Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model

Journal of Sex Research,  August, 2004  by John Bancroft,  Zoran Vukadinovic

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RESULTS

Two SAA volunteers described behavioral patterns (one pedophilic, aged 47, the other exhibitionist, aged 38) that were not described as out of control but rather as behaviors they would want to do if they could "get away with it." Both of these men obtained some benefit from regarding themselves as sex addicts, but as they did not report out of control sexual behavior they were not included in further analyses. This left 29 men, mean age 40.1 years, and 2 women, ages 38 and 41 years.

Behavioral Patterns

Twenty-two men were heterosexual, 1 bisexual, and 6 homosexual in orientation; both women were heterosexual. Ten men reported paraphilic behaviors (6 involving children, 5 voyeurism, and 3 exhibitionism). Five of the gay men were "compulsive cruisers." Nineteen men and both women described "compulsive masturbation" as their principal form of acting out. One of the women told a story reminiscent of persistent sexual arousal disorder (Leiblum & Nathan, 2001), describing herself masturbating as "like a gerbil on a wheel."

The relevance of mood. Of the 31 subjects, only 4 men stated that their sexual acting out was not predictably affected by their mood. Seventeen subjects reported being more likely to sexually act out when depressed, and 19 reported this in relation to anxiety or stress. Eleven subjects (9 men and both women) reported an increase in acting out in states of both depression and anxiety. Two men said that they were less likely to act out when depressed; no one said this in relation to anxiety. There was no apparent difference between those reporting increased acting out when depressed and those reporting it when anxious in terms of the types of behaviors involved.

Resistance to acting out. Subjects were asked whether they found themselves trying to resist the urge to act out or whether at the time it was something they genuinely wanted to do. Eleven men and one of the women indicated that they tried to resist, but most of them did not give a convincing description of resistance. One man, for example, said "sometimes I've wanted to, sometimes I've fought it, and sometimes I've done it without thinking." Another gay man with compulsive cruising said, "I tell myself not to do it, but I do it anyway." He went on to say that he devises tactics to avoid cruising and then forgets them. Another man, when asked to explain how he resisted, said, "I want to do it, yet I know it's unhealthy for me."

The two most convincing accounts of resistance were from men with obsessive-compulsive personalities. In both cases the sexual acting out was masturbation. In one case, the participant had intrusive thoughts about teenage boys or a compulsion to look at pictures of them. This lead to considerable guilt and resistance, and he obtained a very transient calming effect by masturbating, followed quickly by renewed guilt and depression. It should be noted here that the resistance was to the intrusive thoughts about boys rather than the masturbation. The other man described preoccupation with sexual thoughts, which would lead to masturbation followed by a need to take a shower because of the "dirtiness" of the act.