Sex Addiction as a Serious Health Disorder - Coursework Example

SEX ADDICTION by of the of the Introduction Sexual addiction has gained a lot of attention in the last few years. It is estimated that millions of people in the US are suffering from some type of sexual addiction. It is a severe disease that damages family relations and marriages. Sexual addiction exposes people at high risk for HIV/AIDS and other sexually transmitted diseases (STDs). The addiction causes occupational and social problems in the patient’s life due to negligence towards responsibilities resulting from the constant pursuit of the sexual conduct. Overall, sexual addiction is the serious health issue which devastates personal, social, and professional life, and physical and physiological health of the person (Coleman-Kennedy & Pendley 2002, p. 143). The purpose of the following presentation is to analyze sexual addiction through various aspects. By means of scholarly articles, government reports, official data and researches, the paper investigates aetiology, symptomatology, treatment, interventions, preventive measures and the management of the condition. Further, the paper critically evaluates the US governments’ policies, interventions, and public health priorities to manage the disease. Methodology A systematic search, focusing the target group of males aged 19-49 years from the United States, was conducted by means of electronic databases such as, EBSCO, DOAJ, NCBI, and JournalSeek and searched the topic in following journals: Journal of the American Psychiatric Nurses Association, the American Journal of Drug and Alcohol Abuse, Clinical Psychology Review, Psychiatry, and Procedia Social and Behavioural Sciences. The key words such as, “Sexual Addiction”, “the case study of sexual addiction in the United States”, “Sexual addiction among the adults in the United States”, “Sexual addiction: research study” were used for the research on the topic. The Concept and Its History The Concept Since the last few years, there have been numerous reports (for e.g., Colemon 1987, Carnas 1996, Delmoneco 2004, Price 2005, Goodman 1992, Gigliano 2004 etc.) attempting to define “sexual addiction”. However, there is not universal agreement among the scholars over a particular definition of sexual addiction (Fuller 2012, p. 4-5). According to Goodman (1992), sexual addiction is a disorder in which the person seeks pleasure and attempts to escape from internal distress through a particular behaviour that is characterized by repeating failure in controlling the behaviour and continuation of the behaviour regardless of severe harmful effects (Fuller 2012, p. 4-5). The American Psychiatric association defined sexual addiction as an excessive sexual desire that weakens the wish or ability to control sexual behaviour which continues to harm the individual’s life both socially and personally (Fuller 2012, p. 4-7). Further, the American Society of Addiction Medicine (ASAM) has defined sexual addiction in detailed by analyzing its traits and describing the nature of addiction (Ekern 2014). The ASAM states that dysfunction in neurological parts of the body leads to abnormal characteristic psychological, biological, spiritual, and social changes which further causes impairment in behavioural control and emotional response. Similar to other chronic diseases, addiction usually consists of periods of recurrence and remission. Sexual addiction is characterized with uncontrollable compulsion with masturbation, pornography, prostitutes, cyber sex, phone sex, multiple sexual relations, and voyeurism. In some cases, it escalates into paedophilia or rape. The compulsion towards the addiction is stronger than the concern for the potential dangers and devastating effects to the addict and his family, friends, moral code, professional life and financial security (Ekern 2014). History The concept of uncontrolled or excessive sexual habits have its historical roots in medical science, dating back to the primal mentions of “hyperesthesia”, a chronic condition described by Richard Krafft-Ebing which consisted self-abuse and an abnormally heightened and intense sexual urge. Sex addiction is referred with various names such as hyper-sexuality, nymphomania, satyriasis, compulsive sexual behaviour, Don Juan syndrome, or erotomania in various medical reports and studies (Ekern 2014). Especially, medical terms- satyriasis and nymphomania were widely used in the past to signify sex addiction among men and women respectively (Tripodi et al. 2012, p.1-2). The first official conceptualization of uncontrolled and excessive libido as an addiction was presented in the 1970s by Oxford, who characterized it as an uncontrolled maladaptive behaviour that associated with severe effects. The sexual addiction was further generalized as a psychopathological chronic condition by Carnes in his book, Out of the Shadows: Understanding Sexual Addiction (Garcia & Thibaut 2010, p. 255). Later, many authors analyzed the sexual addiction concept in details, but significant