Cinsel Bağımlılık: Tanımı, Etiyolojisi ve Tedavisi

Öz

Günümüzde bağımlılık olgusunun sadece psikoaktif bir maddeden değil, bazı davranışların yarattığı haz ve rahatlama hissinden de kaynaklanabileceği bilinmektedir. Terapötik toplumda diğer davranışsal bağımlılıklara göre kabul edilmesi daha zor olan cinsel bağımlılık psikolojik bir rahatsızlıktır. Bağımlı bireyler ve çevrelerindeki kişiler üzerinde son derece yıkıcı etkilere sahiptir. Oysa 21. yüzyılda kompulsif cinsel davranışlar medikal bağlamda daha iyi anlaşılabilir ve bağımlı kişiler buna göre tedavi edilebilirdi. 2000’ler sonrası uluslararası alanyazında konuyla ilgili yapılan çalışmalar arttığı halde Türkiye’de cinsel bağımlılıkla ilgili neredeyse hiç çalışma yapılmamıştır. Bu sebeple bu çalışmada cinsel bağımlılık hakkında kapsamlı bir alanyazın taraması yapılmış ve elde edilen veriler belli bir çerçeve içinde sunulmuştur. Öncelikle cinsel bağımlılık rahatsızlığı açıklanmış, fenomenolojik özellikleri, karakteristikleri ve tanı kriterleri belirtilmiştir. Daha sonra alanyazındaki isimlendirme anlaşmazlıklarına, alternatif isim önerilerine ve sınıflandırılma sorunsalına, semptomolojisine, doğurduğu sonuçlar ve etkilerine, tedavi yöntemlerine, etiyolojisi ve etiyolojisine ilişkin yapılan çalışmalara yer verilmiştir. Etiyolojik çalışmalar kronolojik olarak 70’ler ve 80’ler, 90’lı yıllar ve 2000’ler ve sonrası olarak gruplandırılmış ve bu şekilde uluslararası alanyazında cinsel bağımlılık olgusuyla ilgili varolan verilere ilişkin gelişme ve ilerlemenin görülmesi amaçlanmıştır. Bu bilgiler ışığında cinsel bağımlılığın Türkiye’de araştırılmasının gerekliliği tartışılmış ve önerilerde bulunulmuştur.

Anahtar Kelimeler

• Cinsel bağımlılık
• Kompulsif Cinsel Davranış
• Hiperseksüalite
• Parafilik olmayan cinsel davranış

Sexual Addiction: Definition, Etiology and Treatment

Öz

In present day, it is known that addiction does not only derive from a psychoactive substance but also from the pleasure and relief after some behaviors. Sexual addiction, having always been more difficult to accept compared to other behavioral addictions in therapeutic societies, is a psychological disease. It has devastating effects on addicted individuals and the people around them. However, compulsive sexual behavior could be understood and addicted people could be treated accordingly in the 21. century. Studies regarding sexual addiction in the international literature after 2000s have increased but there are almost no studies on the issue in Turkey. This study reviews the related literature comprehensively and presents the data in a determined frame. It explains sexual addiction disorder and describes its phenomenological aspects, characteristics and diagnostic criteria. Next, it gives naming disagreements in the literature, alternative name suggestions, classification problem, symptomatology, consequences and impacts, etiology, and etiological researches. The etiological researches are classified chronologically as 70s and 80s, 90s and 2000s and after. It is aimed to demonstrate the scientific progress and improvement regarding sexual addiction phenomenon. In the light of this information, it is discussed that sexual addiction should be researched in Turkey, and suggestions are made accordingly.

Anahtar Kelimeler

• sexual addiction
• compulsive sexual behavior
• hyperseksuality
• non-paraphilic sexual behavior

Kaynakça

1. Angst J (1998) Sexual problems in healthy and depressed persons. Int Clin Psychopharmacol, 13:1-4.
2. Babaoğlu AN (1997) Uyuşturucu ve Tarihi: Bağımlılık Yapan Maddeler, İstanbul, Kaynak Yayınları.
3. Bancroft J, Janssen E (2007) The dual control model of male sexual response: a theoretical approach to centrally mediated erectile dysfunction. Neurosci Biobehav Rev, 24:571–579.
4. Bancroft J, Vukadinovic Z (2004) Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model. J Sex Res, 41:225–234.
5. Barth RJ, Kinder BN (1987) The mislabeling of sexual impulsivity. J Sex Marital Ther,13:15-23.
6. Becker GS, Murphy KM (1988) A theory of rational addiction, Eur J Polit. Econ, 96:675-700.
7. Behere AP, Basnet P, Campbell P (2017) Effects of family structure on mental health of children: a preliminary study. Indian J Psychol Med, 39:457–463.
8. Black DW, Kehrberg LLD, Flumerfelt DL, Schlosser SS (1997) Characteristics of 36 subjects reporting compulsive sexual behavior. Am J Psychiatry, 154:243–249

