Mental Health
Treatments and interventions for compulsive sexual behavior disorder with a focus on problematic pornography use: A preregistered systematic review.
Open Access: Yes.
Abstract
Background and aims. Compulsive sexual behavior disorder (CSBD) which includes problematic pornography use (PPU) is a clinically relevant syndrome that has been included in the ICD-11 as impulse control disorder. The number of studies on treatments in CSBD and PPU increased in the last years. The current preregistered systematic review aimed for identifying treatment studies on CSBD and PPU as well as treatment effects on symptom severity and behavior enactment.
Methods. The study was preregistered at Prospero International Prospective Register of Systematic Reviews (CRD42021252329). The literature search done in February 2022 at PubMed, Scopus, Web of Science, and PsycInfo, included original research published in peer-reviewed journals between 2000 to end 2021. The risk of bias was assessed with the CONSORT criteria. A quantitative synthesis based on effect sizes was done.
Results. Overall 24 studies were identified. Four of these studies were randomized controlled trials. Treatment approaches included settings with cognitive behavior therapy components, psychotherapy methods, and psychopharmacological therapy. Receiving treatment seems to improve symptoms of CSBD and PPU. Especially, evidence for the efficacy of cognitive behavior therapy is present.
Discussion and conclusions. There is first evidence for the effectiveness of treatment approaches such as cognitive behavior therapy. However, strong conclusions on the specificity of treatments should be drawn with caution. More rigorous and systematic methodological approaches are needed for future studies. Results may be informative for future research and the development of specific treatment programs for CSBD and PPU.
Relevance
In 2019, the World Health Organization added a new diagnosis under the impulse control disorder category: “Compulsive sexual behavior disorder” (CSBD, ICD-11 Code: 6C72). This disorder “is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior. The sexual activity increasingly becomes the central focus in one person’s life and other important areas of life are neglected. Furthermore, obligatory for the diagnosis are unsuccessful attempts to reduce or stop the sexual activity despite adverse consequences or deriving little or no satisfaction from it. The problem must exist at least 6 months and cause marked distress or impairment in important areas of functioning.”
Pornography is included in this new disorder.
Is there treatment for pornography? “Based on the current evidence, it cannot be said if specific forms of interventions such as individual therapy vs. group-therapy, digital vs. non-digital, and guided vs. self-help approaches were more effective.” That said, “The current evidence indicates that treatment, especially CBT {cognitive behavior therapy], could be effective. However, the specificity of treatment effects is questionable.”
Citation
Antons, S., Engel, J., Briken, P., Krüger, T. H. C., Brand, M., & Stark, R. (2022). Treatments and interventions for compulsive sexual behavior disorder with a focus on problematic pornography use: A preregistered systematic review. Journal of behavioral addictions, 11(3), 643–666. https://doi.org/10.1556/2006.2022.00061
