Psychometric Validation of the Sexual Distress Scale in Men with Prostate Cancer

Abstract

BackgroundDifferent scales exist for the assessment of sexual distress in men with prostate cancer (PCa); however, these measures narrowly focus on distress associated with sexual function. AimTo validate and examine the psychometric properties of the Sexual Distress Scale (SDS) and Sexual Distress Scale-Revised (SDS-R), which were recently validated for use within men, in samples of sexually functional and sexually dysfunctional men with PCa. MethodsA sample of 538 men (with and without PCa and with and without sexual dysfunction) were used to examine the psychometric properties of the SDS. Confirmatory factor analysis followed by tests of measurement bias, calculations of reliability, and estimation of receiver operating characteristic (ROC) curves were used to examine the psychometric properties of the SDS and SDS-R. A subsample of 321 men completed the survey again 1 month later, and their responses were used to examine test-retest reliability. OutcomesParticipants completed the SDS and SDS-R, as well as measures of sexual bother and sexual concerns, sexual function, sexual attitudes, and mood states. ResultsThe SDS and SDS-R assess 1 general domain of sexual distress; 1 violation of measurement invariance was found between men with and men without PCa, which limits the comparability of scores between these 2 groups. Internal consistency and test-retest reliabilities were above 0.93 and 0.82, respectively. Evidences of validity based on relations with other variables supported our predictions because sexual distress was associated with other measures of distress, sexual function, satisfaction, and mood and not correlated to sexual attitudes. Although the SDS and SDS-R discriminated between sexually functional and dysfunctional men, the accuracy of the cutoff scores was only moderate. Clinical TranslationThis instrument can be used by researchers and clinicians to examine sexual distress and can be used to elucidate how sexual distress relates to sexual function, well-being, and quality of life. Strengths and LimitationsThe SDS and SDS-R assess sexual distress independently of sexual function; however, with the current evidence, they should not be used to compare men with and men without PCa and to classify men with and men without sexual dysfunction. ConclusionThis study provides a validation of the SDS and SDS-R that can be used in samples of men with PCa and with and without sexual dysfunction for the assessment of distress.Santos-Iglesias P, Walker LM. Psychometric Validation of the Sexual Distress Scale in Men with Prostate Cancer. J Sex Med 2018;15:1010–1020.