Psychometric Validation of the Hypersexual Behavior Scale in University Students in Bandar Abbas, Southern Iran

Abstract

Background: Hypersexual behavior represents a significant psychological concern that may adversely affect mental health and interpersonal relationships. Objectives: In line with the study title, this research aimed to perform a psychometric evaluation and validation of the Hypersexual Behavior Scale (HBS) in university students in Bandar Abbas, Southern Iran. Methods: This cross-sectional psychometric study (2023 - 2024) involved 1250 students from five universities in Bandar Abbas — Hormozgan University, Hormozgan University of Medical Sciences, Islamic Azad University, Payame Noor University, and Rezavi Institute — selected via stratified random sampling. Conducted without financial support, the study followed ethical standards approved by the Ethics Committee of Islamic Azad University, Bandar Abbas Branch, and had prior research council approval (September 11, 2023). Undergraduate and postgraduate students participated voluntarily with informed consent; incomplete responses were excluded. The sample size met psychometric requirements: ≥ 400 for exploratory factor analysis (EFA) and ≥ 200 for confirmatory factor analysis (CFA), concurrent validity, and reliability. Results: Demographic characteristics indicated that 62.2% of the participants were female (n = 777) and 37.8% were male (n = 473), with a mean age of 22.1 years (standard deviation [SD] = 2.4). Excellent content validity was reported, and the concurrent validity with the HBI was strong (r = 0.56, P < 0.001). Exploratory factor analysis extracted five factors accounting for 57.95% of the variance, which was confirmed by CFA with root mean square error of approximation (RMSEA) = 0.064 and Comparative Fit Index (CFI) = 0.98. Overall reliability was high (α = 0.959; split-half reliability = 0.909; test-retest r = 0.89). The ROC analysis identified a cut-off point of 61 as optimal with Youden’s Index (J) = 0.989 (sensitivity = 0.989; specificity = 1.000). Conclusions: The HBS scale is a valid and reliable instrument for assessing high-risk sexual behaviors among university students in Bandar Abbas, Southern Iran. However, the cross-sectional design, reliance on self-reported data, and sampling from a single city may have intensified selection and reporting biases, thereby limiting the generalizability of the results to other regions and age groups.