Archives of Sexual Behavior

, Volume 46, Issue 8, pp 2253–2256 | Cite as

Separating Models Obscures the Scientific Underpinnings of Sex Addiction as a Disorder

  • Stefanie CarnesEmail author
  • Todd Love

A foundational concern we have about the Target Article by Walton, Cantor, Bhullar, and Lykins (2017) involves its structure. For example, the manner in which Walton et al. explore various theoretical approaches by dividing them into subtopics is problematic. Of greatest concern is the separation of research on sex addiction from research that utilizes other terms that describe the same basic phenomenon, and from the coverage of neurobiology as it relates to this issue.

Starting with the latter concern, Walton et al. present a largely phenomenological description of sex addiction, and the primary reference to neurobiology in this section is the problematic statement, “The conceptualization of sexual behavior as an addiction has long been criticized, as research has failed to substantiate physiological conditions of tolerance and withdrawal.” We suggest a more accurate wording would be, “The conceptualization of sexual behavior as an addiction has been inaccurately criticized, as some...


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.CrossRefGoogle Scholar
  2. American Society of Addiction Medicine. (2011). Public policy statement: Definition of addiction. Retrieved July 28, 2017 from
  3. Banca, P., Morris, L. S., Mitchell, S., Harrison, N. A., Potenza, M. N., & Voon, V. (2016). Novelty, conditioning and attentional bias to sexual rewards. Journal of Psychiatric Research, 72, 91–101. doi: 10.1016/j.psychires.2015.10.017.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Banz, B. C., Yip, S. W., Yau, Y. H., & Potenza, M. N. (2016). Behavioral addictions in addiction medicine: From mechanisms to practical considerations. Progress in Brain Research, 223, 311–328. doi: 10.1016/bs.pbr.2015.08.003.CrossRefPubMedGoogle Scholar
  5. Brand, M., Young, K. S., Laier, C., Wölfling, K., & Potenza, M. N. (2016). Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model. Neuroscience and Biobehavioral Reviews, 71, 252–266. doi: 10.1016/j.neubiorev.2016.08.033.CrossRefPubMedGoogle Scholar
  6. Carnes, P. (1983). The sexual addiction. Minneapolis, MN: CompCare Publications.Google Scholar
  7. Doidge, N. (2007). The brain that changes itself: Stories of personal triumph from the frontiers of brain science. New York, NY: Penguin Books.Google Scholar
  8. Gola, M., Wordecha, M., Sescousse, G., Lew-Starowicz, M., Kossowski, B., Wypych, M., & Marchewka, A. (2017). Can pornography be addictive? An fMRI study of men seeking treatment for problematic pornography use. Neuropsychopharmacology, 1, 11. doi: 10.1038/npp.2017.78.Google Scholar
  9. Goldstein, R. Z., & Volkow, N. D. (2011). Dysfunction of the prefrontal cortex in addiction: Neuroimaging findings and clinical implications. Nature Reviews Neuroscience, 12, 652–669. doi: 10.1038/nrn3119.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Hilton, D. L. (2014). ‘High desire’ or ‘merely’ an addiction? A response to Steele et al. Socioaffective Neuroscience & Psychology, 4, 23833. doi: 10.3402/snp.v4.23833.CrossRefGoogle Scholar
  11. Hilton, D., Carnes, S., & Love, T. (2016). The neurobiology of behavioral addictions: Sexual addiction. In A. Swann, G. Moeller, & M. Lijffijt (Eds.), Neurobiology of addictions (pp. 176–190). New York, NY: Oxford University Press.Google Scholar
  12. Koob, G. F., & Volkow, N. D. (2010). Neurocircuitry of addiction. Neuropsychopharmacology, 35, 217–238. doi: 10.1038/npp.2009.110.CrossRefPubMedGoogle Scholar
