Compulsive sexual behavior—The role of sexual offending and paraphilias

Abstract

Background: Compulsive sexual behavior (CSB) is characterized by a persistent pattern of failure to control intensive repetitive sexual impulses or urges resulting in repetitive sexual behavior. A growing body of research shows that CSB is also associated with interpersonal difficulties; however, the relationship to sexual offending and paraphilias remains unclear. Objective: The aim of the present study was to increase the knowledge about the role of sexual offending and paraphilias in men with CSB. Material and methods: A group of men with CSB (n = 47) was compared with a group of healthy controls (n = 38). Using questionnaires the study investigated whether sexual offending and paraphilias were present as sexual fantasies and whether they were acted out in reality. Results: It could be shown that men with CSB experienced a stronger sexual arousal through sexual offending in their masturbation fantasies and that they were acted out more often in the past, e.g. nonconsensual coitus, compared to healthy controls (men with CSB 17% vs. healthy controls 3%). Furthermore, paraphilic interests were more pronounced in men with CSB, compared to healthy controls. Conclusion: These findings underline the importance of working with patients with CSB and have far-reaching implications for therapeutic work, especially with respect to the basic therapeutic attitude towards patients with CSB.