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The following questions are designed to help you think honestly about your sexual behaviors. This instrument is not intended to provide an actual diagnosis of a problem, nor to substitute a comprehensive assessment by a qualified professional. If you think you may have a problem, we strongly recommend you seek an evaluation with a licensed mental health professional for treatment recommendations. Contact your personal physician or pastor for assistance with referrals.

  1. I have been dishonest with others about my sexual behaviors.
  2. I have engaged in sexual behaviors that are incompatible with my moral values.
  3. On multiple occasions, I have masturbated to pornographic materials (print, phone, or internet).
  4. Despite my best efforts, I have been unable to stop engaging in these sexual behaviors.
  5. Frequently I feel guilt and/or shame about my sexual behaviors.
  6. My sexual behaviors have caused problems in my relationships.
  7. More than twice I have stolen “time” from my employer by engaging in sexual acts/behaviors while on work time.
  8. I have had problems with my employer due to my sexual behaviors.
  9. No one else knows about my sexual behaviors.
  10. I have stolen “time” from my family or friends to engage in sexual behaviors.
  11. Frequently, when I see an attractive person I can’t help but indulge my lustful feelings.
  12. If my spouse knew about my sexual behaviors, s/he would likely divorce me.
  • If you have answered “Yes” to 1 – 3 questions, you may have a problem.
  • If you have answered “Yes” to 4 – 5 questions, you probably have a problem.
  • If you have answered “Yes” to 6 or more question, you definitely have a problem.