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Lin CY, Tsai MC, Koós M, Nagy L, Kraus SW, Demetrovics Z, Potenza MN, Ballester-Arnal R, Batthyány D, Bergeron S, Billieux J, Briken P, Cárdenas-López G, Carvalho J, Castro-Calvo J, Chen L, Ciocca G, Corazza O, Csako RI, Fernandez DP, Fernandez EF, Fujiwara H, Fuss J, Gabrhelík R, Gewirtz-Meydan A, Gjoneska B, Gola M, Grubbs JB, Hashim HT, Islam MS, Ismail M, Jiménez-Martínez M, Jurin T, Kalina O, Klein V, Költő A, Lee SK, Lewczuk K, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Milea I, Miller DJ, Orosová O, Orosz G, Ponce FP, Quintana GR, Garzola GCQ, Ramos-Diaz J, Rigaud K, Rousseau A, Scanavino MDT, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre-Leirós V, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Strizek J, Štulhofer A, Ünsal BC, Vaillancourt-Morel MP, Van Hout MC, Bőthe B. The short version of the Sexual Distress Scale (SDS-3): Measurement invariance across countries, gender identities, and sexual orientations. Int J Clin Health Psychol 2024; 24:100461. [PMID: 38706570 PMCID: PMC11067538 DOI: 10.1016/j.ijchp.2024.100461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Background The three-item Sexual Distress Scale (SDS-3) has been frequently used to assess distress related to sexuality in public health surveys and research on sexual wellbeing. However, its psychometric properties and measurement invariance across cultural, gender and sexual subgroups have not yet been examined. This multinational study aimed to validate the SDS-3 and test its psychometric properties, including measurement invariance across language, country, gender identity, and sexual orientation groups. Methods We used global survey data from 82,243 individuals (Mean age=32.39 years; 40.3 % men, 57.0 % women, 2.8 % non-binary, and 0.6 % other genders) participating in the International Sexual Survey (ISS; https://internationalsexsurvey.org/) across 42 countries and 26 languages. Participants completed the SDS-3, as well as questions regarding sociodemographic characteristics, including gender identity and sexual orientation. Results Confirmatory factor analysis (CFA) supported a unidimensional factor structure for the SDS-3, and multi-group CFA (MGCFA) suggested that this factor structure was invariant across countries, languages, gender identities, and sexual orientations. Cronbach's α for the unidimensional score was 0.83 (range between 0.76 and 0.89), and McDonald's ω was 0.84 (range between 0.76 and 0.90). Participants who did not experience sexual problems had significantly lower SDS-3 total scores (M = 2.99; SD=2.54) compared to those who reported sexual problems (M = 5.60; SD=3.00), with a large effect size (Cohen's d = 1.01 [95 % CI=-1.03, -0.98]; p < 0.001). Conclusion The SDS-3 has a unidimensional factor structure and appears to be valid and reliable for measuring sexual distress among individuals from different countries, gender identities, and sexual orientations.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mónika Koós
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Léna Nagy
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Shane W. Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, United Kingdom
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Marc N. Potenza
- Yale University School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
| | - Rafael Ballester-Arnal
- Departamento de Psicología Básica, Clínica y Psicobiología, University Jaume I, Castelló, Spain
| | - Dominik Batthyány
- Institute for Behavioural Addictions, Sigmund Freud University, Vienna, Austria
| | - Sophie Bergeron
- Département de Psychologie, Université de Montréal, Montréal, Canada
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Montréal, Canada
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Georgina Cárdenas-López
- Virtual Teaching and Cyberpsychology Laboratory, School of Psychology, National Autonomous University of Mexico, Mexico, Mexico
| | - Joana Carvalho
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Jesús Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Lijun Chen
- Department of Psychology, College of Humanity and Social Science, Fuzhou University, Fuzhou, Fujian province, China
| | - Giacomo Ciocca
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, Hertfordshire, United Kingdom
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Rita I. Csako
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | - David P. Fernandez
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | | | - Hironobu Fujiwara
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Decentralized Big Data Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Johannes Fuss
- Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Biljana Gjoneska
- Macedonian Academy of Sciences and Arts, Skopje, Republic of North Macedonia
| | - Mateusz Gola
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
- Institute for Neural Computations, University of California San Diego, CA, USA
| | - Joshua B. Grubbs
- Center on Alcohol, Substance use, and Addictions, University of New Mexico, Albuquerque, New Mexico, United States
| | | | - Md. Saiful Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, Bangladesh
| | - Mustafa Ismail
- University of Baghdad, College of Medicine, Baghdad, Iraq
| | | | - Tanja Jurin
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Ondrej Kalina
- Department of Educational Psychology and Psychology of Health, Pavol Jozef Safarik University in Kosice, Kosice, Slovakia
| | - Verena Klein
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - András Költő
