Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI)

Abstract

The Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI), developed by Grubbs et al. (2023), functions as a crucial screening instrument for identifying symptoms of Compulsive Sexual Behavior Disorder (CSBD). Its rigorous development process involved three doctoral-level subject-matter experts and was grounded in a comprehensive review of existing measures of out-of-control sexual behavior.

The conceptual foundation of the scale is rooted in the proposed diagnostic criteria for CSBD as outlined in the International Classification of Diseases (ICD-11) and for Hypersexual Disorder (HD) found in the Diagnostic and Statistical Manual of Mental Disorders – 5 (DSM-5). Initially comprising 9 items, the instrument was refined to a 7-item scale that assesses symptoms experienced over the past six months. Initial validation involved community samples from Malaysia, the U.S., Hungary, and Germany, followed by nationally representative samples in the U.S., Poland, and Hungary. The developers successfully demonstrated strong reliability, validity, and measurement invariance across these diverse international populations.

Keywords

Behavioral Addiction, Compulsive Sexual Behavior Disorder, Cut-Off Scores, Diagnostic Criteria, DSM-5, Hypersexual Disorder, ICD-11, Screening Tool, Sexual Addiction, Symptoms.

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, Shane W. Kraus.

Purpose

The primary purpose of the CSBD-DI is to serve as an efficient and reliable screening assessment tool for the identification of symptoms associated with Compulsive Sexual Behavior Disorder.

This inventory is designed to quickly flag individuals who may require further, more detailed diagnostic evaluation, particularly in research and non-clinical settings, by measuring symptom endorsement over a specific retrospective period (the past six months). The goal is to provide a brief, cross-culturally validated measure aligned with contemporary diagnostic conceptualizations.

Construct

The CSBD-DI measures the psychopathology of out-of-control sexual behavior, specifically targeting the proposed criteria for Compulsive Sexual Behavior Disorder (as defined in the ICD-11) and Hypersexual Disorder (as previously proposed in the DSM-5 framework).

The initial 9-item structure specifically differentiated between symptoms common to both diagnostic concepts and those unique to either the ICD-11 framework (one unique item) or the DSM-5 framework (two unique items). The final, validated 7-item version focuses on the core distress and functional impairment inherent in compulsive sexual behavior, providing a streamlined measure of the construct.

Validity

Convergent and Discriminant Validity

The 7-item version of the CSBD-DI demonstrated strong psychometric qualities across all international samples examined in both studies. This evidence was established through significant correlations with established behavioral indicators and longer, existing measures of compulsive sexual behavior, providing robust support for the scale’s convergent validity.

Test Sensitivity and Specificity

Consistent with expectations for a screening instrument, the endorsement rate of items was generally low within non-clinical samples. Receiver Operating Characteristic (ROC) analyses were performed to identify optimal cutoff points for diagnostic screening. The results suggested that a cutoff score of 1 or 2 should be utilized to prompt further clinical evaluation. Ultimately, adopting a cutoff score of 1 or greater on the 7-item scale was supported by strong accuracy classification, yielding reasonable sensitivity and specificity.

Reliability

Internal Consistency

The measure exhibited acceptable to strong internal consistency across the majority of the tested samples. Excluding the undergraduate Malaysian sample, internal consistency indices ranged favorably from 0.78 to 0.82. In these instances, all items maintained standardized loadings of 0.47 or higher, indicating a cohesive measure structure.

In Sample 1, the scale also demonstrated acceptable internal consistency, with calculated measures of Cronbach’s alpha (α = 0.70) and McDonald’s omega (ω = 0.68). All items in this sample showed standardized loadings of 0.39 or higher, further supporting the test’s reliability as a screening tool.

Factor Analysis

Confirmatory Factor Analysis (CFA)

Confirmatory Factor Analysis (CFA) confirmed the structural superiority of the refined 7-item version of the scale. This version, which strategically excluded items related to coping mechanisms, consistently demonstrated a better model fit across all tested international samples.

