What is a Process Addiction?

A process addiction is a compulsive behavior, such as compulsive gambling, sexual addiction, eating disorders and spending addictions. As defined by faqs.org it is “A condition in which a person is dependent on some type of behavior, such as gambling, shopping, or sexual activity.” This term is often used as a blanket for any behavioral addiction which does not involve an addictive chemical. This is ironic as there are actual chemical processes which occur during the behavior which are very similar to the chemical changes which take place during substance abuse. .. More on that later.

When a habit or hobby becomes an addiction. A process addiction is characterized by:

  • An obsessive need to be involved with the activity, or planning the activity.
  • Neglecting responsibilities in favor of doing the behavior (Showing up late to work due to gambling late the night before).
  • Your behavior is interfering with your relationships, such as infidelity, neglect of children or change in friendships.
  • Legal trouble, such as illegal gambling, prostitution, or breaking laws in order to engage in your behavior of choice.
  • You feel as if you do not  have control over whether or not you participate in the activity.
  • Your life revolves around your behavioral addiction.

Process addictions are an often overlooked addiction. They are often overshadowed by substance addictions. This is unfortunate as the suffering, loss of life and family, and debilitating consequences are no less. Process addictions require psychological treatment to be overcome. Even though process addiction is often coupled with drug addiction each addiction needs to be tackled in order for a full recovery to take place.

The reasons that these addictions are often overlooked lie in a combination of shame, guilt and lack of understanding. It is somewhat easy to comprehend the chemical addiction of a person who abuses substances while the strong psychological compulsions of the process addict are often ignored. It is not as simple as “just stopping” or “willpower”. There are real chemical and biological changes which occur in the brain of someone who has a process addiction.

This addictive process is complex, and has several influencing factors. An individual’s mental state, genetics, social status and past experiences all influence the addict and the timeline of their

Most people enjoy this type of “natural high” in one way or another.

addiction. However it is well known both for substance and process addictions that a person’s reward center in their brain is stimulated causing release of chemicals into the body and brain which drive addictive behaviors. Put simply, this chemical charge feels good. So the addict keeps chasing the “high” whether it be the up and down roller coaster of gambling or the highs and lows of cocaine addiction.

Most people enjoy this type of “natural high” in one way or another. Many people gamble for fun, or push their sports car on the freeway. Often we enjoy very large meals or go on a little spending spree when we get a nice bonus at work. This is how it can begin for the process addict however for unknown reasons some individuals keep doing the same “feel good behavior” over and over. This can have very damaging consequences. Obvious side effects of gambling addiction are debt, bankruptcy job and family disruptions. Compulsive eating can lead to health problems and psychological issues.

Whatever the addiction or compulsion is, treatment is often necessary to completely abstain. Treatment methods vary but the most effective include identification and cessation of the behavior with a strong and long term commitment to keep it stopped. This long term commitment is the stumbling block. It can be difficult and include long term therapies, medications and other techniques.

Treatment models and success vary but the most important step is to have a sincere desire to stop the behavior. Nothing can be completed without the crucial first step.

  • mrm717

    This is absolute nonsense and is not reflected in the DSM-5. I would caution against making such a diagnosis or trying to bill insurers because you may well find yourself sued for malpractice for failure to diagnose and treat the underlying disorders of these compulsions and being jailed for insurance fraud.

    • Savance

      What would you say is the root cause for
      -Sexual addictions (the acts of masturbation, intercourse, fellatio, cunnilingus and etc.)
      -Money-rooted addictions (binge spending, gambling)
      -Other miscellaneous addictions (speeding down the freeway, binge eating)?
      You dispute the claims made in this article but your only defense is that it isn’t in the DSM-5, which, mind you, was fraught with error when originally released.

      • mrm717

        Being a healthcare professional, I don’t make diagnoses by internet. I suggest you read this article from a legitimate, peer-reviewed medical journal on the multiple possible etiologies of hypersexual behavior for an example how symptoms are non-specific and need careful diagnosis to render effective treatment. I’ll take the consensual word of the American Psychiatric Association who publishes the DSM over that of poorly trained social workers and other “therapists” any day.

