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The Science: What We Know About Sex Addiction

Founded by Patrick Carnes, PhD, American Foundation for Addiction Research (AFAR) fosters innovations in scientific research, understanding and dissemination of knowledge about addiction disorders. AFAR advances the field of addiction medicine in neuroscience and brain chemistry, substance abuse and process addictions, such as gambling and sex. Dr. Carnes, a pioneer in the field of sexual addiction has made innovations in sexual compulsivity, trauma and outcome measurement through scientific research, treatment and education. He founded AFAR to fund research that influences public policy in addiction. 

Fulbright Genomic Research

Dr. Patrick Carnes has received the prestigious Fulbright - Canada - Palix Foundation award in

Brain Science. He will conduct groundbreaking research into the genetics of sexual addiction and

serve as Distinguished Visiting Chair at the University of Alberta. In receiving this award, Dr. Carnes

joins the ranks of distinguished scholars and scientists including Nobel Prize winners and Pulitzer Prize winners who have received this award. 


The research study is unprecedented in its size and scope. Over 1,000 people will be enrolled (half sex addicts and half non-addicts) from various centers across the U.S. and Canada. Dr. Carnes intends to find answers to the following questions: 

What genes are linked to sexual addiction?


  • How do these genes compare to the genes linked to alcoholism and drug addiction?

  • Are there specific clusters of genes that predispose sexual addicts to behave in specific ways? That is, can we predict whether an addict will become compulsive about adultery or pornography or voyeurism, for instance?

  • What psychological disorders are linked to the different types of sexual addiction? For instance, if one is anti-social, is he more likely to compulsively pay for sex, become a voyeur, or pursue anonymous sex?


The study will involve thorough, full-genome genetic analysis of all participants (via saliva specimens) and careful characterization of psychological disorders using well-validated measurement tools. Sophisticated statistical techniques will be used to identify the genes that are linked to sexual addiction and its various types, and to link psychopathology to sexual addiction type and genetic patterns. 

This will be the very first in-depth genetic investigation into the origins and psychology of sexual addiction. This work could lead to a screening tool for those afflicted by sexual addiction, similar to testing for alcoholism. This work may definitively show that sexual addiction involves the same brain pathways as other addictions, and facilitate coverage of the disorder by insurance companies and reimbursement for treatment. This research may help reduce stigma and lead to prompt and effective treatment for those who are suffering.

Distinguished Visiting Research Chair in Brain Science

Clinical Relevance of the Proposed Sexual Addiction Diagnostic Criteria:  Relation to the Sexual Addiction Screening Test-Revised
Patrick J. Carnes, PhD, Tiffany A. Hopkins, MA, and Bradley A. Green, PhD

With the support of AFAR, researchers have shown that sexual addiction is a valid, distinct medical illness that should be included the Diagnostic and Statistical Manual of Mental Disorders (DSM) which insurance companies use to determine coverage. Through study of 4,100 cases, the researchers have developed diagnostic criteria that define the disease. The diagnostic criteria have been validated across sexual behaviors, gender and sexual orientation. Once included as a diagnosis in the DSM, treatment for sexual addiction will be more easily reimbursed.

Link to JAM article

Comparative Study of Three Levels of Care in a Substance Use Disorder Inpatient Facility on Risk for Sexual Addiction
Erin Deneke, Cheryl Knepper, Bradley A. Green, Patrick J. Carnes
Structural Congruence of the Sexual Dependency
Inventory—4th Edition

Bradley A. Green, Randolph C. Arnau, Patrick J. Carnes, Stefanie Carnes, Tiffany A. Hopkins

The addiction platform as a context for varieties of behavior is  key to AFAR's mission statement. It challenges those who would dismiss, marginalize, or deny addiction's innate properties. This study shows impact separately of preoccupation and behaviors. Reveals vast underlying structure of addiction across behaviors. Result is added confidence in the SDI in the medical and scientific world as well as confidence in properties in the mental health world.

