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Journal of Behavioral Addictions
Authors:
Beáta Bőthe
,
Marc N. Potenza
,
Mark D. Griffiths
,
Shane W. Kraus
,
Verena Klein
,
Johannes Fuss
, and
Zsolt Demetrovics

Abstract

Background

Compulsive Sexual Behavior Disorder (CSBD) is included in the eleventh edition of The International Classification of Diseases (ICD-11) as an impulse-control disorder.

Aims

The aim of the present work was to develop a scale (Compulsive Sexual Behavior Disorder Scale–CSBD-19) that can reliably and validly assess CSBD based on ICD-11 diagnostic guidelines.

Method

Four independent samples of 9,325 individuals completed self-reported measures from three countries (the United States, Hungary, and Germany). The psychometric properties of the CSBD-19 were examined in terms of factor structure, reliability, measurement invariance, and theoretically relevant correlates. A potential threshold was determined to identify individuals with an elevated risk of CSBD.

Results

The five-factor model of the CSBD-19 (i.e., control, salience, relapse, dissatisfaction, and negative consequences) had an excellent fit to the data and demonstrated appropriate associations with the correlates. Measurement invariance suggested that the CSBD-19 functions similarly across languages. Men had higher means than women. A score of 50 points was found as an optimal threshold to identify individuals at high-risk of CSBD.

Conclusions

The CSBD-19 is a short, valid, and reliable measure of potential CSBD based on ICD-11 diagnostic guidelines. Its use in large-scale, cross-cultural studies may promote the identification and understanding of individuals with a high risk of CSBD.

Open access

Abstract

Background and aims

The purpose of this study was to examine the prevalence and correlates of indicators consistent with Compulsive Sexual Behavior Disorder (CSBD)—defined and operationalized according to the ICD-11 guidelines—in a large (n = 4,633; 50.5% male; 49,5% female) probability-based German national sample.

Methods

Participants were asked if they had ever experienced “intense and recurring sexual impulses or sexual urges that I had difficulty controlling and resulted in sexual behavior” over a period of several months. Those who reported this experience were queried about the associated distress.

Results

Overall, 4.9% of men [95% CI = 3.9–6.1] and 3.0% of women [95% CI = 2.3–3.9] reported experiences consistent with ICD-11 diagnostic requirements for lifetime diagnosis. In the 12 months preceding the study, 3.2% of men [95% CI = 2.4–4.2] and 1.8% of women [95% CI = 1.2–2.5] reported experiences consistent with CSBD requirements. Compared to controls and participants who reported elements of compulsive sexuality but without accompanying distress, strict religious upbringing was most prevalent in the CSBD group. The CSBD group was more likely to view sexual practices like men having sex with men as unacceptable and to report the belief that pornography has negative impacts on their sex life and life in general. Compared to the other two groups, the CSBD group was significantly more likely to have received psychiatric treatment for depression or another mental health problem during the past 12 months.

Discussion and conclusions

The current study provides novel and important insights into the prevalence and characteristics of CSBD in the general population.

Open access
Journal of Behavioral Addictions
Authors:
Joshua B. Grubbs
,
Rory C. Reid
,
Beáta Bőthe
,
Zsolt Demetrovics
,
Eli Coleman
,
Neil Gleason
,
Michael H. Miner
,
Johannes Fuss
,
Verena Klein
,
Karol Lewczuk
,
Mateusz Gola
,
David P. Fernandez
,
Elaine F. Fernandez
,
Stefanie Carnes
,
Michal Lew-Starowicz
,
Drew Kingston
, and
Shane W. Kraus

Abstract

Background and aims

The World Health Organization's International Classification of Diseases (ICD-11) includes Compulsive Sexual Behavior Disorder (CSBD), a new diagnosis that is both controversial and groundbreaking, as it is the first diagnosis to codify a disorder related to excessive, compulsive, and out-of-control sexual behavior. The inclusion of this novel diagnosis demonstrates a clear need for valid assessments of this disorder that may be quickly administered in both clinical and research settings.

Design

The present work details the development of the Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI) across seven samples, four languages, and five countries.

Setting

In the first study, data were collected in community samples drawn from Malaysia (N = 375), the U.S. (N = 877), Hungary (N = 7,279), and Germany (N = 449). In the second study, data were collected from nationally representative samples in the U.S. (N = 1,601), Poland (N = 1,036), and Hungary (N = 473).

Findings

Across both studies and all samples, results revealed strong psychometric qualities for the 7-item CSBD-DI, demonstrating evidence of validity via correlations with key behavioral indicators and longer measures of compulsive sexual behavior. Analyses from nationally representative samples revealed residual metric invariance across languages, scalar invariance across gender, strong evidence of validity, and utility in classifying individuals who self-identified as having problematic and excessive sexual behavior, as evidenced by ROC analyses revealing suitable cutoffs for a screening instrument.

Conclusion

Collectively, these findings demonstrate the cross-cultural utility of the CSBD-DI as a novel measure for CSBD and provide a brief, easily administrable instrument for screening for this novel disorder.

Open access
Journal of Behavioral Addictions
Authors:
Beáta Bőthe
,
Mónika Koós
,
Léna Nagy
,
Shane W. Kraus
,
Zsolt Demetrovics
,
Marc N. Potenza
,
Aurélie Michaud
,
Rafael Ballester-Arnal
,
Dominik Batthyány
,
Sophie Bergeron
,
Joël Billieux
,
Peer Briken
,
Julius Burkauskas
,
Georgina Cárdenas-López
,
Joana Carvalho
,
Jesús Castro-Calvo
,
Lijun Chen
,
Giacomo Ciocca
,
Ornella Corazza
,
Rita Csako
,
David P. Fernandez
,
Elaine F. Fernandez
,
Loïs Fournier
,
Hironobu Fujiwara
,
Johannes Fuss
,
Roman Gabrhelík
,
Ateret Gewirtz-Meydan
,
Biljana Gjoneska
,
Mateusz Gola
,
Joshua B. Grubbs
,
Hashim T. Hashim
,
Md. Saiful Islam
,
Mustafa Ismail
,
Martha C. Jiménez-Martínez
,
Tanja Jurin
,
Ondrej Kalina
,
Verena Klein
,
András Költő
,
Chih-Ting Lee
,
Sang-Kyu Lee
,
Karol Lewczuk
,
Chung-Ying Lin
,
Liverpool John Moores University's research team † Liverpool John Moores University's research team
,
Christine Lochner
,
Silvia López-Alvarado
,
Kateřina Lukavská
,
Percy Mayta-Tristán
,
Ionut Milea
,
Dan J. Miller
,
Oľga Orosová
,
Gábor Orosz
,
Sungkyunkwan University's research team †† Sungkyunkwan University's research team
,
Fernando P. Ponce
,
Gonzalo R. Quintana
,
Gabriel C. Quintero Garzola
,
Jano Ramos-Diaz
,
Kévin Rigaud
,
Ann Rousseau
,
Marco De Tubino Scanavino
,
Marion K. Schulmeyer
,
Pratap Sharan
,
Mami Shibata
,
Sheikh Shoib
,
Vera L. Sigre Leirós
,
Luke Sniewski
,
Ognen Spasovski
,
Vesta Steibliene
,
Dan J. Stein
,
Julian Strizek
,
Aleksandar Štulhofer
,
Berk C. Ünsal
, and
Marie-Pier Vaillancourt-Morel

Abstract

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; M age = 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.

Open access