The International Classification of Diseases, 11^th Revision (ICD-11) defines compulsive sexual behavior disorder (CSBD) as “an impulse control disorder with an inability to control repetitive sexual impulses or urges, resulting in repetitive sexual behaviors, which causes clinically significant problems in social and emotional functioning and marked distress” (Koós et al., 2022).

Individuals with CSBD often report feeling a lack of control when it comes to engaging in repetitive sexual behaviors, even when the behaviors do not feel enjoyable or exciting to them. However, this is not to say that a person with CSBD never engages in sex for other reasons. In fact, experts have discussed at length which types of motivational factors might underlie compulsive sexual behavior and have proposed various hypotheses.

Self-determination theory (SDT) provides a useful way to classify sexual motivation ranging from intrinsic motivation (the most self-determined type of motivation) to amotivation (the absence of motivation or intention). With regard to sexual activity, intrinsic motivation would mean that a person engages in sex because they genuinely enjoy it, and it feels good to them. On the other end of the spectrum, amotivation would mean that a person does not know why they engage in sex and is not interested in the activity, yet does not feel in control of the behavior or the outcome.

SDT includes 4 additional types of motivation between intrinsic motivation and amotivation: integrated motivation, identified motivation, introjected motivation, and external motivation. Integrated motivation refers to engaging in a behavior because it is a meaningful part of one’s identity, (e.g., having sex because sexuality is part of one’s identity as a sexual being). Identified motivation describes partaking in an activity because it is significant to a person, though not necessarily attached to their identity. For example, having sex because it is seen as a healthy, natural part of life would demonstrate identified motivation. Introjected motivation is engaging in a behavior to derive self-worth or something else from the activity, such as having sex to feel like a good lover or to cope with negative emotions. Finally, external motivations explain performing a behavior to receive a reward or avoid punishment, (e.g., having sex to avoid an argument with a partner).

The authors of a recent study utilized the SDT framework and self-reported data from two large general populations of men and women from Germany and Hungary (9,814 people total) to better understand which types of motivation may underlie CSBD. For the study, participants were asked to complete two questionnaires: the Sexual Motivation Scale (SexMS) to determine which types of sexual motivation tend to drive their behavior, and the Compulsive Sexual Behavior Disorder Scale (CSBD-19) to assess the presence of compulsive sexual behavior (or lack thereof).

Perhaps unsurprisingly, the researchers found the strongest association between compulsive sexual behavior and amotivation, suggesting that individuals who engage in compulsive sexual behavior may feel a lack of control over this behavior and engage in repetitive actions despite a general disinterest in the activity. Certainly, this finding is in line with the definition of CSBD which describes a seemingly unconscious propulsion toward repeated sexual behaviors.  

Nevertheless, the authors also found associations between compulsive sexual behavior and integrated, introjected, and intrinsic motivations. Though these types of motivation were less strongly linked to compulsive sexual behavior, they may still play a role when a person with CSBD engages in sexual activity. This is to say that an individual’s sexual behavior may be influenced by multiple types of motivation, and they may engage in sexual activity for reasons such as it being pleasurable (intrinsic motivation), it feeling like an integral part of their identity (integrated motivation), and/or it helping them cope with stress or negative emotions (introjected motivation).

Although this study has limitations, (such as the fact that it was conducted by means of convenience samples of general populations and not a CSBD population), it sheds light on the types of motivation that may be underlying compulsive sexual behavior. Further research could expand on these findings and, in time, help guide treatment plans and possible intervention strategies.

Resources:

• Koós, M., Fuss, J., Klein, V., Demetrovics, Z., & Bőthe, B. (2021). Sexual Motivations Underlying Compulsive Sexual Behavior in Women and Men From Germany and Hungary. The Journal of Sexual Medicine, 19(2), 170-181. DOI: https://doi.org/10.1016/j.jsxm.2021.11.005