Background and aims: Despite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide standardized, state-of-the-art screening tools for research and clinical practice.Method: Using data from the International Sex Survey (N = 82,243; M_age = 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.

The three-item Sexual Distress Scale (SDS-3) has been frequently used to assess distress related to sexuality in public health surveys and research on sexual wellbeing. However, its psychometric properties and measurement invariance across cultural, gender and sexual subgroups have not yet been examined. This multinational study aimed to validate the SDS-3 and test its psychometric properties, including measurement invariance across language, country, gender identity, and sexual orientation groups. We used global survey data from 82,243 individuals (Mean _age=32.39 years; 40.3 % men, 57.0 % women, 2.8 % non-binary, and 0.6 % other genders) participating in the International Sexual Survey (ISS; https://internationalsexsurvey.org/) across 42 countries and 26 languages. Participants completed the SDS-3, as well as questions regarding sociodemographic characteristics, including gender identity and sexual orientation. Confirmatory factor analysis (CFA) supported a unidimensional factor structure for the SDS-3, and multi-group CFA (MGCFA) suggested that this factor structure was invariant across countries, languages, gender identities, and sexual orientations. Cronbach's α for the unidimensional score was 0.83 (range between 0.76 and 0.89), and McDonald's ω was 0.84 (range between 0.76 and 0.90). Participants who did not experience sexual problems had significantly lower SDS-3 total scores (M = 2.99; SD=2.54) compared to those who reported sexual problems (M = 5.60; SD=3.00), with a large effect size (Cohen's d = 1.01 [95 % CI=-1.03, -0.98]; p < 0.001). The SDS-3 has a unidimensional factor structure and appears to be valid and reliable for measuring sexual distress among individuals from different countries, gender identities, and sexual orientations.

Background: Not much is known about the correlation between gaming problems and substance use across different countries. This paper presents cross-national analyses of different gaming indicators and their relationship to substance use.Methods: Based on data from the 2015 ESPAD study, differences in the relationship between gaming and substance use across 35 countries were analysed using multi-level logistic regression, using substance use as an individual level predictor, economic wealth as a country-level predictor and a combined problem gaming indicator as the outcome.Results: Multi-level logistic regressions revealed significant correlations between individual substance use and gaming problems, which varied across countries and were moderated by economic wealth. Students who used alcohol, tobacco or cannabis and who lived in high-income countries had a smaller risk of scoring positively on a combined problem gaming indicator than students who used alcohol, tobacco or cannabis and who lived in less prosperous countries.Discussion: Different gaming indicators varied substantially across countries, with self-perceived gaming problems being more common in countries with a low prevalence of gaming. Significant cross-level effects demonstrate the need to take the societal context into account when the relationship between problem gaming and substance use is analysed. Prevention measures need to take the fact into account that patterns of substance use among problem gamers vary across countries.

Background: Adolescents and young adults are a crucial target group for preventing harm related to substance use. Recently, declining alcohol and tobacco consumption in young people has been observed in many countries. Based on survey data from 2004 to 2020, we describe time trends for several subgroups of adolescents and young adults (based on consumption levels and socioeconomic variables) and analyze associations between the level of alcohol per capita consumption or daily smoking and socioeconomic variables. Methods: Time trends for males and females are analyzed by a two-way ANOVA and predictors of use by using multivariate regression and logistic regression. Results: Alcohol per capita consumption decreased significantly for both sexes in the 16-year period, with male and female consumption levels converging. Daily smoking was equally prevalent for young males and females and decreased to a similar degree for both sexes. Being male and living in rural areas are associated with a higher level of alcohol consumption. Daily smoking is associated with a low level of education and is more prevalent among young adults who have already started to work. Conclusions: The decline in alcohol use and daily smoking among adolescents and young adults is taking place simultaneously. However, higher levels of alcohol consumption and daily smoking occur in different groups of adolescents and young adults, which should be considered in prevention strategies.

Objective: This study aimed to evaluate the reliability and validity of the Binge Eating Disorder Screener‐7 (BEDS‐7) across 42 countries and 26 languages, assessing its reliability and validity as a screening tool for binge‐eating disorder (BED) in diverse cultural contexts. Specifically, it sought to enhance early recognition of BED symptoms in primary care settings globally, contributing to a standardized framework for assessing BED.Method: The International Sex Survey, a cross‐sectional online study, was conducted in 42 countries and 26 languages. A diverse community sample of 82,243 participants, aged 18 years or older, completed the BEDS‐7 and measures of sexuality, mental health, substance use, and sociodemographic characteristics. Confirmatory factor analyses and tests of measurement invariance were employed to evaluate the reliability and validity of the BEDS‐7 across languages, countries, genders, and sexual orientations.Results: The BEDS‐7 demonstrated scalar factorial invariance across languages and countries, indicating consistent factor loadings and item intercepts. In contrast, the screener showed residual invariance across gender and sexual orientation groups, supporting its robustness across these demographics. Kruskal–Wallis tests revealed significant differences in BED symptoms across languages, countries, genders, and sexual orientations, with the highest BED scores observed among queer, pansexual, and gender‐diverse individuals. The BEDS‐7 also demonstrated adequate reliability (Cronbach's alpha > 0.80) and moderate criterion validity.Discussion: The findings provide further evidence of the reliability and validity of the BEDS‐7 as a potential screening tool for identifying probable cases of BED globally, facilitating early intervention in primary care settings.