A new study from 42 countries suggests that up to 5% of people may be at high risk for compulsive sexual behavior disorder (CSBD). However, only 14% of them have ever sought treatment for these behaviors, according to the study, which was recently published in the Behavioral Addictions Diary.
CSBD (sometimes also called sex addiction or hypersexuality) is included in the 11e revision of the International Classification of Diseases (ICD-11). According to these new diagnostic guidelines, a diagnosis of CSBD may apply when a person engages in sexual urges and behaviors repetitively with little or no control over them, and these behaviors subsequently result in significant distress. and negative consequences (eg job loss, relationship conflict). ).
However, this diagnosis is still relatively new and some potential issues have not yet been addressed in scientific studies. One such issue is the relative lack of data on CSBD outside of Western, educated, industrialized, affluent, and democratic (WEIRD) countries, among women and gender-diverse individuals (e.g., non-binary people ) and sexually diverse individuals (for example, bisexual people) as well. This is despite preliminary studies showing significant differences based on gender, sexual orientation, and culture in sexual behaviors in general, and in CSBD in particular.
Therefore, to provide a picture of CSBD across different cultures, genders and sexual orientations, we conducted a large-scale study in 42 countries on five continents – the International Sex Survey. First, we took the necessary step to verify whether the scales currently used to assess CSBD were valid and reliable across all the different groups we wanted to compare. Next, we compared CSBD in the aforementioned groups and examined differences in a variety of sexual behaviors between individuals at low and high risk of experiencing CSBD.
Over 82,000 adults responded to our anonymous online survey, including nearly 47,000 women, 2,800 people of diverse gender identities and over 25,000 people of diverse sexual identities (i.e. those who report having a sexual orientation other than heterosexual, such as lesbian or gay). Our results indicate that 4.8% of individuals could be victims of CSBD globally, although a wide range of rates was observed among different countries, genders, and sexual orientations.
The highest levels of CSBD have been reported in Turkey, followed by China and Peru. These findings highlight the importance of examining CSBD in diverse populations outside the domain of WEIRD countries, as sexuality and related values might be associated with its cultural background and norms.
Regarding gender differences, as shown in previous studies, males reported the highest levels of CSBD, followed by gender-diverse individuals, then females. Previous studies have not thoroughly examined sexual orientation-based differences in CSBD without merging groups of individuals with different sexual orientations. This is quite problematic because, for example, there is ample evidence that bisexual people face more mental health issues than lesbian/gay or exclusively same-sex attracted people.
We therefore compared CSBD levels in eight groups based on sexual orientation (i.e., heterosexual, gay or lesbian, bisexual, queer and pansexual, homo- and heteroflexible, asexual, questioning, and self-defeating individuals). identifying with other sexual orientations), and did not see any significant difference between their CSBD levels.
Finally, we looked at the frequency of different sexual behaviors in people at high risk of experiencing CSBD compared to those who were not. As expected, the high-risk CSBD group used pornography more frequently, masturbated more frequently, had more sex partners in their lifetime, had more casual sex partners in the past year, and engaged in sexual activities with casual sex partners more frequently than people in the low-risk CSBD group.
However, they had sex with their romantic partners as often as their peers in the low-risk group. Importantly, only 14% of people in the high-risk CSBD group had ever sought treatment for CSBD, and an additional 33% had not sought treatment for a variety of structural and personal reasons (e.g., stigma, processing costs).
One of the key take-home messages from our study is that with a worldwide occurrence rate of nearly 5%, CSBD appears to be as common as other more widely studied psychiatric disorders, with a wide range of estimates. by country, gender and sexual orientation. These differences in CSBD estimates demonstrate the need for more inclusive research in this area. Additionally, given the low rates of treatment-seeking for CSBD among high-risk individuals, there is a need to raise awareness about CSBD, including affordable, accessible, and evidence-based treatment options, in a culturally appropriate manner.
Like any research, our study had some limitations. For example, although we were able to collect data from diverse populations (e.g., sexually different individuals) in 42 countries, the results are not representative of all populations in each country, which limits the broader generalizability of the findings. results, especially in countries with relatively small populations. sample sizes. Future studies are needed to further examine CSBD in other populations, including nationally representative, longitudinal, and clinical samples.
However, the present study was the first step in a deeper examination of CSBD and other sexual behaviors using data collected through the International Sex Survey.
The study, “Compulsive Sexual Behavior Disorder in 42 Countries: Insights from the International Sex Survey and Introduction to Standardized Assessment Tools,” was authored by Beáta Bőthe, Mónika Koós, Léna Nagy, Shane Kraus, Marc Potenza, Zsolt Demetrovics and others from collaborating countries.