Measurement Invariance

The psychometric properties of the CSBD-DI were further supported by successful establishment of measurement invariance. Strict/residual invariance was achieved across the nationally representative samples from Poland, the United States, and Hungary. Furthermore, strong/scalar invariance was confirmed across gender, suggesting that the scale measures the underlying construct consistently regardless of cultural context or gender identity.

Instrument

Test Type: Original Screener

Format: Respondents are instructed to select the response that best describes their experience based on a three-point frequency scale. The response options are: “This has been true for at least 6 months during the last 12 months,” “This has been true in my lifetime but not during the last 12 months,” and “This has never been true of me.”

Language Available: English, German, Hungarian, Polish

Population Group: Human (Male, Female)

Age Group: Adulthood (18 years and older)

Population Details: Data were gathered across two main studies from diverse international locations, including Malaysia, the United States, Hungary, Germany, and Poland. Participants included undergraduate students, Mturk participants, and nationally representative adult samples.

Test Methodology: Test Validity, Convergent Validity, Discriminant Validity, Test Reliability, Internal Consistency, Factor Analysis, Confirmatory Factor Analysis, Measurement Invariance, Test Sensitivity, Test Specificity.

Keywords

Cutting Scores, Diagnostic and Statistical Manual, International Classification of Diseases, Sexual Addiction, Symptoms, Diagnostic Criteria, Nonsubstance Related Addiction Measures, Psychodiagnostic Measures, Mental Health Screening.

Authors (Detailed Information)

Author ORCID Identifiers:

• Grubbs, Joshua B.: http://orcid.org/0000-0002-2642-1351

• Reid, Rory C.: http://orcid.org/0000-0001-5706-7749

• Bőthe, Beáta: http://orcid.org/0000-0003-2718-4703

• Demetrovics, Zsolt: http://orcid.org/0000-0001-5604-7551

• Klein, Verena: http://orcid.org/0000-0002-5830-7991

• Lewczuk, Karol: http://orcid.org/0000-0003-2437-2450

• Kraus, Shane W.: http://orcid.org/0000-0002-0404-9480

Affiliation Email Addresses:

• Grubbs, Joshua B.: Bowling Green State University, [email protected]

• Reid, Rory C.: University of California Los Angeles

• Bőthe, Beáta: Université du Québec à Trois-Rivières

• Demetrovics, Zsolt: ELTE Eötvös Loránd University Institute of Psychology

• Coleman, Eli: University of Minnesota

• Gleason, Neil: University of Washington

• Miner, Michael H.: University of Minnesota

• Fuss, Johannes: University of Duisburg-Essen

• Klein, Verena: University of Southampton School of Psychology

• Lewczuk, Karol: Cardinal Stefan Wyszynski University in Warsaw

• Gola, Mateusz: University of California San Diego

• Fernandez, David P.: Nottingham Trent University

• Fernandez, Elaine F.: Independent Practice

• Carnes, Stefanie: International Institute for Trauma and Addiction Professionals

• Lew-Starowicz, Michal: Centre of Postgraduate Medical Education Department of Psychiatry

• Kingston, Drew: Royal Ottawa Health Care Group Institute of Mental Health Research

• Kraus, Shane W.: University of Nevada Las Vegas

Correspondence Address:

Grubbs, Joshua B.: [email protected]

Permissions & Fee and Test Year

Permissions: Contact Corresponding Author (Joshua B. Grubbs).

Fee: No Fee is required for use.

Test Year: 2023

References

Grubbs, J. B., Reid, R. C., Bőthe, B., Demetrovics, Z., Coleman, E., Gleason, N., Miner, M. H., Fuss, J., Klein, V., Lewczuk, K., Gola, M., Fernandez, D. P., Fernandez, E. F., Carnes, S., Lew-Starowicz, M., Kingston, D., & Kraus, S. W. (2023). Assessing compulsive sexual behavior disorder: The development and international validation of the Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI). Journal of Behavioral Addictions, 12(1), 242–260. https://doi.org/10.1556/2006.2023.00005

Items of the Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI)

The CSBD-DI is a 7-item measure. No data is Available regarding the specific items themselves.