Derogatis Sexual Functioning Inventory Research Articles

Marital and Sexual Satisfaction among Patients with Schizophrenia

MethodsZZMarital and sexual satisfaction of 66 married schizophrenic patients and 162 married normal controls were assessed with Enriching and Nurturing Relationship Issues, Communication and Happiness and Derogatis Sexual Function Inventory. We compared the differences in marital and sexual satisfaction and influential variables between these two groups through analysis of covariance with adjustment for age and the duration of marriage. Factors associated with marital and sexual satisfaction were identified with multiple regression analysis.

Sexual fantasies and sexual arousal in women with a history of childhood sexual abuse

Treatments of female sexual arousal dysfunction for childhood sexual abuse (CSA) survivors could greatly benefit from more information on mechanisms to the sexual arousal problems specific to this population. In this study, 60 CSA survivors and 120 women with no history of CSA (NCSA) participated in an Internet-based survey on sexual arousal and sexual fantasies. Self-reported sexual arousal was measured with the Female Sexual Function Index and a modified version of the Derogatis Sexual Function Inventory: Sexual Fantasies was used to assess frequency and types of sexual fantasies. The frequency of degrading and violent sexual fantasies was not associated with sexual arousal. The CSA group did not report more degrading and violent sexual fantasies than the NCSA group. Greater frequency of conventional fantasies (i.e. sex with one's partner, sex in unusual positions, oral sex) was associated with greater sexual arousal for both groups. Clinical implications derived from these findings include whether encouraging more conventional sexual fantasies could facilitate sexual arousal.

Exploring Sexual Attitudes of Students in Health Professions

Patients' sexual concerns are frequently underestimated because of health professionals' reluctance to address sexual health issues. Though it has been documented that sexual attitudes are extremely influential in everyday clinical practice, limited data exist on identifying health professionals' attitudes. To explore sexual attitudes in medical students and students in allied health professions. The Derogatis Sexual Functioning Inventory (DSFI)-Attitude Subscale was used to assess sexual attitudes. The sample included 1st and 4th year college students enrolled in the following academic departments/schools of two academic institutions leading to health professions: medical school, psychology, pharmaceutical school, nursing and midwifery. Demographic data were obtained relating to sexual behaviors and information sources on sexual issues. Data were analyzed using independent samples t-test and two-way analysis of variance, as well as logistic regression and Pearson's correlation coefficient. A total of 714 students (81.9% females) participated in the study: 48.5% 1st year students and 51.5% seniors with a mean age of 20.17 years (SD = 1.87, range 17-25). Using iterative cluster analysis on DSFI scores, participants were divided in conservative (N = 167), liberal (N = 224), and neutral (N = 323) clusters. A significant gender difference on sexual attitudes was obtained (P < 0.001) with male students being more liberal compared to females (mean = 18.26 and mean = 11.13, respectively). Differences were also revealed for the field but not for the year of study. Analysis also revealed that liberalism in sexual attitudes is more likely to be affected by a liberal stance toward religion (OR: 2.39), receiving information for sexual matters mainly from peers (OR: 1.86), and media influence on students' sexual life (OR: 1.68). Gender, personal values, and experiences influence students' attitudes toward sexual issues. Since negative attitudes can impede effective sexual health consultations, it is imperative to incorporate courses on effective communication and human sexuality in the medical and allied health professions curricula that will enhance students' awareness of their own values and prejudices.

Impact of common contraceptive methods on quality of life and sexual function in Hong Kong Chinese women