controversy surrounding its classification remained persistent (Garcia & Thibaut 2010, p. 255). Many years after Krafft-Ebbing’s terminology of sexual addiction, Kinsey and his team modified the concept of sexual addiction by developing the term of total sexual outlet (TSO), which indicated the overall number of orgasms achieved by any consolidation of sexual outlets such as, oral sex, sexual intercourse, masturbation per week. Theses researchers found that only 7.5% of American males between the age of 19 and 49 years reported an average total sexual outlet per week more than 7 for minimum 5 years (Garcia & Thibaut 2010, p. 254-256). After analyzing these data and other significant reports, Kafka et al. claimed that hyper sexuality or sexual addiction could be characterized by total sexual outlets (TSOs) of minimum 7 times per week (Garcia & Thibaut 2010, p. 254; Tripodi et al. 2012, p.1-2). Epidemiology Due to feeling of guilt and shaming, many cases of sexual addiction remain unreported. The secretive nature associated with sexual addiction has made it difficult for researchers to collect exact number of people suffering from the condition. However, majority of reports have acknowledged the fact that internet has played a crucial role in prevalence of sexual disorders. In 2005, there were more than 165 million active internet users in the United States which constituted almost 65% of the country’s population (Fuller 2012, p. 5-7). According to data of National Telecommunications and Information Administrations, there are more than 2.5 billion web pages available on the internet, while 250,000 new websites are developed every day. Among all these web pages that people have the option to browse, problems associated with human sexuality are the topmost searched subject on the internet. According to the reports of Butler and Zitzman (2005), since the 1990s, the internet pornography has emerged as the “sexual revolution” with the availability of more than 110,000 web sites containing various kinds of sexual contents and average 55 millions of average visits to such sites alone in the US (Fuller 2012, p. 5-7). In 2005, there were more than 12% of active internet users spent more than 12 hours a week on searching and looking sexual contents. Due to easy access, affordable, and anonymous nature of internet pornography, many users suffering from certain type of sexual compulsive behaviour go unnoticed. Many researchers claimed that majority of people who involve in the excessive use of pornography are usually those who have had preceding sexual addictions and compulsions and pornography gives them a new outlet to satisfy their addiction. Kehoe et al. (2000) performed a research on the American adults aged 19-49 years for few years and found that the majority of internet users in the US are married males and college students. Among these users, almost 40%, i.e., 45 million users consistently go online for sexual reasons. The majority of the people in the US struggling with compulsive sexual behaviour and sexual addictions are heterosexual, married men with average age of 36.5 years (Fuller 2012, p. 4-7). According to the reports of Time magazine, almost 16% of regular visitors to porn websites in the United States exhibit the common traits of sexual addiction (Statistics 2007). Almost 10% of the American adults admitted their addiction to internet pornography and other sexual contents. In 2004, almost 46% of American families claimed that pornography is the issue in their home. The American Academy of Matrimonial Lawyers said that the internet was one of the crucial factors responsible for almost 80% of divorces in the US in 2004 (Statistics 2007). According to the research of the National Council on Sexual Addiction Compulsivity, almost 10% of the US population, i.e., around 19-25 millions of Americans aged 18-49 years, is suffering from certain kind of sexual compulsive behaviour or sexual addiction (Ekern 2014). These staggering numbers highlight the seriousness of the issue in the American society. Symptomatology Sexual addiction has complex traits and varying symptomatology. Various models have been presented by numerous studies to confirm its diversified presentation. Sexual compulsion replaces the intimate needs. It leads to constant changing of partners and reckless sexual relations. With the growing sexual compulsive behaviour, person gets involved in acts such as, pornography, compulsive masturbation, cyber or telephonic sex, adultery, and in some cases, incest, rape, or paedophilia (Burki & Masood 2005, p. 3-5). Sex addicts are often reported to be involved in aphrodisiacs and substance abuse. In most of the cases, it leads to unintended pregnancies and contamination and transmission of sexually transmitted diseases. Unknowingly the patient attempts to soothe own agony with sexual pleasure, however, the feeling of worthlessness and guilt flood back after the climax (orgasm), triggering numerous types of psychological disorders (Burki & Masood 2005, p. 3-4). In 1991, Carnes