Assessment of sexual function in depressed, impotent, and healthy men: Factor analysis of a brief sexual function questionnaire for men

doi:10.1016/0165-1781(88)90106-0

Psychiatry Research

Volume 24, Issue 3, June 1988, Pages 231-250

https://doi.org/10.1016/0165-1781(88)90106-0 Get rights and content

Abstract

We report a study of sexual function in outpatient men with major depressive disorder (n = 42), compared with healthy control men (n = 37) and a clinic sample complaining of erectile dysfunction (n = 13). A principal-components factor analysis of the Brief Sexual Function Questionnaire confirmed differences in the clinical dimensions of sexual activity/performance, interest, satisfaction, and physiological competence. The four factors accounted for 72% of the variance in the analysis. Acceptable test-retest reliability, construct validity, and concurrent validity (with the Derogatis Sexual Function Inventory and a self-report behavioral log) were demonstrated. Parallel observations with findings from previous nocturnal penile tumescence studies in these same men are discussed.

References (23)

J.R. Howell et al.
Assessment of sexual function, interest, and activity in depressed men
Journal of Affective Disorders
(1987)
M.E. Thase et al.
Nocturnal penile tumescence is diminished in depressed men
Biological Psychiatry
(1988)
American Psychiatric Association
DSM-III: Diagnostic and Statistical Manual of Mental Disorders
(1980)
H.R. Conte
Multivariate assessment of sexual dysfunction
Journal of Consulting and Clinical Psychology
(1986)
L.R. Derogatis
The Brief Symptom Inventory
(1975)
L.R. Derogatis
The SCL-90-R Manual 1: Scoring, Administration and Procedures for the SCL-90-R
(1977)
L.R. Derogatis et al.
The DSFI: A multidimensional measure of sexual functioning
Journal of Sex and Marital Therapy
(1979)
M. Hamilton
A rating scale for depression
Journal of Neurology, Neurosurgery and Psychiatry
(1960)
E.S. Herold
Test Review
C.H. Hull et al.
SPSS Update
(1981)

Cited by (156)