9. Bostwick JM, Bucci JA (2008) Internet sex addiction treated with naltrexone. Mayo Clin Proc, 83: 226–230.
10. Briken P, Habermann N, Berner W, Hill A (2007) Diagnosis and treatment of sexual addiction: A survey among German sex therapists. Sex Addict Compulsivity, 14:131–143.
11. Carnes P (1983) Out of Shadows: Understanding Sexual Addiction. Minnesota, Hazelden Publishing.
12. Carnes P (1992) Don't Call It Love: Recovery From Sexual Addiction. London, Bantam.
13. Carnes P, Delmonico D (1996) Childhood abuse and multiple addictions: Research findings in a sample of self-identified sexual addicts. Sex Addict Compulsivity, 3:258–268.
14. Carnes P, Murray RE, Charpentier L (2005) Bargains with chaos: sex addicts and addiction interaction disorder. Sex Addict Compulsivity, 12(2-3), 79–120.
15. Clarkson J, Kopaczewski S (2013). Pornography addiction and the medicalization of free speech. Am J Clin Pathol, 37:128–48 Coleman E (1992) Is your patient suffering from compulsive sexual behavior? Psychiatr Ann, 22: 320-325.
16. Coleman E, Raymond N, McBean A (2003) Assessment and treatment of compulsive sexual behavior. Minn Med, 86: 42–47.
17. Cooper A, Delmonico DL, Burg, R (2000) Cybersex users, abusers, and compulsives: New findings and implications. Sex Addict Compulsivity, 7: 5–29.
18. DSM-IV-TR (Diagnostic and Statistical Manual) (2000) Mental Disorders, The Committee on Nomenclature and Statistics of the American Psychiatric Association, Washington
19. Diehl A, Clemente J, Pillon SC, Santana PRH, da Silva CJ, Mari JJ (2018) Early childhood maltreatment experience and later sexual behavior in Brazilian adults undergoing treatment for substance dependence. Braz J Psychiatry, 41:199–207
20. Farrguia, D. (2011) Sex addiction: recent experimental research and findings, University of Malta.
21. Garcia FD, Thibaut F (2010) Sexual addictions. Am J Drug Alcohol Abuse, 36:254–260.
22. Giugliano J (2006) Out of control sexual behavior: a qualitative investigation. Sex Addict Compulsivity, 13:361–375.
23. Gold SN, Heffner CL (1998) Sexual addiction: Many conceptions, minimal data. Clin Psychol Rev, 18:367–381.
24. Goodman A (1993) Diagnosis and treatment of sexual addiction. J Sex Marital Ther, 19:225–251.
25. Goodman A (1998). Sexual addiction: Diagnosis and treatment. Psychiatric Times, 15.
26. Grant, JE, Kim SW (2001) A case of kleptomania and compulsive sexual behavior treated with naltrexone. Ann Clin Psychiatry, 13:229–231.
27. Grant JE, Potenza MN, Weinstein A, Gorelick DA (2010) Introduction to behavioral addictions. Am J Drug Alcohol Abuse, 36:233-241.
28. Hall P (2011) A biopsychosocial view of sex addiction. Sex Relaths Ther, 26:217–228.
29. Hellman M, Schoenmakers TM, Nordstrom BR, van Holst RJ (2013) Is there such a thing as online video game addiction? A cross-disciplinary review. Addic Res Theory, 21:102–12
30. Hook JN, Hook JP, Davis DE, Worthington EL, Penberthy, JK (2010) Measuring sexual addiction and compulsivity: a critical review of instruments. J Sex Marital Ther, 36:227–260.
31. Hughes B (2010) Understanding ‘sexual addiction’ in clinical practice. Procedia Soc Behav Sci, 5:915–919.
32. Irvine J (1995) Reinventing perversion: sex addiction and cultural anxiety. J Hist Sex, 5: 429-450.
33. Iwen ME (2015) Shame, sexual addiction, and consumption in American culture. Sex Cult, 19: 413–425.
34. Kafka MP (2003) The monoamine hypothesis for the pathophysiology of paraphilic disorders: An update. Ann N Y Acad Sci, 144–153.
