Adaptation and validation of a patient-reported compassion measure in the Spanish population: The Spanish version of the Sinclair Compassion Questionnaire (SCQesp).

International practice guidelines and policies recognize compassion as a fundamental dimension of quality care. A key element in enhancing compassion in healthcare settings is having reliable patient-reported experience measures. In the Spanish context, there is a need for a valid Spanish patient-reported compassion measure for use in both research and clinical practice. The Sinclair Compassion Questionnaire (SCQ) represents the gold standard for patient-reported compassion measures in English-speaking settings. The primary aim of this study is to culturally adapt and validate the SCQ in a Spanish population. A Spanish version of the SCQ (SCQesp) was used to collect data from 303 Spanish patients (in two contexts: hospitalized and medical visit). Confirmatory factor analysis confirmed a one-factor solution in the 15-item (SCQesp) and five-item (SCQesp-SF) short form version. The SCQesp showed excellent values of reliability: Cronbach's α = 0.98; composite variance = 0.98 (0.905-0.854); and stratified variance = 0.78. The SCQesp-SF showed similar values of reliability. The SCQesp has excellent psychometric properties, making it a valid and reliable measure for assessing compassion in healthcare research and clinical care. This scientifically rigorous and psychometrically robust compassion measure in Spanish could allow healthcare providers, researchers, and leaders to routinely assess compassion.

Distortions in time perception related to videogames, pornography, and TV series exposure: An experimental study in three independent samples.

Background and aims: Time perception is a cognitive process involving both the ability to estimate the duration of an event (time estimation, TE) and the subjective perception of its passage (time passage, TP). Studies show that alteration in TE/TP is associated with substance use disorders. However, little is known about the impact of these alterations in potentially problematic online behaviors. We explore TE and TP while participants were exposed to cues related to videogames, pornography, and TV series, and the relationship of TE and TP with scores from instruments that measure problematic gaming (PG), problematic pornography use (PPU), and problematic binge-watching (BW). Methods: Participants from three independent samples (40 men from Luxembourg; 99 Spanish men, 111 Spanish women) completed an experimental task designed to assess TE and TP while they were exposed to short clips related to videogames, pornography, TV series, and documentaries (control condition). Participants also completed different self-reports. Results: Whereas men underestimated the time that they were exposed to pornography and TV series, women overestimated it. For videogames, we showed a consistent pattern of overestimation of time duration. Time was systematically perceived as passing faster while participants were presented with TV series and pornography. Regarding the association between time perception and PG, PPU, and BW, TE did not correlate with any of the indicators of problematic engagement assessed; but TP correlated with several of these indicators. Discussion and conclusions: The present preliminary results showed mixed evidence regarding the involvement of time perception in gaming, pornography use, and binge-watching.

Returning to work in cancer survivors: a multi-center cross-sectional study in Spain / La vuelta al trabajo en supervivientes de cáncer: un estudio transversal multicéntrico en España

Objetivo: Analizar la situación laboral, así como variables sociodemográficas (edad, sexo, estado civil y titulación) relacionadas con el cáncer (tipo de cáncer, estrategia de tratamiento primario y fase de supervivencia) en supervivientes españoles de cáncer. Método y procedimiento: Estudio transversal sobre una muestra heterogénea de 772 supervivientes de cáncer de inicio en la edad adulta en edad laboral. Se realizaron análisis correlacionales y de regresión logística para estudiar la capacidad predictiva de las variables sociodemográficas y relacionadas con el cáncer sobre la situación laboral y la posible modulación de los resultados por la CVRS evaluada mediante el QLACS. Resultados: Sólo el 55% de los supervivientes de cáncer estaban empleados. La edad, la cualificación y el tipo de cáncer fueron predictores independientes de la situación laboral, así como de la fase de supervivencia en los supervivientes con una CVRS baja. Conclusiones: Un alto porcentaje de supervivientes en edad laboral no vuelve a trabajar tras la experiencia oncológica. Algunas variables sociodemográficas y relacionadas con la enfermedad pueden ayudar a la identificación precoz de la población de riesgo en la que centrar la atención (AU)