        The Internet Journal of Urology

        Volume 6

        Number 2

        The Internet Journal of Urology

        Volume 6

        Number 2

        Original Article

        etiology, diagnosis & management of Hypersexuality: a review

        B Chughtai, D Sciullo, S Khan, H Rehman, E Mohan, J Rehman


        B Chughtai, D Sciullo, S Khan, H Rehman, E Mohan, J Rehman. etiology, diagnosis & management of Hypersexuality: a review. The Internet Journal of Urology. 2009 Volume 6 Number 2.


        Objective: This manuscript reviews the etiology, presentation and treatment options of hypersexuality.
        Methods: A MEDLINE search was conducted for English-language articles published over the past 35 years and was supplemented by a search of bibliographies of relevant articles [Compulsive Sexual Behavior, Sexual Addiction, altered sexual preference or Hypersexuality (hetero-, homo-, autosexual)]. Results: Hypersexuality is a change in types and increase in frequency of sexual behaviors. The etiology of hypersexuality is complex and involves a variety of physiological and psychological mechanisms. Frontal lobe dysfunction can lead to disinhibition of sexual behavior and hypersexual behavior. Temporal lobe abnormalities, which have been associated with hypersexuality, also seem to be involved in development of various fetishes, paraphilias, and pedophilia. This sexual behavior may also be the result of other neurologic disorders or a side effect of medications Conclusions: Hypersexuality can be idiopathic or the end result of many underlying disease processes. When the underlying cause may be treated, sexually disinhibited behavior is discontinued. Hypersexuality can cause behaviors in patients that are difficult to manage. But pharmacologic methods can successfully control hypersexual behaviors and paraphilias in most patient population.


        There is no clear definition of hypersexuality; it is characterized by a change in types and increase in frequency of sexual behaviors. For the purpose of this article, hypersexuality is an increased need, even pressure, for sexual gratification. It may be aimed at oneself or at other people. It may include compulsive masturbation in both public and private places but usually involves an insatiable desire for sexual contact with others. It typically involves inappropriate behavior in relation to others, such as a pattern of lewd or suggestive language, fondling, flirtation, disrobing oneself or others, and overt sexual acts. It may start insidiously and escalate to a chronic problem. It usually includes decreased inhibitions. It is estimated that about 8% of men and 3% of women in the US are sexually addicted.[1]


        Clinical Presentation

        There are also a number of specific behaviors which are common to those who struggle with this condition. These behaviors include: compulsive masturbation, compulsive sex with prostitutes, anonymous sex with multiple partners, multiple affairs outside a committed relationship, frequent patronizing of sexually-oriented establishments, habitual exhibitionism, habitual voyeurism, inappropriate sexual touching, sexual abuse of children, and rape. In addition to these, fantasy sex, prostitution, pedophilia, masochism, fetishes, and sex with animals may also be associated behaviors. It is a combination of these behaviors along with the compulsivity that comprises hypersexuality.

        Etiology Of Hypersexuality

        As is the case with many other psychiatric disorders, the etiology of hypersexuality is complex and involves a variety of physiological and psychological mechanisms. Frontal lobe dysfunction can lead to disinhibition of sexual behavior and hypersexual behavior. Temporal lobe abnormalities, which have been associated with hypersexuality, also seem to be involved in development of various fetishes, paraphilias, and pedophilia. Some have theorized that hypersexuality is a result of drive dysregulation in association with a mood disorder—similar to eating disorders.* Others have suggested that anxiety plays an important role and that hypersexuality may be best conceptualized as a variant of obsessive-compulsive disorder in which anxiety triggers the hypersexuality to temporarily relieve symptoms; this is followed by further distress and a self-perpetuating cycle of anxiety and obsessive and compulsive behavior is fueled.* Others have suggested that hypersexuality is best conceptualized as an impulse control disorder such as compulsive gambling, kleptomania, and pyromania.*

        Head traumas, brain surgeries, and medications have been associated with hypersexuality. Onset of hypersexuality has been associated with frontal lobe lesions, frontal and temporal lesions, temporal lobe epilepsy, dementia, Klüver-Bucy syndrome, multiple lesions in multiple sclerosis, and treatment of Parkinson’s disease with dopaminergic agents.

