Assessment Sexual Behavior & Relational Impact – Brief Screening

Dr. Mark Pugsley • December 31, 2025

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Assessment Sexual Behavior & Relational Impact – Brief Screening

Cutaway view of a house showing locked doors on different levels controlled by a central security panel.

Sexual Addiction Assessment

Dr. Mark Pugsley

Sexual Addiction – Working Definition

Sexual addiction can be broadly defined as compulsive sexual behaviors that persist despite negative personal, relational, or life consequences (Carnes 2001; Goodman 1992; Kafka 2010).


Indicators of Compulsive Sexual Behavior

Many people struggling with sexual behavior experience some of the patterns listed below. These questions are offered as a way to reflect honestly on your experience and to support a thoughtful, thorough assessment process. They are not intended as a diagnosis, but as a starting point for clarity and understanding.

Denial and Awareness

Denial is often the first hurdle. Denial is like living in a house with locked rooms and dimmer switches. Certain rooms remain closed, their lights turned low. What is kept behind those doors is not fully seen, named, or integrated, even as it continues to shape the household from the shadows.


In sexual addiction, denial refers to the psychological process by which a person minimizes, rationalizes, compartmentalizes, or remains unaware of the extent, impact, or meaning of their sexual behaviors, despite evidence of harm to themselves, their partner, or the relationship.


As part of this reflection, it is important to consider patterns of entitlement, self-absorption, control, secrecy, gaslighting, and avoidance of ownership—particularly in relation to the impact on one’s partner and the relationship.


Reflective Screening Questions Assessment

Please consider the following ten questions carefully and answer honestly:

  • Have you experienced early sexual trauma, abuse, or exposure that continues to affect your relationship with sex or intimacy?

  • Do you find yourself preoccupied with sexual thoughts, fantasies, or urges in ways that feel difficult to control?

  • Have you felt shame, guilt, distress, or emotional emptiness related to your sexual behavior?

  • Have you made repeated efforts to stop or reduce certain sexual behaviors and found yourself unable to do so?

  • Do you hide, minimize, or withhold information about your sexual behaviors from your partner or others?

  • Has your sexual behavior caused emotional harm, relational disruption, or loss of trust with a partner or family member?

  • Have sexual behaviors interfered with important areas of your life, such as work, relationships, finances, health, or legal safety?

  • Have you used sex, pornography, fantasy, or online connections to cope with stress, emotional pain, loneliness, or escape?

  • Has your use of pornography, online sexual activity, or digital sexual connections become problematic or difficult to stop?

  • Do you believe your sexual behavior has interfered with your ability to form or sustain healthy, intimate, long-term relationships?


These questions are informed by trauma-informed, attachment-based, and addiction-informed clinical frameworks addressing compulsive sexual behavior and relational impact.




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