Objective: To analyze the employment status as well as sociodemographic (age, gender, marital status, and qualification) and cancer-related variables (cancer type, primary treatment strategy, and survival phase) in Spanish cancer survivors. Method and procedure: Cross-sectional study on a heterogeneous sample of 772 working-age survivors of adult-onset cancer. Correlational and logistic regression analyses were performed to study the predictive ability of sociodemographic and cancer-related variables on employment status and the possible modulation of results by HRQOL assessed by the QLACS. Results: Only 55% of cancer survivors were employed. Age, qualification, and type of cancer were independent predictors of employment status as well as the survival phase in survivors with a low HRQOL. Conclusions: A high percentage of working-age survivors do not return to work after the cancer experience. Some sociodemographic and disease-related variables can help in the early identification of the risk population on which to focus attention (AU)

Sexual Health in Spanish People with Intellectual Disability: the Impact of the Lockdown due to COVID-19.

Introduction: The lockdown due to COVID-19 affected the sexual health of the people with intellectual disabilities by differentially modifying the frequency and characteristics of people's sexual activity depending on whether or not they lived with a partner during this period. The aim of this study was to analyze the extent to which the sexual behavior of people with intellectual disabilities (with and without a partner) was affected during the lockdown. Methods: The sample consisted of 73 people with intellectual disabilities between 21 and 63 years old (M = 39.63; SD = 10.11). The variables analyzed were the physical, social, and technological environment during the lockdown, sexual appetite, sexual behavior, online sexual activity, and sexual abuse. The data were collected between the months of May and June of 2020. Results: The lockdown increased the sexual appetite of a third of the sample (38%), especially the youngest participants. Sexual activity focused on autoeroticism and online behavior, particularly sending nude images of oneself (88%) and viewing pornography (83.6%). Rates of sexual abuse during this period were relatively high (6.8%). Conclusions: The sexual activity of people with ID was important during the lockdown, and they had to adapt to the circumstances of isolation in a similar way to the general population. Technological improvements in terms of devices and connection quality at home allowed their sexual behavior to be reoriented, opening the door to new risks for the sexual health of people with ID. Policy Implications: Cybersex and the increase in sexual abuse due to confinement are aspects that should be included in programs to improve the sexual health of this group.

Sexual behavior and sexual health of transgender women and men before treatment: Similarities and differences.

BACKGROUND: There is a lack of research on the sexual health of transgender individuals, as well as a paucity of data about overall sexual health indexes before treatment. AIMS: This study aims to analyze the main issues involved in transgender individuals' sexual behavior (with and without a partner), overall sexual health indexes, and potential predictors of sexual health, comparing trans men and trans women on all the variables assessed. METHODS: 260 trans people were recruited at a transgender health clinic in Spain. Participants completed the Sexual Behavior Questionnaire for transgender people before receiving any treatment. RESULTS: Overall results show that trans women have a more ego-dystonic and problematic experience of their sexuality. Regarding masturbation, there are no differences in its frequency between trans women and trans men, although there are differences in the reasons they do not masturbate. Regarding sexual behavior with a partner, trans women experience more difficulties than trans men, with significant differences in several areas (e.g., the percentage of transgender individuals who never allow their partners to touch their genitals). Regarding sexual health, we found differences between groups, with lower sexual desire, sexual arousal without orgasm, and overall sexual health in trans women. Likewise, different variables such as pain during sex, fantasies, and time with a steady partner seem to be associated with the different sexual health indexes. CONCLUSION: Our results show a clear difference between trans women and trans men in most of the sexual aspects assessed, revealing greater gender dysphoria in trans women. We would recommend taking these data into account, as well as variables that may be associated with different sexual health indexes, when designing interventions for transgender people.

Psychological distress in relatives of critically ill patients: Risk and protective factors.

The admission to an intensive care unit can result in a significant burden of emotional distress in the family. This study analyzes the psychological distress of 89 relatives of intensive care unit patients and the potential risk/protective factors for such distress. Families show high levels of anxiety, depression, and stress. Regarding risk factors, having steady partner, being a woman, and being a mother are associated with increased risk of anxiety, depression, and stress. Contrarily, being younger and having higher educational level are associated with reduced anxiety and stress. Influencing these trends could change positively the suffering course experienced by relatives and intensive care unit patients indirectly.

A Validation Study of the Spanish Version of the Hypersexual Behavior Inventory (HBI): Paper-and-Pencil Versus Online Administration.