- Health Promotion Research Centre, University of Galway, Galway, Ireland
| | - Sang-Kyu Lee
- Department of Psychiatry, College of Medicine, Hallym University, Chuncheon, Republic of Korea
- Chuncheon Addiction Management Center, Republic of Korea
| | - Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Kateřina Lukavská
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Psychology, Faculty of Education, Charles University, Prague, Czech Republic
| | | | - Ion Milea
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Dan J. Miller
- College of Healthcare Sciences, James Cook University, Queensland, Australia
| | - Oľga Orosová
- Department of Educational Psychology and Psychology of Health, Pavol Jozef Safarik Universit y in Kosice, Kosice, Slovakia
| | | | | | - Fernando P. Ponce
- Facultad de Psicología, Universidad de Talca, Talca, Talca, Region del Maule, Chile
| | - Gonzalo R. Quintana
- Departamento de Psicología y Filosofía, Facultad de Ciencias Sociales, Universidad de Tarapacá, Arica, Arica y Parinacota, Chile
| | - Gabriel C. Quintero Garzola
- Florida State University, Panama, Republic of Panama
- Sistema Nacional de Investigación (SNI), SENACYT, Panama, Republic of Panama
| | - Jano Ramos-Diaz
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Perú
| | | | - Ann Rousseau
- Leuven School For Mass Communication, KU Leuven, Leuven, Belgium
| | - Marco De Tubino Scanavino
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Experimental Pathophisiology Post Graduation Program, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Mami Shibata
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sheikh Shoib
- Department of Psychology, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Vera Sigre-Leirós
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Institute of Legal Psychiatry, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - Luke Sniewski
- Auckland University of Technology, Auckland, New Zealand
| | - Ognen Spasovski
- Faculty of Philosophy, University of Ss. Cyril and Methodius in Trnava, Trnava, Slovakia
| | - Vesta Steibliene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health sciences, Kaunas, Lithuania
| | - Dan J. Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | | | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Berk C. Ünsal
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Marie-Pier Vaillancourt-Morel
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Montréal, Canada
| | - Marie Claire Van Hout
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, Merseyside, United Kingdom
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, Canada
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Montréal, Canada
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Baszak-Radomańska E, Wańczyk-Baszak J, Paszkowski T. Women's sexual health improvement: sexual quality of life and pelvic floor muscle assessment in asymptomatic women. Front Med (Lausanne) 2024; 11:1289418. [PMID: 38449880 PMCID: PMC10916695 DOI: 10.3389/fmed.2024.1289418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Problems related to the quality of sexual life in gynecological practice are usually neglected. This study aimed to highlight the significance of this area of concern and evaluate the usefulness of tools, such as patient-reported outcomes (PROs) and pelvic floor examination, to improve women's sexual wellbeing and to identify predictors of poor quality of sexual life during the well-woman annual visit. Methods A cross-sectional study was designed to examine 300 healthy women to determine whether the sexual quality of life (SQOL) questionnaire (on electronic devices) and pelvic floor muscle assessment (the vulva, anus, muscles, and periurethral (VAMP) protocol) of asymptomatic women during the annual bimanual examination (BME) help differentiate patients who would benefit from discussing sexual problems with a gynecologist. Dyspareunia was an exclusion criterion. Results The majority of subjects experienced high sexual wellbeing (82.0% with SQOL score of ≥84), with a mean of 85.7 points. SQOL scores were lower for psychiatric disorders or symptoms (37.0% of subjects), although they did not correlate with age, BMI, parity, contraception use, history of vulvovaginal symptoms, neurosurgical/orthopedic problems, and rectal, bowel, or bladder symptoms. Patients with dyspareunia (16.0% of participants, although they denied it during the face-to-face consultation) had a 3.6 times higher prevalence of low or moderate quality of sexual life. The VAMP protocol score was low in asymptomatic women, 33.0% met positive criteria (VAMP+, NRS ≥3) for pelvic floor dysfunction (overactivity), although at borderline levels. VAMP+ was positively correlated with chronic pain and genitourinary symptoms, but neither with dyspareunia nor incontinence, and was unrelated to the SQOL score (p = 0.151). Conclusion Women's sexual health is a global health priority. Finding a way to start a discussion with an asymptomatic patient is crucial to increasing patients' interest in disclosing a sexual health problem to be resolved. PROs or simple questions about sexual wellbeing direct the discussion mainly toward the at-risk group for sexual deterioration: those with mental health problems and women with dyspareunia. Dyspareunia is considered a predictor of decreased quality of sexual life, a major sexual disorder that should not be overlooked. Gynecological consultation should resolve concerns, identify the problem, and refer for professional sexual care if still needed.
