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

doi:10.1556/2006.2025.00337

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

School of Psychological Sciences
Monash University
General Psychology
University of Siegen
The Institute of Sexual Health Psychology Australia (ISHPA)
Sexual Health and Intimacy Psychological Services (SHIPS)
Department of Psychology
University of Alabama at Birmingham
Center for Behavioral Addiction Research (CeBAR)
University of Duisburg-Essen
General Psychology: Cognition
Erwin L. Hahn Institute for Magnetic Resonance Imaging
Institute for Sex Research
University of Hamburg
Department of Personality
University of Valencia
Department of Psychology
Fuzhou University
University of Minnesota Twin Cities
Department of Psychology
Nottingham Trent University
Institute of Forensic Psychiatry and Sex Research
University of Washington
Institute of Psychology
Polish Academy of Sciences
University of California at San Diego
University of Nevada, Las Vegas
Department of Psychiatry
Medical Centre for Postgraduate Education, Warsaw
Centre of Excellence in Responsible Gaming
University of Gibraltar
Cardinal Stefan Wyszynski University
Center on Alcohol
University of New Mexico
Department of Psychology
Independent Practice
Universidad Internacional de La Rioja
Yale University
Connecticut Council on Problem Gambling
Department of Psychiatry
Western University
Universidade de São Paulo
Experimental Pathophisiology Post Graduation Program
Department for Psychotherapy and Systems Neuroscience
Justus Liebig University Giessen
Center of Mind
University of Marburg
College of Human Sciences and Culture
Flinders University
Eötvös Loránd University
Département de psychologie
University of Montreal
Department of Psychiatry

Research output: Contribution to journal › Review article › peer-review

9 Scopus citations

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 language	English
Pages (from-to)	32-98
Number of pages	67
Journal	Journal of Behavioral Addictions
Volume	15
Issue number	1
DOIs	https://doi.org/10.1556/2006.2025.00337
State	Published - 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)

SDG 3 Good Health and Well-being

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

Access to Document

10.1556/2006.2025.00337

Cite this

Ince, C., Antons, S., Ashton, S., Borgogna, N. C., Brand, M., Briken, P., Castro-Calvo, J., Chen, L., Coleman, E., Efrati, Y., Fernández, D. P., Fuss, J., Gleason, N., Gola, M., Jennings, T. L., Kowalewska, E., Kraus, S. W., Lewczuk, K., Grubbs, J. B., ... Bőthe, B. (2026). Compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU): A comprehensive, interdisciplinary, and expert-informed narrative review with suggested future directions. Journal of Behavioral Addictions, 15(1), 32-98. https://doi.org/10.1556/2006.2025.00337

@article{4ff4dd781581436891503fb3a517c85f,

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

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.",

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",

author = "Campbell Ince and Stephanie Antons and Sarah Ashton and Borgogna, \{Nicholas C.\} and Matthias Brand and Peer Briken and Jes{\'u}s Castro-Calvo and Lijun Chen and Eli Coleman and Yaniv Efrati and Fern{\'a}ndez, \{David P.\} and Johannes Fuss and Neil Gleason and Mateusz Gola and Jennings, \{Todd L.\} and Ewelina Kowalewska and Kraus, \{Shane W.\} and Karol Lewczuk and Grubbs, \{Joshua B.\} and Michal Lew-Starowicz and Todd Love and Gemma Mestre-Bach and Potenza, \{Marc N.\} and Rahm-Knigge, \{Ryan L.\} and \{De Tubino Scanavino\}, Marco and Rudolf Stark and Zsolt Demetrovics and Be{\'a}ta B{\H o}the",

note = "Publisher Copyright: {\textcopyright} 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 {\textendash} if any {\textendash} are indicated.",

year = "2026",

month = mar,

doi = "10.1556/2006.2025.00337",

language = "אנגלית",

volume = "15",

pages = "32--98",

journal = "Journal of Behavioral Addictions",

issn = "2062-5871",

publisher = "Akademiai Kiado",

number = "1",

}

Ince, C, Antons, S, Ashton, S, Borgogna, NC, Brand, M, Briken, P, Castro-Calvo, J, Chen, L, Coleman, E, Efrati, Y, Fernández, DP, Fuss, J, Gleason, N, Gola, M, Jennings, TL, Kowalewska, E, Kraus, SW, Lewczuk, K, Grubbs, JB, Lew-Starowicz, M, Love, T, Mestre-Bach, G, Potenza, MN, Rahm-Knigge, RL, De Tubino Scanavino, M, Stark, R, Demetrovics, Z & Bőthe, B 2026, 'Compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU): A comprehensive, interdisciplinary, and expert-informed narrative review with suggested future directions', Journal of Behavioral Addictions, vol. 15, no. 1, pp. 32-98. https://doi.org/10.1556/2006.2025.00337

Compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU): A comprehensive, interdisciplinary, and expert-informed narrative review with suggested future directions. / Ince, Campbell; Antons, Stephanie; Ashton, Sarah et al.
In: Journal of Behavioral Addictions, Vol. 15, No. 1, 03.2026, p. 32-98.

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - Compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU)

T2 - A comprehensive, interdisciplinary, and expert-informed narrative review with suggested future directions

AU - Ince, Campbell

AU - Antons, Stephanie

AU - Ashton, Sarah

AU - Borgogna, Nicholas C.

AU - Brand, Matthias

AU - Briken, Peer

AU - Castro-Calvo, Jesús

AU - Chen, Lijun

AU - Coleman, Eli

AU - Efrati, Yaniv

AU - Fernández, David P.

AU - Fuss, Johannes

AU - Gleason, Neil

AU - Gola, Mateusz

AU - Jennings, Todd L.

AU - Kowalewska, Ewelina

AU - Kraus, Shane W.

AU - Lewczuk, Karol

AU - Grubbs, Joshua B.

AU - Lew-Starowicz, Michal

AU - Love, Todd

AU - Mestre-Bach, Gemma

AU - Potenza, Marc N.

AU - Rahm-Knigge, Ryan L.

AU - De Tubino Scanavino, Marco

AU - Stark, Rudolf

AU - Demetrovics, Zsolt

AU - Bőthe, Beáta

N1 - 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.

PY - 2026/3

Y1 - 2026/3

N2 - 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.

AB - 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.

KW - addiction

KW - addictive behavior

KW - behavioral addiction

KW - compulsive behavior

KW - compulsive sexual behavior disorder

KW - erotica

KW - hypersexual behavior

KW - impulsive behavior

KW - out-of-control sexual behavior

KW - problematic pornography use

KW - sexual behavior

UR - https://www.scopus.com/pages/publications/105033721326

U2 - 10.1556/2006.2025.00337

DO - 10.1556/2006.2025.00337

M3 - ???researchoutput.researchoutputtypes.contributiontojournal.systematicreview???

C2 - 41879870

AN - SCOPUS:105033721326

SN - 2062-5871

VL - 15

SP - 32

EP - 98

JO - Journal of Behavioral Addictions

JF - Journal of Behavioral Addictions

IS - 1

ER -

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

Abstract

Bibliographical note

UN SDGs

Keywords

Access to Document

Other files and links

Fingerprint

Cite this