Compulsive Sexual Behaviour Disorder (CSBD)

In July 2018 The World Health Organisation added Compulsive Sexual Behaviour Disorder (CSBD) as an impulse control disorder in the ICD‐11. ICD-11 it is the International Classification of Diseases (11th Revision) and is used by The World Health Organisation to record all recognised diseases.

Compulsive sexual behaviour disorder is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour. Symptoms may include repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities; numerous unsuccessful efforts to significantly reduce the repetitive sexual behaviour; and continued repetitive sexual behaviour despite adverse consequences or deriving little or no satisfaction from it. The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behaviour is manifested over an extended period of time (e.g., 6 months or more), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours is not sufficient to meet this requirement.

Psychological dependency is now recognized as a significant contributory factor to addiction and compulsive behaviours. It is now accepted that activities/behaviours like substances, can directly affect our brain chemistry. Repeated behaviours reinforce the brain chemistry linked to those behaviours. CSBD, like gambling and gaming, is known as a ‘behavioural addiction’.

The arousal chemistry of sex is particularly potent, associated with the limbic system of the brain, which is sometimes called ‘the old brain’ – that is, associated with instinctive drives – hunger, aggression, sex, survival. When this is activated, the newer prefrontal cortex, or cognitive brain, responsible for thinking things through and assessing risks and consequences, is over-ridden.

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