More Research Sponsored by AFAR

This is the first large scale residential treatment study of substance and alcohol disorders documenting substantial subsets of both men and women sex addicts. By assessing a large population of substance patients the Caron Foundation found that 20% of admissions and 30% of their relapse unit fit the criteria for sex addiction. The Caron study raises the prospect that one of the leading factors of relapse is undiagnosed sex addiction. If one generalized these findings as typical, 80,000 patients will not get what they need in 2016.

Using the PATHOS Questionnaire for Screening Sexual Addiction Among College Students: A
Preliminary Exploration
Craig S. Cashwell, Amanda L. Giordano, Todd F. Lewis, Kate A. Wachtel, Jodi L. Bartley

AFAR's interest in adolescents and college students is key strategic positioning. This article serves as a confidence builder in our knowledge base. Pathos identified 21% males and 7% of females in need of assessment. The striking part of this study is how whole sample ignored the item on asking for help. Further significance is showing use of PATHOS  in settings beyond medical and pastoral.

Sex Addiction as a Disease: Evidence for Assessment, Diagnosis, and Response to Critics
Bonnie Phillips, Raju Hajela, Donald L. Hilton Jr.

A coherent summary of current criticisms of sex addiction concepts, research, and practices. Field leaders summarize responses and critical flaws in each area of concern. Long needing to be done, critics have uniformed and even glib reviews of sex addiction, its research base and even its therapists. This article by two leading physicians and a family therapist, carefully specify distortions, overlooked bodies of literature and even neurobiological basics. They provide a chart summarizing criticisms, responses and available resources for quick access.

Varieties of Intrusion: Exhibitionism and

Tiffany A. Hopkins, Bradley A. Green, Patrick J. Carnes, Susan Campling

In the general literature exhibitionism and voyeurism have been perceived as more separate and less problematical. This paper documents the connections that can exist, and the resulting escalating mental health issue as well as potential volatility. The internet has escalated both behaviors. Further the issues of men's scoring vs. women's scoring shows extraordinary cultural biases in general and impact on youth.

Empirical Identification of Psychological Symptom Subgroups of Sex Addicts: An Application of Latent
Profile Analysis
Isabel Niño De Guzmán, Randolph C. Arnau, Bradley A. Green, Stefanie Carnes, Patrick Carnes & Jon Jore

From the foundation perspective, the clusters rescaled here are great adjuncts to the Caron Foundation paper. The grouping of sex addicts by substructures adds further to the study that the addiction community needs to hear. Presenters can pair this with Caron's distinction between initial admissions and patients in their relapse unit. This furthers the argument that out of 800,000 substance abuse admits, over 160,000 will need additional treatment for sex addiction - and a portion of these much more treatment.

Attachment Dysfunction and Relationship
Jonathan Jore, Bradley Green, Kenneth Adams & Patrick Carnes

The study shows important contrast of the attachment styles of men and women in both isolation and relationships. More importantly how key attachment is to cycles of avoidance and compulsive relationships. For example, sex avoidance exists for both men and women, but often from different attachment patterns.

Contrasting Preoccupation With Relationships to
Preoccupation With Isolative Sex

Jonathan Jore, Bradley A. Green, Patrick Carnes & Randolph C. Arnau

A contrast between isolation and preoccupation in men and women, and the associated problems and consequences. Coupled with the Attachment Dysfunction and Relationship Preoccupation article, this dynamic is critical for therapists to understand.

MMPI-2 Correlates of Sadomasochism in a Sexual Addiction Sample: Contrasting and Men and Women
Tiffany A. Hopkins and Corey A. Brawner, Monica Meyer, Laci Zawilinski, Patrick J. Carnes, Bradley A. Green

First study to document psychopathology in a population of patients who struggled with issues of bondage and sadomasochism. Previous studies show no associated psychopathology in general (non-clinical) populations. This study reveals significant psychopathological density and raises possibility of significant pressure of high risk behaviors for women. Further, it adds to existing literature about the role of PTSD.

Confirmatory Analysis of the Partner Sexuality
Stefanie Carnes, Suzanne O'Connor

The description and architecture of a new instrument for assessing partners of sex addicts. This is a new tool in an area of sex addiction filled with assumptions and controversies. Its very practical goals are to identify the impact of addiction, discovery, and disclosure. It will help cool the debates by providing concrete numbers. Clinical utility will be very helpful.

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