The combined oral contraceptive (COC) pills, injectables, intrauterine contraceptive device (IUCD) and female sterilization are the most common contraceptive methods used by women. Women's choice, compliance and satisfaction with specific contraceptive methods are influenced by any impact of the method on their quality of life and sexual function. Anxiety regarding possible adverse effects of the contraceptive methods on their quality of life and sexual function is one of the common concerns. The aim of this prospective observational study was to determine the impact of the abovementioned contraceptive methods on the quality of life and sexual function of the users. A sample of 361 Hong Kong Chinese women who were first-time users of the following contraceptive methods completed the study: COC pills ( n=87), injectables ( n=67), IUCD ( n=96) and female sterilization ( n=111). Quality of life and sexual function of the subjects were assessed before and 3–4 months after use of the method by a standardized questionnaire. The questions were adopted from the validated Chinese versions of the World Health Organization Quality of Life (WHOQOL) questionnaire and the Derogatis Sexual Functioning Inventory (DSFI). In the female sterilization group, we found a significantly higher score for sexual satisfaction (p=.004) and sexual drive (p=.003) 3–4 months after sterilization, as well as an improved WHOQOL social domain score (p=.009). However, the other DSFI subscale scores and WHOQOL domain scores were not significantly different (p>.05). No significant difference was demonstrated in all the WHOQOL domain scores and DSFI subscale scores after use of COC pills, injectables and IUCD (p>.05). We conclude that the COC pills, injectables, IUCD and female sterilization all do not have significant adverse impact on quality of life and sexual function. After female sterilization, there is a significant improvement in sexual satisfaction and sexual drive.

Characteristics of psychosexual functioning in adults with cerebral palsy.

To investigate the characteristics of psychosexual functioning in adults with cerebral palsy, as compared with able-bodied control subjects, matched by gender and marital status, and to identify the factors affecting psychosexual functioning. Interview and survey using the Derogatis Sexual Functioning Inventory (DSFI). Inpatient and outpatient units in a rehabilitation hospital and welfare facilities. Sixty-two adults with cerebral palsy and 142 age-matched able-bodied controls participated in this study. The participants were grouped into four subgroups according to gender and marital status. General characteristics of the subjects, 10 domain scores of the DSFI and Sexual Functioning Index (SFI) as a global score were assessed. The scores for each cerebral palsy group according to gender and marital status were compared with those of their corresponding able-bodied control group. Unmarried men with cerebral palsy demonstrated lower SFI and weakness in sexual information, experience, drive, attitude, psychological symptoms, affect and satisfaction, compared with unmarried able-bodied men (p < 0.05). In contrast to unmarried men, unmarried women did not reveal any significant differences in all but body image domain score (p < 0.05) between the groups. Married adults with cerebral palsy showed higher levels of psychological distress in both men and women and lower sexual satisfaction in women (p < 0.05). Nonambulatory people with cerebral palsy had significantly a lower sexual information, experience and satisfaction, and a lower SFI than ambulatory (p < 0.05). Barthel Index was significantly related to body image (p < 0.05). Psychosexual functioning was not significantly different according to cerebral palsy type. This study revealed the characteristics on psychosexual functioning in adults with cerebral palsy, depending on gender and marital status. The results suggested that nonambulatory unmarried men with cerebral palsy were at high risk in terms of psychosexual dysfunction.

Prediction of recidivism in exhibitionists: psychological, phallometric, and offense factors.

Exhibitionists have traditionally been regarded as nuisance offenders. However, empirical studies show that some offenders can be highly recidivistic and can escalate to incidents of Hands-on sexual assault. The objective of this study was to investigate predictors of recidivism in exhibitionists and clarify the differences between Hands-on and Hands-off sexual recidivists. The hundred and twenty-one exhibitionists were assessed at a university teaching hospital between 1983 and 1996. Archival data came from medical files and police files. The Psychopathy Checklist-Revised (PCL-R) was assessed retrospectively. Results indicated that over a mean follow-up period of 6.84 years, 11.7, 16.8, and 32.7% of exhibitionists were charged with or convicted of sexual, violent, or criminal offenses, respectively. Sexual reoffending recidivists were less educated, and had more prior sexual and criminal offenses. Violent, recidivists were also less educated, had lower Derogatis Sexual Functioning Inventory (DSFI) scores, higher PCL-R Totals, and more prior sexual, violent, and criminal offenses. Criminal recidivists were younger, less educated, had lower DSFI scores, higher PCL-R scores, higher Pedophile Indices, and more prior sexual, violent, and criminal offenses. Hands-on sexual recidivists demonstrated higher PCL-R ratings, higher Pedophile and Rape indices, and more prior sexual, violent, and criminal offenses than did Hands-off counterparts.

