sex addiction screening tests & PATHOS

am I a sex addict?

Compulsive sexual behavior is not the result of a diminished moral capacity or a lack of faith.  It is rooted in addiction! How do you know if you or someone you love might be a sex addict?  

diagnostic criteria for sex addiction

  1. Loss of Control:  Recurrent failure to resist sexual impulses 
  2. Compulsive Behavior:  More extensive/longer sexual acting out than intended 
  3. Efforts to Stop:  Ongoing, but unsuccessful, efforts to stop, reduce, or control behavior 
  4. Loss of Time:  Inordinate time spent obtaining sex, being sexual, or recovering from sexual experiences
  5. Preoccupation:  Feeling preoccupied with sexual behavior and/or preparatory activities
  6. Inability to Fulfill Obligations:  Acting out takes significant time away from obligations: occupational, academic, domestic, or social
  7. Continuance:  Continuation of behavior despite consequences such as: 
    Risk of VD Abortions/unwanted pregnancies
    Lost partner or had marital problems
    Career problems
    Lost rights to be with children
    Risk arrest 
  8. Escalation—Tolerance:  More frequency or intensity of behavior is needed over time to obtain the desired result
  9. Losses:  Deliberately limiting social, occupational, or recreational activities to keep time open for acting out
  10. Withdrawal:  Distress, restlessness, or irritability if unable to do behavior (withdrawal)
A minimum of three of the above 10 are needed for sex addiction to be considered present. Many sex addicts have five signs, while over 50% have seven.

PATHOS screening test

In a 2012 study headed by Dr. Patrick Carnes* estimated to afflict up to 3% to 6% of the population. However, many clinicians lack clear criteria for detecting potential cases. 

PATHOS is a brief sexual addiction screening questionnaire. The aforementioned clinical study from Carnes, et. al., found PATHOS as clinically significant for effectively classifying patient’s appropriateness for entering treatment as potential sex addicts. 

PATHOS stands for the six assessment questions: 

Preoccupied:  Do you often find yourself preoccupied with sexual thoughts? 
Ashamed:  Do you hide some of your sexual behavior from others? 
Treatment:  Have you ever sought therapy for sexual behavior you did not like? 
Hurt others:  Has anyone been hurt emotionally because of your sexual behavior? 
Out of control:  Do you feel controlled by your sexual desire? 
Sad:  When you have sex, do you feel depressed afterwards? 

A positive response to just one of the six questions would indicate a need for additional assessment with a certified sex addiction therapist. Two or more are considered to certainly indicate sexual addiction.

Carnes PJ, Green BA, Merlo LJ, Polles A, Carnes S, Gold MS, March 6, 2012 (1):29-34. PATHOS: a brief screening application for assessing sexual addiction. doi: 10.1097/ADM.0b013e3182251a28. PATHOS is reprinted here with permission from the International Institute of Trauma and Addiction Professionals (iitap).
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