Compulsive Sexual Behavior and Dysregulation of Emotion

Introduction Dysregulation of emotion (DE) is commonly seen in individuals suffering from compulsive sexual behavior (CSB), as well as represents a crucial element of its common comorbidities like mood, anxiety, and substance use disorders. Aim To investigate the links between CSB and DE. Methods A review of pertinent literature on CSB and DE was performed using EBSCO, PubMed, and Google Scholar databases. Main Outcome Measure Patterns of DE were evaluated as a common clinical feature, underlying mechanisms, as well as a target for psychological and pharmacological interventions in CSB. Results Across different conceptualizations of CSB, DE represents the core element of a failure to cope with sexual impulses, thoughts, urges, or resulting uncontrolled sexual behaviors. DE may contribute to the occurrence of CSB while for individuals affected by this condition, sexual arousal and release act as an easier/learned (yet uncontrolled and leading to negative consequences) way of coping with negative mood states. CSB may represent a delusive form of self-regulation. Experience of child sexual abuse and insecure attachment patterns are considered risk factors for CSB (likely to be mediated by DE) but require further investigation. DE is also positively associated with CSB symptom severity. Pharmacological treatments affecting mood regulation, anxiety, impulsivity, and regulation within the brain reward system have been reported to help people with CSB achieve better control over their sexual urges and behavior. However, the available data are scarce and well-powered randomized controlled trials are needed to support these observations. Although improvement in one's emotional self-regulation is considered as an important healing factor in treatment, its benefit in psychological therapies specific to CSB requires further investigation. Conclusion DE represents a core symptom of compulsive sexual behavior disorder and related comorbidities as well as a predisposing factor to the development of compulsive sexual behavior disorder. Addressing DE may facilitate better treatment outcomes for patients with CSB. Lew-Starowicz M, Lewczuk K, Nowakowska I, et al. Compulsive Sexual Behavior and Dysregulation of Emotion. J Sex Med 2020;8:191–205.