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Affiliation(s)
| | - Jadwiga Wańczyk-Baszak
- Terpa Clinic, OB/GYN Department, Lublin, Poland
- Department of Gynecology, Medical University of Lublin, Lublin, Poland
| | - Tomasz Paszkowski
- Department of Gynecology, Medical University of Lublin, Lublin, Poland
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The Efficacy of a Posterior Approach to Surgical Correction for Neglected Idiopathic Scoliosis: A Comparative Analysis According to Health-Related Quality of Life, Pulmonary Function, Back Pain and Sexual Function. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020299. [PMID: 36832428 PMCID: PMC9955926 DOI: 10.3390/children10020299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND This study aimed to evaluate the treatment outcomes of severe idiopathic scoliosis (IS) and hypothesized that surgical treatment would have a superior impact on the health-related quality of life (HRQoL), pulmonary function (PF), back pain, and sexual function. METHODS We retrospectively reviewed 195 consecutive patients with IS classified into severe (SG) and moderate groups (MG) with a minimum follow-up of two years. RESULTS The mean preoperative curve was 131° and 60° in the SG and MG, respectively. The mean preoperative flexibility in the bending films averaged between 22% in the SG and 41% in the MG. After definitive surgery, the main curve was corrected to 61° and 18° in the SG and MG, respectively. The mean preoperative thoracic kyphosis was 83° in the SG and 25° in the MG, which was corrected to 35° in the SG and 25° in the MG. At baseline, the percentage of predicted lung volume (FVC) was significantly lower in the SG than that in the MG (51.2% vs. 83%). The baseline percentage of the predicted FEV1 values was also significantly lower in the SG than in the MG (60.8% vs. 77%). During the two-year follow-up, the percentage of predicted FVC showed significant improvement in the SG (69.9%) (p < 0.001), and the percentage of predicted FEV1 values during the follow-up improved significantly in the SG (76.9%) (p < 0.001) compared with the MG (81%), with no statistical difference observed during the two-year follow-up. The SRS-22r showed a clinically and statistically significant improvement in the preoperative results to those of the final follow-up (p < 0.001). CONCLUSIONS Surgical treatment of severe scoliosis can be safe. It provided a mean correction of the deformity for 59% of patients and significantly improved respiratory function, with the percentage of predicted forced expiratory volume in 1 s improving by 60% and the forced vital capacity improving by 50%, resulting in clinically and statistically significant improvements in the SRS-22r, HRQoL outcome scores, and back pain (reduced from 36% to 8%), as well as improved sexual function. The planned surgical treatment can achieve a very significant deformity correction with a minimal risk of complications. The surgical treatment has a superior impact on the quality of life patients with severe spinal deformities and significantly improves function in every sphere of life.
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Burzynski B, Gibala P, Soltysiak-Gibala Z, Jurys T, Przymuszala P, Rzymski P, Stojko R. How Urinary Incontinence Affects Sexual Activity in Polish Women: Results from a Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113818. [PMID: 36360700 PMCID: PMC9657329 DOI: 10.3390/ijerph192113818] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/15/2022] [Accepted: 10/21/2022] [Indexed: 05/21/2023]
Abstract
Urinary incontinence (UI) in women can cause a number of sexual dysfunctions and reduce their quality of life. Sexual health is essential to the self-esteem, emotional state, and overall quality of life. We aimed to assess the quality of sexual life of women with UI. The study included a group of 145 sexually active women diagnosed with UI. The research was conducted using the diagnostic survey method with authorial and validated questionnaires. As many as 49.1% of the respondents reported a deterioration of sexual relations in comparison with the time before the onset of UI symptoms. According to the FSDS-R results, 83.45% of respondents were dissatisfied with their sex life. The higher the result obtained by respondents in the FSDS-R scale, the lower was their quality of life in the IIQ-7 scale (p ≤ 0.002, R = 0.53). The greatest impact was observed in the domains of emotional health and physical activity. The more incontinence symptoms reported by the respondent in the UDI-6 scale, the worse was her sexual satisfaction in the FSDS-R (p = 0.003, R = 0.39). UI in women contributes to the development of sexual dysfunctions, including decreased interest in sexual life, limited intercourse, and dissatisfaction with sexual life.
