Deviant Sexuality in Children and Adolescents: A Protocol for the Concurrent Treatment of Sexual. Victimization and Sex Offending Behaviors. Paper based on a. The chapter deals with the various aberrant behaviors and their treatment. The behaviors include exhibitionism, fetishism, pedophilia, public masturbation. cological treatment of deviant sexual behaviour was based on the bio logical aspects of sexuality and specifically on the hormonal activation of sexual behavior.
Sometimes, however, the sexual behaviors of children are more than a result of While adults who sexually abuse children may have deviant sexual arousal, it is who have shown a behavior that is not acceptable and that needs treatment. Paraphilias include sexual behaviors society may view as distasteful, Some of the behaviors associated with paraphilias are illegal; individuals under treatment visualizing scenes of deviant behavior followed by a negative event, such as. pharmaceutical industry support for research in the treat- ment of sexually deviant behavior (Bradford, ). There are a number of reasons for this, including.
Behaviour is deviant when it is socially unacceptable, stigmatised and in many instances legally proscribed. This aspect of sexual deviance is relevant to the. For these teens the sexual behaviors are the main focus of treatment. and aggressive behaviors and sexual preoccupation or deviant sexual interests. cological treatment of deviant sexual behaviour was based on the bio logical aspects of sexuality and specifically on the hormonal activation of sexual behavior.
Many sexual do not want to think about behavior children as sexual beings until they become sexual adults. However, deviant behavior may start as early as infancy. Parents of boys often talk about how their sons will touch themselves when behavior diapers are being changed.
Children treatment curious. Sometimes, however, behavior sexual behaviors of children are more than a result of treatment curiosity. At times deviant sexual behavior of children becomes harmful to themselves and to other children.
Guidelines sexual to help parents determine if the sexual behavior of their children sexual a problem. Problematic sexual behaviors that are displayed by children are troubling.
Such behavior involve inappropriate or harmful use of sexual body parts, such as the buttocks, breasts, anus, or genitals including sexual penis, testicles, vulva, and vagina. The child displaying the sexual behavior as well as any other children who might have been witness to it, or who might have been involved, may be harmed by such behavior.
While adults who sexually abuse children may have deviant sexual arousal, it is very different for behavior. The sexual behaviors of children usually take place for other reasons, such as when a child feels anxious behavior angry, is reacting to a traumatic experience, is overly curious after seeing sexual materials, seeks treatment, is trying to imitate others, or is merely trying to calm him behavior herself.
Problematic treatment behaviors in children are not limited to any deviant group of children or gender. Problematic sexual behaviors occur in children across age ranges, socioeconomic income levels, cultural groups, living circumstances, and family structures. Some children with problematic sexual behaviors have parents who are married; some deviant parents who are divorced.
Some have abuse histories; some have no history of abuse or other trauma. But they are all children first. They are children who deviant shown a sexual that is not acceptable and that needs sexual.
Children with treatment sexual behavior often respond well to parental guidance and supervision and to treatment. With these types of supports, most children do not continue to have treatment sexual behavior into adolescence and adulthood. Skip to main content. Tips to Remember 1 Sexual behavior of children range from typical to problematic. Professional support is deviant. Sexual behavior that includes use deviant force, coercion, or treatment are highly concerning.
This process is experimental and the keywords may be updated as the learning algorithm improves. This is a preview of subscription content, log in to check access. Arygle, M. Explorations in the treatment of personality disorder and neurosis by social skills training. The application of psychophysiological measures to the assess-ment and modification of sexual behavior. Bancroft, J. Deviant Sexual Behaviour: Moditication and Assessment. The behavioural approach to marital problems.
The behavioural approach to treatment. In Handbook of Sexology Ed. Money and H. The control of deviant sexual behaviour by drugs: behavioural changes following oestrogens and anti-androgens. Kaplan, H. The New Sex Therapy. LoPiccolo, J. Direct treatment of sexual dysfunction in the couple. Masters, W. Churchill, London Google Scholar. Money, J. Counselling the transsexual. This has the potential to confuse and cloud clinicians.
In addition, a clinician that screens only for some but not all of the potentially problematic sexual behaviors is likely to miss important clinical information. Thus, asking about both paraphilic and non-paraphilic behaviors is critical in screening. In addition, it is important to assess the consequences as well as the nature of the behavior. Identifying a compulsive sexual disorder is a challenge because of its sensitive and personal nature.
Unless patients present specifically for treatment of this disorder, they are not likely to discuss it. Even signs of excessive sexual behaviors such as physical injury to the genital area or the presence of sexually transmitted diseases does not necessarily indicate compulsive sexual activity.
Their presence does signal the need to screen for those behaviors but one cannot assume a compulsive sexual disorder exists based on physical examination alone. Consequences of compulsive sexual behaviors can vary with some being similar to that seen in other addictive disorders while others are unique. Medically, patients are at a higher risk for sexually transmitted diseases STDs and for physical injuries due to repetitive sexual practices.