        Klüver Bucy Syndrome

        The Klüver Bucy syndrome (KBS) is defined by psychic blindness, tendency to orally examine available objects, emotional unresponsiveness, an increase in sexual activity, hypermetamorphosis and difficulties with memory. Most cases of KBS have been associated with a trauma or progressive neuropathological syndrome.*


        The behavioral syndromes of KBS observed include aphasia, amnesia, dementia, and seizures. KBS has also been associated with a variety of neurological disorders. These include herpes encephalitis, Pick’s disease, Alzheimer’s disease, cerebral trauma, cerebrovascular accidents, and temporal lobe epilepsy. Other etiologies include Huntington chorea, hypoxia, hypoglycemia, subarachnoid hemorrhage, and some neuroleptic medication. The most common feature of all etiologies is bilateral mesial temporal lobe destruction or dysfunction. There have been documented cases of KBS resulting from such incidents as heat stroke and encephalopathic illness.*

        The symptoms of the Klüver-Bucy Syndrome vary with each individual. In individuals with this syndrome, emotional states may often vary. Some individuals may display blunted affect, apathy, and even pet-like compliance. Others may become demanding and enraged, and at times depressed. Most individuals have visual agnosia which is characterized by the inability to distinguish among friends, relatives and strangers. Auditory agnosia has also been discovered in some cases and occasionally tactile agnosia may be present. Hypermetamorphosis is regarded as consistent exploration of the environment and with subsequent placement of objects into the mouth. Another of the symptoms of KBS is that of altered sexual behavior. Some cases of sexual behavior such as copulation and masturbation has been documented.[2] However, these cases are infrequent and most cases involve sexual overtures, comments, and attempted physical contact. Some cases consist of aphasia, amnesia, and even dementia in the individuals. A combination of at least 3 or more of the symptoms is typically suggestive of the Klüver-Bucy Syndrome. Carbamazepine treatment has been discovered as a useful agent for eliminating some of the symptoms of the syndrome.[3] Carbamazepine is an effective anticonvulsant in temporal and limbic seizure foci. It is considered as a potent inhibitor of amygdaloid firing.[4]

        Klein Levine Syndrome

        Kleine-Levin syndrome is a rare sleep disorder, involving intermittent episodes of increasing drowsiness with a strong association with lack of sexual inhibition. People affected by this syndrome can spend 10 to 20 hours asleep (hypersomnia) in bed.[5] Episodes may last days to weeks and occur several times per year. The start and end of each attack is usually inconsistent and may be either rapid or gradual.


        This syndrome occurs mostly in young males and usually diminishes or disappears after the age of 40.[6] The start of this syndrome is usually spontaneous. The exact cause of Kleine-Levin Syndrome is not yet known.[5] It is thought that symptoms of Kleine-Levin Syndrome may be related to malfunction of the portions of the brain (hypothalamus) that help to regulate functions such as sleep, appetite, and body temperature.[5] It appears to be self limiting with cessation of episodes by early adult life.

        Kleine-Levin syndrome is strongly associated with compulsive overeating, lack of sexual inhibition and personality change. Sexual responses include inappropriate sexual advances and overt masturbation, especially in males. Compulsive overeating with rapid weight gain may occur. Personality changes may include irritability, depersonalization, depression, confusion, occasional hallucinations and impulsive behavior.[7] On recovery, total or partial loss of memory (amnesia) for what has happened is usual, although disgust at overeating is common. There may be a short period of depression, or sometimes euphoria and sleeplessness. Between episodes, physical and mental health is usually normal. There appears to be no relationship between Kleine-Levin syndrome and other neurological disorders, such as epilepsy.[8] Amphetamines, which stimulate the central nervous system, have been used to reduce the frequency and severity of attacks.[9]


        Hypersexuality as a result of Alzheimer’s disease, Pick’s disease, or AIDS dementia may be neurological in origin that affects the part of the brain that controls inhibition of impulses and feelings of satiation.[10] The person with dementia may derive little satisfaction from the sexual act and be driven by a compulsive need to initiate sex again and again. Alternatively, the person may simply forget that sex had taken place and initiate a sexual advance soon after having had intercourse. Any cause of dementia that leads to damage to the temporal lobes, or other areas of the brain associated with pleasure, may lead to signs and symptoms of overt hypersexuality.[10, 11]


