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<!-- Psychological outcomes among highly active people in the study varied depending on the presence of a stable partner.

People who score high on the sexual addiction questionaire tend to also have a lot of anxiety, avoidance, and personality disorders. The HBI and SAST do not correlate with other addictions. People who score high on the HBI tend to have problems with executive functioning.

Symptoms
Common manifestations of hypersexuality are repetitive fantasy, masturbation, pornography, telephone sex, cybersex, protracted promiscuity, voyerism, strip clubs, incompatibility with a partner, and anonymous or group sex. One study found the three most common to be pornography, masturbation, and promiscuity. Promiscuity may include prostitution, unprotected sex, or affairs. They can become disordered and cause negative side effects. It generally causes impairment and preoccupation and may come as a response to negative events. The risk of HIV is a major possible negative when hypersexuality manifests as promiscuity. Other possible negatives can include pregnancy and relationship problems. Hypersexual people vary in whether their behaviors increase and decrease or steadily increase. There are several similarities between people with norophilic hypersexuality and paraphiles, such as age, onset, consumption of time, occurrence during stress, and diversity of actions. Hypersexuality is often found among paraphilic males, as well.

Masturbation, Pornography, Sexual Behavior With Consenting Adults, Cybersex, Telephone Sex, and Strip Clubs were proposed by Kafka as subtypes of the condition. Studies have shown that fifty to seventy five percent of people who see themselves as sex addicts or sexual compulsives have issues with "compulsive masturbation". In a couple studies, about half of the people who saw themselves as having an issue were beset by pornography dependence. Studies showed about twenty to forty percent as having issues with non-paraphilic promiscuity. Severe problems with cybersex and phone sex are rare. These subtypes have not been studied in large groups outside of clinical issues.

Causes and mechanisms
Some believe that hypersexuality is caused in a similar was as paraphilias are, i.e. sexual motivation. It is sometimes seen as a sexual desire disorder, sometimes as a impulsive compulsive disorder, and sometimes as a behavioral addiction.

Several neuropsychaitric conditions, brain injuries, and some medications can cause hypersexual behavior. Hybersexual behavior is sometimes found in patients with dementia, temporal lobe epilepsy, and tourrettes. Brain injury and lombotomy can also play a role, particularly frontal lobe lesions. Methamphetimine and cocaine can cause hypersexuality. Dopaminergic treatment for Parkinson’s Disease can cause hypersexuality. This indicates that dopamine can increase sexual drive. Bipolar disorder can definitely cause hypersexuality. Most other theories of eitology are based on clinical practice. There has been much more emphasis on defining and classifying it than finding an eitology.

Researchers affiliated with the Kinsey Institute proposed a "dual control" model. Under the model, low inhibition or high desire combine with anxiety to produce a pattern of behavior that includes high-risk sexual activity. Bancroft used this to study non-paraphilic people who could not control their sexual urges. Their results found that anxiety and depression correlated with increased promiscuity and masturbation in people with self-control problems. One large study of a convenience sample found that sexual compulsivity was largely a function of increased desire and distress about the management of sexual behavior. One model focused on the way that the brain's monoaminergic receptors and sex hormone receptors function. Animal studies have found that testosterone, dopamine, and serotonin changes can cause hypersexuality. As Axis I disorders tend to occur along with hypersexuality, they may be the cause.

In the late 1970s and early 1980s, excessive sexual desire was first classified as an addiction by some academics. Patrick Carnes argued that the sexual behavior of some displayed key characteristics of addiction, such as self-medication, tolerance, loss of control, and withdrawal. This later received play in the media, and many people adopted the idea. Goodman proposed that sex could be seen as a substance dependence, thus fitting with the DSM better than calling it an addiction. One study of self-described sex addicts should that many of them reported tolerance and withdrawal while attending a 12 step meeting. Carnes saw addiction as being caused by early childhood trauma.