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Affiliation(s)
- Bartlomiej Burzynski
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 12, 40-752 Katowice, Poland
| | - Piotr Gibala
- Chair and Department of Gynecology, Obstetrics and Gynecological Oncology, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 12, 40-752 Katowice, Poland
| | - Zuzanna Soltysiak-Gibala
- Chair and Department of Gynecology, Obstetrics and Gynecological Oncology, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 12, 40-752 Katowice, Poland
| | - Tomasz Jurys
- Doctoral School, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 12, 40-752 Katowice, Poland
- Correspondence: ; Tel.: +48-727-519-946
| | - Piotr Przymuszala
- Department of Medical Education, Poznan University of Medical Sciences, Fredry 10, 61-701 Poznan, Poland
| | - Pawel Rzymski
- Department of Mother and Child Health, Poznan University of Medical Sciences, Gynecological and Obstetric University Hospital, Polna 33, 60-535 Poznan, Poland
| | - Rafal Stojko
- Chair and Department of Gynecology, Obstetrics and Gynecological Oncology, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 12, 40-752 Katowice, Poland
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Cross-cultural adaptation and validation of the Brazilian Portuguese version of the Female Sexual Distress Scale-Revised questionnaire for women with vaginal laxity. Int Urogynecol J 2022; 33:3163-3170. [PMID: 35588319 PMCID: PMC9118812 DOI: 10.1007/s00192-022-05227-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/29/2022] [Indexed: 12/02/2022]
Abstract
Introduction and hypothesis Vaginal laxity (VL) can impair women´s quality of life and there are not many tools aimed at quantitatively addressing this complaint. Sexual distress can be present within this group of patients. The aim of our study is to carry out the cross-cultural adaptation/translation and validation of the Female Sexual Distress Scale-Revised (FSDS-R) for Brazilian Portuguese women with VL. Methods Women age ≥ 18 years, with VL (n=82), and without VL (n=53) were included. Continuous variables were described in the form of mean/standard deviation or median/range, and Student’s t test was used. The Chi-squared test was used for dichotomous variables. Cronbach's alpha coefficient was used for internal consistency and Spearman's correlation was used to assess construct validity (FSDS-R, Female Sexual Function Index [FSFI], and Incontinence Questionnaire Vaginal Symptoms [ICIQ-VS]). A significance level of 5% was established using a two-tailed test. Results Women with VL presented more anal/vaginal sexual intercourse than women without VL (p=0.030). All three instruments (FSDS-R, FSFI, and ICIQ-VS) presented discriminant validity between women with and without VL (p<0.001). A high internal consistency (Cronbach´s alpha =0.887) was found in women with VL and without VL (0.917). Regarding construct validity (n=82), there was a strong positive correlation between FSDS-R score and ICIQ-VS scales, except for a weaker correlation between the ICIQ-VS vaginal symptoms subscale (r: +0.2788; p=0.013). A moderate negative correlation was found between FSDS-R and all FSFI domains (p<0.001), except for pain (p<0.062). Conclusions The Brazilian version of the FSDS-R showed adequate internal consistency and discriminant validity, and a correlation was found with other instruments such as FSFI and ICIQ-VS.
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Tavares IM, Santos-Iglesias P, Nobre PJ. Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples. J Sex Med 2022; 19:834-845. [PMID: 35370102 DOI: 10.1016/j.jsxm.2022.02.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/14/2022] [Accepted: 02/25/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Female Sexual Distress Scale and the Female Sexual Distress Scale-Revised-herein called the Sexual Distress Scale (SDS and SDS-R)-are among the most widely used self-report instruments to assess sexual distress, but no version for use in the Portuguese population is available to date. AIM The current study aimed to validate the Portuguese version of the SDS/SDS-R in samples of women and men with and without distressing sexual problems. METHODS A sample of 1,109 participants without distressing sexual problems (761 women) and 382 participants with distressing sexual problems (283 women), ages ranging from 18 to 72 years, were used to examine the psychometric properties of the Portuguese SDS and SDS-R. OUTCOMES Participants completed a survey that included a sociodemographic and health questionnaire, the Portuguese version of the SDS and SDS-R, and measures of sexual satisfaction, sexual quality of life, sexual function, dyadic adjustment, and psychological distress. RESULTS Results indicated that the Portuguese SDS and the SDS-R assess 1 general domain of sexual distress and showed good evidences of validity based on content and on relations with other variables. Sexual distress was associated with poorer sexual function, satisfaction, and quality of life, with higher psychological distress, and lower dyadic adjustment. Internal consistency and test-retest (1 month) reliabilities were excellent. Tests of differential functioning of items indicated that the SDS and SDS-R scores can be used to compare women and men on sexual distress, but the SDS/SDS-R scores flagged differential functioning of items and test (DFIT) between participants with and without distressing sexual problems. CLINICAL TRANSLATION Clinicians and researchers can now make use of the SDS and of the SDS-R in the Portuguese population, facilitating the assessment of sexual distress in clinical settings. STRENGTHS & LIMITATIONS The Portuguese SDS/SDS-R scores can be compared between women and men, providing information on sexual distress independently of sexual function. With the current evidence, comparisons between individuals with and without distressing sexual problems should be made with caution, as the scores may be biased against the former. CONCLUSION This study provides a validation of the Portuguese version of the SDS/SDS-R that can be used to assess sexual distress in Portuguese women and men and can be used to compare between these 2 groups. Tavares IM, Santos-Iglesias P, Nobre PJ. Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples. J Sex Med 2022;19:834-845.
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Affiliation(s)
- Inês M Tavares
- Center for Psychology, University of Porto, Faculty of Psychology and Educational Sciences, Porto, Portugal.