        Mania, which plays a role in bipolar disease, mania/hypomania, and cyclothymia, is a mood disorder in which feelings; thoughts, behaviors, and perceptions are altered. The hallmark symptoms of mania include an abnormal, often expansive and elevated mood lasting for at least 1 week. Mania also may include a decreased need for sleep, racing thoughts or a sense that thoughts are “out of control,” rapid and often pressured speech, increased goal-directed activities or projects, hypersexuality, reckless behaviors and risk taking, and “delusions of grandeur.[12] Mania results from neurochemical imbalances within the brain.

        One proposal suggests that several neurotransmitters acting in unison but with dynamic balance act as modulators of mood states. In particular, serotonin, dopamine, and norepinephrine appear to modify mood, cognition, and sense of pleasure or displeasure leading to sexually disinhibited behavior.

        Parkinson’s disease

        Hypersexuality associated with Medical Management

        Parkinson disease (PD), which affects the dopamine regulation in the basal ganglia, may be accompanied by a variety of psychiatric symptoms. It is important to distinguish these from psychiatric syndromes that are associated with the treatment of PD. Parkinsonian patients may experience hypersexuality as a consequence of anti-parkinsonian therapy.[13] There was no relation between functional improvement and increased sexuality. Most patients showed some element of dose dependency between antiparkinsonian drugs and the hypersexual behavior.[14] In addition cases have been reported that patients developed penile mutilation in response to levodopa-carbidopa treatment of Parkinsonism. Approximately half of Parkinson’s patients respond to levodopa with an activation of sexual behavior.[14] Neither the prior history of psychiatric illness nor brain damage predisposed to such response on treatment, and in most patients, it was not a part of hypomania or a more diffuse psychiatric disturbance. It is proposed that hypersexuality on antiparkinsonian drugs is consequent to inhibition of prolactin secretion, which leaves dopamine unopposed.[15]

        Hypersexuality associated with Surgical Management

        Surgical management of Parkinsonian patients may lead to symptoms of hypersexuality due to dopamine regulation dysfunction.[16] Case reports of patients with right pallidotomy developed a psychiatric syndrome, including prominent hypersexuality, after surgical implantation of a deep brain stimulator electrode in the left globus pallidus. This demonstrates that patients may be at risk for the development of psychiatric sequelae after pallidal surgery.

        Among Parkinson’s disease patients who received high frequency stimulation of the subthalamic nucleus, 16% developed remarkable disorders of mood or sexual behavior after the implant.[17]

        Traumatic Brain Injury

        Head injury comprises traumatic damage to the skull and its contents, from penetration or acceleration/deceleration forces. Clinically, it implies evidence of raised intracranial pressure, loss of consciousness, post-traumatic amnesia, neurological signs of impaired brain function, and/or skull fracture.

        Sexually-inappropriate behavior (purposeful use of lewd language, frotteurism, exhibitionism, sadism and rape) occurring for the first time following the head-injury, was consistently associated with evidence of frontal lobe damage. In other patients with frontal lobe syndrome (constricted emotional expression, reduced inhibition, impaired foresight, personality change, usually intellectual impairment), there was total loss of libido as part of global amotivation.[18]

        Hypersexual behavior is much less common than hyposexuality following brain injury.[18] There is a correlation with the development of hypersexual states with the site of a brain lesion in patients with nontraumatic brain injury. Patients with basal frontal lesions or injury to the thalamic and periventricular regions of the right hemisphere are accompanied by a sexual preoccupation in the context of a manic syndrome.[19]

        Damage to the temporal lobe causes interictal hyposexuality punctuated by hypersexual arousal after seizures. Similar hypersexuality has been documented following temporal lobectomy for epilepsy. Klüver-Bucy Syndrome, has been described after a gunshot wound to the temporal lobe. Temporal lobe structures also appear to mediate sexual preference. The Klüver-Bucy Syndrome in humans, both atraumatic and following head injury, is usually associated with aphasia, amnesia, dementia and sometimes seizures. It has involved changes in sexual preference more commonly than hypersexuality. For example, a case of safety-pin fetish was reported to be associated with temporal lobe epilepsy. Both the fetish and the epileptic seizures disappeared when the epileptic focus was successfully removed surgically.