Hypersexuality is a problematic behavior characterized by the combination of an excessive sexual desire and the pathological inability to control it. This study presents the psychometric properties of the Spanish paper-and-pencil and online versions of the Hypersexual Behavior Inventory (HBI), one of the most popular scales to assess this issue. A total of 2,250 participants (1,070 men) completed a translated version of the HBI (1,450 in paper-and-pencil; 800 online). The exploratory factor analysis yielded three factors that explained 67.53% of total variance for the HBI paper-and-pencil version. This factor structure was confirmed in the HBI online version through confirmatory factor analysis (CFA). Factorial, structural, scalar and error variance-invariance according to gender was also confirmed through multigroup CFA. Reliability of the total score and subscales ranged between .89 and .96. Likewise, correlations with other related scales were positive and significant (r between .511 and .743). Temporal stability one year after the first application was .77 (paper-and-pencil format) and .68 (online version). These results support the reliability and validity of the HBI and justify its use in the assessment of hypersexuality in Spanish-speaking countries.

Spanish validation of the Sexual Addiction Screening Test.

BACKGROUND AND AIMS: Sexual addiction is a pathological behavior characterized by a combination of excessive sexual desire and impaired ability to control it. Its incidence ranges between 1.2% and 32.2%, although this number may vary depending on the screening tool used. This wide variability is largely due to the use of non-validated instruments (e.g., structural validity relying on exploratory analyses, instruments translated without an additional validation process, or instruments validated in another format). To deal with these limitations, this study tested the psychometric properties of the Spanish paper-and-pencil and online versions of the Sexual Addiction Screening Test (SAST). METHODS: A total of 2,528 participants (1,163 males) completed the Spanish version of the SAST, along with other instruments assessing sexual compulsivity (1,585 = paper-and-pencil, 943 = online). RESULTS: The exploratory factor analysis yielded a four-factor structure explaining 57.39% of the variance for the SAST paper-and-pencil version. This factor structure was then verified for the online version through the use of confirmatory factor analysis [χ2(264) = 441.59; χ2/df = 1.66; RMSEA = 0.02; CFI = 0.94; IFI = 0.94]. This methodology was also used to support measurement invariance (configural, metric, and scalar invariance) according to gender. The reliability of the total score ranged from .82 to .85. Similarly, correlations with related scales were positive and significant (r between .22 and .71). Temporal stability 1 year after the first application was 0.65 (paper-and-pencil format) and 0.60 (online version). CONCLUSION: These results, together with the absence of questionnaires translated into Spanish to assess this construct, justify the use of the SAST in the evaluation of sexual addiction in Spanish-speaking countries.

[Assessment of the ICU stay from the point of view of patients and their relatives]. / Valoración de la estancia en UCI desde el punto de vista de pacientes y familiares.

OBJECTIVE: The quality of care is a key aspect in the gene- ral hospital setting and particularly in ICU. The objective of this study was to analyze the assessment of ICU stay by patients and relatives, as well as the influence of socio-demographic/psychological variables on this assessment. METHODS: 71 critically ill patients and 89 relatives answered the Questionnaire of the ICU stay assessment and the Hospital Anxiety-Depression Scale. Descriptive and frequency analyzes were performed. Likewise, correlation coefficients (Pearson/ Spearman), Student's t test, ANOVA analysis and multiple regression equations were used. RESULTS: Results show a positive evaluation in patients, both globally (Mean=4,06; SD=1,25) and in relation to different and inherent to ICU aspects, highlighting the attention/care of professionals (Mean=4,73; SD=0,68). As unpleasant/annoying aspects, they show the scarce possibilities of distraction (Mean=2,41; SD=1,38), lack of silence (Mean=3,15; SD=1,19) and visits policy (Mean=3,66; SD=1,04). Families evaluate globally the patient stay in ICU as "something" pleasant (Mean=3,31; SD=1,76). They also assess most aspects of the unit positively and underline the care/attention of professionals and the attention to psycho- logical needs. The valuation of the ICU stay shows differences in some aspects on the basis of socio-demographic variables. Likewise, family assesses more negatively the patient stay in ICU than patients do. CONCLUSIONS: The general evaluation of the ICU stay was positive, although with aspects susceptible to be improved. To know this reality is the prior step to the implementation of those measures that reinforce the well-valued issues and improve the worst- valued aspects in order to optimize the quality of the offered care.

