police had already suspected tallying an appalling 25 suspected rapes. He was truly a sex addict who let his sexual fantasies escalate to an extreme level.
Jeffrey Dahmer
Jeffrey Dahmer

Jeffrey Dahmer

Jeffrey Lionel Dahmer a.k.a “The Milwaukee Monster“ was born May 21, 1960 in West Allis, Wisconsin . He was one of America’s most ruthless sex offenders and a serial killer. Dahmer seemed to have a regular childhood but he grew increasingly withdrawn and uncommunicative between the ages 10-15, showing little interest in hobbies or social interaction (A&E, 1996). Also in his adolescence, he fantasized about homosexual scenarios and was struggling with his sexual identity. These fantasies played a critical role in his sexual crimes. In the summer of 1978, at the tender age of 18, Jeffrey claimed his first life when he invited over a hitchhiker over to his father’s house who he planned on having sex with. However, after the hitchhiker refused to have sex with him, Jeffrey became violent and bludgeoned the man to death. After his first murder, Dahmer did not kill for another 9 years, but in-between he frequently visited gay bathhouses where he would have consensual and non-consensual intercourse, whichever sustained his sexual addiction (Pardue, 2007). In 1987, he killed his second victim who was sexually assaulted before murdered. After killing his second victim Dahmer begin to sexually assault and kill more and more frequently until his arrest in 1991. Between the years 1987-1991 the ruthless savage had murdered at least 16 people, killing almost every week right before he was arrested. Fortunately, Jeffrey Dahmer was convicted of fifteen counts of murder and sentenced to fifteen life sentences in 1992, after the court decided that he was sane and not insane (A&E, 1996) This gives reason to believe that Dahmer killed the men of his own free will, however it was his sexual desires and needs that led him to rape and murder.


A & E (1996). Jeffrey Dahmer [Video file]. Video posed to
A&E has compiled an accurate sequence of events that took place in Jeffrey Dahmers life from when he was a child up until his murder in jail. This interview gives the information on his murder victims including who they were and the location/nature of their deaths. Also, this interview shows that Jeffrey Dahmer's sexual compulsion played a key role in his string of sexual assaults and homicides.

ABC News (2010). Jesse James Speaks Out: Exclusive Nightline Interview. Video posted to
The interview conducted by ABC News delves into the adultery and sexual addiction of Jesse James. It allows the viewer to gain knowledge of what a sexual addict/hypersexual person suffers from as well as reasoning behind their addictions.

CBS. (2009). Tiger Woods May Be A Sex Addict [Video file]. Video posted to
The interview conducted by CBS describes the addictions and infidelities of Tiger Woods. It describes the idea of what a sexual addiction is, as well as sexual rehabilitation centres that have been created in order to aid those who are suffering from the addiction.

Pardue, Angela & Arrigo, Bruce A. (2010). Power, Anger, and Sadistic Rapists: Towards a differentiated model of offender personality. International Journal of Offender Therapy and Comparative Criminology, 52(4), 378-400. Retrieved March 23, 2011, from the PsychInfo database
This is a sophisticated article that talk about three different types of rapists and about the typical characteristics of a rapist. The authors focus on power rapists, anger rapists and sadistic rapists. Both Jeffrey Dahmer and Paul Bernardo are found in this article. Paul Bernardo is classified as a anger-retaliatory rapists by the FBI in 1988. Jeffrey Dahmer is classified as a sexual sadistic rapist. Authors go on to give details of how they are classified by analyzing specific characteristics of the individual.

Stone, Micheal H. (2010). Sexual Sadism: a Portrait of evil. Journal of the American Academy of Psychoanalysis & Dynamic Psychiatry. Special Issue: Sex and psychodynamic psychiatry, 38(1), 153-157. Retrieved March 17, 2011, from the PsychInfo database
Stone's article of sexual sadism gives the reader a brief introduction to sexual disorders currently mentioned in the DSM. It lets the reader know of sexual fantasies and the like, and the turning point when these aforesaid fantasies turn into nightmares for the victims. The article makes mention of serial killers and the way they achieve their orgasms by murdering their victims. This leads to an addiction of murdering as well as release when murdering. The killer must kill again to achieve an orgasm. Karla Homolka and Paul Bernardo are examples used by Stone. This article gives more detailed insight of the connection of sexual addiction to murdering.

Williams, Stephen (1998). Invisible darkness : the strange case of Paul Bernardo and Karla Homolka. New York, NY: Bantam Books.
William's book Invisible darkness: The strange case of Paul Bernardo and Karla Homolka gives the reader a background story of both Bernardo and Homolka from their childhoods. It mentions both lives growing up, to the point of when they met. The book makes great mention of how Bernardo and Homolka both started to kill with the first victim of Homolka's sister, Tammy. It lets the reader see the sexual addictions of both Bernardo and Homolka. It also shows the reader the sentencing and imprisonment of both, with the release of Homolka.

