"Sex in stone" by Nagarjun Kandukuru is licensed under CC BY 2.0

Over 8% of Americans Expressed Distress About Having Difficulty Controlling Their Sexual Urges and Behaviors

MedicalResearch.com Interview with:
"Sex in stone" by Nagarjun Kandukuru is licensed under CC BY 2.0Janna A Dickenson, PhD

Doug Braun-Harvey Postdoctoral Fellow
Program in Human Sexuality
Department of Family Medicine
University of Minnesota Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Researchers and clinicians have contested the term “sex addiction” in favor of alternative definitions and symptom presentations. Recently, the ICD-11 has characterized compulsive sexual behavior disorder (CSBD) as a persistent pattern that involves failing to control intense sexual urges or sexual behaviors that results in significant levels of distress and/or impairment in one’s functioning.

Researchers estimate that CSBD affects 2-6% of the population and is much more common among cisgender men than cisgender. Using a randomized national sample, we assessed the prevalence of a key feature of CSBD that researchers and clinicians agree upon: distress and impairment associated with difficulty controlling sexual feelings, urges, and behaviors.

We performed this assessment with a screening tool called the Compulsive Sexual Behavior Inventory (CSBI). Of the 2,325 adults, 8.6 percent overall (10.3 percent of individuals who identified as men and 7 percent of individuals who identified as women) met the clinical threshold of the CSBI; meaning that 8.6% of people expressed difficulty controlling their sexual feelings, urges and behaviors and experienced distress and/or impairment as a result. To be clear, this does not mean the 8.6% of the sample endorsed CSBD, but that 8.6% of our sample exhibited significant distress or impairment related to difficulty controlling one’s sexual behaviors.

MedicalResearch.com: What should readers take away from your report?

Response: The fact that 8.6% of the our nationally representative sample met the clinical threshold of our screening tool suggests that a substantial number of people are feeling significantly distressed and/or are impaired by their difficulty controlling their sexual behavior. Although men made up the majority of people who show clinically relevant levels of distress about having difficulty controlling sexual feelings, urges, and behaviors, 40 percent of those who met the clinical threshold were women.

These results prompt us to thoughtfully consider our assumptions and biases about gender and sexuality and how they can contribute to sexual health concerns. More research needs to be done to determine whether women’s distress about their sexual urges and behaviors is comparable to the distress that men feel about their sexual urges and behaviors.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: It is important for us to begin to understand why the prevalence appears to be so high. We need to consider what factors contribute to people’s perception about their level of self control over their sexual behavior. Some of the results suggested that sociocultural factors affect the proportion of people who expressed distress and/or impairment associated with having difficulty controlling out one’s sexual urges, feelings, and behavior. Cross-cultural studies would be particularly beneficial. As well, investigating the developmental, psychosocial, and biological factors that lead to difficulty controlling one’s sexual behaviors would be a useful next step. Finally, a prevalence study actually assessing the new specific criteria of CSBD is also warranted. 

Our results call attention to the importance of studying women’s experience of sexuality. One of the limitations of this study was its idea of gender as a binary construct. In order to understand the factors that lead to the gender differences in failing to control one’s sexual urges or behaviors, it would be necessary to include a broader range of gender diversity. This means not only including individuals who identify as cisgender women in future studies, but to also include transgender and gender non-conforming people.

MedicalResearch.com: Is there anything else you would like to add? 

Response: It is important to note that several organizations and scientists have refuted the popular notion of sex addiction. Our study is about a key aspect of compulsive sexual behavior and doesn’t measure CSBD specifically. As well, it is important to remember that every screening tool has measurement error. This means that when someone’s assessment has met the clinical threshold, it is meant to signal to the clinician or researcher that a more thorough assessment is warranted to determine whether the person actually has the diagnosis. Therefore, the meaning of meeting the clinical threshold is to have exhibited significant distress or impairment related to difficulty controlling one’s sexual behaviors. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.


Dickenson JA, Gleason N, Coleman E, Miner MH. Prevalence of Distress Associated With Difficulty Controlling Sexual Urges, Feelings, and Behaviors in the United States. JAMA Netw Open. 2018;1(7):e184468. doi:10.1001/jamanetworkopen.2018.4468

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Last Updated on November 15, 2018 by Marie Benz MD FAAD