Compulsive Sexual Behavior Inventory

Abstract

The Compulsive Sexual Behavior Inventory (CSBI) is a widely utilized self-report measure consisting of 22 multiple-choice items designed to quantify the severity of Compulsive Sexual Behavior (CSB). CSB is conceptualized as a clinical syndrome marked by recurrent, intense, and distressing sexual urges and fantasies that significantly impair a person’s daily functioning. Individuals affected by CSB frequently experience an inability to control these distressing thoughts and behaviors, despite a strong desire to cease them. The CSBI is specifically designed to assess both major forms of this condition: paraphilic CSB, which involves compulsive behavior related to deviant or nonconventional sexual interests, and nonparaphilic CSB, which involves similar compulsivity centered on normative or conventional sexual activities. The scale items are scored on a 5-point Likert-type rating scale, ranging from Never to Very Frequently.

Keywords

Compulsive Sexual Behavior, CSBI, Sexual Addiction, Hypersexuality, Paraphilic, Nonparaphilic, Sexual Control, Psychometric Scale, Self-report.

Authors

Eli Coleman, Rebecca E. Swinburne Romine (University of Minnesota).

Purpose

The primary purpose of the CSBI is to provide a standardized, quantifiable measure for assessing the severity of Compulsive Sexual Behavior (CSB) in clinical and research settings. It helps differentiate the intensity of symptoms related to lack of control and potential violence associated with the behavior.

The instrument was developed to be applicable across the spectrum of CSB presentations, specifically distinguishing between paraphilic and nonparaphilic forms of the condition. Initial validation studies focused on its utility among adult men, including those diagnosed with nonparaphilic CSB and those diagnosed with pedophilia, allowing for comparative analysis across different sexual behavior presentations.

Construct

The CSBI measures the construct of Compulsive Sexual Behavior (CSB), characterized by an inability to control sexual urges and behaviors that result in personal distress or functional impairment. The scale operationalizes this construct through two distinct, underlying factors: Control and Violence.

The Control factor (Items 1–13) captures the subjective experience of loss of control, preoccupation, emotional distance, and the negative life consequences (e.g., financial problems, interference with relationships) stemming from sexual activity. The Violence factor (Items 14–22) assesses behaviors related to force, aggression, and physical pain associated with sexual encounters, directed both toward others and experienced by the respondent.

Validity

Preliminary validity research has demonstrated the utility of the CSBI in distinguishing between clinical and control groups. The initial study compared scores among three groups of men: those diagnosed with nonparaphilic CSB, those diagnosed with pedophilia, and a community control group, showing significant score differences aligned with clinical diagnosis.

Further evidence of concurrent validity (Miner et al., 2007) showed that respondents scoring above the median on the total CSBI scale reported significantly greater numbers of sexual partners, more unprotected anal intercourse, and were more likely to report being intoxicated, depressed, lonely, or driven during intercourse. Importantly, self-reports of depression correlated strongly with the total score and the Control score, but not specifically with the Violence score, suggesting distinct measurement properties for the two factors.

Reliability

The CSBI demonstrates strong test-retest reliability across both available language versions. For the English version, test-retest reliability was reported at an intercorrelation of r = .86. The Spanish version showed even stronger reliability, with an intercorrelation of r = .93 (p < .001). This consistency supports the stability of the measure over time (Miner et al., 2007).

Factor Analysis

The structural integrity of the CSBI is supported by a consistent two-factor model, which holds true for both the English and Spanish versions of the scale. These two factors represent the core dimensions of the compulsive sexual behavior construct: Control and Violence.

The Control scale is comprised of the first thirteen items (Items 1 through 13), focusing on subjective experiences of loss of control, promises to change, use of sex for coping, and negative life interference. The subsequent nine items (Items 14 through 22) constitute the Violence scale, capturing behaviors related to sexual aggression, physical pain (given or received), and legal issues related to sexual acts.

Instrument

Test Type: Self-report measure; Clinical assessment inventory.

Format: 22 multiple-choice items scored on a 5-point Likert-type scale (Never to Very Frequently).

Language Available: English, Spanish (Inventario de Comportamiento Sexual Compulsivo).

Population Group: Initially validated primarily on adult men, including clinical and community samples. Current research is expanding validation for use with adult women.

Age Group: Adult.

Population Details: Validation samples included men clinically diagnosed with nonparaphilic CSB, men diagnosed with pedophilia, community control groups, and Latino men who have sex with men (MSM).

Test Methodology: Can be administered via pencil-and-paper or online formats. Completion time is approximately 10 minutes.

Scoring

The CSBI utilizes a straightforward scoring system where numerical values are assigned to the 5-point rating scale responses:

• 1: Never

• 2: Rarely

• 3: Occasionally

• 4: Frequently

• 5: Very Frequently

The final score is obtained by summing the values across all 22 items. Higher total scores are indicative of greater severity and frequency of Compulsive Sexual Behavior (CSB). Subscale scores can also be calculated by summing the items corresponding to the Control factor (Items 1–13) and the Violence factor (Items 14–22) separately for detailed clinical interpretation.

Keywords

Sexual health, impulsivity, control disorders, hypersexual disorder, sexual compulsivity, psychological assessment, scale development, psychometrics.

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: [email protected] (Eli Coleman)

Correspondence Address: Eli Coleman, Professor and Director, Program in Human Sexuality, Department of Family Practice and Community Health, Medical School, 1300 South 2nd Street, Suite 180, Minneapolis, MN 55454.

