Kowalewska Ewelina, Gola Mateusz, Kraus Shane W, Lew-Starowicz Michal
Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland.
Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California, San Diego, CA, USA.
Neuropsychiatr Dis Treat. 2020 Sep 4;16:2025-2043. doi: 10.2147/NDT.S221540. eCollection 2020.
World Health Organization recently included compulsive sexual behavior disorder (CSBD) to the upcoming 11th edition of International Classification of Diseases (6C72). Despite the potential benefits of this decision (eg, the acceleration of research in the field will allow the development of effective treatments), previous research focused mainly on men, and as a result, we do not have an accurate clinical picture of compulsive sexual behavior (CSB) among women. Therefore, in this systematic review, we aim to present available knowledge on this topical subject. Literature search was conducted in the guideline of PRISMA methodology. Studies were identified from multiple databases including Academic Search Ultimate, SocINDEX, PsycARTICLES, PsycINFO, PubMed, and MEDLINE. Out of a total of 10,531 articles identified and screened, 58 were included in this review. Included studies covered the following topics: prevalence and etiology of CSB, behavioral and cognitive processes involved, comorbidities, personality traits, psychosocial and interpersonal difficulties, traumatic experiences, and treatments.
Available studies indicate that CSB symptom severity is lower in women than in men. Overall, women reported consuming pornography less often than men and exhibit lower rates of feeling urges to these materials. CSB symptoms (including problematic pornography use) have been found to be positively related to trait psychopathy, impulsivity, sensation seeking, attention-deficit/hyperactivity disorder symptoms, obsessive-compulsive disorder, pathological buying, sexual dysfunctions, general psychopathology, child sexual abuse, while negatively related to dispositional mindfulness.
Conclusions that can be drawn from prior studies are considerably limited. There are no accurate estimates of the CSB prevalence or severity among women, and studies have been mostly conducted on non-clinical populations, which has limited application for women diagnosed with CSBD.
世界卫生组织最近将强迫性行为障碍(CSBD)纳入即将发布的第11版《国际疾病分类》(6C72)。尽管这一决定可能带来诸多益处(例如,该领域研究的加速将有助于开发有效的治疗方法),但以往的研究主要聚焦于男性,因此,我们对女性强迫性行为(CSB)尚无准确的临床认识。所以,在本系统综述中,我们旨在呈现关于这一热门话题的现有知识。文献检索按照PRISMA方法指南进行。研究从多个数据库中筛选得出,包括《学术搜索大全》《社会科学索引》《心理学文摘》《心理学文摘数据库》《医学期刊数据库》以及《医学在线数据库》。在总共10531篇被识别和筛选的文章中,有58篇被纳入本综述。纳入的研究涵盖以下主题:CSB的患病率和病因、所涉及的行为和认知过程、共病情况、人格特质、心理社会和人际困难、创伤经历以及治疗方法。
现有研究表明,女性CSB症状的严重程度低于男性。总体而言,女性报告观看色情内容的频率低于男性,且对这些内容产生冲动的比例也较低。已发现CSB症状(包括问题性色情内容使用)与特质精神病态、冲动性、感觉寻求、注意力缺陷多动障碍症状、强迫症、病态购物、性功能障碍、一般精神病理学、儿童性虐待呈正相关,而与特质正念呈负相关。
从前瞻性研究中得出的结论相当有限。目前尚无对女性CSB患病率或严重程度的准确估计,并且研究大多在非临床人群中进行,这对于被诊断为CSBD的女性的适用性有限。