‘High desire’, or ‘merely’ an addiction? A response to Steele et al.

T he validity of an argument depends on the sound-ness of its premises. In the recent paper by Steele et al., conclusions are based on the initial construction of definitions relating to 'desire' and 'addiction'. These definitions are based on a series of assumptions and qualifications, the limitations of which are acknowledged by the authors initially, but inexplicably ignored in reaching the firm conclusions the authors make. Yet, the firmness of these conclusions is unwarranted, not only as a result of conceptually problematic initial premises but also due to problematic methodology. Consider, for instance, the concept of 'sexual desire'. The first paragraph acknowledges that 'sexual desires must be consistently regulated to manage sexual behaviors', and must be controlled when either illegal (pedophilia) or inappropriate (infidelity). The paragraph ends with the inference that the term 'sexual addiction' does not describe a problematic entity per se, but that it merely describes a subset of individuals with high levels of desire. The next paragraph references a paper by Winters et al., which suggests that 'dysregulated sexuality. .. may simply be a marker of high sexual desire and the distress associated with managing a high degree of sexual thoughts, feelings, and needs' (Winters, Christoff, & Gorzalka, 2010). It is based on these assumptions that Steele et al. then proceeds to question a disease model for this 'distress' associated with controlling sexual 'desire'. For a comparison of different 'desire' templates, television viewing in children is used as an example. The last two sentences in this paragraph establish the premise that the rest of the paper then tries to prove: Treatments focus on reducing the number of hours viewing television behaviorally without a disease overlay such as 'television addiction' and are effective. This suggests a similar approach might be appropriate for high sexual desire if the proposed disease model does not add explanatory power beyond merely high sexual desire. Based on this comparison, that of desire to watch TV in children and desire for sex in adults, the authors then launch into a discussion on event-related potentials (ERPs) and a subsequent description of their study design, followed by results and discussion, and culminating in the following summary: In conclusion, the first measures of neural reactivity to visual sexual and non-sexual stimuli in a sample reporting problems regulating their viewing of similar stimuli fail to provide support for models of pathological hypersexuality, as measured by questionnaires. Specifically, …