Compulsive Sexual Behavior Inventory (CSBI)

The CSBI measures loss of control over sexual behaviour and the consequences that follow from it. Developed by Eli Coleman and colleagues, it focuses on the two features that most directly correspond to the ICD-11 threshold: control, and harm.

It is a screening and research instrument. It does not diagnose.

What it measures

Where the SAST-R casts a wide net across the pattern and the PCI examines motivation, the CSBI is narrower and more direct: how much control the person experiences over the behaviour, and what it has cost them.

That focus maps closely onto the ICD-11 6C72 criteria, where the diagnosis turns on a persistent failure to control intense, repetitive sexual impulses resulting in behaviour that produces marked distress or significant impairment.

It is a useful instrument precisely because it does not ask about frequency. It asks whether you can stop, and what has happened because you could not.

What a result means

An elevated score indicates that both control and consequences are in the range where clinical assessment is warranted. It does not establish a diagnosis, and it cannot distinguish CSBD from conditions that produce a similar surface picture.

The differentials matter here more than on most instruments, because impaired control over sexual behaviour appears in several distinct clinical pictures:

• Bipolar hypersexuality — mood-driven and time-limited rather than persistent. See CSBD vs. bipolar hypersexuality.
• OCD with sexual content — where the repetition is thought and ritual rather than behaviour, and where the wrong treatment makes it worse. See CSBD vs. OCD.
• Substance-related disinhibition — where the sexual behaviour tracks the substance use rather than standing on its own.

An instrument cannot make those distinctions. A clinical assessment can.

The consequences questions are the hard ones

Most men find the control items straightforward and the consequences items uncomfortable, because the second set requires naming what the behaviour has actually cost — relationally, occupationally, financially, legally.

That discomfort is diagnostically relevant. Difficulty answering honestly about consequences is one of the more consistent features of the presentation, and it is worth mentioning to a clinician rather than resolving alone.

Where it fits at Iron Ridge

The CSBI is used alongside other instruments at intake and repeated at week 4, week 8, and six-month follow-up, so change in control and consequences is measured rather than recalled.

A note on self-administering it

The CSBI is a clinical and research instrument, not a consumer quiz, and interpreting it requires knowing how control and consequence items weight against each other. It is administered and scored within assessment rather than published as a self-test.

If you want somewhere to start on your own, the confidential CSBD self-assessment takes a few minutes, stores nothing, and is clear about what it cannot tell you.

Whatever the instrument, the same limit applies: a score indicates whether a conversation is warranted. Only a clinical assessment establishes what is actually going on.

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