Numerous debates surround the recent inclusion of compulsive sexual behavior disorder (CSBD) in the International Classification of Diseases (11th ed.), such as the appropriate classification of this construct and what symptom criteria best capture this syndrome. Although controversy surrounding CSBD abounds, there is general agreement that researchers should examine this syndrome in diverse groups, such as lesbian, gay, bisexual, and transgender populations. However, there have been few investigations into how diverse sociocultural contexts may influence the assessment and treatment of CSBD. Therefore, we propose several differential diagnosis considerations when working with sexual and gender diverse clients to avoid CSBD misdiagnosis.
In recent years, increasing attention has been given to the relationship between compulsive sexual behavior (CSB), religiosity, and spirituality. This review summarizes research examining the relationship CSB has with religiosity and spirituality, clarifying how these constructs inform the assessment and treatment of this syndrome.
The present paper reviews research published through August 1, 2021, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Only studies providing quantitative analyses were included.
This review identified 46 articles, subsuming 59 studies, analyzing the relationship between CSB and religiosity or spirituality. Most studies used cross-sectional designs with samples primarily composed of heterosexual White men and women. Generally, the studies found small to moderate positive relationships between religiosity and CSB. Studies considering the mediating or moderating role of moral incongruence identified stronger, indirect relationships between religiosity and problematic pornography use (PPU), a manifestation of CSB. Few studies examined the association between spirituality and CSB, but those that did either reported negative relationships between indicators of spiritual well-being and CSB or positive relationships between CSB and aspects of spiritual struggles.
Discussion and conclusions
Although research examining CSB and religiosity has flourished, such growth is hampered by cross-sectional samples lacking in diversity. Moral incongruence assists in explaining the relationship between religiosity and PPU, but future research should consider other manifestations of CSB beyond PPU. Attention should also be given to examining other religiosity and spirituality constructs and obtaining more diverse samples in research on CSB, religiosity, and spirituality.