1. Do you often find yourself preoccupied with thoughts about sex?
Yes No
2. Do you have trouble controlling your sexual behaviour even though you are aware it may be inappropriate or dangerous to your health?
Yes No
3. Were you sexually abused as a child or adolescent?
Yes No
4. Have you subscribed to or regularly purchased sexually explicit material such internet downloads, magazines or videos, or have you ever paid for sex?
Yes No
5. Has your use of online pornography, phone sex lines or internet sex chat-rooms etc exceeded your ability to pay for those services or become greater than your intimate contact with your romantic partner(s)?
Yes No
6. Did / do your parents have difficulties with their own sexual or romantic behaviours?
Yes No
7. Do you hide the extent or nature of your sexual activities from your partner(s) or friends (other than for reasons of your sexual orientation)?
Yes No
8. Do you look forward to events with family and friends being over so that you can go out and have sex?
Yes No
9. Do you visit sex clubs or sex video / book stores or sexual bath-houses as part of your sexual activity?
Yes No
10. Do you believe that anonymous or casual sex has prevented you from developing long-term intimate relationships and / or achieving personal goals?
Yes No
11. Do you experience difficulties in maintaining intimate sexual relationships once the initial excitement of a new partner has worn off?
Yes No
12. Do your sexual encounters ever create risks that you will be arrested for lewd conduct, public indecency or other sexual offences?
Yes No
13. Has anyone ever been hurt emotionally by events linked to your sexual behaviour, for example lying to a partner or friends, failing to attend an appointment or event because you were involved in sexual activity?
Yes No
14. Do you ever feel depressed or ashamed after sex?
Yes No
15. Have you made repeated promises to yourself to change aspects of your sexual activity, only to break them later (for reasons other than your sexual orientation).
Yes No
16. Has sex ever interfered with any aspect of your professional or personal life, for example being unable to concentrate at work or causing the break-up of a relationship?
Yes No
17. Have you ever engaged in unsafe or risky sexual practices even though you knew it could harm to either you or others?
Yes No
18. Have you ever had sex with someone just because you felt aroused and subsequently regretted it?
Yes No
19. Have you veer cruised public lavatories, rest areas or parks looking for a sexual partner?
Yes No
20. Does your partner, friends or family every worry about your sexual behaviour (other than for reasons of your sexual orientation)?
Yes No
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