examined 610 self-identified sex addicts aged 19-49 years in the US for several months. Based on the study, Carners distinguished sex addiction into 11 major patterns, namely, fantasy sex, seductive role sex, paying for sex, anonymous sex, voyeuristic sex, trading sex, exhibitionist sex, exchange of pain, intrusive sex, sex with children, and object sex (Schneider 1991). Carners found that sex addicts typically involved in more than one type of sex addiction patterns. For instance, they may involve in compulsive masturbation in addition to intimating with prostitutes and regularly watching pornography. Even though sex addicts are hypersexual, constantly looking for orgasm or sexual intercourse many times in a day, majority of sex addicts prefer to achieve the euphoria through the thrill of the conquest and chase rather than the sexual acts itself (Schneider 1991). Carnes further stated that majority of respondents in the study reported the escalation of their addiction as they had to take growing risks or keep looking for new sexual behaviour for maintaining the same level of euphoric experience. The study also found that majority (almost 80%) of sex addicts came from dysfunctional families in which parents were abusive, addicted to substance, or emotionally unattached. Out of 610 respondents, around 40% of sex addicts reported having one or both parents as sex addicts. Also, almost 50% of sex addicts admitted to be victim of sexual abuse in their childhood (Schneider 1991). The major symptoms of hypersexual disorder or sexual addiction were issued by the American Psychiatric Association in 2010. The report stated that sexually addicted person experiences repeating and excessive sexual fantasies, sexual behaviour, and sexual urges in response to dysphoric psychological states such as, depression, anxiety, irritability, stressful conditions, or boredom (Herkov 2013). The patient repetitively involves in sexual behaviour ignoring the risk of emotional or physical harm to others or oneself. The person suffers with clinically intense psychological stress or impairment in professional, personal, or social areas with the intensity and frequency of the sexual desires, behaviour, and urges (Herkov 2013). Further, the inability to control, resist, or stop the instincts to involve in sexual acts, frequently engaging in sexual relations with random partners, abnormally great energy and time spend in seeking sex, being sexual, or recovering from sexual experience, excessive obsession with sexual activities regardless of the negative effects on self or others, entering high risk of transmitting or getting contaminated with the sexually transmitted diseases (STDs), and repeated numerous unsuccessful attempts to break the cycle of excessive sexual compulsion are some of the significant symptoms of sexual addiction (Ekern 2014). Aetiology The causes of sexual addiction among men are intertwined and complex. There are various psychological, biological, and social theories that attempt to analyze the potential triggers of sexual addiction. According to cognitive-behavioural theory of Brasted and Schwartz, the origin of sexual addiction can be traced through absurd belief system that involves a self-image destroyed by unrealistic assumptions of what life has to offer, from a common sense of helplessness and a failure of personal, social, or professional life (Tripodi et al. 2012, p.9-13). The theorists analyzed the development of sexual addiction through the use of sexual behaviour as a means to soothe the psychological pain or to seek relief from sufferings. According to Carnes, the basic three beliefs, i.e., one, I am a worthless and bad person, second, no one can love me the way I am, and third, my needs will never be fulfilled if I depend on others, are the base of sexual addiction. A false belief system encourages these ideas, triggering an impaired though that escalates into an addictive behaviour (Tripodi et al. 2012, p.11-12). According to Schwartz, sex-addicts with the history of sexual victimization in childhood develop the symptoms of sexual addiction in later life as a part of PTSDs (posttraumatic stress disorders). Difficulties in establishing emotional attachment with partner have been theorized as an influencing factor for abnormal sexual behaviours (Tripodi et al. 2012, p.10-12). According to neuroscientists, damaged emotional attachment capacity due to history of abuse or broken personal, professional, or social life causes barriers in psychological maturation, leading difficulties in thinking ability, decision-making, comprehending moral principles and values, and evaluating own acts. Clearly, significant deficiencies in such delicate areas affect regulation and control of behaviour, causing the further development of sexual addiction or hyper-sexuality (Tripodi et al. 2012, p.12-13). According to Sussmen (2007), sex turns into addiction through a process addiction. It develops when a male pursuits the pleasure through alteration of physical activities which then manipulate