Hypersexuality that results in risk-taking behaviors with multiple partners is sometimes referred to as "Sexual compulsivity". A measurement of this was created to identify people who were likely to take a lot of sexual risks. It focused on hypersexual behaviors such as impaired judgment negative consequences. Coleman defined sexual compulsion as repeating actions through which relief from anxiety or depression was sought. Another behavioral inventory looks at two things, inability to control the self and the harms encountered.

In 1987, Barth and Kinder saw the root of hypersexuality as an impulse control disorder. Impulsivity is very similar to risk taking and sensation seeking. This is often used when referring to STD exposure. It has goes along with substance abuse and frequent gambling at times. Hypersexuality is sometimes defined as an impulsive-compulsive behavioral addiction. Like substance abuse, the compuslivity may increase as it progresses. In a study of inpatient psychiatric patients, about 5% met the criteria for sexual compulsivity in an impulsive disorders test.

Sexual abuse may cause hypersexuality.

In one study of people who reported sexually compulsive behavior, lower and higher frequency of sex having people scored the same for depression, anxiety, and obsessive compulsiveness. In another situation, hypersexual non-paraphilic people who did the SCL-90 showed them as more neurotic, obsessive, and alienated than others. In a German study, neurotic disorders and to a lesser extent eating disorders were found to go along with patients of sex researchers. Studies have shown that sexually compulsive people generally have mood, axiety, substance, and impulsive disorders. In one study of sexually compulsive people, two thirds had substance issues, half had anxiety issues, and over a third has serious depression issues. Another study of people with sexually compulsive or addictive behavior found over 70 percent had anxiety, substance, or mood disorders. An outpatient study showed mood disorders in the 60 percents and anxiety and substance abuse in the 40 percents. ADHD has also been shown to be somewhat common in these people, though it can vary somewhat. Manic behavior often results in hypersexuality. Two studies have shown comorbidity of Axis II disorders in the 40 percents.

Kafka says "the empirical evidence suggests that persons afﬂicted with Hypersexual Disorder are heterogeneous and the clinical course associated with these conditions may have differing presentations and characteristics precedent to adverse consequences and help-seeking behavior".

It does not appear to be part of obsessive compulsive disorder. Kafka says sex addiction merits further study, but finds a lack of evidence for withdrawal or tolerance symptoms. Describing it as an impulsive disorder contradicts the treatment of bulimia, among others. Kafka recommends treating it as a sexual disorder.

History
A number of commentators in history have discussed excessive non-paraphilic sexual urges, including Benjamin Rush, Richard von Krafft-Ebing, Havelock Ellis, and Magnus Hirshfeld. In 1975 and 1969, Stoller and Allen used the term "Don Juanism" and "satyrisis", respectively, to refer to excessive promiscuous sex. In 1975, Ellis & Sagarin used the term "nymphomania" to describe the same condition in women. The prefix "hyper-" denotes excessive pathological behavior, and the term "hypersexuality" has been used since 1965. In the DSM-II, published in 1968, no mention was made of nonparaphilic hypersexuality. In the DSM-III, published in 1980, Psychosexual Disorder Not Otherwise Speciﬁed (302.89) included distress about a pattern of promiscuity. In the 1987 DSM-III-R, the concept of an addition to non-paraphilic sex was included as a Sexual Disorders Not Otherwise Speciﬁed (302.90). Owing to a lack of empirical research to demonstrate sexual behavior as a behavioral addiction, the DSM ceased describing hypersexuality this way in the DSM-IV (1994) and the DSM-IV-TR (2000). These two documents used a similar description as the DSM-II in the Sexual Disorders Not Otherwise Speciﬁed (302.9) category. The 2000 edition of the International Classification of Diseases includes "excessive sexual drive" (F52.7).