        Male patients with lesions in or near the limbic system seem to develop pedophilia and uncharacteristic voyeurism, and in heterosexual woman develop homosexual orientation.[20] Limbic encephalitis, characteristic of rabies, is associated with acute sexual disinhibition; a similar picture was seen chronically in a young woman who suffered young childhood encephalitis.[21]

        Kennedy-Alter-Sung Syndrome

        Kennedy-Alter-Sung Syndrome (KAS) is an x-linked recessive disease, which is characterized by an unstable nucleotide repeat expansion. The disease causes progressive neuromuscular degeneration of lower motor neurons resulting in proximal muscle weakness, muscle atrophy, and fasciculations. KAS occurs only in males. Patients often show gynecomastia, testicular atrophy, and reduced fertility due to androgen insensitivity. There have been case reports of the disease presenting with hypersexuality demonstrating the clinical varieties of KAS.[22]

        Multiple Sclerosis

        Changes in sexual function are commonly associated with Multiple Sclerosis (MS) and occur in many forms. Hypersexual thoughts or behavior are rare, but can present on the background of persistent cognitive impairment or psychiatric conditions such as mania, whereas isolated hypersexuality is still rarer. The clinical, neuropsychological, electrodiagnostic, neuroimaging and endocrine findings in an MS patient with episodes of greatly increased libido are described. Imaging and neuropsychological studies indicated frontal lobe dysfunction; hormone studies showed no significant changes. Episodic hypersexuality can be a recurrent transient manifestation of MS. [23]


        Hypersexuality is the end result of many underlying disease processes, each of which requires slightly different therapy. When the underlying cause may be treated, as is the case with mania, sexually disinhibited behavior discontinues. Patients with dementia may become sexually disinhibited as cognitive deficits progress. This behavior may also be the result of other neurologic disorders or a side effect of medications used to treat Parkinson’s disease. Both hypersexuality and paraphilias can cause behaviors in patients that are difficult to manage. In the event that nonpharmacologic treatments are unsuccessful, many pharmacologic agents may be used to treat hypersexuality. [24]

        Several medications have been studied in the pharmacologic treatment of sexually disinhibited behavior. These medications include antiandrogens, estrogens, gonadotropin-releasing hormone (GnRH) analogs and serotonergic agents. Antiandrogens are thought to reduce testosterone levels, which then impairs sexual functioning and eliminates hypersexual behavior. Medroxyprogesterone acetate and cyproterone acetate are the most commonly used antiandrogenic agents.[25] Both of these medications can cause fatigue, weight gain and depression. In one study, patients were given medroxyprogesterone acetate in a dosage of 300 mg per week intramuscularly for one year. Undesirable behaviors were eliminated within two weeks of initiation of treatment, and at one-year follow-up, the effect continued in 75 percent of patients who received the treatment.[25] Another study used medroxyprogesterone acetate in a dosage of 100 mg intramuscularly every other week and increased the dosage to 150 mg intramuscularly every other week, at which point all inappropriate behaviors were suppressed.[26]

        Estrogen has not been used often in the treatment of hypersexual behaviors. One study reported a significant reduction in these behaviors in men who received estrogen either orally or in transdermal patches.[27] In another study, a 94-year-old man with dementia was treated with diethylstilbestrol (starting with a dosage of 1 mg per day); within the first week, his inappropriate sexual behaviors were successfully controlled.[21]

        GnRH analogs stimulate the secretion of follicle-stimulating hormone and luteinizing hormone, thereby increasing estrogen and androgen concentration and decreasing testosterone production. To maintain effectiveness, these medications must be used continuously and may cause hot flashes, decreased libido and erectile dysfunction. Leuprolide acetate has been reported to be successful in treating patients with hypersexual behavior or paraphilias.