35. Kafka MP (2009). Hypersexual disorder: a proposed diagnosis for DSM-V. Arch Sex Behav, 39: 377–400. Karakuş G, Tamam L, Öztürk Z, Eroğlu MZ, Bahalı K, Nebioğlu M (2011) Bir grup üniversiteye hazırlık öğrencisinde dürtü kontrol bozukluğu. Neuropsychiatry Archieve, 48:238-42.
36. Khazaal Y, Zullino DF (2006) Topiramate in the treatment of compulsive sexual behavior, case report. BMC Psychiatry, 6.
37. Levine MP, Troiden RR (1988) The myth of sexual compulsivity: Sexual addiction. J Sex Res, 25:347-363.
38. Livingstone S, Smith PK (2014) Annual research review: Harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age. J Child Psychol Psychiatry, 55:635-54
39. Malladi SS, Singh AN (2005) Hypersexuality and its response to citalopram in a patient with hypothalamic hamartoma and precocious puberty. Int J Neuropsychopharmacol, 8:1–2.
40. Mathews RJ, Weinman ML (1982) Sexual dysfunctions in depression. Arch Sex Behav, 11:323–328.
41. McPherson S, Wood H, Hiskey S, Andrews L (2014) The role of childhood experiences in the development of sexual compulsivity. The Journal of Treatment and Prevention, 20:259-278
42. Mestre-Bach G, Blycker GR, Potenza MN (2020) Pornography use in the setting of the COVID-19 pandemic. J Behav Addict, 9(2)
43. Nofzinger EA, Thase ME, Reynolds CF, Frank E, Jennings R, Garamoni GL, Fasiczka AL, Kupfer DJ (1993) Sexual function in depressed men: assessment by self-report, behavioral and nocturnal penile tumescence measures before and after treatment with cognitive behavioral treatment. Arch Gen Psychology, 50:24–30.
44. Orford J (1978) Hypersexuality: Implications for a theory of dependence. Br. J Addict, 73:299-310.
45. Perera B, Reece M, Monahan P, Billingham R, Finn P (2009) Childhood characteristics and personal dispositions to sexually compulsive behavior among young adults. Sex Addict Compulsivity, 16(2):131-14
46. Pornhub (2020) Coronavirus insights. Available from: https://www.pornhub.com/insights/corona-virus. Accessed date: 03.08.2020
47. Roostin E (2018) The family influence on the development of children. Journal of Elementary Education, 2.
48. Schaeffer B (2009) Sexual addiction. Transactional Analysis Journal, 39:153–162.
49. Schneider J (1994) Sex addiction controversy, diagnosis and case histories. Sex Addict Compulsivity, 1:19-44.
50. Schwartz MF (1992) Sexual compulsivity as post-traumatic stress disorder: Treatment perspectives. Psychiat Ann, 22:333-338
51. Sevin A (2018) Yetişkinlerde cinsel bağımlılık, erken dönem uyumsuz şemalar ve yaşam doyum ilişkileri. (Yüksek Lisans Tezi). İstanbul Maltape Üniversitesi
52. Shepherd L (2009) Cognitive behavior therapy for sexually addictive behavior. Clin Case Stud, 9:18–27.
53. Sussman S, Lisha N, Griffiths M (2011) Prevalence of the addictions: a problem of the majority or the minority? Evaluation of Health Profession, 34:3–56
54. Sussman S, Moran M. (2013) Hidden addiction: television. J Behav Addict, 2:125–32
55. Sussman S (2007) Sexual addiction among teens: a review. Sex Add Compulsivity, 14: 257–278.
56. Teicher MH, Andersen SL, Polcari A, Anderson CM, Navalta CP (2002) Developmental neurobiology of childhood stress and trauma. Psychiatr Clin North Am, 25:397–426.
57. Thege B, Woodin EM, Hodgins DC, Williams JR (2015) Natural course of behavioral addictions: a 5-year longitudinal study. BMC Psychiatry, 15(1).
58. Zengin Eroğlu M, Tamam L (2016) Geç başlangıçlı bir kompulsif seks bağımlılığı olgusu, J Mood Disord, 6.