Creation and Psychometric Validation of the Sexual Minorities and Prostate Cancer Scale (SMACS) in Sexual Minority Patients-The Restore-2 Study
2022, Journal of Sexual Medicine
Citation Excerpt :
Conversely, some sexual minority men may benefit from the option to adjust their role in anal sex (eg, from insertive to receptive partner) in response to dysfunction,16 although it is not clear how common or effective this strategy is. In a review of twelve common sexual functioning scales in prostate cancer survivors,17-33 all focused primarily or exclusively on erectile function and seven (58%) explicitly defined intercourse as vaginal penetration. None addressed anal sex, receptive anal pain, role-in-sex adjustment, or urinary incontinence problems during sex (arousal incontinence) or at orgasm (climacturia).
Existing measures of sexual functioning in prostate cancer survivors focus primarily on erectile function and do not adequately measure the experiences of sexual minority men.
To develop and psychometrically evaluate a new scale to measure sexual functioning among sexual minority men with prostate cancer.
Sexual minority prostate cancer patients (n = 401) completed an online battery of urinary and sexual functioning tests in 2019, including a new 37-item instrument about their sexual functioning post-treatment for prostate cancer.
We used confirmatory factor analysis to determine the construct validity of a new scale including five subscales: a four-factor model for all participants (n = 401) evaluated Sexual Satisfaction, Sexual Confidence, Frequency of Sexual Problems, and Urinary Incontinence in Sex. A single-factor model completed only by participants who had attempted or desired receptive anal sex (n = 255) was evaluated in the fifth subscale: Problematic Receptive Anal Sex. To evaluate criterion validity, we calculated the intercorrelations between each Sexual Minorities and Prostate Cancer Scale (SMACS) subscale and four related scales: the Expanded Prostate Cancer Index Composite-50 (EPIC), the Functional Assessment of Cancer Therapy-Prostate, the Brief Symptom Inventory-18, and the International Consultation on incontinence questionnaire. Cronbach's alphas were calculated to measure internal consistency (ie, reliability).
Cronbach's alpha values ranged from 0.64 to 0.89. Loadings (0.479–0.926) and model fit indices were strong (Root Mean Square Error of Approximation: 0.085, Standardized root mean squared residual: 0.063, comparative fit index: 0.927, Tucker-Lewis Index: 0.907). For criterion validity, Sexual Satisfaction, Sexual Confidence, and Frequency of Sexual Problems were moderately correlated with EPIC function and bother scores (r = 0.50–0.72) and Urinary incontinence in sex correlated moderately with EPIC Urinary Function and International Consultation on incontinence questionnaire scores (0.45–0.56).
The SMACS can be used by clinicians and researchers to comprehensively measure sexual functioning in sexual minority men, in conjunction with existing scales.
This new scale is validated in a large, geographically diverse cohort of sexual minority cancer survivors and fills an important gap in existing measures of sexual functioning. Limitations include a lack of a validation sample.
The SMACS is a valid and reliable new scale that measures sexual minority men's experience of urinary incontinence in sex, problematic receptive anal sex, and sexual distress.
Polter EJ, Kohli N, Rosser BRS, et al. Creation and Psychometric Validation of the Sexual Minorities and Prostate Cancer Scale (SMACS) in Sexual Minority Patients-The Restore-2 Study. J Sex Med 2022;19:529–540.
Sexual dysfunction among patients with ostomies
2021, Foundations of Colorectal Cancer
Sexual dysfunction in ostomy patients is caused by different factors and differs according to gender; the main problem in men is erectile dysfunction, whereas in women it is dyspareunia. Encouraging patients to discuss these issues is important, as is assessing sexual function using a validated questionnaire and recommending more suitable resources, depending on the type of problems the patient presents.
Brain processing of pictures of children in men with pedophilic disorder: A positron emission tomography study
2019, NeuroImage: Clinical
Although structural and functional neuroimaging techniques have recently been used to investigate the mechanisms of sexual attraction to children, a hallmark of pedophilic disorder, the differences in the processing of child sexual stimuli between men attracted to children and those attracted to adults remain unclear. Here, our purpose was to identify through positron emission tomography the brain responses of 15 male outpatients with pedophilic disorder to validated visual sexual stimuli depicting children (VSSc) and to compare them with 15 male healthy controls matched for sexual orientation (to female or male adults), age, and handedness. The patients' sample comprised both offenders and non-offenders. In response to VSSc, the between-groups analysis showed that activation in the right inferior temporal cortex [Brodmann area (BA) 20] was lower in patients than in controls. Moreover, in patients but not in controls, the presentation of VSSc induced an activation in a more caudal region of the right inferior temporal gyrus (BA 37) and in the left middle occipital gyrus (BA 19). In addition, in patients the level of activation in the caudal right inferior temporal gyrus was positively correlated with ratings of sexual arousal elicited by VSSc, whereas this correlation was negative in BA 20. These results implicate the right inferior temporal gyrus as a possible candidate area mediating sexual arousal in patients with pedophilic disorder and suggest that two of its areas play opposite, i.e., activating and inhibitory, roles.
