Collegiate Sexual Addiction: Exploring Religious Coping and Attachment

The two hallmarks of addiction are continued use despite negative consequences and the loss of control (Goodman, 1993, 2001). Based on these features, both chemicals and behaviors can become addictive. Over the past several decades, there has been growing acceptance of the validity of behavioral addictions. The American Society of Addiction Medicine (2011) revised its definition of addiction to include addictive behaviors such as sex, food, gambling, and spending. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) contains a chapter for Substance-Related and Addictive Disorders, including criteria for substance use disorders as well as one behavioral addiction, namely, gambling disorder. Although Internet gaming disorder was included in Section III of the DSM-5, indicating a need for further research, other proposed addictive behaviors were not recognized in the fifth edition. Specifically, Kafka (2010,2013) proposed diagnostic criteria for hypersexual disorder (HD) with characteristics such as mental preoccupation with sexual urges, fantasies, and behaviors; the use of sexual acts to cope with emotional distress; and failed attempts to control the behavior. Despite several pivotal research projects examining the nature, prevalence, and treatment of sexual addiction or hypersexual behavior, including survey research with approximately 1,000 individuals with sexual addiction (Carnes, 1991) and a comprehensive field trial of the proposed HD criteria (Reid et al., 2012), the rationale for excluding HD included concerns regarding the need for more evidence and research and the effect of the diagnosis within forensic settings (Kafka, 2014). Specifically, DSM-5 reviewers had concerns about the misuse of an HD diagnosis in evaluations of sexually violent predators for civil commitments (Kafka, 2014). Thus, we sought to examine sexual addiction in a population reported to experience elevated levels--the college population (Cashwell, Giordano, Lewis, Wachtel, & Bartley, 2015; Giordano & Cecil, 2014; Seegers, 2003)--with the aim of continuing the research in the field of compulsive sexual behavior. * Collegiate Sexual Addiction Individuals with sexual addiction, much like those with chemical dependence, rely on sexual behaviors as their primary coping mechanism for emotional distress (Goodman, 1993). Both positive (pleasure) and negative (reduction of undesirable affect) reinforcement perpetuate the continuation of the sexual behavior. Beyond psychological and behavioral features of sexual addiction, researchers have also found that compulsive sexual behaviors affect the reward circuitry in the brain in similar fashion to drugs of abuse (Blum et al., 2012). Specifically, sexual behaviors trigger dopamine release in the brain activating the reward cascade, which can lead to neuroadaptations if chronically and excessively activated (Blum et al., 2012). In other words, what might begin as behavior to tolerate emotional distress results, over time, in changes in brain chemistry and functioning. Therefore, sexual addiction is a complex condition with biological, psychological, and behavioral elements. Additionally, the fact that many researchers have found sexual addiction to be more prevalent among specific subsets of the population suggests a sociocultural component. For example, Carnes (2005) posited that up to 6% of the general U.S. population has a sexual addiction, and Smith et al. (2014) reported that 16.7% of male veterans engaged in sexually compulsive behavior. Additionally, Stavro, Rizkallah, Dinh-Williams, Chiasson, and Potvin (2013) found that 25% of clients in treatment for substance abuse met the criteria for sexual addiction. College students are another population with elevated sexual addiction rates. For example, Giordano and Cecil (2014) found that 16.2% of college men were in the clinical range for hypersexuality. …