Psychological Functioning and Quality of Life in Lung Transplant Candidates and Recipients

The purpose of this study was to examine the psychological functioning and quality of life (QOL) of lung transplant candidates and recipients. The following measures were completed by 36 lung transplant candidates (the pretransplant group [PRE]) and 73 recipients (the posttransplant group [POST]): the Rand-36 Item Health Survey 1.0 (RAND-36), visual analog scale of overall QOL (OQOL), Brief Symptoms Inventory (BSI), Derogatis Sexual Functioning Inventory (DSFI), Hospital Anxiety and Depression Scale (HAD), Rosenberg Self-Esteem Scale (RSES), and Body Cathexis Scale (BC). Compared to the PRE, POST patients had significantly better scores on the following measures: RAND-36 total, physical health, role limitations due to physical health, general health, vitality, and social functioning subscales (all p < 0.0001); visual analog scale of OQOL (p < 0.0001); BSI (p < 0.05); BC (p < 0.05); HAD anxiety (p < 0.05) and depression (p < 0.0001); and RSES (p < 0.05). Despite better scores, some areas did not differ between the PRE and the POST, and many patients continued to experience impairments in psychological functioning. Specifically, the RAND-36 emotional health and role limitations due to emotional health subscale scores did not differ between the PRE and the POST and they remained lower than published norms. A significant proportion of patients in both groups (44% of PRE patients and 28% of POST patients) had borderline or clinical levels of anxiety (ie, the HAD). Finally, PRE and POST mean scores were significantly lower than published norms on the RSES (p < 0.05) and the body image scale of the DSFI (p < 0.05). Although lung transplant recipients have better general, physical, and psychological health than their pretransplant counterparts, the present research suggests that both groups experience impairment in several areas of psychological functioning. Future research into the QOL of the lung transplant population should be aimed at recognizing, intervening, and improving patients' psychological and emotional well-being.

Pregnant Women's Attitude and Satisfaction for Sexuality

【The relationship between the attitude and satisfaction for sexuality of pregnant women was observed to provide rationales of nursing intervention to help promote healthy sexual lifestyles. Questionnaires were collected from 211 obstetric outpatients of H university hospital in C city, Korea from February to May 1999. The research tools were D.S.F.I (Derogatis Sexual Function Inventory in Korean, Chronbach's $\alpha=$ 0.710) and Sexuality Satisfaction Method (Kim, 1997, Chronbach's $\alpha$ =0.864). 0.864). Data was analyzed for frequency, mean, standard deviation, Pearson correlation, t-test and ANOVA by Windows SAS. The results of this study were as follows: Mean age of the subjects were 29.8; the average score of attitude to sex was moderate (27.60), and that of satisfaction sex was high (54.11); the positive relationship was shown between attitude and satisfaction for sexuality (r=0.51, p=.000); the higher educational and income levels of pregnant women and their husbands, were the better the attitude and satisfaction for was; professional women had better attitude than housewives. According to the results, it is suggested that the study is necessary to develop an effective nursing intervention related with the sexuality of pregnant women.】

Sexual functioning in ambulatory men with HIV/AIDS.

Sexual functioning is often neglected in the care of HIV-infected patients. Little information exists about the relationship between hormonal factors, psychological factors, medication, HIV disease stage and sexual functioning among persons with HIV disease. In this study, 50 HIV+ men completed the Derogatis Sexual Functioning Inventory (DSFI), and had serum hormonal assays drawn (testosterone, thyroid function test, leuteinizing hormone, prolactin and oestradiol). Although all the subjects reported some degree of sexual dysfunction, persons with symptomatic HIV/AIDS reported more negative mood, lower sexual satisfaction scores and worse body image than persons with asymptomatic HIV. Persons with asymptomatic HIV also tended to have normal testosterone levels compared with persons with symptomatic HIV/AIDS. No relationship was found between medications and low testosterone, although numbers were small. These results suggest that sexual dysfunction is prevalent among persons with HIV disease, is more common as patients become symptomatic and progress to AIDS and that both physiological (low testosterone) and psychological issues play a role.

