CSBD assessments

Screening instruments indicate whether a clinical conversation is warranted. None of them diagnose. Compulsive sexual behaviour disorder is diagnosed through clinical assessment against the ICD-11 6C72 criteria by a qualified clinician — not by a score on a questionnaire, however well validated the questionnaire is.

That distinction matters more here than in most areas of mental health, because the internet is full of "sex addiction tests" that return a verdict. A verdict is precisely what a screening instrument cannot give you.

What screening instruments are for

They do three useful things.

They organise a vague worry into specific questions. Most men arrive at a screener knowing something is wrong without being able to describe it. Being asked directly about escalation, failed attempts to stop, and continued use despite consequences turns a diffuse feeling into observable facts.

They give a clinician a starting point. A completed instrument is a faster and more honest opening than twenty minutes of general questions, because it has already surfaced the areas where the answers were uncomfortable.

They track change over time. Administered at intake, mid-treatment, and follow-up, the same instrument shows movement that memory does not reliably report.

What they cannot do

• They cannot diagnose. A high score is not a diagnosis and a low score does not rule anything out.
• They cannot distinguish CSBD from its differentials on their own. Intrusive sexual thoughts in OCD, hypersexuality during a manic episode, and high sexual interest without impairment can all produce elevated scores on instruments designed for a different picture. Those distinctions require clinical judgement — see CSBD vs. OCD, CSBD vs. bipolar hypersexuality, and CSBD vs. high libido.
• They cannot account for moral distress. The ICD-11 is explicit that distress arising entirely from moral judgements about sexual impulses is not sufficient for the diagnosis. A screener does not know the difference between "this is harming my life" and "I was raised to believe this is shameful."

The instruments covered here

• SAST-R — the Sexual Addiction Screening Test, Revised. The most widely used screening instrument in this field.
• PCI — the Pornography Consumption Inventory, which measures why someone uses pornography rather than how much.
• CSBI — the Compulsive Sexual Behavior Inventory, focused on control and consequences.

Iron Ridge also uses a brief confidential screener on this site. Take the CSBD self-assessment — it takes a few minutes and nothing is stored.

How Iron Ridge uses assessment

Assessment is administered at baseline, at week 4, at week 8, and at six-month follow-up across the eight-week clinical arc. The instruments used are selected against the presenting picture rather than applied uniformly, and they sit alongside screening for the co-occurring conditions that usually drive the behaviour.

The results inform the treatment plan. They do not constitute it.

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