A specific diagnosis for hypersexuality was opposed because of a lack of empirical data. Kafka defined hypersexual disorder as that of "normophilic sexual fantasies, arousal, urges, and behaviors" that have led to "clinically signiﬁcant personal distress and volitional and social role impairment". In August 2009, proposed criteria for Hypersexual disorder were released. Some academics have opposed the addition of any non-paraphilic sexual disorder, and there has been little consensus about the proposed disorder's eitiology, as well as little empirical proof.

Epidemiology
There is little data on the epidemiology of hypersexuality. Since 1990, several sources have estimated that hypersexuality occurs in three to six percent of people in the United States. The criteria used to define the condition may have varied between those who made estimates. There has been disagreement about how hypersexuality should be measured, and how to compensate for inaccurate self-reporting. Most people who are studied in studies of hypersexuality are self-reported, casting doubt on the accuracy of estimates of its prevalence.

In 1948, Alfred Kinsey found that seven percent of men under the age of 30 had seven or more orgasms weekly. A 1987 study of high school students found that five percent matched that frequency; in the same study only three percent of college students matched that level. The study only included white males. A 1994 study of American men found that seven percent had sex at least four times a week and only two percent masturbated daily. A 2005 study of psychiatric patients found that four percent exhibited what the authors' termed "sexual compulsion". A 2006 Swedish study that examined the frequency of sexual activity classified twelve percent of men and six percent of women as hypersexual. The men classified as hypersexual in the study engaged in sexual activity a median 17 times a month and the women classified as hypersexual engaged in sexual activity a median of 11 times monthly. Kafka defined hypersexuality as a total sexual output of seven or more orgasms a week for more than six months after the age of 15.

Most people who seek treatment for hypersexuality are male. Men's natural lead in sexual desire may play a role in making them more likely to be hypersexual. Some studies of hypersexuality have included up to 20% women. There is little research or data on hypersexual women.

Diagnosis
There have been tests developed to gauge hypersexuality. The Sexual Addiction Screening Test (SAST) and the Hypersexual Behavior Inventory (HBI) are two assessments that have been developed. The SAST is used for screening sexual addition. It has shown much higher prevalence rates among sex offenders and low-income people than are typically put in that category during epedimiological estimates, possibly indicating that it overestimates the problem. The HBI uses the criteria of the proposed Hypersexual disorder to develop questions. It has generally been only used on clinical populations and has not been the subject of much academic research.

Treatment
A variety of treatments for hypersexuality have been recommended, and many clinicians support a combination of different approaches. The goal of treatment is to allow the patient to control sexual behavior. Cognitive-Behavioral therapy can help control sexual behavior. Relapse prevention, originally developed to combat substance abuse, has also been applied to sexual behavior. It has been effective in helping sex offenders control themselves and thus likely helps others control their sexual behavior. One study also demonstrated that behavior therapy could help control sexual compulsions. Some clinicians also recommend psychodynamic therapy or 12-step programs that focus on sexual behavior. Owing to the effect that hypersexual behavior can have on relationships, couples therapy is often recommended to patients. Childhood trauma may play a role in how patients respond to treatment.

The use of drugs to control sexual behavior has been studied as it relates to paraphilias, and their effects on hypersexual behavior are being studied. Efficacy in the former may justify use for the latter. Triptorelin has been explored for use in treating uncontrolled sexual behavior. In a study of 100 men with paraphilias or uncontrolled sexual behavior, the drug effected a decrease in sexual desire and behavior. In an Iranian study of 76 men with nonparaphilic hypersexuality, it led to a decrease in sexual activity. The drug decreases testosterone levels, and thus poses the risk of side effects such as bone density decrease. One study of citalopram also helped treat sexual compulsions and the use of SSRIs have been recommended in general.

Patients who also suffer from psychiatric conditions such as depression and anxiety should be treated for their co-morbid conditions, as these often lead to hypersexual behavior. It has been argued that focusing on treating hypersexual behavior is problematic because hypersexuality is often a symptom of an underlying condition. Therefore, it is argued that treatment should focus on underlying issues, the resolution of which may cause the cessation of hypersexuality.