| | | | - Pedro J Nobre
- Center for Psychology, University of Porto, Faculty of Psychology and Educational Sciences, Porto, Portugal
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Predictors of Sexual Function and Performance in Young- and Middle-Old Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074207. [PMID: 35409888 PMCID: PMC8999058 DOI: 10.3390/ijerph19074207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/04/2022]
Abstract
Background: Maintaining sexual life in older women might be perceived as a measure of healthy and successful aging. This study aimed to establish the prevalence of female sexual dysfunction (FSD) based on the DSM-5 criteria and predictors of sexual performance in older women. Methods: A total of 185 women between 55 and 79 years old were included in the study. Validated scales were used to assess sexual function (Changes in Sexual Function Questionnaire (CSFQ)), the propensity for sexual excitation/inhibition (Sexual Excitation/Sexual Inhibition Inventory for Women), and sexual anxiety/avoidance (Body Exposure during Sexual Activity Questionnaire (BESAQ)). Multiple regression was used to assess the factors affecting sexual function and the prevalence of FDS. Results: Sexual distress was diagnosed in 14.1% of women, and FSD in 16.2% (n = 53), whereas sexual problems (CSFQ) were diagnosed in 33.3% of women, and distressing sexual concerns in 35.1%. Women with a lower number of male sexual partners (β = −0.22), a better attitude toward sex (β = 0.25), higher importance of sex (β = 0.31), a higher level of sexual excitation (β = 0.34), and that were sexually active (β = 0.39) had better sexual function, as evaluated by CSFQ. Conclusions: Most older women remain sexually active. The diversity of sexual activity in later life should be affirmed to encourage women to be sexually active and to strengthen the response to sexual stimuli.
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Lim-Watson MZ, Hays RD, Kingsberg S, Kallich JD, Murimi-Worstell IB. A Systematic Literature Review of Health-related Quality of Life Measures for Women with Hypoactive Sexual Desire Disorder and Female Sexual Interest/Arousal Disorder. Sex Med Rev 2021; 10:23-41. [PMID: 34481749 DOI: 10.1016/j.sxmr.2021.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Hypoactive Sexual Desire Disorder (HSDD) / Female Sexual Interest/Arousal Disorder (FSIAD) impacts health-related quality of life (HRQoL) of women and their partners, yet existing measures fail to adequately capture relevant concepts (ie, what is essential to measure including symptoms/impacts) important to women with HSDD/FSIAD. OBJECTIVES To identify HRQoL tools used to assess women with HSDD/FSIAD, and to evaluate their psychometric properties (ie, reliability, validity, and responsiveness). METHODS We conducted searches in PubMed, Embase and PsychINFO from June 5, 1989 to September 30, 2020 for studies in women with HSDD/FSIAD and psychometric analyses (English only). Principles of the Preferred Reporting Items for Systematic reviews and Meta-Analyses, the COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias Checklist and other psychometric criteria were applied. Based on this search, 56 papers were evaluated including 15 randomized-controlled trials, 11 observational/single arm/open label studies, and 30 psychometric studies. RESULTS Of the 18 measures identified, the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R) were included in most studies (> 50%). General HRQoL instruments were not used in any of the clinical trials; the SF-12, SF-36 and EQ-5D-5L were reported in two observational studies. No instruments achieved positive quality ratings across all psychometric criteria. The FSFI, FSDS-R, Sexual Event Diary (SED) and the Sexual Desire Relationship Distress Scale (SDRDS), were the only measures to receive a positive rating for content validity. CONCLUSION Reliable and valid HRQoL measures that include sexual desire and distress are needed to provide a more systematic and comprehensive assessment of HRQoL and treatment benefits in women with HSDD/FSIAD. While inferences about HRQoL are limited due to the lack of uniformity in concepts assessed and limited psychometric evaluation of these measures in women with HSDD/FSIAD, opportunities exist for the development of reliable and validated tools that comprehensively measure the most relevant and important concepts in women with HSDD/FSIAD. Lim-Watson MZ, Hays RD, Kingsberg S, et al. A systematic literature review of health-related quality of life measures for women with Hypoactive Sexual Desire Disorder and Female Sexual Interest/Arousal Disorder. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Michelle Z Lim-Watson
- Department of Pharmacoeonomics and Policy, Massachusetts College of Pharmacy and Health Sciences University, Boston, MA, USA.
| | - Ron D Hays
- Department of Health Policy and Management, School of Public Health, University of California, Los Angeles, CA, USA; Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, CA, USA; RAND Corporation, Santa Monica, CA, USA
| | - Sheryl Kingsberg
- OB/GYN Behavioral Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Joel D Kallich
- Department of Pharmacoeonomics and Policy, Massachusetts College of Pharmacy and Health Sciences University, Boston, MA, USA
| | - Irene B Murimi-Worstell
- Department of Pharmacoeonomics and Policy, Massachusetts College of Pharmacy and Health Sciences University, Boston, MA, USA
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Nowosielski K, Kurpisz J, Kowalczyk R. Sexual inhibition and sexual excitation in a sample of Polish women. PLoS One 2021; 16:e0249560. [PMID: 33822822 PMCID: PMC8023475 DOI: 10.1371/journal.pone.0249560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 03/20/2021] [Indexed: 11/23/2022] Open
Abstract
The contemporary concept of sexual counseling for women with sexual problems, distress, and female sexual dysfunction (FSD) includes tailored medical and/or psychological intervention. The dual control model and the Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) are helpful for identifying risk factors and tailoring therapy for FSD. The current study aimed to (1) validate the Polish translation of the SESII-W in a sample of Polish women, and (2) verify the usefulness of the SESII-W in clinical practice. Five hundred nine white women age 18 to 55 years old (M ± SD age = 39.7 ± 11.3 years) were included in this cross-sectional study. Linguistic validation of the Polish translation of the SESII-W was first performed. A battery of tests was then used to evaluate reliability, convergent and discriminant validity, measurement invariances, and correlations between the SESII-W and other measures. Given that the original version of the SESII-W had unsatisfactory model fit, exploratory and confirmatory factor analyses were subsequently performed. Results showed a new final model that included 26 items with seven lower- and two higher-order factors and explained 58.9% of the variance in the data, with CFI = 0.93, RMSEA = 0.05 and χ2 = 693.39, p < 0.001. Cronbach’s α was 0.77 for Sexual Excitation (SE) and 0.88 for Sexual Inhibition (SI) scales. A moderate negative association between SI and the presence of FSD according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria was noted. SE was positively associated with engaging in risky sexual behaviors, Extraversion and Openness to Experiences traits, and was negatively correlated with relationship quality. Finally, age was negatively correlated with all domains of the SESII-W except Arousal Contingency. SE and SI were both lower in older women as compared to younger once. These results demonstrate that the Polish version of SESII-W shows good psychometric properties. A higher propensity for SI was associated with the presence of sexual problems, distress, and FSD, whereas a higher propensity for SE was associated with greater engagement in risky sexual behaviors and personality type. However, future studies on larger and more diverse populations are required to confirm the replicability of the factor structure of the scale.
