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Hypersexual Disorder February 11, 2010

Posted by Ashraf Faden in Healthcare, Mental Health, Prevention, Wellness.
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This is one of the proposed terms, according to the American Psychiatric Association (APA), to be considered as a mental disorder and to be included in the new completely revised Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is considered the bible for mental disorders.  As noted in the DSM-5 development website, the criteria for a hypersexual disorder would include:

A.    Over a period of at least six months, recurrent and intense sexual fantasies, sexual urges, and sexual behavior in association with four or more of the following five criteria:
(1) A great deal of time is consumed by sexual fantasies and urges, and by planning for and engaging in sexual behavior.
(2) Repetitively engaging in these sexual fantasies, urges, and behavior in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability).
(3) Repetitively engaging in sexual fantasies, urges, and behavior in response to stressful life events.
(4) Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges, and behavior.
(5) Repetitively engaging in sexual behavior while disregarding the risk for physical or emotional harm to self or others.
B.    There is clinically significant personal distress or impairment in social, occupational or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges, and behavior.
C.     These sexual fantasies, urges, and behavior are not due to the direct physiological effect of an exogenous substance (e.g., a drug of abuse or a medication).

So, what implications might this decision have on public health?

The moment I read the news about this consideration in the Washington Post, I immediately thought of how it might be wrongly used in justifying improper sexual activities and sexual violence.  According to the facts on sexual violence from the Centers for Disease Control and Prevention (CDC), almost 11% of adult women and 2% of adult men reported experiencing forced sexual activity at some point in their lifetime, and 20-25% of college women reported to experience rape or an attempt to rape in college.  Moreover, in children and youth victims, about 60% of females and 69% of males were raped before they reached the age of 18 years.  A term like hypersexual disorder might increase those percentages because it could be used as a justification for actions.  Looking back at the criteria for hypersexual disorder, we notice that there is no specific exclusion of abnormal extreme and dangerous sexual activities and desires; otherwise known as paraphilia.  Therefore, it is possible the term could be used in the court of law to set free many dangerous people to roam the streets.

In addition, the term could be used to inflict psychological distress on people.  Imagine a husband with sexual violence intentions manipulating his wife psychologically into having unwanted sex under the excuse that he has a problem called, hypersexual disorder.  The violence might continue for a long time because the wife does not want to report her husband since she loves him and thinks he has a mental disorder.

In a different scenario, we might see an increase in extramarital sexual activities.  Such increase might disrupt family ties and intimate relationships.  Divorce and separation rates might start rising; which, according to the U.S. Census Bureau in 2000, it is about 10%.  That is about 11.2 million divorces and separations combined.  Consequently, there might be an increase in mental disorders due to these breakdowns of important societal ties.  In addition, there is a possibility of increase in the rates of sexually transmitted diseases with all the unnecessary and uncontrolled sexual activities.  These are just some of the possible examples where people with twisted thoughts and minds could justify their actions under the name of hypersexual disorder.  So, is it really necessary to include the term into the new DSM-V?  Do we need a new term that encourages people to act on their twisted sexual desires?  I don’t think so!

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