OBJETIVO: La calidad asistencial es un aspecto primordial en el ámbito hospitalario general y particularmente en UCI. Nuestro objetivo fue analizar la valoración de pacientes y familiares sobre la estancia en UCI, y la influencia en dicha valoración de variables sociodemográficas y psicológicas. METODOS: 71 pacientes críticos y 89 familiares de una UCI polivalente de la Comunidad Valenciana respondieron el Cuestionario de Valoración de la Estancia en UCI y la Escala de ansiedad-depresión hospitalaria durante 2014-2015. Se realizaron análisis descriptivos y de frecuencias. Asimismo, se utilizaron coeficientes de correlación (Pearson/Spearman), Prueba t de Stu- dent, análisis ANOVA y ecuaciones de regresión múltiple. RESULTADOS: Los resultados mostraron una valoración positiva en los pacientes tanto a nivel global (Media=4,06; DE=1,25) como en relación con distintos aspectos inherentes a UCI, destacando las atenciones/cuidados de los profesionales (Media=4,73; DE=0,68). Como aspectos más desagradables/molestos señalaron las escasas posibilidades de distraerse (Media=2,41; DE=1,38), la falta de silencio (Media=3,15; DE=1,19) y el régimen de visitas (Media=3,66; DE=1,04). Los familiares, evaluaron globalmente la estancia del paciente en UCI como "algo" agradable (Media=3,31; DE=1,76), y valoraron positivamente la mayoría de aspectos propios de la unidad. La valoración de la estancia en UCI mostró diferencias en algunos aspectos en función de variables sociodemográficas. Asimismo, la familia valoró más negativamente que el paciente su estancia en UCI. CONCLUSIONES: La valoración de la estancia en UCI en líneas generales fue positiva aunque con aspectos susceptibles de mejora. Conocer esta realidad es el paso previo a la puesta en marcha de medidas que refuercen lo bien valorado y mejoren los aspectos peor valorados para poder optimizar la calidad asistencial ofrecida.

Valoración de la estancia en UCI desde el punto de vista de pacientes y familiares / Assessment of the ICU stay from the point of view of patients and their relatives

Fundamentos: La calidad asistencial es un aspecto primordial en el ámbito hospitalario general y particularmente en UCI. Nuestro objetivo fue analizar la valoración de pacientes y familiares sobre la estancia en UCI, y la influencia en dicha valoración de variables sociodemográficas y psicológicas. Métodos: 71 pacientes críticos y 89 familiares de una UCI polivalente de la Comunidad Valenciana respondieron el Cuestionario de Valoración de la Estancia en UCI y la Escala de ansiedad-depresión hospitalaria durante 2014-2015. Se realizaron análisis descriptivos y de frecuencias. Asimismo, se utilizaron coeficientes de correlación (Pearson/Spearman), Prueba t de Student, análisis ANOVA y ecuaciones de regresión múltiple. Resultados:Los resultados mostraron una valoración positiva en los pacientes tanto a nivel global (Media=4,06; DE=1,25) como en relación con distintos aspectos inherentes a UCI, destacando las atenciones/cuidados de los profesionales (Media=4,73; DE=0,68). Como aspectos más desagradables/molestos señalaron las escasas posibilidades de distraerse (Media=2,41; DE=1,38), la falta de silencio (Media=3,15; DE=1,19) y el régimen de visitas (Media=3,66; DE=1,04). Los familiares, evaluaron globalmente la estancia del paciente en UCI como "algo " agradable (Media=3,31; DE=1,76), y valoraron positivamente la mayoría de aspectos propios de la unidad. La valoración de la estancia en UCI mostró diferencias en algunos aspectos en función de variables sociodemográficas. Asimismo, la familia valoró más negativamente que el paciente su estancia en UCI. Conclusiones: La valoración de la estancia en UCI en líneas generales fue positiva aunque con aspectos susceptibles de mejora. Conocer esta realidad es el paso previo a la puesta en marcha de medidas que refuercen lo bien valorado y mejoren los aspectos peor valorados para poder optimizar la calidad asistencial ofrecida

