Psychological Science and Sexual Medicine Perspectives Regarding Sexual Addiction
The Research for Betrayed Men (RBM) project centers on psychological science and sexual medicine studies that are grounded in biological, empirical, and evidence-based methods and approaches. Data presented in such studies tends to align with experiences that bonded, committed, conscientious betrayed men (fathers) speak about. Regarding sexual infidelity, the RBM project does not pick and choose which psychological science and sexual medicine data it aligns with.
The experiences betrayed men speak about tend not to align with assertions found in popular and clinical sexual addiction literature. More broadly, betrayed men, counselors, and coaches we have spoken with tend to be unaware of the expansive psychological science and sexual medicine research regarding infidelity. More to the point, many tend to be unaware of significant differences in approach and methodology between psychological science and sexual medicine studies on the one hand, and sexual addiction literature on the other.
Clear definitions are essential to research projects. Sexual addiction literature tends to define sexual infidelity loosely, apparently including solo masturbation. The RBM project defines sexual infidelity as sexual contact with another person.
Popular and clinical literature regarding sexual addiction tends to convey sexual infidelity as mainly engaged in by men. Clinical literature, for example, oftentimes alleges that 10-15 percent of women engage in sexual infidelity (Allen et al., 2005). However, research has shown that women sexually betray their spouses at the same rates as men (Brand, 2007; Johnson, 2005; Wróblewska-Skrzek, 2021). Furthermore, 30-55 percent of women in long-term, committed relationships (not necessarily marriage) engage in sexual contact with another person during their lifetime (Apostolou & Panayiotou, 2019; Bell et al., 1975; Boekhout et al., 1999). Culture, religiosity, and particularly, social desirability responding, account for such a broad range (30-55 percent) of data (Fincham & May, 2017; Maykovich, 1976; Thompson, 1983). This essay presents a survey of psychological science and sexual medicine studies regarding sexual addiction, delineated by themes.
Definitions, Diagnosis, and Prognosis
Studies have called attention to vague definitions and diagnostic criteria (Briken et al., 2024; Gold & Heffner, 1998; Hurlbert et al., 1994). Researchers have noted that behaviors associated with addiction may indicate complex psychopathology (Fuss et al., 2024). Controversy regarding implications that sexual addiction can be cured have been highlighted (Andersson et al., 2024).
Validity, Excuses, and Decisions
Researchers have observed that data does not support contentions that sex is addictive (Prause et al., 2017). Studies have shown that sexual addiction, out-of-control sexual behaviors, and sexual infidelity are often conflated, but they should not be (Briken et al., 2024; Griffin et al., 2021; Grubbs et al., 2020). Researchers have argued that the complex decisions required for sexual affairs do not align with widely recognized addiction patterns (Johnson, 2017).
Compulsive Sexual Behavior Disorder (CSBD)
The inclusion of CSBD in the ICD-11 has sparked controversy (Bőthe et al., 2023). Researchers have differentiated CSBD from sexual addiction (Briken et al., 2024). Researchers have also shown that CSBD afflicts men and women equally (Grant et al., 2025).
Classification, Assessment, and Treatment
The ICD-11 classified CSBD as an impulsive disorder (Sassover & Weinstein, 2022). Sexual impulsivity is associated with complex psychopathology (Fuss et al., 2024; Grubbs, et al., 2020; Kowalewska et al., 2018). Researchers have also argued that CSBD must be assessed and treated exclusively by sexual medicine experts (Briken et al., 2024).
Works Consulted
Allen, E. S., Atkins, D. C., Baucom, D. H., Snyder, D. K., Gordon, K. C., & Glass, S. P. (2005). Intrapersonal, interpersonal, and contextual factors in engaging in and responding to extramarital involvement. Clinical Psychology: Science and Practice, 12, 101–130.
Andersson, C., Carlström, C., Amroussia, N., & Lindroth, M. (2024). Using Twelve-Step Treatment for Sex Addiction and Compulsive Sexual Behaviour (Disorder): A Systematic Review of the Literature. Sexual Health & Compulsivity, 31(2), 170–188.
Apostolou, M., & Panayiotou, R. (2019). The reasons that prevent people from cheating on their partners: An evolutionary account of the propensity not to cheat. Personality and Individual Differences, 146, 34–40.
Bell, R. R., Turner, S., & Rosen, L. (1975). A multivariate analysis of female extramarital coitus. Journal of Marriage and the Family, 37, 375-384.
Boekhout, B., Hendrick, S., & Hendrick, C. (1999). Relationship infidelity: A loss perspective. Journal of Personal & Interpersonal Loss, 4(2), 97-124.