        Because hypersexual behaviors are thought by some to be related to obsessive-compulsive disorder, selective serotonin reuptake inhibitors (SSRIs) have been proposed as effective treatment agents. Others think that the antilibidinal effects of SSRIs explain their effectiveness. Reports demonstrate patients successfully treated with 20 mg per day of paroxetine. Other patients have had good results from treatment with clomipramine, which is a tricyclic antidepressant with some SSRI properties, titrated to a dosage of 150 to 175 mg per day. SSRIs have adverse effects that include nausea and vomiting, headache, fatigue and insomnia. Clomipramine is associated with both anticholinergic effects and orthostatic hypotension, and should therefore be used with caution in elderly patients.


        Hypersexuality can be multifactorial and while controlled trials have not been done, various pharmacologic methods have been reported to successfully control hypersexual behaviors and paraphilias in most patient population.

        1. Barth, R.J. and B.N. Kinder, The mislabeling of sexual impulsivity. J Sex Marital Ther, 1987. 13(1): p. 15-23.
        2. Hayman, L.A., et al., Kluver-Bucy syndrome after bilateral selective damage of amygdala and its cortical connections. J Neuropsychiatry Clin Neurosci, 1998. 10(3): p. 354-8.
        3. Goscinski, I., et al., The Kluver-Bucy syndrome. Acta Neurochir (Wien), 1997. 139(4): p. 303-6.
        4. Varon, D., et al., Transient Kluver-Bucy syndrome following complex partial status epilepticus. Epilepsy Behav, 2003. 4(3): p. 348-51.
        5. Kesler, A., et al., Kleine Levin syndrome (KLS) in young females. Sleep, 2000. 23(4): p. 563-7.
        6. Wurthmann, C. and E. Klieser, [Kleine-Levin syndrome]. Fortschr Neurol Psychiatr, 1991. 59(5): p. 190-4.
        7. Da Silveira Neto, O. and O.A. Da Silveira, [Kleine-Levin syndrome. Report of a case]. Arq Neuropsiquiatr, 1991. 49(3): p. 330-2.
        8. Hansen, D. and L. Lonborg-Moller, [Kleine-Levin syndrome]. Ugeskr Laeger, 1992. 154(43): p. 2975-8.
        9. Masi, G., L. Favilla, and S. Millepiedi, The Kleine-Levin syndrome as a neuropsychiatric disorder: a case report. Psychiatry, 2000. 63(1): p. 93-100.
        10. Robinson, K.M., Understanding hypersexuality: a behavioral disorder of dementia. Home Healthc Nurse, 2003. 21(1): p. 43-7.
        11. Tang-Wai, D., et al., Familial frontotemporal dementia associated with a novel presenilin-1 mutation. Dement Geriatr Cogn Disord, 2002. 14(1): p. 13-21.
        12. Geller, B., et al., DSM-IV mania symptoms in a prepubertal and early adolescent bipolar disorder phenotype compared to attention-deficit hyperactive and normal controls. J Child Adolesc Psychopharmacol, 2002. 12(1): p. 11-25.
        13. Trosch, R.M., et al., Clozapine use in Parkinson’s disease: a retrospective analysis of a large multicentered clinical experience. Mov Disord, 1998. 13(3): p. 377-82.
        14. Berger, C., et al., [Sexual delinquency and Parkinson’s disease]. Nervenarzt, 2003. 74(4): p. 370-5.
        15. van Deelen, R.A., et al., [Hypersexuality during use of levodopa]. Ned Tijdschr Geneeskd, 2002. 146(44): p. 2095-8.
        16. Roane, D.M., et al., Hypersexuality after pallidal surgery in Parkinson disease. Neuropsychiatry Neuropsychol Behav Neurol, 2002. 15(4): p. 247-51.
        17. Romito, L.M., et al., Transient mania with hypersexuality after surgery for high frequency stimulation of the subthalamic nucleus in Parkinson’s disease. Mov Disord, 2002. 17(6): p. 1371-4.
        18. Braun, C.M., et al., Opposed left and right brain hemisphere contributions to sexual drive: a multiple lesion case analysis. Behav Neurol, 2003. 14(1-2): p. 55-61.
        19. Miller, B.L., et al., Hypersexuality or altered sexual preference following brain injury. J Neurol Neurosurg Psychiatry, 1986. 49(8): p. 867-73.
        20. Absher, J.R., et al., Hypersexuality and hemiballism due to subthalamic infarction. Neuropsychiatry Neuropsychol Behav Neurol, 2000. 13(3): p. 220-9.
        21. Zencius, A., et al., Managing hypersexual disorders in brain-injured clients. Brain Inj, 1990. 4(2): p. 175-81.
        22. Hokezu, Y., et al., [A case of Kennedy-Alter-Sung (KAS) syndrome presenting as hypersexuality and elevated serum CK: usefulness of genetic analysis]. Rinsho Shinkeigaku, 1996. 36(3): p. 471-4.
        23. Gondim Fde, A. and F.P. Thomas, Episodic hyperlibidinism in multiple sclerosis. Mult Scler, 2001. 7(1): p. 67-70.
        24. Levitsky, A.M. and N.J. Owens, Pharmacologic treatment of hypersexuality and paraphilias in nursing home residents. J Am Geriatr Soc, 1999. 47(2): p. 231-4.
        25. Volpe, F.M. and A. Tavares, Cyproterone for hypersexuality in a psychotic patient with Wilson’s disease. Aust N Z J Psychiatry, 2000. 34(5): p. 878-9.
        26. Britton, K.R., Medroxyprogesterone in the treatment of aggressive hypersexual behavior in traumatic brain injury. Brain Inj, 1998. 12(8): p. 703-7.
        27. Namer, M., Clinical applications of antiandrogens. J Steroid Biochem, 1988. 31(4B): p. 719-29. {full_citation}

