BACKGROUND AND AIMS: Despite 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. METHOD: Using 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. RESULTS: A 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 CONCLUSIONS: This 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.

Artois University France

Auckland University of Technology New Zealand

Austrian Public Health Institute Austria

Babeș Bolyai University Romania

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

Bowling Green State University USA

Center for Excessive Gambling Addiction Medicine Lausanne University Hospitals Lausanne Switzerland

Centre for Advanced Research Excellence in Public Health Dhaka 1342 Bangladesh

Centre of Excellence in Responsible Gaming University of Gibraltar Gibraltar Gibraltar

Chuncheon Addiction Management Center South Korea

Connecticut Council on Problem Gambling Wethersfield CT USA

Connecticut Mental Health Center New Haven CT USA

CPUP Center for Psychology at University of Porto Portugal

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

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

Département de Psychologie Université de Montréal Montréal Canada

Département de Psychologie Université du Québec à Trois Rivières Trois Rivières Canada

Department of Addictology 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Addictology General University Hospital Prague Czech Republic

Department of Clinical Pharmaceutical and Biological Sciences University of Hertfordshire United Kingdom

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

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

Department of Neuropsychiatry Graduate School of Medicine Kyoto University Kyoto Japan

Department of Personality Assessment and Psychological Treatments University of Valencia Spain

Department of Psychiatry All India Institute of Medical Sciences New Delhi 110029 India

Department of Psychiatry Faculdade de Medicina Universidade de São Paulo Brazil

Department of Psychiatry Hallym University Chuncheon Sacred Heart Hospital South Korea

Department of Psychology and Cognitive Science University of Trento Italy

Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand

Department of Psychology College of Humanity and Social Science Fuzhou University China

Department of Psychology Humanities and Social Sciences University of Zagreb Croatia

Department of Psychology Shardha University India

Department of Psychology University of Nevada Las Vegas Las Vegas NV USA

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

Department of Sociology Faculty of Humanities and Social Sciences University of Zagreb Croatia

Departmento de Psicología Básica Clínica y Psicobiología University Jaume 1 of Castellón Spain

Doctoral School of Psychology ELTE Eötvös Loránd University Budapest Hungary

Escuela de Psicología Universidad de Talca Chile

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

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

Facultad de Ciencias de la Salud Universidad Privada del Norte Lima Perú

Facultad de Medicina Universidad Científica del Sur Lima Perú

Faculty of Education Department of Psychology Charles University Prague Czech Republic

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

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

Faculty of Psychology University of Cuenca Ecuador

Florida State University Republic of Panama

Grupo de Investigación Biomédica y de Patología Colombia

Health Promotion Research Centre University of Galway Ireland

HELP University Malaysia

Institute for Behavioural Addictions Sigmund Freud University Vienna Austria

Institute for Neural Computations University of California San Diego USA

Institute for Sex Research Sexual Medicine and Forensic Psychiatry University Medical Centre Hamburg Eppendorf Hamburg Germany

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

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

Institute of Legal Psychiatry Lausanne University Hospitals Lausanne Switzerland

Institute of Psychology Cardinal Stefan Wyszynski University Warsaw Poland

Institute of Psychology ELTE Eötvös Loránd University Budapest Hungary

Institute of Psychology Polish Academy of Sciences Poland

Institute of Psychology University of Lausanne Lausanne Switzerland

James Cook University Australia

Laboratory of Behavioral Medicine Neuroscience Institute Lithuanian University of Health Sciences Lithuania

Leuven School for Mass Communication KU Leuven Leuven Belgium

Macedonian Academy of Sciences and Arts Republic of North Macedonia

Nottingham Trent University United Kingdom

SAMRC Unit on Risk and Resilience in Mental Disorders Department of Psychiatry and Neuroscience Institute University of Cape Town South Africa

SAMRC Unit on Risk and Resilience in Mental Disorders Stellenbosch University South Africa

School of Psychology University of Southampton United Kingdom

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

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

Sistema Nacional de Investigación SENACYT Panama

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

Universidad Pedagógca y Tecnológica de Colombia Colombia

Universidad Privada de Santa Cruz de la Sierra Bolivia

University of Baghdad College of Medicine Iraq

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

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

Yale University School of Medicine New Haven CT USA

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Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective