Measures Of Sexual Dysfunction Research Articles

PLISSIT Interventions and Sexual Functioning: Useful Tools for Social Work in Palliative Care?

Discussing sexual health with healthcare patients and their partners is difficult and often avoided. The PLISSIT model is a framework to effectively initiate the conversation about sexual concerns. This rapid review and small meta-analysis explores and clarifies knowledge about the effectiveness of PLISSIT in resolving sexual dysfunction and glean insight into its utility as a social work intervention in a palliative care setting. Evidence from 15 interventional studies was synthesized. Cohen’s d-index served as the meta-analytic effect size statistic for each individual study. Significant ds were converted to Cohen’s U3 statistic to aid in practical interpretations. Between-study heterogeneity was evaluated with Cochran’s Q statistic to examine possible relationships between effect sizes and moderator variables. Statistically and practically significant evidence revealed that PLISSIT is effective in treating sexual dysfunction (d = 1.00, U3 = 84%, 95% CI = 1.06, 1.08): 84% of participants who received PLISSIT interventions scored lower on sexual dysfunction measures than did the typical participant in the comparison condition. Study design and frequency of intervention delivery moderated the overall effect. The findings and inferences may be best thought of as developed hypotheses for future research testing.

Critical Flaws in the Female Sexual Function Index and the International Index of Erectile Function

The Female Sexual Function Index (FSFI; Rosen et al., 2000) and International Index of Erectile Function (IIEF; Rosen et al., 1997) are two of the most widely used measures of sexual dysfunction. However, they have potential measurement and psychometric flaws that have not been addressed in the literature. This article examines the measurement capabilities of these measures based on data collected from an online study in 2010. A convenience sample of 518 sexually active adults (65% female) drawn from the general community were included in the analyses. Both measures displayed critical theoretical and measurement problems for the assessment of sexual problems beyond sexual arousal, and for the sexual desire domains in particular. Based on these results, we encourage clinicians and researchers to think critically about whether the FSFI and IIEF are appropriate measures for their practice and research. In particular, these measures are inappropriate for use among individuals who are not currently sexually active, and research with a focus other than sexual arousal should consider supplementary measures of sexual function. The psychometric properties of these measures should be reassessed in clinical samples, but the theoretical issues with the measures raised in this article are relevant across clinical and research contexts.

A Systematic Review of Sexual Dysfunction Measures for Gay Men: How Do Current Measures Measure Up?

The measurement of subjective components of sexual functioning is of increasing importance in clinical research and practice. Differences have been reported in prevalence rates and experiences of sexual difficulties between heterosexual and gay men. The aim of this article is to identify reliable and valid measures of sexual dysfunction suitable for use with gay men. Seven measures were reviewed; details about item development, dimensionality, reliability, and validity are provided. Heteronormative and heterosexist wording were evident throughout. Several areas of concern emerged in relation to psychometric properties (e.g., questionable validity). No psychometrically robust sexual function measure was identified for use with gay populations.

The Natsal-SF: a validated measure of sexual function for use in community surveys

Sexual dysfunction often features as an outcome variable in community health surveys and epidemiological surveys. Key design imperatives for measures included in large scale, population-based surveys are acceptability, brevity and relevance to diverse sexual lifestyles. None of the available measures of sexual dysfunction are entirely suited to this task. We developed a new measure of sexual function for the third British National Survey of Sexual Attitudes and Lifestyles (Natsal 3). Items for the measure were derived from qualitative work from patients and community members. The draft measure was developed and validated using a general population sample (internet panel survey (n = 1,262)) and a clinical sample (patients attending sexual problems clinics (n = 100). Confirmatory factor analysis established that a ‘general-specific model’ had the best fit and was equivalent between general population and clinical samples (Comparative Fit Index = 0.963 Tucker Lewis Index = 0.951; Root Mean Square Error of Approximation = 0.064). The 17-item Natsal-SF is positively associated with the Female Sexual Function Index-6 (B = 0.572) and Brief Sexual Function Questionnaire for men (B = 0.705); it can discriminate between clinical and general population groups (OR = 2.667); and it has good test–retest reliability (r = 0.72). The Natsal-SF provides an estimate of the level of sexual function in the last year. By including items on distress about sex and sexual relationships, and by being relevant to all regardless of sexual lifestyle, it addresses some of the gaps in current measurement design.