Bőthe, B., Koós, M., Nagy, L., Kraus, S. W., Demetrovics, Z., Potenza, M. N., Michaud, A., Ballester-Arnal, R., Batthyány, D., Bergeron, S., Billieux, J., Briken, P., Burkauskas, J., Cárdenas-López, G., Carvalho, J., Castro-Calvo, J., Chen, L., Ciocca, G., Corazza, O., Csako, R., Fernandez, D. P., Fernandez, E. F., Fournier, L., Fujiwara, H., Fuss, J., Gabrhelík, R., Gewirtz-Meydan, A., Gjoneska, B., Gola, M., Grubbs, J. B., Hashim, H. T., Islam, M. S., Ismail, M., Jiménez-Martínez, M. C., Jurin, T., Kalina, O., Klein, V., Költő, A., Lee, C., Lee, S., Lewczuk, K., Lin, C., Liverpool John Moores University's research team, Lochner, C., López-Alvarado, S., Lukavská, K., Mayta-Tristán, P., Milea, I., Miller, D. J., Orosová, O., Orosz, G., Sungkyunkwan University's research team, Ponce, F. P., Quintana, G. R., Quintero Garzola, G. C., Ramos-Diaz, J., Rigaud, K., Rousseau, A., De Tubino Scanavino, M., Schulmeyer, M. K., Sharan, P., Shibata, M., Shoib, S., Sigre Leirós, V. L., Sniewski, L., Spasovski, O., Steibliene, V., Stein, D. J., Strizek, J., Štulhofer, A., Ünsal, B. C., & Vaillancourt-Morel, M. (2023). Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools. Journal of Behavioral Addictions, 12(2), 393-407.
Brand, R., Markey, C., Mills, A., & Hodges, S. (2007). Sex differences in self-reported infidelity and its correlates. Sex Roles, 57(1–2), 101–109.
Briken, P., Bőthe, B., Carvalho, J., Coleman, E., Giraldi, A. Kraus, S. W., Lew-Starowicz, M., Pfaus, J. G. (2024). Assessment and treatment of compulsive sexual behavior disorder: A sexual medicine perspective. Sexual Medicine Reviews, 12(3) 355–370.
Fincham, F., & May, R. (2017). Infidelity in romantic relationships. Current Opinion in Psychology, 13, 70-74.
Fuss, J., Keeley, J. W., Stein, D. J., Rebello, T. J., García, J. Á., Briken, P., Robles, R., Matsumoto, C., Abé, C., Billieux, J., Grant, J. E., Kraus, S. W., Lochner, C., Potenza, M. N., & Reed, G. M. (2024). Mental health professionals’ use of the ICD-11 classification of impulse control disorders and behavioral addictions: An international field study. Journal of Behavioral Addictions, 13(1), 276–292.
Gold, S. N., & Heffner, C. L. (1998). Sexual addiction: Many conceptions, minimal data. Clinical Psychology Review, 18(3), 367–381.
Grant, J. E., Boutouis, S., Collins, M., & Chamberlain S. R. (2025). Compulsive sexual behavior disorder: rates and clinical correlates in a community sample. Frontiers in Psychiatry 16, 1561885.
Griffin, K. R., Way, B. M., & Kraus, S. W. (2021). Controversies and clinical recommendations for the treatment of compulsive sexual behavior disorder. Current Addiction Reports, 8(4), 546–555.
Grubbs, J. B., Hoagland, K. C., Lee, B. N., Grant, J. T., Davison, P., Reid, R. C., & Kraus, S. W. (2020). Sexual addiction 25 years on: A systematic and methodological review of empirical literature and an agenda for future research. Clinical Psychology Review, 82, 101925.
Hurlbert, D. F., Apt, C., Gasar, S., Wilson, N. E., & Murphy, Y. (1994). Sexual narcissism: A validation study. Journal of Sex and Marital Therapy, 20, 24–34.
Johnson, S. (2005). Your cheatin’ heart: Myths and absurdities about extradyadic relationships. Journal of Couple and Relationship Therapy, 4, 161–172.
Johnson, S. A. (2017). Sexual Addiction or Simply Cheating? Journal of Forensic Research 8, 1000368.
Kowalewska, E., Grubbs, J. B., Potenza, M. N., Gola, M., Draps, M., & Kraus, S. W. (2018). Neurocognitive mechanisms in compulsive sexual behavior disorder. Current Sexual Health Reports, 10(4), 255–264.
Maykovich, M. K. (1976). Attitudes versus behavior in extramarital sexual relations. Journal of Marriage and the Family, 38, 693–699.
Prause, N., Janssen, E., Georgiadis, J., Finn, P., & Pfaus, J. (2017). Data do not support sex as addictive. The Lancet Psychiatry, 4(12), 899.
Sassover, E., & Weinstein, A. (2022). Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view. Journal of Behavioral Addictions, 11(2), 166-179.
Thompson, A. P. (1983). Extramarital sex: A review of the research literature. Journal of Sex Research 19(1), 1–22.
Wróblewska-Skrzek, J. (2021). Infidelity in relation to sex and gender: The perspective of sociobiology versus the perspective of sociology of emotions. Sexuality & Culture, 25, 1885-1894.