        • Savance

          Your extensive information is appreciated but your snide comments are not.

          • mrm717

            You, and the followers of Patrick Carnes, set themselves up for snide comments. My comments have done a lot less damage than those uninformed, money-grabbers have done.

          • Savance

            Congrats, oh mighty keyboard warrior. You have “told” a stranger over the internet that rubbed you the wrong way (I apologize that your ego is so frail).
            Now, if you’re a healthcare professional as you say, you should get lost. Also, don’t bother replying, I won’t read it.

          • mrm717

            You may not read it, but perhaps others will. Stay away from pop psychologists who get their theory base from the self-help section of their local bookstore. That’s the section on “recovered memory therapy,” “codependency,” and the schlock Carnes and his followers in the “sexual addiction” cult have their “literature.” Find a competently trained therapist with a medical background if you find yourself in the unfortunate position of needing mental health care..

          • EllenHar

            I think you are proving that you are not a healthcare professional. Do you know how to use the DSM V? Do you work with addictions or have one? Your responses prove my point. What is your real agenda?

          • Brenda Sanders

            I think every one has an addiction of some sort of another, and I do believe that pron, over eating, video gaming, over internet use, gambling, over exercising, and so on are addictions process (behavioral addictions). I am in school right now doing this for my class and I came across this. These are very real problems that come with very real issues. Just because something is not written in a book, a book that we use to diagnose people, which at times I have to wonder about that because what is something is not in there yet? The mind will never be understood it is to completed no matter how hard we try, or how many things that are in or not in a book. That book is a good book and a good guide, but what if there is more that is missing? This is why they keep revising it. Things change every day, and we learn every day. I think we should all look at it as an open door because you just can’t close a door on the mind and say that it is not right because it is not in a book.

          • Cheryl Gerson

            Thanks for your open-minded wisdom, Brenda. I’ve been in psychotherapy practice for over 25 years, and I know that there IS such a thing as “process” or “behavioral” addiction. The difficulty with this particular type of addiction is that (as our learned commentators have pointed out) we have to learn to LIVE WITH the thing we’re addicted to — we can’t just “put it down.” So a person with a process addiction has to become even better acquainted with the addictive cycle, and the addictive impulses, than someone who can “just” (in quotes, because there’s a LOT of pain in that “just”) put down the drink or the pill…
            Of course we can’t use it as a diagnosis! there isn’t a medication for it. Once again, the DSM has been created without a mental health professional involved. (sour grapes, perhaps!)

