Multidimensional Measure of Comfort With Sexuality‌

Multidimensional Measure of Comfort With Sexuality‌

PHILIP TROMOVITCH,Tokyo Medical and Dental University

One of the goals of sexuality educators has been to increase student comfort with sexuality, including com- fort talking about sexual issues. This chapter reports on a multidimensional measure of comfort with sexuality— the MMCS1—and a nine-item short form, the MMCS1- S, which correlates well with the total score from the MMCS1.

The MMCS1 is a multidimensional measure of comfort with sexuality that can be easily administered in college- level sexuality classrooms. Note that comfort with sexuality is not the same as acceptance of sexuality as a positive thing. For example, a person might be comfortable talking about a sexual behavior they believe people should not do; the MMCS1 measures comfort, not necessarily acceptance.

Although scale development work typically proceeds with a single ordering of items (thereby embedding each item in a specific context), in the “real” world, scales are often misused; researchers often extract and administer only those items that constitute a particular subscale. This practice pulls the items out of the context in which they were validated, raising questions about the validity of the subscale using the new format. The MMCS1 was developed using data from three semirandom orderings of the items—only items that were relatively position/context independent were retained—allowing more confidence to be placed in the use of a single subscale.

The MMCS1 was developed using a convenience sample of 463 college students, most of whom were recruited from sexuality education classrooms. The MMCS1 was developed as part of my doctoral work. See my doctoral dissertation for full details on the development of the instrument (Tromovitch, 2000; available as a PDF).

Description

The MMCS1 contains 32 items, each of which is written as a statement. Respondents indicate the extent to which they agree or disagree with each statement by checking one of six non-numbered boxes. Data from the MMCS1 produces four subscales:

Comfort discussing sexuality. This subscale is designated as the TS subscale (Talking, Sexuality). The TS subscale contains 11 items. Most were designed to tap comfort talking about sexuality of a personal nature, and a few were designed to tap comfort talking about

sexuality of a nonpersonal nature (contrary to my expectations, statistical analyses did not support a psychometrically meaningful distinction between personal and nonpersonal discussions of sexual topics).

Comfort with one’s own sexual life. This subscale is designated as the AP subscale (Activities, Personal). The AP subscale contains 8 items, all of which were designed to tap comfort with one’s own sexual activities.Comfort with the sexual activities of others. This sub- scale is designated as the AO subscale (Activities, Others). This subscale contains nine items, all of which were designed to tap comfort interacting with people who engage in various sexual activities.

Comfort with the taboo sexual activities of others. This subscale is designated as the AT subscale (Activities, Taboo). This subscale contains four items, all of which were designed to tap comfort interacting with people who engage in a variety of sexual activities. They are distinguished from those constituting the AO subscale in that they all deal with taboo sexual activities (e.g., sibling incest, youth-adult sex, bestiality).

A 9-item short form, the MMCS1-S, was also created so as to have a high correlation with the total score from the MMCS1 (= .93) and good internal consistency (α = .80).

The instruments were derived for use in college-level sexuality education classrooms, but may have applicability with other populations.

Response Mode and Timing

The full, 32-item MMCS1 takes approximately 10 minutes to complete. Respondents indicate the degree to which they agree or disagree with the 32 statements by checking one of six non-numbered boxes with the anchors Strongly Disagree and Strongly Agree.

Scoring

Subscale scores are calculated as the arithmetic mean of the individual responses for the appropriate items, after adjusting for reverse valence items. This approach keeps all subscales on the same measurement scale (1 to 6) and allows for an easy way to deal with missing data (i.e., if an item is left blank, it does not enter into the calculation). A

1Address correspondence to Philip Tromovitch, College of Liberal Arts and Sciences, Tokyo Medical and Dental University, 2-8-30 Konodai, Ichikawa, Chiba, 272-0827, Japan; e-mail: [email protected]

single blank item is not expected to meaningfully reduce the validity of the scores; however, if multiple items are left blank, scores should be interpreted with caution.

