A questionnaire called the Internet Sex Screening Test (ISST) can help doctors identify people affected by cybersex addiction, recent findings from an Italian research team indicate. Cybersex addiction is a behavioral disorder that combines features of sex addiction and Internet addiction. Currently, the condition has no consistently applied definition in the U.S. In a study review published in late 2014 in the journal Cyberpsychology, researchers from three Italian institutions conducted a detailed analysis of the available methods for uncovering potential symptoms of cybersex addiction in various population groups. These researchers concluded that one existing questionnaire, the Internet Sex Screening Test, has enough scientific rigor to separate possibly affected individuals from unaffected individuals. Sex Addiction and Internet Addiction Sex addiction and Internet addiction are examples of behavioral addictions, which are non-substance-based addictions that nevertheless produce some of the key dysfunctional brain changes and real-world actions classically linked with an addiction to drugs or alcohol. In the U.S., there are no universally agreed upon terms for diagnosing either of these conditions. However, considerable scientific evidence supports their existence, and the American Psychiatric Association (the prime source of official mental health diagnoses in the U.S.) has provisionally recognized a form of addictive, Internet-related behavior it calls Internet gaming disorder. The core characteristic of sex addiction is the maintenance of a damaging pattern of sexual behavior and\/or a damaging pattern of sexual thinking or fantasizing. Affected individuals commonly do such things as lose control over key aspects of their sexual lives, prioritize sex-related thoughts or behaviors above important responsibilities or obligations, experience a sex-related decline in the health of their relationships and continue their patterns of damaging behavior after experiencing relationship damage or damage in other daily life areas. Internet addiction produces many of the same problems, but in the context of Internet use, not in the context of sexual behavior, thought or fantasy. Cybersex Addiction Cybersex combines sex addiction and Internet addiction because it allows an individual to engage in sexually addictive thought, fantasy or behavior over the Internet rather than in person. Like the two conditions on which it\u2019s based, the disorder has no standard definition in the U.S. However, potential indications of cybersex addiction include using the Internet for sex-related activities that you hide from family members or other loved ones, failing to meet important responsibilities as a result of sex-related use of the Internet, using the Internet to access illegal forms of pornographic material, feeling unable to stop or set limits on your sex-related Internet use, feeling shame in the aftermath of your sex-related Internet use and feeling preoccupied with sex-related Internet use while engaged in other types of daily activities. Are There Accurate Screening Tools? In the study review published in Cyberpsychology, researchers from Italy\u2019s Sapienza University of Rome, Institute of Clinical Sexology and Kore University of Enna analyzed a range of screening tools designed to identify symptoms of cybersex addiction. In the project\u2019s initial phase, the researchers found 1,160 studies that included a reference to some sort of questionnaire or test. They ultimately concluded that just eight of these studies examined screening tools potentially capable of meeting minimum criteria for diagnosing cybersex addiction. In addition to the Internet Sex Screening Test, these tools included the Cyber-Pornography Use Inventory, the Internet Addiction Test\u2014Sex, the Online Sexual Experience Questionnaire and the Sexual Addiction Screening Test\u2014Revised. After completing their analysis of all of the tools under consideration, the researchers concluded that only the 25-question, true-false Internet Sex Screening Test consistently identifies people likely affected by cybersex addiction while simultaneously consistently excluding people likely unaffected by this form of addiction. Specific features of the ISST that contribute to its effectiveness include the classification of all individuals into a low-, moderate- or high-risk category and the use of seven factors to determine who falls into which category. These factors include any given individual\u2019s level of interest in various forms of online sex or sex-related material, level of compulsive sexual behavior while online, degree of interaction with others while engaged in online sex-related activities, lack of interaction with others while engaged in online sex-related activities, level of expenditure on sex-related online activities, level of involvement in sex-related online activity while not at home and level of involvement in illegal sex-related activity while online.