Screening tools for sex addiction have clear validity and work in a range of population groups, a team of Canadian and German researchers reports.
Sex addiction is a form of behavioral addiction that lacks an official definition from the American Psychiatric Association (APA), despite the fact that significant amounts of credible research support the real-world existence of the condition. In a study review published in late 2014 in the journal Current Opinion in Psychiatry, researchers from Germany’s University of Hamburg and Canada’s University of Ottawa examined the usefulness of several screening tools designed to detect people affected by sex addiction. The researchers concluded that effective screening tools are available for use in several major segments of the general population.
In the U.S., the American Psychiatric Association, a professional organization for medical doctors licensed to practice as psychiatrists, has long been the source of the standard definitions for all conditions known to have a substantially damaging impact on mental health. In 2013, the APA established a new category of conditions, referred to by the organization as addictive disorders, specifically intended to allow doctors to diagnose cases of behavioral addiction (i.e. addiction-related changes in brain function and behavior that stem from excessive participation in commonplace, non-substance-related activities).
As of 2015, the American Psychiatric Association does not include a definition of sex addiction (also known by terms that include compulsive sexual behavior, hypersexual disorder and hypersexuality) on its list of recognized behavioral addictions/addictive disorders. However, in the past, the organization went so far as to propose a detailed possible definition of the condition. According to this proposed definition, people with sex addiction are affected by strong and recurring sexual urges, sexual behaviors and/or sexual fantasies for a minimum of half a year. These urges, behaviors and fantasies must have a clearly negative impact on an individual’s personal life, social life, work life or any other important aspect of a stable daily routine. In addition, the symptoms of sex addiction must not stem from the consumption of alcohol, drugs or medications. The tentative definition also asks doctors to specify the nature of the behaviors/urges/fantasies found in each individual.
Currently Available Screening Tools
Doctors and researchers in Europe and North America have developed a number of screening tools designed to detect the symptoms of sex addiction. Prominent examples of these tools include a 19-item questionnaire called the Hypersexual Behavior Inventory, a 10-item questionnaire called the Sexual Compulsivity Scale and a seven-item questionnaire from the American Psychiatric Association called the Hypersexual Disorder Screening Inventory. Each of these screening procedures has been tested in specific population groups. For example, doctors use the Sexual Compulsivity Scale in groups that include homosexual men and women, heterosexual men and women, and young adults enrolled in college. Doctors have used the Hypersexual Disorder Screening Inventory in groups that include bisexual men and homosexual men. Another screening tool, called the Assessment of Hypersexual Behaviors in Patients With Neurodegenerative Disorders, is specifically intended to detect sex addiction-related symptoms in people affected by brain-based physical conditions that include dementia and Parkinson’s disease.
Are Sex Addiction Tests Accurate?
The University of Hamburg and University of Ottawa researchers examined the results of five previous studies that focused on the real-world validity of the screening tools currently used to identify people affected by sex addiction. All of the studies under consideration were published in 2013 or 2014. In addition to the term sex addiction, these studies referenced equivalent terms that included sexual compulsivity, hypersexuality and sexual preoccupation. The researchers used a detailed statistical analysis to gauge the usefulness of the screening tools.
After completing their analysis, the researchers concluded that two of the screening tools under consideration—the Sexual Compulsivity Scale and the Hypersexual Behavior Inventory—have clear validity as tests for sex addiction and work in a range of population groups. The researchers also concluded that the Hypersexual Disorder Screening Inventory might have validity as a sex addiction screening tool. However, they note several potential problems with this test and point toward a need for further research to resolve issues of concern.
In addition to screening tools for sex addiction, the researchers looked at several screening tools used to identify people affected by the group of mental illnesses known as paraphilic disorders (which includes conditions such as voyeuristic disorder, pedophilic disorder and sexual sadism disorder). They concluded that doctors typically need to use multiple types of tests to accurately detect these illnesses.