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Compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU): A comprehensive, interdisciplinary, and expert-informed narrative review with suggested future directions

  • Campbell Ince
  • , Stephanie Antons
  • , Sarah Ashton
  • , Nicholas C. Borgogna
  • , Matthias Brand
  • , Peer Briken
  • , Jesús Castro-Calvo
  • , Lijun Chen
  • , Eli Coleman
  • , Yaniv Efrati
  • , David P. Fernández
  • , Johannes Fuss
  • , Neil Gleason
  • , Mateusz Gola
  • , Todd L. Jennings
  • , Ewelina Kowalewska
  • , Shane W. Kraus
  • , Karol Lewczuk
  • , Joshua B. Grubbs
  • , Michal Lew-Starowicz
  • Todd Love, Gemma Mestre-Bach, Marc N. Potenza, Ryan L. Rahm-Knigge, Marco De Tubino Scanavino, Rudolf Stark, Zsolt Demetrovics, Beáta Bőthe

Research output: Contribution to journalReview articlepeer-review

Abstract

Background and aimsThe nature and classification of dysregulated sexual behaviors remain widely debated. Compulsive Sexual Behavior Disorder (CSBD) and Problematic Pornography Use (PPU) are the two most commonly studied constructs in this area, each carrying significant implications for mental health, interpersonal functioning, and broader well-being. Although scientific output on these topics has expanded rapidly in the past decade, recent reviews have tended to focus on specific subthemes, single constructs, or narrow disciplinary perspectives. Accordingly, this review provides an updated and interdisciplinary overview of empirical and theoretical knowledge.MethodsIn this narrative review, we summarize current knowledge regarding CSBD and PPU, with contributions from diverse experts across multiple disciplines (e.g., psychology, psychiatry, sexology, addiction science, neuroscience). We provide research and clinical perspectives to ensure a comprehensive and balanced discussion.ResultsWe extensively summarize eleven key areas, namely historical context, conceptualization and symptomatology, assessment and measurement, epidemiology, co-occurring disorders, etiology, potential negative consequences, intervention, treatment, and policy considerations. Additionally, we consider underrepresented populations and contexts, including adolescents, LGBTQ+ (i.e., lesbian, gay, bisexual, trans, queer, and other diverse identities) individuals, women, and cultural factors. The review concludes with a critical discussion of prevailing controversies, methodological challenges, and key directions for future research.Discussion and ConclusionsBy providing a comprehensive and integrative overview, this work aims to advance scientific discourse, promote interdisciplinary collaborations, inform clinical practice, and support public health initiatives in the field of CSBD and PPU.

Original languageEnglish (US)
Pages (from-to)32-98
Number of pages67
JournalJournal of Behavioral Addictions
Volume15
Issue number1
DOIs
StatePublished - Mar 2026

Bibliographical note

Publisher Copyright:
© 2026 The Author(s). Open Access statement. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 5 - Gender Equality
    SDG 5 Gender Equality

Keywords

  • addiction
  • addictive behavior
  • behavioral addiction
  • compulsive behavior
  • compulsive sexual behavior disorder
  • erotica
  • hypersexual behavior
  • impulsive behavior
  • out-of-control sexual behavior
  • problematic pornography use
  • sexual behavior

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