Quetiapine XR efficacy and tolerability as monotherapy and as adjunctive treatment to conventional antidepressants in the acute and maintenance treatment of major depressive disorder: a review of registration trials

Results from pivotal registration trials in major depressive disorder cohere with outcomes from effectiveness studies indicating that the majority of individuals receiving single-agent pharmacotherapy fail to achieve and sustain symptomatic remission. Several factors provided the impetus for this review: suboptimal efficacy with existing pharmacotherapy for major depressive disorder, quetiapine XR efficacy in the acute and maintenance treatment of bipolar depression, emerging pharmacodynamic evidence that quetiapine XR (and/or its metabolites) uniquely engages monoaminergic systems salient to symptom relief in depressive syndromes, the increasing use of second-generation antipsychotics in the treatment of major depressive disorder and the recent FDA review of quetiapine XR in major depressive disorder. Studies reviewed herein are pivotal registration trials that evaluated the acute and maintenance efficacy and tolerability of quetiapine XR (as monotherapy and as adjunctive treatment) in major depressive disorder. In addition, we also review recent investigations characterizing the pharmacodynamic effect of quetiapine's principal active metabolite, norquetiapine. All studies were obtained from AstraZeneca (Wilmington, DE, USA) and have been presented at national/international scientific meetings. Taken together, extant studies demonstrated that quetiapine XR (50 – 300 mg) provides rapid and sustained symptomatic improvement in the acute and maintenance treatment of major depressive disorder. Quetiapine XR may also offer advantages relative to duloxetine in time to onset of antidepressant action. The major limitations of quetiapine XR use in major depressive disorder relate to weight gain and disrupted glucose/lipid homeostasis as well as sedation/somnolence. Quetiapine XR has tolerability advantages compared with duloxetine on measures of sexual dysfunction. The data from the studies reviewed herein also indicate that quetiapine XR poses a low risk for extrapyramidal side effects in middle-aged and elderly individuals with major depressive disorder.

ORIGINAL RESEARCH—PSYCHOLOGY: Acculturation and Sexual Function in Canadian East Asian Men

ABSTRACT Introduction Recent studies have demonstrated the importance of considering acculturation when investigating the sexuality of East Asian women in North America. Moreover, bidimensional assessment of both heritage and mainstream cultural affiliations provides significantly more information about sexual attitudes than simple unidimensional measures, such as length of residency in the Western culture. Aim The goal of this study was to extend the findings in women to a sample of East Asian men. Main Outcome Measures Self-report measures of sexual behaviors, sexual responses, and sexual satisfaction. Methods Euro-Canadian (N=124) and East Asian (N=137) male university students privately completed a battery of questionnaires in exchange for course credit. Results Group comparisons revealed East Asian men to have significantly lower liberal sexual attitudes and experiences, and a significantly lower proportion had engaged in sexual intercourse compared with the Euro-Canadian sample. In addition, the East Asian men had significantly higher Impotence and Avoidance subscale scores on the Golombok Rust Inventory of Sexual Satisfaction, a measure of sexual dysfunction. Focusing on East Asian men alone, mainstream acculturation, but not length of residency in Canada, was significantly related to sexual attitudes, experiences, and responses. Conclusion Overall, these data replicate the findings in women and suggest that specific acculturation effects over and above length of residency should be included in the cultural assessment of men’s sexual health.

