lyses. Multivariable analyses suggested these associations were accounted for by PTSD and CST, both of which are associated with social impairment and vulnerability to stress ([@B8]; [@B29]; [@B31]). However, causal inference cannot be drawn from these findings. Overall, results suggest that in military samples, distal risk factors such as childhood trauma and psychiatric co-morbidity may be more relevant with regard to CSB than deployment/post-deployment experiences, including TBI.

A discussion of non-significant findings is also relevant. We did not find any associations between CSB and hours of TV watching or Internet use. This finding might suggest that the CSB might not be taking the form of extensive pornography viewing or online sexual behavior. However, because we do not have any information on the nature of the CSB activities (e.g. whether they were mostly fantasies, urges or actual sexual behavior), we cannot make this conclusion. Further examination of the context of CSB in military samples is needed.

Implications {#S4c}
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This investigation has important implications. Clinically, health care providers should be aware of CSB and assess for the condition. Awareness of CSB may facilitate referrals for assessment and treatment, which may reduce distress related to CSB, improve relationships and possibly prevent other problems such as sexual offending. Mental health clinicians, particularly those treating individuals with PTSD, should be aware of CSB as a potential co-morbidity with PTSD. Future studies are needed to examine how CSB may influence treatment for PTSD or vice-versa. It is possible that CSB may be improved by effective PTSD treatment; however, it is also possible that CSB may inhibit successful PTSD treatment by serving as an avoidance behavior. In PTSD treatment, patients are encouraged to reduce learned avoidance behaviors; if these behaviors include CSB, it may be necessary to pay special attention to sexual behavior specifically as an avoidance mechanism.

Limitations {#S4d}
