What is compulsive sexual behaviour disorder?

Compulsive Sexual Behaviour Disorder is the WHO's ICD-11 diagnosis (code 6C72) for a persistent pattern of failing to control intense sexual impulses or urges, with real cost to the person's life. Pornography use can fall under it. It is classified as an impulse-control disorder, not an addiction.

Well established

It is the closest thing to an official diagnosis that exists for this, and the details of how it is defined are more interesting than the name.

It sits in ICD-11 under impulse-control disorders, next to conditions like kleptomania and pyromania, rather than under disorders due to addictive behaviours, where gambling and gaming live. The classifiers looked at the evidence and chose not to call it an addiction. That does not make it less real; it makes it a different kind of thing.

The American DSM-5 has no equivalent entry at all. So a clinician working from ICD-11 has a diagnosis to reach for, and one working from the DSM does not. The research community is likewise unresolved on whether "addiction" is the right frame.

What the diagnosis turns on is not how much porn someone uses. It is impaired control, distress, and functional impairment: the behaviour continuing despite the person trying to stop it and despite what it costs them. Those are the same three things that distinguish a problem from a habit in the research, and they are what the course's own baseline measures.

Where this comes from

Read the full lesson: The disagreement at the centre of all this →

Sources and how strong they are (4)
  • Well establishedICD-11 includes Compulsive Sexual Behaviour Disorder (6C72), classified as an impulse control disorder rather than an addictive disorder. Pornography use can fall under it.WHO ICD-11, 6C72
  • Well established"Pornography addiction" is not a diagnosis in DSM-5 or DSM-5-TR.APA, DSM-5-TR (2022)
  • Well establishedWhether compulsive pornography use is best modelled as an addiction is genuinely unresolved among researchers.Kraus et al. 2018; Grubbs et al. 2020; Prause critiques
  • Well establishedFrequency of use alone is a poor indicator of problematic use. Distress, impaired control and functional impairment are what distinguish it.Bőthe et al. 2018, 2020; ICD-11 CSBD criteria

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