Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools

Author:

Bőthe Beáta12ORCID,Koós Mónika34ORCID,Nagy Léna34ORCID,Kraus Shane W.5ORCID,Demetrovics Zsolt46ORCID,Potenza Marc N.789ORCID,Michaud Aurélie2,Ballester-Arnal Rafael10ORCID,Batthyány Dominik11ORCID,Bergeron Sophie2ORCID,Billieux Joël1213ORCID,Briken Peer14ORCID,Burkauskas Julius15ORCID,Cárdenas-López Georgina16ORCID,Carvalho Joana1718ORCID,Castro-Calvo Jesús19ORCID,Chen Lijun20ORCID,Ciocca Giacomo21ORCID,Corazza Ornella2223ORCID,Csako Rita24ORCID,Fernandez David P.25ORCID,Fernandez Elaine F.26ORCID,Fournier Loïs12ORCID,Fujiwara Hironobu272829ORCID,Fuss Johannes30ORCID,Gabrhelík Roman3132ORCID,Gewirtz-Meydan Ateret33ORCID,Gjoneska Biljana34ORCID,Gola Mateusz3536ORCID,Grubbs Joshua B.37ORCID,Hashim Hashim T.38ORCID,Islam Md. Saiful3940ORCID,Ismail Mustafa38ORCID,Jiménez-Martínez Martha C.4142ORCID,Jurin Tanja43ORCID,Kalina Ondrej44ORCID,Klein Verena45ORCID,Költő András46ORCID,Lee Chih-Ting47ORCID,Lee Sang-Kyu4849ORCID,Lewczuk Karol50ORCID,Lin Chung-Ying5152ORCID,_ _53,Lochner Christine54ORCID,López-Alvarado Silvia55ORCID,Lukavská Kateřina3156ORCID,Mayta-Tristán Percy57ORCID,Milea Ionut58,Miller Dan J.59ORCID,Orosová Oľga44ORCID,Orosz Gábor60ORCID,_ _61,Ponce Fernando P.62ORCID,Quintana Gonzalo R.63ORCID,Quintero Garzola Gabriel C.6465ORCID,Ramos-Diaz Jano66ORCID,Rigaud Kévin60ORCID,Rousseau Ann67ORCID,De Tubino Scanavino Marco686970ORCID,Schulmeyer Marion K.71ORCID,Sharan Pratap72ORCID,Shibata Mami27ORCID,Shoib Sheikh73ORCID,Sigre Leirós Vera L.1274ORCID,Sniewski Luke75ORCID,Spasovski Ognen7677ORCID,Steibliene Vesta15ORCID,Stein Dan J.78ORCID,Strizek Julian79ORCID,Štulhofer Aleksandar80ORCID,Ünsal Berk C.34ORCID,Vaillancourt-Morel Marie-Pier1ORCID

Affiliation:

1. Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada

2. Département de Psychologie, Université de Montréal, Montréal, Canada

3. Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary

4. Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary

5. Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA

6. Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar

7. Yale University School of Medicine, New Haven, CT, USA

8. Connecticut Council on Problem Gambling, Wethersfield, CT, USA

9. Connecticut Mental Health Center, New Haven, CT, USA

10. Departmento de Psicología Básica, Clínica y Psicobiología, University Jaume I of Castellón, Spain

11. Institute for Behavioural Addictions, Sigmund Freud University Vienna, Austria

12. Institute of Psychology, University of Lausanne, Lausanne, Switzerland

13. Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland

14. Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

15. Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania

16. Virtual Teaching and Cyberpsychology Laboratory, School of Psychology, National Autonomous University of Mexico, Mexico