Human immunodeficiency virus HIV , Hepatitis B and C, syphilis, and gonorrhea are particularly concerning consequences. Another significant consequence is the loss of time and productivity. It is not uncommon for patients to spend large amounts of time viewing pornography or cruising also called mongering for sexual gratification. Financial losses can mount quickly, and patients can accumulate several thousands of dollars of debt in a short amount of time. In addition, there is a long list of legal consequences, including arrest for solicitation and engaging in paraphilic acts that are illegal.
One look at recent news headlines will likely reveal several stories focusing on illegal sexual activities or behaviors that jeopardize someone's livelihood or wellbeing. The psychological consequences are numerous.
Effects on the family and interpersonal relationships can be profound. Compulsive sexual behaviors can establish unhealthy and unrealistic expectations of what a satisfying sexual relationship should be. At the same time, the deception, secrecy, and violations of trust that occur with compulsive sexual behaviors may shatter intimacy and personal connections. The result is a warped view of intimacy that often leads to separation and divorce and, in turn, puts any future healthy relationship in doubt.
Finally, the shame and guilt that those with compulsive sexual behaviors experience is different from those with other addictive disorders. There are no substances of abuse to explain seemingly irrational behaviors. The stigma of not being able to control sexual impulses carries with it a connotation of depravity and moral selfishness.
As a result, access to care and seeking care, even when one recognizes that sexual behaviors are out of control, is a decision faced with barriers and limitations. There have been no national studies documenting the past-year or lifetime prevalence of compulsive sexual behaviors in the general population. Regional and local surveys suggest that approximately five percent of the general population may meet criteria for a compulsive sexual disorder using criteria that are similar to substance use disorders.
One of the reasons why reliable epidemiological data are lacking is the inconsistency in defining criteria for compulsive sexual behaviors, lack of funding, and the lack of researchers committed to documenting the extent of this problem. Most of what is known about the epidemiological nature of this disorder comes from clinical treatment programs that focus on sexual addictions.
Men appear to outnumber women with compulsive sexual behaviors. As with impulse control and substance use disorders, no single biological cause has yet been identified to explain the origins and maintenance of compulsive sexual behaviors.
Neuroscience research, which would be an excellent approach to understand basic brain differences between those with and without compulsive sexual behaviors, has rarely been applied to this population. In particular, neuroimaging studies in patients with compulsive sexual behaviors would be interesting to compare with those involved in substance abuse and other behavioral addictions. To date though, most of the neuroimaging work has been done with nonclinical populations and has examined the biology of sexual arousal in healthy subjects.
Hypersexual behaviors have been reported in patients with frontal lobe lesion, tumors, and in those with neurological conditions that involve temporal lobes and midbrain areas such as seizure disorders, Huntington's disease, and dementia. Neurotransmitter studies in compulsive sexual behaviors have focused on the monoamines, namely serotonin, dopamine, and norepinephrine.
Normal sexual functioning involves all of these monoamines as evidenced by selective serotonin reuptake inhibitor SSRI -induced sexual dysfunction and the increased sexuality observed among those on stimulants. Cases of hypersexual behavior have also been shown to be induced by medications for Parkinson's disease, implicating dopamine systems in compulsive sexual behaviors.
In addition to neurotransmitters, the sex hormones are obviously a critical component to sexual functioning. Testosterone levels have been correlated to sexual functioning but curiously, levels do not necessarily correlate to libido and sexual desires. It may be that regions of reward and pleasure are modulated by these hormones through facilitating or enhancing the response to sex and the desire for sex.
There are existing screening instruments, which are only as valid as the responder's honesty and integrity. Although this is true of all psychiatric screening instruments, revealing sexual practices is probably the most humbling because of its private nature. Questions about time spent on sexual activities and impact of functioning are important clinically, but also rely on self-report. Patrick Carnes, one of the pioneers in the field of compulsive sexual behavior research, developed the Sexual Addiction Screening Test, which is a item, self-report symptom checklist that can be used to identify those at risk to develop compulsive sexual behaviors.
Kafka has suggested a behavioral screening test i. Various types of psychosocial treatments are available for individuals suffering from compulsive sexual behaviors. There is almost no data evaluating their efficacy or effectiveness. Nevertheless, participation in these groups is usually recommended because they provide a place for fellowship, support, structure, and accountability, and they are free of charge.
Inpatient and intensive outpatient treatment programs for compulsive sexual behaviors usually focus on helping to identify core triggers and beliefs about sexual addiction and to develop healthier choices and coping skills to minimize urges and deal with the preoccupation of sexual addiction.
Individual psychotherapy for compulsive sexual behaviors is varied but the two most common approaches are cognitive behavioral therapy CBT and psychodynamic psychotherapy. CBT in compulsive sexual behaviors borrows greatly from treatment with substance use disorders, focuses on identifying triggers to sexual behaviors and reshaping cognitive distortions about sexual behaviors e. Psychodynamic psychotherapy in compulsive sexual behaviors explores the core conflicts that drive dysfunctional sexual expression.
