Compulsive Sexual Behaviour Disorder and its Psychopathological Correlates: Data from the International Sex Survey (ISS)

Introduction: Sexuality is a fundamental part of every individual's life and encompasses a wide range of basic and highly complex behaviors. In 2011, WHO included Compulsive Sexual Behaviour Disorder (CSBD) within the ICD-11 classification. More than 80 percent of people with CSBD may also manifest Problematic Pornography Use (PPU), which is therefore its most prominent clinical manifestation. Recent studies have shown that individuals with CSBD and PPU might show low levels of mental well-being, with a focus on anxiety and depressive symptoms. Methods: The ISS (http://internationalsexsurvey.org/) is an international, multi-laboratory, multi-language study using cross-sectional and self-report survey methods, involving more than 45 countries worldwide. Participants were asked sociodemographic questions, specific questions about sexuality and pornography use, and assessment scales already validated in the literature to analyze problematic pornography use (Problematic Pornography Consumption Scale - PPCS, Brief Pornography Screen - BPS), its motivations (Pornography Use Motivations Scale - PUMS) and associated psychopathological dimensions (anxiety and depression scales of the Brief Symptom Inventory - BSI). The presence of a compulsive sexual behavior was indagated with the Compulsive Sexual Behavior Disorder Scale (CSBD-19). Results: The study registered 2874 participants (842 from UK and 2032 from Italy). UK sample showed a lower number of heterosexual individuals (56,4% vs 72,3%), and a high percentage of sexually diverse individuals (43,5% vs 27,7%). British individuals revealed a higher number of sexual experiences with a partner (83,3% vs 91,5%), a lower age at first sexual experience with a partner (17,3 ± 2,8 vs 16,8 ± 3,4), a higher number of lifetime partners (7,8 ± 24,4 vs 20,8 ±74,0). In terms of CSBD and PPU the UK sample showed overall statistically significant higher scores on both CSBD-19 (5,3% vs 2,4%) and BPS (14,6% vs 9,8%) scale. Italian males begin using pornography at a significantly lower age than English males and statistically significant differences emerged in the analysis of the motivation behind pornography use, especially in regarding the Control, Salience and Negative Consequences scales. Conclusions: This is the first study conducted on a large population and with a systematic methodology in relation to the assessment of sexual behavior and pornography addiction in the UK and Italy. The data that emerged provide several interesting insights into CSBD and PPU and their cross-cultural differences. Future studies will be needed to examine a wider range of variables, preferably in longitudinal settings, providing information on the natural course and temporal stability of the associations assessed.