Homicidal and Nonhomicidal Child Molesters: Psychological, Phallometric, and Criminal Features

Seventeen extrafamilial homicidal child molesters (HCM) were compared to 35 convicted extrafamilial child molesters (CM) who had not murdered, or attempted to murder, their victims. The two groups did not differ on age, IQ, education, history of marriage, or family history, although marriage rates of both groups were well below the national average. Similarly, both groups had high rates of features representing family instability. HCM more frequently victimized strangers. The results on the self-report psychological inventories, the Derogatis Sexual Functioning Inventory (DSFI) and the Buss-Durkee Hostility Inventory (BDHI), did not distinguish between the groups, although the DSFI revealed sexual inadequacy in both groups. The BDHI did not describe the groups as pathological. The Psychopathy Checklist—Revised Total Score, Factor 1, and Factor 2 described both groups as demonstrating high levels of psychopathy, with the HCM scoring significantly higher. Factor 1 and Factor 2 scores placed the HCM group in the 93rd and 82nd percentiles, respectively, compared to published norms for forensic patients. A greater proportion of HCM suffered from antisocial personality disorders and paraphilias, especially sexual sadism. Over 53% of the HCM, and none of the CM, were comorbid for pedophilia and sexual sadism. Significantly more HCM received three or more DSM III-R diagnoses. The phallometric assessments generally supported DSM diagnoses. The HCM demonstrated significantly higher levels of deviant arousal to pedophilic and adult assault stimuli. Police files revealed that, prior to the index offense, a significantly greater proportion of HCM had been charged with, or convicted of, violent nonsexual, and sexual offenses. The HCM had been charged with, or convicted of, more than 2.5 times as many criminal charges than the CM. A discriminant function analysis revealed that two variables, Factor 1 of the PCL-R and the number of violent entries in the police records, correctly predicted 78.6% of the HCM and 97.1% of the CM. Implications for understanding homicidal child molesters and for future research are discussed.

Psychological aspects of sexual functioning among cleric and noncleric alleged sex offenders

Cleric sexual misconduct with minors is a problem receiving increased attention from the media, victims groups, and church authorities. Mental health professionals are increasingly being asked to assist church and civil authorities to help better understand the problem of cleric sexual misconduct with minors. In the current study we compared self-reported sexual functioning among cleric alleged child molesters, noncleric alleged child molesters, and normal control subjects. We hypothesized clerics would differ from nonclerics and normals in reported sexual functioning. Our sample included 30 Roman Catholic clerics and 39 nonclerics who were alleged to have engaged in sexual misconduct with minors, and 38 normal control subjects, all of whom took the Derogatis Sexual Functioning Inventory (DSFI) as part of their forensic psychiatric evaluation. Our results indicated clerics were more likely to report fewer victims, older victims, and victims of male gender than noncleric alleged child molesters. Clerics differed from nonclerics and normal control subjects on several dimensions of self-reported sexual functioning. Lower offense rate histories among clerics suggest that, as a group, clerics may be less seriously psychologically disordered than noncleric child molesters. Low DSFI scores among Roman Catholic clerics may be accounted for in part by their unique training and socialization process. Future studies should attempt to study the influence of social desirability on DSFI scores. Normative data from nonoffending celibate clergy are needed.

Personality characteristics and sexual functioning of 188 cross-dressing men.

The literature on cross-dressing men has been primarily limited to self-identified patients at psychiatric clinics who are in distress. To understand the personality trait characteristics and sexual functioning of nonpatient cross-dressers, 188 non-treatment-seeking male cross-dressers completed the NEO Personality Inventory (NEO-PI) and the Derogatis Sexual Functioning Inventory (DSFI). Respondents were classified as transvestites (TV; N = 83), transgenderists (TG; N = 61), or transsexuals (TS; N = 44) based on self-report and the nature of their cross-gender activities (e.g., use of female hormones, desire for sex reassignment, and amount of time spent in female role). These diagnostic groups did not differ on the five broad personality domains of the NEO-PI, but TS men scored higher than TV and TG men on the Aesthetics facet scale of Openness to Experience (O). In terms of the DSFI scales, TS men reported lower sexual drive than TV and TG men, and TS and TG men exhibited greater psychiatric symptoms and feminine gender role, and poorer body image than TV men. Upon exclusion of a group of 49 respondents who previously sought treatment for psychological problems, no significant differences emerged among the three diagnostic groups on the NEO-PI domain and facet scales. Consideration of the DSFI scales showed that TS men experienced less sexual drive, more psychiatric symptoms, and a greater feminine gender role than TV or TG men. This study suggests that cross-dressers not seen for clinical reasons are virtually indistinguishable from non-cross-dressing men using a measure of personality traits, a sexual functioning inventory, and measures of psychological distress. These results emphasize the importance of using clinical significance criteria as required by DSM-IV guidelines before diagnosing men who cross-dress with an axis I disorder.