Insecure Attachment Style and Dysfunctional Sexual Beliefs Predict Sexual Coercion Proclivity in University Men
2015, Sexual Medicine
Past studies have shown an association between low sexual functioning and engaging in sexually coercive behaviors among men. The mechanism of this relationship is not well understood. Moreover, most studies in this area have been done in incarcerated sex offenders.
The aim of the current study was to investigate the role of potential distal predictors of sexual coercion, including insecure attachment style and dysfunctional sexual beliefs, in mediating the relationship between sexual functioning and sexual coercion. The study also seeks to extend past findings to a novel non-forensic population.
Male university students (N = 367) anonymously completed online questionnaires.
Participants completed the Sexual Experiences Survey, Improved Illinois Rape Myth Acceptance Scale, Hostility Towards Women Scale, Likelihood of Rape Item, Experiences in Close Relationships Scale, Dysfunctional Sexual Beliefs Scale, and Brief Sexual Functioning Questionnaire.
Sexual functioning was not significantly associated with sexually coercive behaviors in our sample (r = 0.08, P = 0.247), though a significant correlation between sexual functioning and rape myth acceptance was found (r = 0.18, P = 0.007). Path analysis of all variables showed that the likelihood of rape item was the strongest correlate of sexually coercive behaviors (β = 0.34, P < 0.001), while dysfunctional sexual beliefs appeared to mediate the association between anxious attachment and likelihood of rape item score. Anxious (r = −0.27, P = 0.001) and avoidant (r = −0.19, P = 0.004) attachment also correlated significantly with lower sexual functioning.
These findings suggest the relationship between sexual functioning and sexual coercion may be less robust than previously reported, and may be due to a shared association with other factors. The results elaborate on the interrelation between attachment style and dysfunctional sexual beliefs as predictors of sexual coercion proclivity, suggesting avenues for further research. Dang SS and Gorzalka BB. Insecure attachment style and dysfunctional sexual beliefs predict sexual coercion proclivity in university men. Sex Med 2015;3:99–108.
Surgical procedures for BPH/LUTS: Impact on male sexual health
2014, Sexual Medicine Reviews
Lower urinary tract symptoms (LUTS) because of benign prostatic hyperplasia (BPH) are a highly prevalent condition in men over 50 years old, and their incidence increases with age. The relationship between LUTS and erectile dysfunction (ED) has received increased attention recently because both diseases are highly prevalent, frequently co‐associated in the same aging male group, and contribute significantly to the overall quality of life. In this review, we will examine the literature to assess the impact of surgical and minimally invasive treatments for LUTS/BPH on the male's sexual health.
The impact of the various surgical and minimally invasive treatments for LUTS/BPH was reviewed to ascertain the impact on erectile and ejaculatory function.
Sexual side effects of treatment for LUTS/BPH are underappreciated by urologists but likely play a prominent role in patient decision making, creating a disparity between provider and patient. Almost all accepted therapies for LUTS (surgical or medical) can affect some aspect of sexual health, making it imperative that health‐care professionals understand their patients' concerns and motivations in these two linked diseases. The incidence of newly diagnosed postoperative ED in patients treated with monopolar transurethral resection (TURP) is around 14%, with reported values in various studies ranging from 0–32.5%, 7.7%, 6.5%, 17%, to 14%. Importantly, there is no significant difference reported between bipolar and monopolar TURP on sexual function.
The risk of sexual side effects is an important one to consider in discussing the implications for any LUTS intervention as they play a prominent role in patient motivation, acceptance of bother and decision making concerning surgical intervention, thus creating a potential disparity between provider and patient. Becher EF and McVary KT. Surgical procedures for BPH/LUTS: Impact on male sexual health. Sex Med Rev 2014;2:47–55.
Psychometric properties of the Persian adaptation of quality of sexual function questionnaire
2024, Quality and Quantity

View all citing articles on Scopus

View full text

Assessment of sexual function in depressed, impotent, and healthy men: Factor analysis of a brief sexual function questionnaire for men

Abstract

Journal of Affective Disorders

Biological Psychiatry

DSM-III: Diagnostic and Statistical Manual of Mental Disorders

Multivariate assessment of sexual dysfunction

Journal of Consulting and Clinical Psychology

The Brief Symptom Inventory

The SCL-90-R Manual 1: Scoring, Administration and Procedures for the SCL-90-R

The DSFI: A multidimensional measure of sexual functioning

Journal of Sex and Marital Therapy

A rating scale for depression

Journal of Neurology, Neurosurgery and Psychiatry

Test Review

SPSS Update