Recommendations for Diagnosing and Quantifying treatment outcomes in clinical trials of compulsive sexual behavior disorder

Abstract

This article proposes minimum requirements for reporting efficacy in treatment studies of compulsive sexual behavior (CSB). CSB disorder (CSBD) is a condition whose diagnostic criteria were only recently defined by the World Health Organization. Multiple primary and secondary outcomes have been used in treatment trials of CSB, and possible neuropsychological measures have been considered. We suggest including clinical interviews, specifying the nature of the problem behavior and ensuring that the concerns are not entirely related to distress linked to moral judgments or paraphilic interests exclusively. The minimum requirements of reporting the efficacy of behavioral and pharmaceutical treatment outcome studies proposed are measures of: CSB symptom severity – problems in personal health, relationships, work and finance; these measures may be complemented by additional measures of quality of life or sexual health; behavioral engagement in CSB − frequency (in days per week) of CSB, including time spent thinking about or engaged in the pursuit of CSB; change processes – assessing mechanisms of change hypothesized. There are currently no objective (i.e., neuropsychological) measures that can provide a valid picture of the success of therapies. However, promising areas in the brain which reflect treatment changes include prefrontal areas and the reward system. We believe that the guidelines presented should promote harmonized clinical research involving the treatment of CSB and CSBD.