Background: The quality of care is a key aspect in the general hospital setting and particularly in ICU. The objective of this study was to analyze the assessment of ICU stay by patients and relatives, as well as the influence of socio-demographic/psychological variables on this assessment. Methods: 71 critically ill patients and 89 relatives answered the Questionnaire of the ICU stay assessment and the Hospital Anxiety-Depression Scale. Descriptive and frequency analyzes were performed. Likewise, correlation coefficients (Pearson/Spearman), Student's t test, ANOVA analysis and multiple regression equations were used. Results: Results show a positive evaluation in patients, both globally (Mean=4,06; SD=1,25) and in relation to different and inherent to ICU aspects, highlighting the attention/care of professionals (Mean=4,73; SD=0,68). As unpleasant/annoying aspects, they show the scarce possibilities of distraction (Mean=2,41; SD=1,38), lack of silence (Mean=3,15; SD=1,19) and visits policy (Mean=3,66; SD=1,04). Families evaluate globally the patient stay in ICU as "something " pleasant (Mean=3,31; SD=1,76). They also assess most aspects of the unit positively and underline the care/attention of professionals and the attention to psychological needs. The valuation of the ICU stay shows differences in some aspects on the basis of socio-demographic variables. Likewise, family assesses more negatively the patient stay in ICU than patients do. Conclusion: The general evaluation of the ICU stay was positive, although with aspects susceptible to be improved. To know this reality is the prior step to the implementation of those measures that reinforce the well-valued issues and improve the worst-valued aspects in order to optimize the quality of the offered care

Cybersex Addiction: A Study on Spanish College Students.

The aim of this study was to determine the type and frequency of online sexual practices among Spanish college students, the prevalence of risk and pathological cybersex use profiles, and the correlates/predictors of this behavior. Participants were 1,557 males and females between 18 and 25 years old. Results showed that cybersex use is not as frequent as that documented in other Western countries. However, a significant percentage of participants with a risky (8.6%) or pathological (1.7% in men and 0.1% in women) profile was identified. Finally, we found a set of variables that, in interaction with gender, explains 58% of the variance for cybersex addiction scores.

Ansiedad, depresión y malestar emocional en los profesionales sanitarios de las Unidades de Cuidados Intensivos / Anxiety, depression and emotional distress in the Intensive Care Units health professionals

Los profesionales sanitarios (PS) de las Unidades de Cuidados Intensivos (UCI) no son inmunes a los efectos emocionales que supone enfrentarse diariamente a situaciones de sufrimiento y muerte. Los estudios sobre afectación emocional en PS se han centrado en el síndrome burnout y han presentado ansiedad y depresión como consecuencias de éste. Nuestro objetivo es evaluar los problemas de ansiedad, depresión y percepción subjetiva del estado de ánimo en profesionales de las UCIs. Los participantes fueron 117 PS de la UCI de un Hospital de la Comunidad Valenciana (España). Los análisis descriptivos muestran que entre 14.6%-20% y un 4-7% de los participantes presentan síntomas de ansiedad y de depresión respectivamente. Los análisis diferenciales, muestran diferencias en función del género en ansiedad y en función del puesto laboral en depresión. La edad y la experiencia mostraron relación con depresión y ansiedad. Además, se realizaron análisis de regresión para conocer qué variables juegan un papel más importante en la presencia de síntomas de ansiedad y depresión, Los resultados muestran que trabajar a diario en contacto con el sufrimiento y la muerte, en un ambiente con numerosas demandas, puede tener consecuencias sobre la salud mental de los profesionales

Health Workers (HW) who work in the Intensive Care Units (ICU), are not exempt from emotional effects of coping with suffering and death situations daily. Many studies in HW have focused on the burnout syndrome and have presented anxiety and depression as consequences of this syndrome. The aim of this work is to assess the anxiety and depression problems, as well as the subjective perception of mood of the ICU health workers. Participants were 117 ICU health workers of a Hospital in the Valencian Community (Spain). The descriptive analyses show that between 14.6-20% and a 4-7% of participants have symptoms of anxiety and depression, respectively. Differential analyses, show gender differences in several measures of anxiety, as well as on depression scores. Age and experience are related to depression and anxiety. Furthermore, we performed regression analyses to know the importance of the different variables in the presence of symptoms of anxiety and depression. The results show that working in daily contact with suffering and death, in a Unit in which the demands are many, could have implications for the mental health of professionals

Afrontamiento de la muerte en familiares de pacientes ingresados en una unidad de cuidados intensivos: valoración diferencial en función de variables sociodemográficas / Confronting death in families of patients admitted to Intensive Care Units: differential assessment using sociodemographic variables