17. William James Center for Research, Departamento de Educação e Psicologia, Universidade de Aveiro, Aveiro, Portugal

18. CPUP: Center for Psychology at University of Porto, Portugal

19. Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain

20. Department of Psychology, College of Humanity and Social Science, Fuzhou University, China

21. Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy

22. Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, United Kingdom

23. Department of Psychology and Cognitive Science, University of Trento, Italy

24. Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand

25. Nottingham Trent University, United Kingdom

26. HELP University, Malaysia

27. Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan

28. Decentralized Big Data Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan

29. The General Research Division, Osaka University Research Center on Ethical, Legal and Social Issues, Osaka, Japan

30. Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany

31. Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic

32. Department of Addictology, General University Hospital in Prague, Czech Republic

33. School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel

34. Macedonian Academy of Sciences and Arts, Republic of North Macedonia

35. Institute of Psychology, Polish Academy of Sciences, Poland

36. Institute for Neural Computations, University of California San Diego, USA

37. Bowling Green State University, USA

38. University of Baghdad, College of Medicine, Iraq

39. Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh

40. Centre for Advanced Research Excellence in Public Health, Dhaka, 1342, Bangladesh

41. Universidad Pedagógca y Tecnológica de Colombia, Colombia

42. Grupo de Investigación Biomédica y de Patología, Colombia

43. Department of Psychology, Humanities and Social Sciences, University of Zagreb, Croatia

44. Department of Educational Psychology and Psychology of Health, Pavol Jozef Safarik University in Kosice, Slovakia

45. School of Psychology, University of Southampton, United Kingdom

46. Health Promotion Research Centre, University of Galway, Ireland

47. Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

48. Department of Psychiatry, Hallym University Chuncheon Sacred Heart Hospital, South Korea

49. Chuncheon Addiction Management Center, South Korea

50. Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland

51. Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

52. Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

53. Public Health Institute, Faculty of Health, Liverpool John Moores University, United Kingdom

54. SAMRC Unit on Risk & Resilience in Mental Disorders, Stellenbosch University, South Africa

55. Faculty of Psychology, University of Cuenca, Ecuador

56. Faculty of Education, Department of Psychology, Charles University, Prague, Czech Republic

57. Facultad de Medicina, Universidad Científica del Sur, Lima, Perú

58. Babeș-Bolyai University, Romania

59. James Cook University, Australia

60. Artois University, France

61. Department of Psychology, Sungkyunkwan University, South Korea

62. Escuela de Psicología, Universidad de Talca, Chile

63. Departamento de Psicología y Filosofía, Facultad de Ciencias Sociales, Universidad de Tarapacá, Arica, Arica y Parinacota, Chile

64. Florida State University, Republic of Panama

65. Sistema Nacional de Investigación (SNI), SENACYT, Panama

66. Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Perú

67. Leuven School for Mass Communication, KU Leuven, Leuven, Belgium

68. Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, Brazil

69. Experimental Pathophisiology Post Graduation Program, Faculdade de Medicina, Universidade de São Paulo, Brazil

70. Excessive Sexual Drive and Prevention of Negative Outcomes Associated to Sexual Behavior Outpatient Unit (AISEP), Institute of Psychiatry, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil

71. Universidad Privada de Santa Cruz de la Sierra, Bolivia

72. Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, 110029, India

73. Department of Psychology, Shardha University, India

74. Institute of Legal Psychiatry, Lausanne University Hospitals (CHUV), Lausanne, Switzerland

75. Auckland University of Technology, New Zealand

76. Faculty of Philosophy, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia

77. Faculty of Philosophy, University of Ss. Cyril and Methodius in Trnava, Slovak Republic

78. SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa

79. Austrian Public Health Institute, Austria

80. Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia

Abstract

AbstractBackground and aimsDespite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide standardized, state-of-the-art screening tools for research and clinical practice.MethodUsing data from the International Sex Survey (N = 82,243; Mage = 32.39 years, SD = 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD.ResultsA total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were present in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability.Discussion and conclusionsThis study contributes to a better understanding of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive prevention and intervention strategies for CSBD that are currently missing from the literature.

Publisher

Akademiai Kiado Zrt.

Subject

Psychiatry and Mental health,Clinical Psychology,General Medicine,Medicine (miscellaneous)

Reference44 articles.

1. Global epidemiology of mental disorders: What are we missing?;Baxter, A. J.,2013

2. Hypersexuality, gender, and sexual orientation: A large-scale psychometric survey study;Bőthe, B.,2018

3. Contradicting classification, nomenclature, and diagnostic criteria of compulsive sexual behavior disorder (CSBD) and future directions ·: Commentary to the debate: “Behavioral addictions in the ICD-11;Bőthe, B.,2022

4. International Sex Survey: Study protocol of a large, cross-cultural collaborative study in 45 countries;Bőthe, B.,2021

5. The development of the Compulsive Sexual Behavior Disorder Scale (CSBD-19): An ICD-11 based screening measure across three languages;Bőthe, B.,2020

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