          • EllenHar

            Savanna, this guy is not a “healthcare professional”. Ignore him.

      • mrm717

        Anyone who would treat bipolar disorder, GAD, narcissistic personality disorder and Parkinson’s Disease as the same disease would be guilty of malpractice.

        Functional Abnormalities Underlying Pathological Gambling in Parkinson Disease FREE

        Roberto Cilia, MD; Chiara Siri, PsyD; Giorgio Marotta, MD; Ioannis U. Isaias, MD; Danilo De Gaspari, PsyD; Margherita Canesi, MD; Gianni Pezzoli, MD; Angelo Antonini, MD

        [+-] Author Affiliations

        Author Affiliations: Parkinson Institute, Istituti Clinici di Perfezionamento, Milan (Drs Cilia, Siri, Isaias, Canesi, Pezzoli, Antonini, and De Gaspari); Department of Neurology, University of Milan-Bicocca, San Gerardo Hospital, Monza (Drs Cilia and Isaias); and Nuclear Medicine, IRCCS-Ospedale Maggiore, Milan (Dr Marotta), Italy.

        Arch Neurol. 2008;65(12):1604-1611. doi:10.1001/archneur.65.12.1604.

        Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

        Nancy M Petry

        Nancy M Petry

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        Frederick S Stinson

        Frederick S Stinson

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        Bridget F Grant

        Bridget F Grant

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        Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA. The Journal of Clinical Psychiatry (Impact Factor: 5.14). 06/2005; 66(5):564-74. DOI: 10.4088/JCP.v66n0504

        Source: PubMed

        ABSTRACT To present nationally representative data on lifetime prevalence and comorbidity of pathological gambling with other psychiatric disorders and to evaluate sex differences in the strength of the comorbid associations.
        Data were derived from a large national sample of the United States. Some 43,093 household and group quarters residents age 18 years and older participated in the 2001-2002 survey. Prevalence and associations of lifetime pathological gambling and other lifetime psychiatric disorders are presented. The diagnostic interview was the National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. Fifteen symptom items operationalized the 10 pathological gambling criteria.
        The lifetime prevalence rate of pathological gambling was 0.42%. Almost three quarters (73.2%) of pathological gamblers had an alcohol use disorder, 38.1% had a drug use disorder, 60.4% had nicotine dependence, 49.6% had a mood disorder, 41.3% had an anxiety disorder, and 60.8% had a personality disorder. A large majority of the associations between pathological gambling and substance use, mood, anxiety, and personality disorders were overwhelmingly positive and significant (p .05).
        Pathological gambling is highly comorbid with substance use, mood, anxiety, and personality disorders, suggesting that treatment for one condition should involve assessment and possible concomitant treatment for comorbid conditions.

      • mrm717

        Calling speeding down the highway an addiction is as inane as many of the list of “process disorders (e.g. praying, rescue inhalers , “laziness,” or antidepressants to name a few) given here. If we’re not careful Prozac and other antidepressants and Proair HFA are sure to overtake meth and prescription opiates in the illegal drug trade. LMDAO.

        • EllenHar

          Speeding down the highway can be a red flag – it can
          indicate fewer dopamine-inhibiting receptors in the brain which can trigger high risk behaviors. The Journal of
          Neuroscience is discussing studies of the lack of the same dopamine-inhibiting receptors in the brain of addicts. As a “healthcare professional” I’m sure you’re aware of the explosion of study and new information regarding the brain and addictions of all kinds. This article is stating much of what has already been observed in the addicted brain.

          • mrm717

            I’m sure you’re aware the American Psychiatric Association rejected all behavioral addictions except for gambling in the most recent version of the DSM. I question that inclusion since many gambling “addicts” have underlying psychiatric diagnosis. I am sure that you being the great scientist that you aren’t that the dopaminergic process you describe are also present id those without addictive or compulsive behavior. Perhaps you need a review of the various types of validity- construct, convergent and discriminate that you seem to have never learned, nor ever used since you have a very naïve grasp of research.

          • mrm717

            Whose neuroscience, the quacks who use fMRIS? You obviously are a social worker, counselor or psychologist who has zero training in medicine.