Permissions & Fee and Test Year

The scale was initially developed and published in 2001 (Coleman et al., 2001), with subsequent psychometric validation published in 2007 (Miner et al., 2007). The copyright for the Compulsive Sexual Behavior Inventory (CSBI) is held by Eli Coleman, Ph.D., Program in Human Sexuality, University of Minnesota. Specific information regarding usage fees or formal permissions for clinical or research use should be directed to the corresponding author.

Reference’s

• Coleman, E., Miner, M., Ohlerking, F., & Raymond, N. (2001). Compulsive Sexual Behavior Inventory: A preliminary study of reliability and validity. Journal of Sex and Marital Therapy, 27, 325–332.

• Miner, M. H., Coleman, E., Center, B. A., Ross, M., & Rosser, B. R. S. (2007). The Compulsive Sexual Behavior Inventory: Psychometric properties. Archives of Sexual Behavior, 36, 579–587.

Items of the Compulsive Sexual Behavior Inventory

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Never Rarely Occasionally Frequently Very Frequently

CSBI (English Version)

Circle the answer that most accurately describes your response.

1. How often have you had trouble controlling your sexual urges? 1 2 3 4 5

2. Have you felt unable to control your sexual behavior? 1 2 3 4 5

3. How often have you used sex to deal with worries or problems in your life? 1 2 3 4 5

4. How often have you felt guilty or shameful about aspects of your sexual behavior? 1 2 3 4 5

5. How often have you concealed or hidden your sexual behavior from others? 1 2 3 4 5

6. How often have you been unable to control your sexual feelings? 1 2 3 4 5

7. How often have you made pledges or promises to change or alter your sexual behavior? 1 2 3 4 5

8. How often have your sexual thoughts or behaviors interfered with the formation of friendships? 1 2 3 4 5

9. How often have you developed excuses and reasons to justify your sexual behavior? 1 2 3 4 5

10. How often have you missed opportunities for productive and enhancing activities because of your sexual activity? 1 2 3 4 5

11. How often have your sexual activities caused financial problems for you? 1 2 3 4 5

12. How often have you felt emotionally distant when you were engaging in sex with others? 1 2 3 4 5

13. How often have you had sex or masturbated more than you wanted to? 1 2 3 4 5

14. Have you forced anyone against his or her will to have sex? 1 2 3 4 5

15. Have you ever hit, kicked, punched, slapped, thrown, choked, restrained, or beaten any of your sexual partners? 1 2 3 4 5

16. Have you given others physical pain for sexual pleasure? 1 2 3 4 5

17. In fighting, have you been hit, kicked, punched, slapped, thrown, choked, restrained, or beaten by your current or most recent partner? 1 2 3 4 5

18. Have you received physical pain for sexual pleasure? 1 2 3 4 5

19. Have you received money to have sex? 1 2 3 4 5

20. Have you been forced to have sex with your husband, wife, or lover? 1 2 3 4 5

21. Have you been watched masturbating or having sex without giving permission? 1 2 3 4 5

Inventario de Comportamiento Sexual Compulsivo (Spanish Version)

Nunca Rara Ocasional Frec Muy Frec Circule la respuesta que más aplique.

1. Con qué frecuencia ha tenido usted dificultad en controlar sus impulsos sexuales? 1 2 3 4 5

2. Se ha sentido usted incapaz de controlar su comportamiento sexual? 1 2 3 4 5

3. Con qué frecuencia ha usado usted el sexo para tratar sus preocupaciones o problemas? 1 2 3 4 5

4. Con qué frecuencia se ha sentido usted culpable o avergonzado acerca de los aspectos de su comportamiento sexual? 1 2 3 4 5

5. Con qué frecuencia ha ocultado usted su comportamiento sexual a otros? 1 2 3 4 5

6. Con qué frecuencia se ha sentido usted incapaz de controlar sus sentimientos sexuales? 1 2 3 4 5

7. Con qué frecuencia ha hecho usted compromisos o promesas de cambiar o de alterar su comportamiento sexual? 1 2 3 4 5

8. Con qué frecuencia sus pensamientos o comportamientos sexuales han interferido con la formación de amistades? 1 2 3 4 5

9. ¿Con qué frecuencia ha inventado usted excusas y razones para justificar su comportamiento sexual? 1 2 3 4 5

10. ¿Con qué frecuencia ha perdido usted la oportunidad para hacer actividades productivas debido a su actividad sexual? 1 2 3 4 5

11. Con qué frecuencia su actividad sexual le ha causado a usted problemas financieros? 1 2 3 4 5

12. ¿Con qué frecuencia se ha sentido emocionalmente distante cuando ha tenido sexo con otros? 1 2 3 4 5

13. Con qué frecuencia ha tenido sexo o masturbación más de lo que usted ha querido? 1 2 3 4 5

14. Con qué frecuencia ha sido arrestado o legalmente sancionado por su comportamiento sexual? 1 2 3 4 5

15. Ha obligado usted a algún hombre/mujer hacer algo en contra de su voluntad? 1 2 3 4 5

16. Alguna vez ha golpeado, empujado, cacheteado, lanzado, sofocado, sometido o le ha pegado usted a alguna de sus parejas sexuales? 1 2 3 4 5

17. Le ha causado usted a otras personas dolor físico por placer sexual? 1 2 3 4 5

18. En peleas, ¿ha sido usted golpeado, pateado, empujado, cacheteado, ha sido tirado, estrangulado, frenado, o le ha pegado su pareja actual o la más reciente? 1 2 3 4 5

19. Ha recibido usted dolor físico por placer sexual? 1 2 3 4 5

20. ¿Ha recibido dinero por tener sexo? 1 2 3 4 5

21. Ha sido obligado a tener sexo con su esposo, esposa u amantes? 1 2 3 4 5

22. Ha sido usted visto masturbándose o teniendo sexo sin dar su permiso? 1 2 3 4 5