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Affiliation(s)
- Krzysztof Nowosielski
- Faculty of Medical Sciences, Department of Gynecology and Obstetrics, Medical University of Silesia, Katowice, Poland
- Institute of Medical Sciences, University of Opole, Opole, Poland
- * E-mail: ,
| | - Jacek Kurpisz
- Department and Clinic of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Robert Kowalczyk
- Department of Sexology, Andrzej Frycz Modrzewski Krakow University, Cracow, Poland
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Keramat A, Malary M, Moosazadeh M, Bagherian N, Rajabi-Shakib MR. Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image. BMC Pregnancy Childbirth 2021; 21:87. [PMID: 33499805 PMCID: PMC7836496 DOI: 10.1186/s12884-021-03575-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/19/2021] [Indexed: 01/21/2023] Open
Abstract
Background Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI). Methods This was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R). Results Analysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P < 0.001) and in the mean score of GSI between the groups with varying degrees of depression (P = 0.01) and anxiety (P < 0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score. Conclusion Various factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03575-1.
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Affiliation(s)
- Afsaneh Keramat
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mina Malary
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Haft-e Tir Square, Po Box: 7394736147, Shahroud, Iran.
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.,Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nastaran Bagherian
- Midwifery Counseling, Mazandaran University of Medical Sciences, Sari, Iran
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Grzybowska ME, Wydra D. Responsiveness of two sexual function questionnaires: PISQ-IR and FSFI in women with pelvic floor disorders. Neurourol Urodyn 2020; 40:358-366. [PMID: 33150611 DOI: 10.1002/nau.24568] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/11/2020] [Accepted: 10/27/2020] [Indexed: 12/13/2022]
Abstract
AIMS To assess responsiveness of sexual function questionnaires: Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR) and Female Sexual Function Index (FSFI) in women with pelvic floor disorders (PFD). METHODS The study included 261 subjects who completed PISQ-IR and FSFI at baseline and after treatment (median: 8 months). Standardized response mean (SRM) and effect size (ES) were calculated for sexually active (SA) and not-SA (NSA) women. Patient Global Impression of Improvement (PGI-I) was applied to assess treatment outcomes. RESULTS A total of 184 women reported "very much better"/"much better" on the PGI-I scale posttreatment and were enrolled for further study. After treatment, 21.7% of the NSA women resumed sexual activity, 13.9% of the initially SA-abstained, and no change was reported for 152 (82.6%) subjects (87-SA and 65-NSA). Significant improvement in PISQ-IR SA domains was observed, with mild responsiveness for Arousal/Orgasm (SRM = 0.34, ES = 0.29, p = .003) and good responsiveness for Condition Specific, Global Quality and Summary Score (SRM = 0.51, ES = 0.50; SRM = 0.54, ES = 0.47; SRM = 0.75, ES = 0.63, p < .001). The Condition Impact domain demonstrated excellent responsiveness (SRM = 1.13, ES = 1.17, p < .001). In NSA, PISQ-IR had good responsiveness in Condition Impact (SRM = -0.76, ES = -0.59, p < .001), and mild in Condition Specific (SRM = -0.30, ES = -0.28, p < .03) domains. In FSFI, posttreatment sexual function in SA was improved in Desire, Arousal, Orgasm, Satisfaction, Pain domains and Total score, proving mild responsiveness (SRM, 0.24-0.48; p < .04). In NSA, FSFI proved nonresponsive. CONCLUSION PISQ-IR and FSFI are responsive tools, useful to investigate the effects of treatment on sexual function in SA (both questionnaires) and NSA (only PISQ-IR) women with PFD.