  13. Kraus, S. W., Voon, V., & Potenza, M. N. (2016). Neurobiology of compulsive sexual behavior: Emerging science. Neuropsychopharmacology, 41, 385–386. doi: 10.1038/npp.2015.300.CrossRefPubMedGoogle Scholar
  14. Kühn, S., & Gallinat, J. (2016). Neurobiological basis of hypersexuality. International Review of Neurobiology, 129, 67–83. doi: 10.1016/bs.irn.2016.04.002.CrossRefPubMedGoogle Scholar
  15. Love, T., Laier, C., Brand, M., Hatch, L., & Hajela, R. (2015). Neuroscience of internet pornography addiction: A review and update. Behavioral sciences, 5, 388–433. doi: 10.3390/bs5030388.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Messina, B., Fuentes, D., Tavares, H., Abdo, C. H., & Scanavino, M. D. T. (2017). Executive functioning of sexually compulsive and non-sexually compulsive men before and after watching an erotic video. Journal of Sexual Medicine, 14, 347–354. doi: 10.1016/j.jsxm.2016.12.235.CrossRefPubMedGoogle Scholar
  17. Negash, S., Sheppard, N. V. N., Lambert, N. M., & Fincham, F. D. (2016). Trading later rewards for current pleasure: Pornography consumption and delay discounting. Journal of Sex Research, 53, 689–700. doi: 10.1038/nn1578.CrossRefPubMedGoogle Scholar
  18. Nestler, E. J. (2005). Is there a common molecular pathway for addiction? Nature Neuroscience, 8, 1445–1449. doi: 10.1038/nn1578.CrossRefPubMedGoogle Scholar
  19. Olsen, C. M. (2011). Natural rewards, neuroplasticity, and non-drug addictions. Neuropharmacology, 61, 1109–1122. doi: 10.1016/j.neuropharm.2011.03.010.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Robinson, T. E., & Berridge, K. C. (2008). The incentive sensitization theory of addiction: Some current issues. Philosophical Transactions of the Royal Society of London B: Biological Sciences, 363, 3137–3146. doi: 10.1098/rstb.2008.0093.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Stark, R., & Klucken, T. (2017). Neuroscientific approaches to (online) pornography addiction. In C. Montag & M. Reuter (Eds.), Internet addiction (pp. 109–124). Cham, Switzerland: Springer International Publishing.CrossRefGoogle Scholar
  22. Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374, 363–371. doi: 10.1056/NEJMra1511480.CrossRefPubMedGoogle Scholar
  23. Volkow, N. D., Wang, G. J., Fowler, J. S., & Telang, F. (2008). Overlapping neuronal circuits in addiction and obesity: Evidence of systems pathology. Philosophical Transactions of the Royal Society of London B: Biological Sciences, 363, 3191–3200. doi: 10.1098/rstb.2008.0107.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Volkow, N. D., Wang, G. J., Fowler, J. S., Tomasi, D., & Telang, F. (2011). Addiction: Beyond dopamine reward circuitry. Proceedings of the National Academy of Sciences, 108, 15037–15042. doi: 10.1073/pnas.1010654108.CrossRefGoogle Scholar
  25. Volkow, N. D., Wang, G. J., Fowler, J. S., Tomasi, D., Telang, F., & Baler, R. (2010). Addiction: Decreased reward sensitivity and increased expectation sensitivity conspire to overwhelm the brain’s control circuit. BioEssays, 32, 748–755. doi: 10.1002/bies.201000042.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Volkow, N. D., & Wise, R. A. (2005). How can drug addiction help us understand obesity? Nature Neuroscience, 8, 555–560. doi: 10.1038/nn1452.CrossRefPubMedGoogle Scholar
  27. Walton, M. T., Cantor, J. M., Bhullar, N., & Lykins, A. D. (2017). Hypersexuality: A critical review and introduction to the “Sexhavior Cycle”. Archives of Sexual Behavior. doi: 10.1007/s10508-017-0991-8.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.American Foundation for Addiction ResearchCarefreeUSA
  2. 2.Society for the Advancement of Sexual HealthArdmoreUSA

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