Objetivo: analizar qué aspectos son más importantes en el afrontamiento de la muerte según los familiares de pacientes de unidad de cuidados intensivos (UCI), considerando la influencia de distintas variables sociodemográficas (sexo, edad, estado civil y nivel de estudios).Material y método: Se realizó un estudio descriptivo con familiares de pacientes ingresados en la UCI del Hospital General de Castellón (de octubre de 2008 a diciembre de 2009). De las 53 entrevistas iniciales, el 26% de los sujetos no cumplía los criterios de inclusión para participar en el estudio, quedando la muestra final compuesta por 39 familiares que voluntariamente contestaron el cuestionario de ayuda a morir en paz. Resultados: Los aspectos que más ayudarían a los familiares llegado el momento de la muerte serían sentirse cerca, comunicarse y estrechar vínculos afectivos con las personas queridas (63,2%) y pensar que los médicos puedan controlar el dolor/síntomas (..) (AU)

Objective: To analyze the main factors that could help to face one’s own death from relatives of ICU patients perspective, taking into account the influence of sociodemographic variables (gender, age, marital status and educational level).Material and method: a descriptive study was carried out with family members of patients admitted to the ICU in the General Hospital (Castellón, Spain) (October 2008- December 2009). From 53 initial interviews, 26% of subjects were excluded of the study, so the total sample was made up of 39 relatives who voluntarily answered the Helping to Die in Peace Questionnaire. Results: The most relevant factors that could help relatives at the time of death would be to be close, to communicate and to strengthen bonds with loved ones (63.2%) and to receive adequate pain/symptom management (52.6%). In these assessments were found statistically significant differences by gender and educational level. According to gender, women prioritize the meaning of life (P=.012) and that their deaths do not (..) (AU)

[Psychometric properties of an instrument for assessing cyber-sex addiction]. / Propiedades psicométricas de un instrumento de evaluación de la adicción al cibersexo.

Psychometric properties of an instrument for assessing cyber-sex addiction. Cyber-sex addiction is a «new pathology¼ whose prevalence has grown rapidly in recent years. Therefore, it is important to have validated assessment instruments. The aim of this study was the adaptation and validation of the Internet Sex Screening Test (ISST) for its use in a Spanish population. The instrument was administered to 1239 Spanish college students. The results yielded five components that account for 47.5% of the variance. Internal consistency was .88 and temporal stability was .84. Moreover, the instrument had adequate convergent and discriminant validity and was related to other behaviors such as the use of pornography, internet addiction, number of hours online and sexual frequency. Therefore, this tool is proposed as an appropriate measure to assess cyber-sex addiction.

Propiedades psicométricas de un instrumento de evaluación de la adicción al cibersexo / Psychometric properties of an instrument for assessing cyber-sex addiction

La adicción al cibersexo constituye una «nueva patología» cuya prevalencia ha aumentado con rapidez en los últimos años, por lo que se precisa de instrumentos de evaluación validados. En este trabajo presentamos la adaptación y validación para su administración en población española del Internet Sex Screening Test (ISST). El instrumento fue administrado a 1.239 estudiantes universitarios españoles. Los resultados muestran cinco componentes que explican el 47,5% de la varianza. La consistencia interna es de 0,88 y la estabilidad temporal de 0,84. Por otro lado, el instrumento presenta una adecuada validez convergente y discriminante, mostrando la puntuación total una correlación positiva significativa con otros comportamientos como el consumo de material pornográfico, la adicción a Internet, el número de horas online y la frecuencia sexual. Por todo ello se propone este instrumento como medida apropiada para la evaluación de la adicción al cibersexo (AU)

Cyber-sex addiction is a «new pathology» whose prevalence has grown rapidly in recent years. Therefore, it is important to have validated assessment instruments. The aim of this study was the adaptation and validation of the Internet Sex Screening Test (ISST) for its use in a Spanish population. The instrument was administered to 1239 Spanish college students. The results yielded five components that account for 47.5% of the variance. Internal consistency was .88 and temporal stability was .84. Moreover, the instrument had adequate convergent and discriminant validity and was related to other behaviors such as the use of pornography, internet addiction, number of hours online and sexual frequency. Therefore, this tool is proposed as an appropriate measure to assess cyber-sex addiction(AU)