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Affiliation(s)
- Magdalena Emilia Grzybowska
- Department of Gynecology, Gynecologic Oncology, and Gynecologic Endocrinology, Medical University of Gdańsk, Gdańsk, Poland
| | - Dariusz Wydra
- Department of Gynecology, Gynecologic Oncology, and Gynecologic Endocrinology, Medical University of Gdańsk, Gdańsk, Poland
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Derogatis LR, Revicki DA, Clayton AH. Instruments for Screening, Diagnosis, and Management of Patients with Generalized Acquired Hypoactive Sexual Desire Disorder. J Womens Health (Larchmt) 2020; 29:806-814. [PMID: 32096691 DOI: 10.1089/jwh.2019.7917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Screening, diagnosis, and management of hypoactive sexual desire disorder (HSDD) and research into the condition have been challenging due to its biopsychosocial complexity and lack of consensus on relevant measures. Although physician interviews yield much clinically valid information, self-reported questionnaires appear more acceptable to patients and physicians. Consequently, validated patient-reported outcome (PRO) tools are essential for evaluation and management of HSDD, including any therapeutic intervention. The US Food and Drug Administration (FDA) has issued guidance on the use of appropriate endpoints and associated measures for female sexual dysfunction, including HSDD. Although many of the available measures were not designed specifically for HSDD assessment, as per FDA guidelines, most clinical studies have used individual domains or items from established tools, such as the Female Sexual Function Index-desire domain and Item 13 of the revised Female Sexual Distress Scale. For clinical practice, several professional societies recommend the Decreased Sexual Desire Screener and/or a sexual history as tools to diagnose HSDD. This review discusses frequently used PRO tools as well as the newly developed and validated Elements of Desire Questionnaire, which may be appropriate for clinical trials or clinical practice.
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Affiliation(s)
| | | | - Anita H Clayton
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, Virginia
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Assessment of sexual dysfunction in patients with inflammatory bowel disease. GASTROENTEROLOGY REVIEW 2019; 14:104-108. [PMID: 31616523 PMCID: PMC6791133 DOI: 10.5114/pg.2019.85893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 03/08/2019] [Indexed: 12/17/2022]
Abstract
Inflammatory bowel disease (IBD) represents a diverse variety of chronic inflammatory intestinal conditions. Sexuality is often disturbed in patients with IBD, more often affecting women than men. Many factors seem to contribute to intimacy concerns. The most popular questionnaires used in empirical research around the world are the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men. Sexual satisfaction was negatively correlated with depression, anxiety, sexual problems, and illness perceptions. When analysing the problem of IBD, disorders of sexual function should not be ignored. Patients should be screened for psychological diseases and sexual dysfunction, and necessary treatments should be given as soon as possible. By understanding what factors contribute to poor sexual functioning in patients with IBD, we may try to minimise adverse psychosocial events. Screening for sexual disorders should be a part of daily medical practice.
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Ahmed MR, Shaaban MM, Meky HK. Assessment of sexually related personal distress accompanying premenopausal sexual dysfunction with an Arabic version of the Female Sexual Distress Scale. Int J Gynaecol Obstet 2017; 139:65-70. [DOI: 10.1002/ijgo.12255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/27/2017] [Accepted: 07/03/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Magdy R. Ahmed
- Faculty of Medicine; Obstetrics and Gynecology Department; Suez Canal University; Ismailia Egypt
| | - Mohamed M. Shaaban
- Faculty of Medicine; Obstetrics and Gynecology Department; Suez Canal University; Ismailia Egypt
| | - Heba K. Meky
- Faculty of Education; Mental Health Department; Port Said University; Port Said Egypt
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Development and Validation of Turkish Version of The Female Sexual Distress Scale-Revised. Sex Med 2016; 4:e43-50. [PMID: 26796854 PMCID: PMC4822479 DOI: 10.1016/j.esxm.2015.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 09/03/2015] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION The sexually related personal distress becomes an obligation for the diagnosis of female sexual dysfunction (FSD). The Female Sexual Distress Scale-Revised (FSDS-R) was developed, extensively validated, and is among the most widely used tools to measure distress associated with impaired sexual function. AIM This study aims to develop a Turkish version of the FSDS-R, to evaluate its psychometric reliability and validity, and to estimate the optimal cutoff score that corresponds best to the clinical diagnosis of sexual dysfunction. METHODS Ninety-five participants were diagnosed with female sexual interest and arousal disorder (FSIAD), 25 participants were diagnosed with another FSD, and 128 participants were healthy. Alpha coefficients (α) were used as an indicator of internal consistency. Test-retest reliability over a 2-week period was estimated using intraclass correlation coefficients (ICCs). Correlation analysis conducted between the FSDS-R total score, the Female Sexual Function Index subscale, and total score was examined for convergent validity. Discriminant validity was assessed by comparing mean scores of the FSD and control groups in a between-groups analysis of variance. Receiver operating characteristic analysis was performed to determine optimal cutoff values of the Turkish version of Female Sexual Distress Scale-Revised (Tr-FSDS-R). MAIN OUTCOMES MEASURES Sexuality-related distress measured by the Turkish version of the FSDS-R. RESULTS Internal consistencies of the FSDS-R across the two assessments point for the three groups of women ranged from α = 0.87 to α = 0.99. ICCs ranged from 0.92 to 0.94 for baseline and day 15 for FSIAD, other FSD, and no FSD groups. One-factor unidimensional model explained 85.7% of the total variance of the Tr-FSDS-R items. The optimal cutoff score was found to be >11.5 to provide optimal sensitivity (97.9%) and specificity (83.2%). Significant differences in the FSDS-R scores were found between healthy women, women with hypoactive sexual desire disorder, and women with other types of FSD. CONCLUSION The Turkish version of FSDS-R is a valid, reliable tool with well discriminative and psychometric validity for use in the Turkish female population and can be used as a screening questionnaire for females with sexual interest/arousal disorder. The score of ≥11.5 was proposed as a cutoff to detect the presence of sexually related personal distress in Turkish women with FSD.