the neuro-transmitting functions. Similar to substance addiction, the male continuously seeks the regular “dosage” of sexual pleasure and on lower dosages of sexual pleasure becomes numb (Olivas et al. 2008). In other words, sexual addiction is a process that starts at one point and continues to grow into bigger issue throughout the life. Also, the study of Brown, La-Engle and Kennaevy (2006) found that constant exposure to sexual contents through TV, movies, music, and pornography boost the development of compulsive sexual behaviour or sexual addiction among teenagers and adults (Olivas et al. 2008). Further, neurobiological theories associate the causes of sexual addiction with brain pathology, endocrine abnormality, or substance abuse. Various studies have identified the hormonal abnormality among the sex addicts. It is commonly acknowledged that neuropeptides, androgenic hormones, and neuro-transmitters, especially serotonin and dopamine, play a crucial role in development of sexually compulsive behaviour (Tripodi et al. 2012, p.12-15). Dopamine is one of the major neuro-transmitters responsible for escalating both the compulsive and the appetitive phase of sexual addiction. Also, Berlin and Gaffney suggested that the impairment in the level of the axis can contribute greatly to the aetiology of sexual addiction. Also, substance abuse significantly provokes the hyper-sexuality. Various studies have acknowledged the direct relation between cocaine and methamphetamine and hypersexual behaviour as these substances trigger excessive sexual instincts and arousal among men (Tripodi et al. 2012, p.12-15). Preventive Measures and the Management of Sexual Addiction Sexual addiction is a serious health issue that can cause severe effects on physical and psychological health of the person. However, with the proper and systematic approach and support of family members, it can be prevented from developing in the big problem. According to Dr. Carnes, addiction generally starts as a smaller thing before it gets completely unmanageable. Carnes created a special system called, “the Personal Craziness Index” (PCI) for people to trace the early warning indications of potential dangers of particular habit (Hatch 2013). According to Carnes, identifying own personal warning signals such as, spending excessive time watching sexual contents, neglecting own health, failing to perform well at work, isolating from social life allows the person to evaluate own blunder and prevent own particular obsession from escalating into an addiction. Further, maintaining right balance in the life is important. Devoting excessive time to particular activity is always dangerous. For instance, workaholic nature can trigger sex addiction among some people as they try to spend every spare minute in experiencing the euphoria through particular sexual behaviour and relieve the workload pressure (Hatch 2013). A life with no time for rejuvenation, rest, and reflection can be stressful and imbalanced. It is necessary to find some time from busy schedule to do nothing, to meditate, to spend good time with loved ones. Such activities keep the mind and soul fresh and prevent the frequent phases of depression, anxiety, and frustration which often lead to addiction as the person attempts to find an escape from stressful reality through addiction. Keeping oneself motivated, maintaining proper balance in life, and identifying early warning signs and intervening at the right time can help a person to prevent from developing sexual addiction (Hatch 2013). Further, management of sexual addiction is highly dependent on person’s willingness to improve and approach to life. Addicts often return to their addiction due to the lack of motivation and failure to deal with guilt and shame associated with addiction. Various therapies and programs such as, a Relapse Preventing (RP) program can be helpful in management of addiction (Hayden 2012). The RP program helps the patients to cultivate realist and meaningful goals and clarify personal values. The programs develop mindful awareness of own inner processes which allow the patient to rightfully evaluate own actions and improve self-control. Accepting own addiction allows the patient to get rid of the constant feeling of guilt and shame, boosting his confidence to fight against the addiction (Hayden 2012). Surrounding to oneself with the loved ones, getting informed about the dangers of addictive behaviour, choosing healthy lifestyle and positively responding to the treatments can prove effective in the management of the condition (Prevention 2015). Interventions Medical Treatment Currently, there is not any US Food and Drug Administration (FDA)-approved drugs or other medications for sex addiction. However, various types of medications including, mood stabilizers, antidepressants, antiandrogens, and antipsychotics have been tried on patients in clinical treatments and medical research trails (Fong 2006, p. 56). Also, in some cases, doctors prescribe serotoninergic (SSRI) medications to