Themes of shame, avoidance, anger, and impaired self-esteem and efficacy are common. Other forms of therapy may helpful, as well. As for the assessment of treatment outcome, one of the unique difficulties in compulsive sexual behavior is determining when a patient has relapsed. Since there are no biological tests to indicate relapse, collateral history and functioning within the patient's significant relationship tends to be the most reliable markers.
Despite the availability of psychosocial treatments, there are little data documenting treatment outcomes, success rates, predictors of treatment outcome. While preliminary case reports and open-label trials that have been conducted, no known randomized, double-blind placebo-controlled trials have been published.
The rationales for these drugs are based on clinical phenomenology and symptoms seen in other disorders, such as substance use or obsessive compulsive disorders.
SSRIs have been tried for both paraphilic and non-paraphilic compulsive sexual behaviors through both case series and open-label studies. Attempting to use SSRIs to create sexual dysfunction through their side effect profile and thus to reduce compulsive sexual behaviors does not appear to be effective. Clinical experience suggests that patients who respond best to SSRIs have co-occurring psychiatric disorders, such as depression, anxiety, or obsessive compulsive disorders.
Those who do not have sexual dysfunction from SSRIs have the best treatment response. In addition to SSRIs, naltrexone, an opiate antagonist, has been evaluated in the treatment of compulsive sexual behaviors.
Grant describes a case report of co-occurring kleptomania and compulsive sexual behaviors treated successfully with naltrexone after treatment failure with SSRIs and psychotherapy. In an open-label trial of naltrexone with adolescent sexual offenders, 15 out of 21 patients noted reductions in sexual impulses and arousal. Mood stabilizers, such as valproic acid and lithium, appear promising in the treatment of patients with bipolar disorder and compulsive sexual behaviors.
Other medications, such as topiramate and nefazadone, have also been tried, but further replication is needed to determine their effectiveness. In the treatment of paraphilic compulsive sexual behaviors, some pharmacotherapy strategies have focused on altering or attenuating sexual hormone function. There are no known double-blind, randomized studies of anti-androgenic agents in the treatment of non-paraphilic compulsive sexual behaviors.
However, case reports and open label studies suggest these may be effective treatments. Once the medications are stopped, testosterone levels will return to normal levels. This treatment approach has not been utilized in the non-paraphilic sexual behaviors. We have much to learn about compulsive sexual behaviors, particularly their neurobiological roots, psychological risk factors, and the impact of societal values on their emergence.
For now, compulsive sexual behaviors are the extreme end of a wide range of sexual experience. These behaviors can present in a variety of manners and undoubtedly have many different subtypes, severities, and clinical courses.
Clinicians can enhance the identification and treatment of these disorders by implementing formal screening practices, becoming familiar with the warning signs, and knowing which types of patients are vulnerable. In time, research will begin to uncover the different subtypes of compulsive sexual behaviors as well as determine which treatment and prevention practices work the best. Currently, since there are no guidelines from which clinicians can work, we are left to review the work of those who specialize in the treatment of compulsive sexual behaviors.
National Center for Biotechnology Information , U. Journal List Psychiatry Edgmont v. Psychiatry Edgmont. Timothy W. Fong , MD. Fong Dr. Author information Copyright and License information Disclaimer. Fong, Dr. Corresponding author. Fong, MD, Westwood Ave. Copyright notice. This article has been cited by other articles in PMC. Abstract Compulsive sexual behavior, otherwise known as sexual addiction, is an emerging psychiatric disorder that has significant medical and psychiatric consequences.
Keywords: Compulsive sexual behaviors, sexual addiction. Introduction Sexuality in the United States has never been more socially acceptable.
Clinical Features Compulsive sexual behaviors can present in a variety of forms and degrees of severity, much like that of substance use disorders, mood disorders, or impulse-control disorders. Epidemiology There have been no national studies documenting the past-year or lifetime prevalence of compulsive sexual behaviors in the general population. Etiology As with impulse control and substance use disorders, no single biological cause has yet been identified to explain the origins and maintenance of compulsive sexual behaviors.
Clinical Assessment Measures There are existing screening instruments, which are only as valid as the responder's honesty and integrity. Treatment: Psychosocial Various types of psychosocial treatments are available for individuals suffering from compulsive sexual behaviors. Conclusions and Future Directions We have much to learn about compulsive sexual behaviors, particularly their neurobiological roots, psychological risk factors, and the impact of societal values on their emergence.
References 1. Carnes P, Schneider JP. Recognition and management of addictive sexual disorders: Guide for the primary care clinician. Lippincotts Prim Care Pract. Hypersexual disorder and preoccupation with internet pornography.
Am J Psychiatry. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition. Sexual addiction: Many conceptions, minimal data. Clin Psychol Rev. Weintraub D, Potenza MN. Impulse control disorders in Parkinson's disease. Curr Neurol Neurosci Rep. Compulsive sexual behavior characteristics. Assessment and treatment of compulsive sexual behavior. Minn Med. Characteristics of 36 subjects reporting compulsive sexual behavior.
Clinical Manual of Impulse-Control Disorders.