Female Sexual Distress Scale—Revised

Female Sexual Distress Scale—Revised

LEONARD R. DEROGATIS,Center for Sexual Medicine at Sheppard Pratt, Baltimore, MD

ROBERT PYKEBoehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT

JULIE MCCORMACK, ADRIA HUNTERAND GALE HARDINGUnited BioSource Corporation, Bethesda, MD

The Female Sexual Distress Scale—Revised (FSDS-R) is a self-administered questionnaire designed to assess distress related to sexual dysfunction in women with Hypoactive Sexual Desire Disorder (HSDD), and other sexual dysfunctions.

Description

The FSDS-R is a self-administered questionnaire consisting of 13 items that relate to different aspects of sex-related personal distress in women. Responses are based on the frequency with which each problem has bothered the subject or caused them distress within different recall periods (past 7 or 30 days).

The FSDS-R is an extended version of the 12-item Female Sexual Distress Scale (FSDS; Derogatis, Rosen, Leiblum, Burnett, & Heiman, 2002). The FSDS was developed by a national group of experts in human sexuality under the auspices of the American Foundation for Urologic Disease (AFUD). The FSDS-R includes an additional question (Item 13) that specifically assesses distress related to low sexual desire. The FSDS-R is for use in both pre- and postmenopausal women.

Response Mode

Respondents read a list of feelings and problems that women sometimes have concerning their sexuality and circle the number that best describes how often that problem has bothered them or caused them distress during the past 30 days. They are provided with an example before completing the questionnaire and are free to ask any questions they may have.

Scoring

All items are rated in terms of the frequency with which that problem has bothered the individual or caused her distress in the past 30 days. Respondents rate every item from 0 to 4: (Never [(0]), Rarely [(1]), Occasionally [(2]), Frequently

[(3]), or Always [(4])). The total score ranges from 0 to 52, with higher scores indicating more distress. A total score of ≥ 11 or more indicates a clinical level of sexual distress.

Reliability

The FSDS was tested for reliability and validity in three studies involving over 500 women with and without sexual dysfunction (Derogatis et al., 2002). The reliability and the validity of the FSDS-R were established in a multicenter, 4-week, nontreatment study, conducted in adult North American women with generalized acquired HSDD (= 136), other Female Sexual Dysfunction (FSD; Female Sexual Arousal Disorder [FSAD] or Female Orgasmic Disorder [FOD], = 48); or no FSD (= 75; Derogatis, Clayton, Lewis-D’Agostino, Wunderlich, & Fu, 2008).

Cronbach’s coefficient alpha was used to measure the internal consistency of the FSDS-R. Cronbach’s alpha was > .88 for subjects with HSDD, other FSD, and no FSD on days 0, 7, and 28 (Derogatis, Clayton, et al., 2008).

Intraclass correlation coefficient (ICC) was used to estimate test-retest reliability. For all subjects, the ICC for the FSDS-R total and Item 13 scores between days 0 and 28 wasere .88 and .83, respectively (Derogatis, Clayton, et al., 2008). A version that was identical except for using 7-day recall gave equivalent results to the standard 30-day recall version in reliability.

Validity

In the validation study, mean FSDS, FSDS-R, and FSDS-R Item 13 scores were significantly higher in women with HSDD or other FSD than in women with no FSD (< .001 at all time points), demonstrating that all these tests had discriminant validity (Derogatis, Clayton, et al., 2008). Receiver operating characteristic analyses of FSDS and FSDS-R total scores confirmed these findings (Derogatis, Clayton, et al., 2008). A version that was identical except for using 7-day recall gave equivalent results to the standard 30-day recall version in discriminant validity.

The content validity (relevance, clarity, and comprehensiveness) of the FSDS-R (7-day recall version) and the potential of Item 13 (bothered by low sexual desire) as a stand-alone measure of distress associated with decreased sexual desire were assessed through saturation interviewing in women with generalized acquired HSDD in a multicenter, single-visit study conducted in the U.S. (Derogatis, Pyke, McCormack, Hunter, & Harding, 2008). Saturation was reached (i.e., no new information obtained) with 25 subjects. Subjects completed the FSDS-R prior to undergoing cognitive debriefing to capture information on their perceptions of the instrument. Subjects rated the relevancy of every item in the FSDS-R from 0 (Not at all Relevant) to 4 (Extremely Relevant). Item 13 (bothered by low sexual desire) was rated as the most relevant item, with a mean rating of 3.33. The majority of participants found every item clear and easy to understand; the percentage of respondents answering “Yes” to the question “Was this item clear and easy to understand?” was 76% for Item 9 (regrets about your sexuality), 80% for Item 8 (sexually inadequate) and 88%–100% for the remaining items. Item 13 alone demonstrated good content validity and 56% of respondents felt that it covered all of their feelings about their decreased sexual desire.

Other Information

Copyright © 2002 by American Foundation of Urological Disease, Inc. This scale may not be used without permission.

Address correspondence to Leonard Derogatis, Johns Hopkins Department of Psychiatry and Behavioral Sciences—Center for Sexual Medicine at Sheppard Pratt, Baltimore, MD 21285; e-mail: [email protected]

Instructions: Below is a list of feelings and problems that women sometimes have concerning their sexuality. Please read each item carefully, and circle the number that best describes HOW OFTEN THAT PROBLEM HAS BOTHERED YOU OR CAUSED YOU DISTRESS DURING THE PAST 30 DAYS INCLUDING TODAY. Circle only one number for each item, and take care not to skip any items. If you change your mind, erase your first circle carefully. Read the example before beginning, and if you have any questions please ask about them.

Example: How often did you feel: Personal responsibility for your sexual problems.

Never

Rarely

Occasionally

Frequently

Always

0

1

2

3

4

HOW OFTEN DID YOU FEEL:

1. Distressed about your sex life

0

1

2

3

4

2. Unhappy about your sexual relationship

0

1

2

3

4

3. Guilty about sexual difficulties

0

1

2

3

4

4. Frustrated by your sexual problems

0

1

2

3

4

5. Stressed about sex

0

1

2

3

4

6. Inferior because of sexual problems

0

1

2

3

4

7. Worried about sex

0

1

2

3

4

8. Sexually inadequate‌

0

1

2

3

4

9. Regrets about your sexuality

0

1

2

3

4

10. Embarrassed about sexual problems

0

1

2

3

4

11. Dissatisfied with your sex life

0

1

2

3

4

12. Angry about your sex life

0

1

2

3

4

13. Bothered by low sexual desire

0

1

2

3

4

Copyright © 2000 by American Foundation for Urological Disease Inc.

References

Derogatis, L. R., Clayton, A., Lewis-D’Agostino, D., Wunderlich, G., & Fu, Y. (2008). Validation of the Female Sexual Distress Scale— Revised for assessing distress in women with Hypoactive Sexual Desire Disorder. Journal of Sexual Medicine, 5, 357–364.

Derogatis, L. R., Pyke, R., McCormack, J., Hunter, A., & Harding, G. (2008, December). Content validity of the Female Sexual Distress Scale—Revised (FSDS-R) in women with Hypoactive Sexual Desire Disorder (HSDD). Poster presented at the Joint Congress of the European and International Societies for Sexual Medicine, Brussels, Belgium.

Derogatis, L. R., Rosen, R., Leiblum, S., Burnett, A., & Heiman, J. (2002). The Female Sexual Distress Scale (FSDS): Initial validation of a standardized scale for assessment of sexually related personal distress in women. Journal of Sex and & Marital Therapy, 28, 317–330.