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Types of Assessment
Recognising Sexual Addiction
There are very many tests that can be used to help sufferers recognise that they may addicted. A Google search for "Sexual Addiction Test" produces over half a million hits!
The questions, being based on honest answers to factual enquires, provide a more frank and searching assessment or the difficulties. It may be easy to delude yourself that your behaviour is OK, but questionnaires tend to highlight and quantify the problem, based on criteria that are acknowledged as indicative of addiction.
A few examples are given below
Ten Warning Signs
Dr Patrick Carnes, one of the world’s leading experts in sexual addiction, suggests that there are 10 possible warning signs
1. Feeling that your behaviour is out of
A Test for Men & Women
Patrick Carnes has developed 'The Sexual Addiction Screening Test' (SAST) which can be taken online on his website. The test appears to be suitable for both men and women. Unlike some tests, it is quite general and does not focus on specific sex-related activities. Dr Carnes also offers an Internet Sex Screening Test. This is part of an ongoing study of addiction and the test enables you to compare your 'score' with the average for the study.
A test designed specifically for use by women is the Women's Sexual Addiction Screening Test (WSAT), developed jointly by Patrick Carnes and and Sharon O Hara. Sharon is a Licensed Marriage & Family Therapist. She has a private practice in Los Angeles, that specialises in treating sexual addiction or other relationship problems. She is also the Chair of the National Council of Sex Addiction, California Chapter. The test is similar to that used for men but recognises some of the differences between male and female patterns of addiction, namely the use of sexual activity in relation to power, a sadomasochistic element and the involvement that female addicts often have with teenagers or men/women much younger than themselves.
A series of questions specific to pornography addiction can be found in "Hope and Recovery : A Twelve Step Guide for Healing from Compulsive Sexual Behaviour" (Hazelden Information & Educational Services [May 1998] ISBN: 156838050X - about £15 on Amazon). The book is the current basic text of SAA (Sex Addicts Anomyous) a twelve-step group for people recovering from sexual addiction.
Unfortunately, the questions do not constitute a standardised test that can be 'scored'. I have included them here because I feel they are highly relevant. In assessing your answers to the 27 questions I suggest you consider that all these questions are relevant indicators of a problem. Answering 'yes' to some of them, such as "Do you dig through other people's garbage to find pornography?", is a strong indication of out of control behaviour. The more you answer 'yes', the greater the extent of your problem. You need to be honest, in spirit as well as in fact. For example, if you don't go through other people's dustbins but you do look in public bins or in roadside gutters then the answer to this question should still be still 'yes!'
This section is aimed at clinicians, especially GPs, and support workers who may be in the front line of helping patients or clients to recognise sexual addiction. However those coming to terms with addiction may also find it useful.
"WASTE Time" was created for working with clients presenting with sexual addiction. The acronym seemed appropriate, given the tremendous amount of wasted time that most clients who are sexually addicted admit to in the pursuit of their sexual behaviours. I find this to be a useful tool as I can tailor it to the client and his or her circumstances.
Each of the acronym's letters corresponds to one or more of the diagnostic criteria for sexual addiction
W: Withdrawal. "Have you experienced any withdrawal symptoms when you are unable to engage in sexual activities?"
Typical responses may include irritability, anxiety, depression, anger, and/or other negative mood states. Clients may also reveal using other behaviours or chemicals to supplement their addiction to sex.
A: Adverse consequences. "Have you experienced any negative or adverse consequences as a result of your sexual behaviours?"
Typical responses may include broken relationships, lost career opportunities, financial difficulties, physical injury, and/or psychological trauma. This question can lead to a discussion of the activities and areas of life that have been reduced or sacrificed for the addictive disorder.
S: Inability to Stop. "Have you attempted to cut back, control, or stop your sexual behaviours without success, even when you know that continuing will cause you harm?"
Typical responses may include multiple attempts at stopping or controlling the addictive behaviours without success, even when faced with the knowledge that continuing poses a physical or psychological problem.
T: Tolerance or intensity. "Have you found it necessary to increase the amount or intensity of your sexual behaviours to achieve the same effect?"
Typical responses may include increasing the time spent on the activity, increasing the intensity of the stimulus (eg looking at 'harder' or more specialist materials or movement from compulsive-like, online sexual encounters coupled with masturbation to real-life encounters with multiple anonymous partners.
E: Escape. "Do you use sexual activity as an escape from negative mood states, such as stress, anxiety, depression, sadness, loneliness, or anger?"
Typical responses may include any negative mood state.
Time (two Time domains):
Time spent (preparing, engaging, or recovering). "Have you found yourself spending a lot of time preparing for, engaging in, or recovering from a sexual activity?" Typical responses may include such ritualistic behaviours as cruising all evening in search of a sexual conquest, sexual exercises to increase stamina, or the use of addictive chemicals in preparation for sexual activities.
Time wasted: "Have you been spending more time and/or more resources on your sexual activities than you intended?" will elicit such typical responses as hours spent on the Internet, a loss of sleep due to an entire weekend spent on voyeuristic activities, or large amounts of money spent on sexual activities, often leading to debt.
Clinical practice has demonstrated the efficacy of this approach as an assessment tool. An answer of 'Yes' to one or more of the above questions suggests a strong possibility that a sexual addiction is present and indicates the need for treatment.
Page modified 21 March 2013