sex addict patients to lower their anxiety and depression (Sex Addiction 2015). In case of failure with psychotherapies and SSRIs, an opiate antagonist called, naltrexone, has been used in the treatment of sex addiction. A research study on 22 sex addict male offenders in the US found that a treatment with naltrexone significantly effective for 16 out of 22 adult male sex offenders. On a more critical stage, surgical intervention has been found effective in reducing recidivism in sex addicts by practically reducing testosterone levels to lower sexual cravings and urges (Fong 2006, p. 55-56). Social, Cultural, and Environmental Interventions There are numerous psychosocial treatments available for people suffering from sexual addiction. Shame-reduction strategic therapy is considered to be the first intervention for sex addict person. The therapy assists the patient to defend oneself from rage, contempt, and anxiousness arises from the feeling of shame and guilt associated with the addiction. The therapy teaches the patients to face their feelings and how to deal with the guilt. Also, group therapy boosts the confidence of patients and motivates them to response to recovery treatments (Carnes & Adams 2002, p. 72-75). Also, cognitive-behaviour therapy (CBT), impatient treatment program, and 12-step theory assist sex addicts to identify major triggers of their addiction and eventually teach them how to deal with them by means of step-by-step behavioural changes and adoption of healthy lifestyle (Fong 2006, p. 55). Also, organizations like, Sex and Love Addicts Anonymous, the Society for Advancement of Sexual Health, and Sexual Recovery Institute provide sex addict people environmental and cultural platform to get away from their addiction and improve own lifestyle through social and cultural interactions. The organizations assist sex addicts to recover from their addiction and maintain healthy lifestyle (Tyler 2014). Public Health Policies The US government has introduced some major health policies and laws including, the Affordable Care Act, Addiction Equity Act, and the Mental Health Parity to assist people struggling with their addiction (Health Net 2015). The Affordable Care Act has forced the insurance companies to provide insurance covering mental and behavioural health services for its customers. Consequently, many addicts who once suffered with mental health problems and addictions without any support can now seek treatment and insurance companies are compelled to cover the treatment costs. Health Net Insurance provides complete insurance coverage for the rehab treatment of compulsive sexual behaviour or sex addiction (Health Net 2015). Critical Evaluation Sex addiction has largely been neglected regardless of many pieces of evidence that highlight it as a serious psychological health disorder, affecting majority of people in the United States and worldwide. Even though policies such as, the Affordable Care Act and the Addiction Equity, provides insurance benefits to sex addict patients, its accessibility and availability is highly limited. Further, there is a significant absence of any governmental intervention programs, rehab centers, or policies regarding sex addiction awareness and management of the condition in the United States. Also, there is not any governmental funding for research programs associated with sex addiction. Due to lack of funds and empirical research, treatments for sex addiction are largely limited with psychosocial therapies and social programs. The effectiveness of available medications for treating sex addiction is highly questionable as there are not any precise medications in the market for sex addiction. Therefore, it is necessary for the US health department to invest in research and development programs to find effective interventions and preventive measures for sex addiction. Conclusion Sex addiction is a serious health disorder which is rapidly growing in the United States, especially among men aged 18-49 years. Various researches and reports have identified numerous triggers such as, childhood sexual abuse, psychological disorders, substance abuse, and environmental factors for the development of sexual addiction among men. Sex addiction causes significant negative impact on the patient’s personal, social, and professional life as well as it affects his family and friends. Due to the stigma and guilt associated with sexual addiction, many cases of sexual addiction remain hidden and without proper treatments, it rapidly escalates into big problem, leading rape, paedophilia, incest, or sex offence. Due to a lack of research and constant negligence, there are not effective medications for sex addiction; however, with the support of family members and some psychosocial therapies and programs one can certainly overcome his addiction and enjoy healthy life. Reference List Burki, MH., & Masood, M. (2005). Sex Addiction and Spectrum Disorder. Word Psychiatric Association [online], pp. 1-11. 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