The Development and Evolution of the Criteria for a Newly Proposed Diagnosis for DSM-5: Hypersexual Disorder

Abstract

This manuscript discusses the empirical foundations for the initial development and subsequent revisions of the diagnostic criteria for Hypersexual Disorder (HD). Historically, DSM manuals are constructed using behaviors descriptors or symptoms (A Criteria) and a threshold (Criterion B) characterizing distress or impairment associated with the consequences of Criterion A behaviors. In addition, many psychiatric disorders, like HD, are additionally defined by adding “exclusionary” criteria (e.g., Criterion C and D) to reduce the unintended consequences associated false positive or “over-diagnosis.” The definition and criteria associated with Hypersexual Disorder evolved over 3 years and its development was modified by professional discourse, published critiques, input by educated lay persons, as well as, a rigorous internal review by committees associated with the American Psychiatric Association's DSM-5 project. Although ultimately rejected for placement in DSM-5, there have been substantive gains associated with this proposal including a successful multicenter field trial as well as continued research in the U.S. and Europe incorporating the operational definition and rating instruments associated with Hypersexual Disorder. Suggested areas for further research of HD are recommended so that this proposal can continue to be taken seriously by researchers as well as clinicians.