METHODS: Systematic literature searches in accordance with PRISMA guidelines found 51 eligible studies that met inclusion criteria. Eight studies utilized both Waves 1 and 2 NESARC data, and selection of sample sizes varied from 185 to 43,093 individuals, consistent with specified research objectives of each study.
RESULTS: The prevalence of lifetime pathological gambling was 0.42% (0.64% among men, 0.23% among women), while past-year prevalence was 0.16%. Pathological gambling rates were generally higher in populations with substance-use disorders and other psychiatric diagnoses. Rates of adverse childhood experiences and suicidal attempts were higher among individuals with problem or pathological gambling. Early-onset gamblers were more likely to be male, be never married, have incomes below $70,000, belong to younger cohorts and have Cluster B personality disorders, but less likely to be diagnosed with mood disorders. While pathological gambling was related to obesity, increased stress, and poorer physical health among general age groups, recreational gambling was linked with improved physical and mental functioning in older adults.
CONCLUSIONS: The NESARC has provided important information on the correlates of pathological gambling and subdiagnostic patterns of gambling behaviors. Additional studies should examine these relationships in the current gambling environment and longitudinally with aims of implementing policies to improve the public health.
DESIGN: The present work details the development of the Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI) across seven samples, four languages, and five countries.
SETTING: In the first study, data were collected in community samples drawn from Malaysia (N = 375), the U.S. (N = 877), Hungary (N = 7,279), and Germany (N = 449). In the second study, data were collected from nationally representative samples in the U.S. (N = 1,601), Poland (N = 1,036), and Hungary (N = 473).
FINDINGS: Across both studies and all samples, results revealed strong psychometric qualities for the 7-item CSBD-DI, demonstrating evidence of validity via correlations with key behavioral indicators and longer measures of compulsive sexual behavior. Analyses from nationally representative samples revealed residual metric invariance across languages, scalar invariance across gender, strong evidence of validity, and utility in classifying individuals who self-identified as having problematic and excessive sexual behavior, as evidenced by ROC analyses revealing suitable cutoffs for a screening instrument.
CONCLUSION: Collectively, these findings demonstrate the cross-cultural utility of the CSBD-DI as a novel measure for CSBD and provide a brief, easily administrable instrument for screening for this novel disorder.
METHOD: Using data from the International Sex Survey (N = 82,243; Mage = 32.39 years, SD = 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD.
RESULTS: A total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were present in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability.
DISCUSSION AND CONCLUSIONS: This study contributes to a better understanding of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive prevention and intervention strategies for CSBD that are currently missing from the literature.