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Abstract
BACKGROUND Previous research shows that smoking status is unrelated to female sexual difficulties. However, degree of nicotine dependence has not been measured, and the assessment of sexual functioning has not specified penile-vaginal intercourse (henceforth, intercourse), which is more clearly impaired by sexual difficulties than other sexual behaviors. OBJECTIVES To test if smoking status is associated with poorer female sexual function during intercourse, and if nicotine dependence rather than smoking status is related to poorer female sexual function. METHODS During 2012, 129 Portuguese community women reported their smoking status, and completed the Fagerström Test for Nicotine Dependence, the Female Sexual Function Index (FSFI), and an adaptation of the FSFI to assess sexual functioning specifically during intercourse, as well as the desire thereof. RESULTS Smokers reported higher desire for intercourse and were more likely to have actually engaged in it in the past 4 weeks. Among the coitally active women in the preceding 4 weeks, nicotine dependence correlated with lower desire for intercourse. Smoking status and nicotine dependence were unrelated to arousal, lubrication, orgasm, satisfaction, pain. CONCLUSIONS The findings are consistent with many studies that fail to demonstrate an increased risk of sexual difficulties among female smokers. However, nicotine dependence, rather than smoking status per se, might be associated with lower libido. The results suggest the possibility of an inverse U-shaped relationship between smoking and libido with a moderate use of tobacco being associated with higher sexual desire.
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Azimi Nekoo E, Burri A, Ashrafti F, Fridlund B, Koenig HG, Derogatis LR, Pakpour AH. Psychometric properties of the Iranian version of the female sexual distress scale-revised in women. J Sex Med 2014; 11:995-1004. [PMID: 24641598 DOI: 10.1111/jsm.12449] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Several tools for the assessment of sexuality-related distress are now available. The Female Sexual Distress Scale (FSDS) and its revised version (FSDS-R) are extensively validated and among the most widely used tools to measure sexually related personal distress. AIM The aim of the study was to determine the psychometric properties of the Iranian version of the FSDS-R in a population sample of Iranian women. METHODS A total of 2,400 married and potentially sexually active women were recruited and categorized into three groups including (i) a healthy control group; (ii) a group of women with hypoactive sexual desire disorder (HSDD); and (iii) a group of women suffering from other female sexual dysfunction (FSD). Participants were asked to complete a set of questionnaires including the Iranian version of the Female Sexual Function Index (FSFI-IV), the FSDS-R, and the Hospital Anxiety and Depression Scale. MAIN OUTCOME MEASURES Sexuality-related distress and FSD as assessed by the Iranian version of the FSDS-R and the FSFI-IV are the main outcome measures. RESULTS Internal consistencies and test-retest reliability of the FSDS-R across the three assessments points for the three groups were >0.70. The FSDS-R correlated significantly with anxiety, depression, and the FSFI total score. Significant differences in the FSDS-R scores were found between healthy women, women with HSDD, and women with other types of FSD. Factor analysis of the FSDS-R yielded a single-factor model with an acceptable fit. CONCLUSIONS The Persian version of the FSDS-R is a valid and reliable instrument for the assessment of sexuality-related distress in Iranian women and can be used to screen patients with HSDD.
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Affiliation(s)
- Elham Azimi Nekoo
- Vali-e-Asr Reproductive Health Research CenterTehran University of Medical SciencesTehranIran
| | - Andrea Burri
- Department of PsychologyUniversity of ZurichZurichSwitzerland
| | - Farzaneh Ashrafti
- Neurology Research CenterDepartment of MidwiferySchool of Nursing and MidwiferyKerman University of Medical SciencesKermanIran
| | - Bengt Fridlund
- School of Health SciencesJönköping UniversityJönköpingSweden
| | - Harold G Koenig
- Departments of Medicine and PsychiatryDuke University Medical CenterDurhamNCUSA; Department of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Leonard R Derogatis
- Center for Sexual Medicine at Sheppard PrattDepartment of PsychiatryJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Amir H Pakpour
- Social Determinants of Health Research CenterQazvin University of Medical SciencesQazvinIran; Department of Public HealthQazvin University of Medical SciencesQazvinIran.
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