Sexual dysfunction in men treated with depot antipsychotic drugs: a pilot study

Sexual dysfunction is common, but often under-recognised, in people with schizophrenia. Many antipsychotic drugs are known to cause prolactin elevation, and it is often assumed that sexual dysfunction is a consequence of prolactin elevation. We investigated the relationship between sexual function and serum concentrations of prolactin and testosterone in men receiving regular long-acting depot injections of antipsychotic medication. Twenty-two men attending a community depot clinic participated. A structured interview was used to collect information about sexual function, and serum prolactin and testosterone concentrations were measured. Sexual dysfunction was common, with 73% of men reporting problems in at least one area of sexual function. Six men had elevated serum prolactin and one had reduced serum testosterone. Antipsychotic drug dose was positively correlated with serum prolactin and negatively correlated with serum testosterone, but there was no association between serum prolactin or testosterone concentrations and any measure of sexual dysfunction. Sexual dysfunction is a major problem for men living with chronic schizophrenia, but our results suggest that it is not directly attributable to elevated prolactin or reduced testosterone concentrations.

MP-09.09: The effects of BMI, alcohol and smoking on measures of sexual dysfunction: baseline data from dutasteride studies involving a total of 18,966 subjects

MP-09.09: The effects of BMI, alcohol and smoking on measures of sexual dysfunction: baseline data from dutasteride studies involving a total of 18,966 subjects

ORIGINAL RESEARCH—EPIDEMIOLOGY: What can Prevalence Studies Tell Us about Female Sexual Difficulty and Dysfunction?

ABSTRACT Introduction Many recent studies have investigated the prevalence of female sexual difficulty/dysfunction. Aim Investigate female sexual difficulty/dysfunction using data from prevalence studies. Methods We reviewed published prevalence studies excluding those that had not included each category of sexual difficulty (desire, arousal, orgasm, and pain), were based on convenience sampling, or had a response rate <50% or a sample size <100. Main Outcome Measures For each study we used the prevalence of any sexual difficulty as the denominator and calculated the proportion of women reporting each type of difficulty. For each category of sexual difficulty we used the prevalence of that difficulty lasting 1 month or more as the denominator and calculated the proportion of difficulties lasting several months or more and 6 months or more. Results Only 11 of 1,248 studies identified met our inclusion criteria. These studies used different measures of sexual dysfunction, so generating a simple summary prevalence was not possible. However, we observed consistent patterns in the published data. Among women with any sexual difficulty, on average, 64% (range 16–75%) experienced desire difficulty, 35% (range 16– 48%) experienced orgasm difficulty, 31% (range 12–64%) experienced arousal difficulty, and 26% (range 7–58%) experienced sexual pain. Of the sexual difficulties that occurred for 1 month or more in the previous year, 62–89% persisted for at least several months and 25–28% persisted for 6 months or more. Two studies investigated distress. Only a proportion of women with sexual difficulty were distressed by it (21–67%). Conclusions Desire difficulty is the most common sexual difficulty experienced by women. While the majority of difficulties last for less than 6 months, up to a third persist for 6 months or more. Sexual difficulties do not always cause distress. Consequently, prevalence estimates will vary depending on the time frame specified by researchers and whether distress is included in these estimates.

Sexual Function in 131 Patients with Benign Prostatic Hyperplasia before Prostatectomy

