Am I A Sex Addict?

The question many have when acknowledging the presence of problematic sexual behaviors is simply, “Am I a Sex Addict”?  There are many aspects to keep in mind when conceptualizing Sex Addiction; specific addiction criteria along with collateral indicators that when examined together formulate the behaviors and make-up of a sex addict.  The collaboration of this data allows us to use pathology to assess and treat individuals for Sex Addiction.  The common assessment instrument used to screen for Sex Addiction is the SAST (Sexual Addiction Screening Test) which comprises of 20 yes or no questions where the clinical threshold on this predominantly used tool is 6 endorsed yes questions out of 20.  Often when a score of 6 or greater is acknowledged, there is the opportunity to further assess using the SDI (Sexual Dependency Inventory) which is a battery of assessments, having the SAST embedded along with other assessments measuring collateral indicators, attachments styles, behavioral scales and entitlement scores that allows clinicians the ability to formulate appropriate treatment plans to fit the particular needs of the client.  This is a crucial process as it can be very detrimental to use pathology when treating individuals who do not meet addiction criteria and simply have issues around intimacy, attachment, trauma or other problematic sexual behaviors present.  When addiction is present, the following criterion becomes identified:

1. Distress, anxiety, restlessness, or irritability when unable to engage in the behavior, otherwise known simply as withdrawal symptoms.
2. Withdrawing or limiting social, recreational, or occupational activities due to engaging in the behavior.
3. The progressive need to increase the intensity, number, frequency, and or risk of behaviors to experience and achieve the desired effect or reward.  This can also look like a diminished effect with continued behaviors at the same level of risk, intensity, number, or frequency otherwise known as a continued increase in tolerance.
4. The continuation of the behavior despite knowledge of having recurrent or persistent financial, social psychological or physical problems that has developed or become exacerbated by the behavior, otherwise known as powerlessness.
5. Progressive and frequent engagement in the behavior when expected to fulfill obligations and responsibilities in areas of life such as social, academic, domestic and occupational.
6. Preoccupation or mental obsession with the behavior, preparatory activities surrounding the behavior or adverse emotions and mental states due to the behavior.
7. Loss of time spent in obtaining sex, being sexual, or recovering from sexual experiences.
8. Persistent desire or unsuccessful efforts to stop, control or reduce sexual behaviors.
9. Frequent engagement in sexual behaviors to a greater extent or over longer periods of time than intended.
10. Recurrent patterns of failure to resist impulses to engage in specific sexual behavior.

It is important to note that this criteria for addiction is the same used for any other mood altering behavior or chemical dependency.  Along with basic addiction criteria, collateral indicators are used to further assess sex addiction and of 20 specific indicators, 6 endorsed typically leads to the pathology of sex addiction.  Collateral indicators are as follows:

1. Having experienced severe consequences because of the behavior.
2. Having struggled with depression and it relating to sexual acting out.
3. Having struggled with depression and it relating to sexual aversion.
4. A history of sexual abuse.
5. A history of physical abuse.
6. A history of emotional abuse.
7. Sexual life used to self-medicate (intoxicate, relief of pain and or tension, to sleep)
8. Persistent pursuing of high risk or self destructive behavior.
9. Finding high risk or self destructive behavior to be more arousing that safe sexual behavior.
10. The presence of other addictive or compulsive behaviors.
11. The simultaneous use of sexual behavior in combination with other addictive behaviors, otherwise known as addiction interaction.
12. Having a history of deception around sexual behavior.
13. Having other family members fit criteria of addiction.
14. Feeling extreme self loathing due to sexual behaviors.
15. Having few intimate relationships that do not involve sexual behavior.
16. Present crisis because of sexual matters.
17. History of crisis surrounding sexual behaviors.
18. The experience of diminished pleasure from same sexual experience (decrease in tolerance)
19. “Rigid” family system.
20. “Disengaged” family system.

It is strongly encouraged to not self diagnosis but to seek a professional in the area of sex addiction to be carefully assessed using diagnostic material and specific interviewing skills to formulate criteria for addiction. 

Mike Quarress CSAT