Psychosexual functioning in opioid‐dependent women

Psychosexual functioning of opioid‐dependent women (N = 63) was compared to a socioeconomically similar group of non‐drug‐abusing women (N = 53) using the Derogatis Sexual Functioning Inventory (DSFI). Initial analyses revealed differences in sexual drive, liberal attitude, and both masculine and feminine gender‐role affiliation. When demographic differences between the two groups were statistically controlled, however, only liberal attitude and femininity subscale differences remained significant. Although both opioid‐dependent and comparison group women reported similar types of sexual experiences (lifetime), opioid‐dependent women reported greater recent reduction in sexual behaviors related to anal intercourse and anal stimulation. Both opioid‐dependent and clinic women differed significantly from the DSFI normative sample, highlighting the importance of controlling for demographic differences when using standardized psychological assessment tools. Implications of study findings for AIDS prevention an...

Orgasm in women with spinal cord injuries: A laboratory-based assessment

Objective: To understand the characteristics and physiological sexual responses of women with spinal cord injuries (SCI) during orgasm. Design: Controlled laboratory-based analysis of women's physiological and subjective responses during a single session in which they attempted to perform stimulation to orgasm. Setting: The sexual physiology laboratory at our free-standing rehabilitation hospital. Participants: A volunteer sample of 25 women with SCI and 10 able-bodied control subjects, matched for age. Intervention: A 75-minute protocol designed to obtain information on the physiological events accompanying orgasm. Dependent Variables: Included vaginal pulse amplitude, heart rate, respiration rate, blood pressure, subjective arousal and subscores on the Derogatis Sexual Functioning Inventory (DSFI). Results: Data were analyzed both within and across neurological groups: complete SCI, incomplete SCI, and able-bodied controls. All able-bodied subjects achieved orgasm whereas 52% of SCI subjects achieved orgasm. Degree and type of SCI did not significantly relate to subjects' ability to achieve orgasm. Subjects with no lower extremity function took significantly longer than able-bodied subjects to achieve orgasm. Differences between baseline and orgasm readings are described for each of the major physiological measures. Results of DSFI revealed that able-bodied subjects acknowledged greater sexual satisfaction than SCI subjects. Subjects who achieved orgasm scored higher on sexual information and sex drive. Conclusion: Results support previous self-report studies, in that a large percentage of SCI women achieved orgasm regardless of pattern or degree of neurological injury. No consistent characteristics were identified that would allow prediction of which women with SCI would be able to experience orgasm. However, subjects who achieved orgasms had a higher sex drive and greater sexual knowledge. Implications for sex therapy treatment programs with spinal cord injured women are discussed.

Diabetes, psychological function and male sexuality

The aim of the study was to assess psychological contributors or correlates of sexual dysfunction in diabetic men. The study was conducted on 40 diabetic men and 40 age-matched healthy volunteers. The subjects underwent a psychosexual interview with their sexual partners and had a comprehensive medical evaluation to rule out the confounding effects of other illnesses or medications. Psychiatric, psychological and marital information was obtained with the Schedule for Affective Disorders and Schizophrenia (SADS-L), the SCL-90-R, the Derogatis Sexual Function Inventory, the Locke-Wallace Marital Adjustment test and the Dyadic Adjustment Inventory. Compared to controls, diabetic patients had significantly lower levels of erotic drive, sexual arousal, enjoyment and satisfaction. Problems in these areas coexisted with alterations in sexual attitudes and body image but were not related to group differences in marital adjustment as reported separately by the patients and their partners. There was no evidence that psychological distress or psychiatric disorders are associated with diabetes or with its effects on sexual function.