A proposed diagnosis for the DSM-V

A stack of various editions of the DSM
A stack of various editions of the DSM
The Diagnostic and Statistical Manual of Mental Disorders, or the DSM, is the standard by which mental health professionals discover and diagnose mental disorders in patients. Although the DSM has gone through many editions and revisions, the current edition is the DSM-IV-TR which was released in 2000. With each edition, the DSM includes and removes certain "disorders", the most recent removal being homosexuality as it is no longer considered to be a mental disorder. The DSM-V is being set for release in 2013. All findings and classifications within all editions of the DSM are based on empirical evidence (American Psychiatry Association, 2000).

What does the DSM consider a mental disorder?

According to the American Psychiatry Association (2000), there are many controversies when trying to define "Mental Disorder". One major issue is that there is no concrete operational definition that defines all aspects of a mental disorder. For example, symptom presentation, physiological norm, etiology, etc. Many consider mental disorders to be concepts such as: statistical deviation, etiology, distress, irrationality, etc.
According to the DSM-IV, a mental disorder is a behavioural or psychological syndrome that occurs in an individual that is affiliated to distress or disability, or with a highly increased risk of death, pain, disability, or loss of freedom.

Why should hypersexuality be added to the DSM-V?

As previously stated in the previous section, hypersexuality is associated with factors prevalent in the definition of a mental disorder. Hypersexuality is associated with considerable personal distress and adverse consequences such as sexually transmitted infections, unwanted or unplanned pregnancies, work or educational impairment and other physical and mental anguishes.
The following is a list of proposed diagnostic criteria for Hypersexual Disorder:
Image:DSM_criteria.jpg(Kafka, 2009).
The selected criteria provides an operational definition of Hypersexual Disorder.


American Psychiatric Association (2000). Definition of Mental Disorder. Diagnostic and statistical manual of mental disorders, (4th ed., text revision). Retrieved March 25, 2011, from York University eResources database.
The Diagnostic and Statistical Manual of Mental Disorders is the main means for mental health workers to assess a patient's "disorder". This section of the DSM-IV-TR informs the reader of what the American Psychiatric Association believes to consider a mental disorder. It also gives historical background of how the APA came to agree on the definition. This article greatly aids in defining what a mental disorder is considered and the factors that aid in defining them. This article gives a very basic skeleton in regards to how hypersexual disorders can be proven to be a mental disorder.

Kafka, M.P. (2009). Hypersexual Disorder: A Proposed Diagnosis for DSM-V. Archives of Sexual Behavior, 39, 377-400. Retrieved March 23, 2011, from PsychInfo database.
This journal by Martin P. Kafka introduces the idea of Hypersexual Disorder being proposed as a new psychiatric disorder for consideration in the Sexual Disorders section of the DSM-V. Kafka describes the diagnosis criteria for Hypersexual Disorder as well as empirical evidence obtained in non-clinical samples. The journal also describes in detail what behaviours (or DSM specifiers) are exactly affected when it comes to Hypersexual Disorder. This journal introduces the reader to many new and common terms in the field of research on Hypersexual Disorder. Kafka states historical discourses in regards to hypersexual disorder and how exactly they aid in the justification of adding hypersexual disorder to the DSM-V.


To conclude our research on Hypersexual Disorder our group has provided the definition of Hypersexuality, history, symptoms, the impact, media and criminal cases and treatment. The thought of whether Hypersexual is considered as a diagnosis for the DSM-V is still undecided. Hypersexual Disorder has been primarily characterized as compulsive, impulsive, a behavioral addiction or a sexual desire disorder. There is a proposal that Hypersexual Disorder relates to the DSM-V diagnostic criteria, and should be included in the DSM-V to further address the possibility of individuals suffering from this disorder. With a recognized, adequate classification and diagnosis of this disorder practitioners will be better equipped to help these individuals overcome their possible sex addiction. However, it has been argued that there were "insufficient data" and these conditions have been relegated to Sexual Disorders Not Otherwise Specified (Kafka, 2009). With insufficient and incomplete data to support the claims of this disorder, it may be detrimental to the diagnosis and treatment of patients as the appendix for diagnosis is not entirely accurate. In the possibility of misdiagnosis and possible mistreatment, the integrity of health practice could be affected. Through research and analysis of this topic, we believe that Hypersexuality Disorder should be included in the DSM-V as there is a vast amount of data and research available which proves the legitimacy of Hypersexuality Disorder and its classification as an addiction.


Kafka, Martin P. (2009). Hypersexual Disorder: A Proposed Diagnosis for DSM-V. Archives of Sexual Behavior, 39, 377-400. Retrieved March 23, 2011, from PsychInfo database.
This journal by Martin P. Kafka introduces the idea of Hypersexual Disorder being proposed as a new psychiatric disorder for consideration in the Sexual Disorders section of the DSM-V. Kafka describes the diagnosis criteria for Hypersexual Disorder as well as empirical evidence obtained in non-clinical samples. The journal also describes in detail what behaviours (or DSM specifiers) are exactly affected when it comes to Hypersexual Disorder. This journal introduces the reader to many new and common terms in the field of research on Hypersexual Disorder. Kafka states historical discourses in regards to hypersexual disorder and how exactly they aid in the justification of adding hypersexual disorder to the DSM-V.

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