Current (descriptive) accounts of hypersexuality are Axis I models in that they explain “out of control” excessive sexual behavior by comparing it to one or more Axis I disorders, e.g., substance addiction, obsessive compulsive disorder. This article presents an Axis II model for a subset of hypersexual patterns that seem more similar in structure to personality disorders. Persons can exhibit an “Axis II” hypersexual pattern without necessarily meeting sufficient criteria for a wider Axis II personality diagnosis. Case vignettes that illustrate Axis II subtypes (e.g., narcissistic, borderline) are discussed, along with treatment implications.
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