Objective: The aim of the present study was to ascertain the frequency of sexual dysfunction in patients with benign prostatic hyperplasia (BPH) before prostatectomy.Methods: The study population included 131 patients aged 55–74 years (mean 61.4±2.7) with BPH. The patients had been complaining of daytime urgency and nocturia for the last 1–14 years (average 4.5±1.5 years). The diagnosis of BPH was based on the anamnestic data, the International Prostate Symptom Score (IPSS_0–35) and quality of life assessment (L_0–6), and results of digital rectal examination, transrectal ultrasound, and uroflowmetry. Sexual dysfunction was determined by retrospective analysis of the psychosexual history (with and separately from the spouse), penile brachial index (PBI), nocturnal penile tumescence (NPT), and blood hormone levels (testosterone).Results: The patients were divided into two groups by severity of the urinary disorder: group I, severe (IPSS_0–35–L₆; n = 70); and group II, mild relative to group I (IPSS_32–34–L_4–5; n = 61). In group I, 15 patients (21.4%) performed normal coitus, 24 (34.2%) had weak coitus with incomplete penetration, and 21 (44.2%) had unsuccessful coitus because of a weak erection. In group II, 28 patients (45.9%) had normal coitus, 25 (40.9%) incomplete penetration, and 8 (13.1%) unsuccessful coitus. There was no significant correlation between sexual function and the patients’ general health condition. The quantitative assessment of sexual dysfunction yielded the following results in groups 1 and 2, respectively: negative NPT in 32.4±1.8 and 24.4±2.1% (p<0.05); PBI <0.6 in 33.4±1.7 and 22.3±1.2% (p<0.001); and testosterone decrease to <12 nmol/l in 36.4±1.2 and 28.5±1.2% (p<0.05), respectively. The differences between the groups were significant (p<0.05) for all three parameters.Conclusions: Considering the 44.2% rate of unsuccessful coitus in the patients with a severe urinary dysfunction compared to only 13.1% in those with a milder dysfunction and the significant correlation between severe urinary dysfunction and measures of sexual dysfunction, we suggest that BPH may be a risk factor for sexual dysfunction.

Childhood sexual abuse and women's substance abuse: national survey findings.

Clinical studies have found elevated rates of childhood sexual abuse (CSA) in women seeking treatment for alcohol or drug abuse, and elevated rates of alcohol and drug disorders among female psychiatric patients with histories of CSA. The present study examines the relationship of CSA to women's use of alcohol and other drugs in a large, nationally representative sample of U.S. women. As part of a national survey of women's drinking, 1,099 women were asked about sexual experiences occurring before age 18. Women who reported sexual experiences classified as abusive were compared to women without histories of CSA on nine measures of substance use, self-perception of anxiousness, the occurrence of one or more lifetime depressive episodes, five measures of sexual dysfunction, and early onset of masturbation and consensual sexual intercourse. Results of logit analyses, controlling for age, ethnicity and parental education, indicated that women with histories of CSA were significantly more likely than women without CSA histories to report recent alcohol use, intoxication, drinking-related problems and alcohol dependence symptoms; lifetime use of prescribed psychoactive drugs and illicit drugs; depression and anxiety; pain that prevented intercourse; and consensual sexual intercourse before age 15. Findings from this U.S. national sample support those of previous clinical studies and suggest that women's experience of sexual abuse in childhood may be an important risk factor for later substance abuse, psychopathology and sexual dysfunction. Implications of these findings for future research, treatment and prevention are discussed.

Sexual Dysfunction Associated with the Drug Treatment of Psychiatric Disorders

Adverse sexual effects of psychiatric medication can cause considerable distress to patients and so lead to noncompliance. Despite the clinical importance of psychotropic-induced sexual dysfunction, there is relatively little systematic research on its incidence and treatment. Investigation is complicated by the fact that sexual dysfunction may predate the onset of medication or may be secondary to the presenting illness. In addition, objective measures of sexual dysfunction have been difficult to construct. Few studies have attempted to combine phenomenological and physiological measures of sexual dysfunction.

Intercorrelations among general arousability, emerging and current sexual desire, and severity of sexual dysfunction in women.

Intercorrelations among general trait arousability, emerging sexual desire, current sexual desire, lack of sexual desire perceived as a problem, and sexual dysfunction were assessed in 65 women currently involved in marital or de facto heterosexual relationships. The Stimulus Screening Test was used to measure general arousability and the Assessment of Sexual Function and Dysfunction Questionnaire was used to measure emerging sexual desire, current sexual desire lack of sexual desire, and sexual dysfunction. Analysis showed that arousability was positively associated with current levels of sexual desire which was negatively associated with sexual dysfunction. There was a curvilinear relationship between arousability and sexual dysfunction, with women experiencing both high and low levels of arousability being more likely to score higher on measures of sexual dysfunction than those experiencing medium levels of arousal. The possible implications of these results are discussed.