Self-report assessment of female sexual function: Psychometric evaluation of the brief index of sexual functioning for women

Previous self-report measures of female sexual function have been either overly restrictive or inappropriate for use in large-scale clinical trials. Accordingly, we have developed the Brief Index of Sexual Functioning for Women (BISF-W), a 22-item, self-report instrument for the assessment of current levels of female sexual functioning and satisfaction. The BISF-W was administered at monthly intervals to a standardization sample of 269 women, ages 20-73 years. A principal components analysis yielded a three-factor solution--interest/desire, sexual activity, and satisfaction--which accounted for 51.2% of the variance. Concurrent validity was demonstrated by means of a comparison with the Derogatis Sexual Function Inventory. In addition, the BISF-W was compared to the Brief Sexual Function Questionnaire, a similar self-report measure of sexual functioning for men. Major advantages of the BISF-W are its ease of administration and scoring, suitability for use in both clinical and nonclinical samples, and assessment of key dimensions of female sexuality. However, based on its moderate test-retest reliability and internal consistency, further development of the instrument is indicated.

Sexual satisfaction in healthy aging men.

Systematic information on the contributing factors to sexual satisfaction in healthy older men is lacking. The central aim of the study was to explore the predictive significance of psychological, marital, and behavioral variables and their interaction on the satisfaction of healthy married volunteers aged 45 to 74. All subjects had an extensive psychosexual and medical evaluation and completed a battery of psychological tests which included the Derogatis Sexual Functioning Inventory (DSFI), the Locke-Wallace Marital Adjustment Test (L-W) and the Dyadic Adjustment Scale (DAS). Step-wise regression analysis demonstrated that the subjects' perception of erectile difficulties, sexual information, affect, and marital adjustment had a differential correlation pattern with three measures of sexual satisfaction explaining a substantial amount of the variance. There is a need to move beyond an exclusive focus on performance to the determinants of sexual enjoyment and satisfaction in the later years.

A profile of psychosexual functioning in males following spinal cord injury

The psychosexual functioning of 47 men with spinal cord injury was studied using the Derogatis Sexual Functioning Inventory (DSFI). Subjects with paraplegia did not differ significantly from subjects with quadriplegia on any of the scales of the DSFI. Subject groups were then aggregated, and the means across DSFI scales were compared to the means of the non-disabled DSFI normative group. This comparison revealed significantly below-normal scores for subjects with spinal cord injury on the Body Image, Gender Role Definition, Experience, and Psychological Symptoms scales, as well as on a composite measure of sexual functioning, the Sexual Functioning Index. The meaning of these results is discussed, and implications for intervention are considered.

Psychometric characteristics of individuals with sexual dysfunction and their partners.

This study assessed psychological dimensions and marital adjustment of 52 couples in which one of the partners met operational criteria for hypoactive sexual desire or erectile dysfunction. Information was obtained independently from the dysfunctional subjects and their partners by means of validated inventories: the Derogatis Sexual Function Inventory (DSFI), Locke-Wallace Marital Adjustment Test (L-W), and the Dyadic Adjustment Scale (DAS). The global measures of sexual function and satisfaction of the DSFI showed marked impairment in all groups, while its subscale scores suggested characteristic differences in the profiles of the dysfunctional groups and their partners. In contrast to individual psychologic measures, the assessment of marital adjustment was within the scale's normative limits in all diagnostic groups. There is a need for controlled studies to better characterize sexual and marital dimensions in diagnostically well-defined dysfunctional couples.

Personality and Sexual Functioning of Transvestitic Fetishists and Other Paraphilics

Utilizing the NEO Personality Inventory (NEO-PI) and the Derogatis Sexual Functioning Inventory (DSFI), 24 transvestitic fetishists (TVs) were compared with a similar clinic-evaluated group of 26 other paraphilics (OPs). The data replicated previous results and extended them by showing that TVs did not differ from OPs on most dimensions of the NEO-PI and the DSFI. Both groups were significantly higher on neuroticism and significantly lower on agreeableness than the NEO-PI male normative population. The other paraphilic group tended to score lower on conscientiousness than the TVs and the normative comparison group. For nine of the 10 DSFI variables, there were no significant differences between the TVs and the OPs. The TVs were significantly higher than the OPs on role identity, indicating a more feminine identification. Both the TVs and OPs reported elevated levels of fantasy. The implications of these findings suggest that, in general, TVs and OPs are more similar than they are different, with a common personality profile and a similar pattern of sexual functioning.