By summing the TS, AP, and AO subscales, a comfort

TABLE 1

Information on the MMCS1 Subscales

Subscale Subscale Cronbach’s Items Constituting Intercorrelations α Subscales

with sexuality total score is formed (thus having a range of

3 to 18). It must be remembered that this total score is not

TS (Talking,

AP

AO

AT

necessarily related to comfort with the taboo sexual activities of others (statistical analyses indicated that a total score is warranted, yet is relatively independent of the construct

Sexuality)

.38

.46

.08

.89

2, 4, 5*, 7, 8, 13,

AP (Activities,

15, 19, 24, 27, 31

measured by the AT subscale).

For normal valence items, Strongly Disagree is scored as 1, with scores increasing to Strongly Agree, which is scored as 6—higher scores indicating greater comfort. See Table 1 for item numbers and the subscale to which they belong; items with an asterisk are reverse scored.

The MMCS1-S is scored by averaging the responses to its 9 items; it does not contain reverse valence items

Reliability

Cronbach’s alpha indicated excellent reliability for the TS, AP, and AO subscales and low but acceptable reliability for the AT subscale (see Table 1).

Item-total correlation analyses were also performed. All 32 MMCS1 items were found to have item-total correlations in the commonly recommended ranges (.2 or .3 through .8).

Validity

To ensure face and content validity, an initial pool of items was reviewed by an expert panel including expertise in both sexuality education and psychometric scale development. The panel included one MD, one psychology PhD, and two sexuality educators. Only 60 of the items passing the first expert panel were considered for use.

To ensure construct validity, over 400 factor analyses were calculated. Factor analytic methods included principal components analysis, common factor analysis, and image analysis. Types of rotation employed included varimax, equamax, and promax (with = 2 and = 3). In addition to analyzing the entire derivation dataset as a whole, various subgroups were separately examined including, but not limited to, males, females, respondents aged 18–20, respondents aged 21–23, White/Caucasian respondents, and data from each of the three different semirandom ordered forms of the derivation instrument. The 32 items retained in the MMCS1 possess a clear factor structure evidencing great reproducibility across factor analytic method, type of rotation, and subsample.

As a further check on face and content validity, a second expert panel reviewed the 34 best items (based on numerous statistical analyses, at both the factor level and the individual item level (e.g., kurtosis, means, and standard deviations of responses to each item). The second expert panel consisted of this author and two others, both of whom have PhDs in sexuality.

Personal) .23 –.01 .84 3, 9, 10, 12*, 14,

16*, 21, 29

AO (Activities,

Others) .19 .83 1, 11*, 17, 23, 25,

26, 28*, 30, 32

AT (Activities,

Taboo) .62 6, 18, 20*, 22*

Note. Items marked with an asterisk (*) are reverse scored. An α greater than .9 may indicate the presence of bloated specifics, which raise α without improving a scale’s usefulness; an α less than .6 indicates low reliability.

The four factors that were used to define the subscales accounted for over 40% of the variance in the 32 items. This large value suggests the four subscales significantly explain response variance in items dealing with comfort with sexuality, further supporting construct validity.

As a final test of construct validity, a confirmatory analy- sis was conducted (oblique principal components cluster analysis), which also indicated high construct validity.

Image analysis indicated that the TS, AO, and AP sub- scales shared common variance, supporting their use (and excluding the AT subscale) in calculating a comfort with sexuality total score.

Other Information

In the derivation sample, males and females did not sig- nificantly differ in most of their comfort levels; people who masturbate more than one time per month were more comfortable discussing sexuality and with the sexuality of others than people who rarely masturbate or who declined to indicate their masturbation frequency; people who described themselves as liberal were more comfortable with sexuality; people whose family of origin was open about sexual issues and nudity were more comfortable discussing sexuality and with their own sexual lives; and people reporting higher frequencies of religious attendance or importance showed significantly less comfort with the sexuality of others.

Because of the small number of items on the AT subscale, its lower reliability, and the fact that what constitutes taboo activity varies greatly from one population to another, the AT subscale should be interpreted carefully; further, owing to widely varying and constantly changing definitions of taboo, when feasible the AT subscale should be tested for internal consistency.

Note that, as with most measures containing subscales, the scoring of the MMCS1 produces raw scores, not stan- dardized scores. Consequently scores cannot be precisely compared across subscales (e.g., if a respondent has an AP

subscale score of 3.2 and a TS subscale score of 3.4, one cannot conclude that the respondent is more comfortable talking about sexuality than the respondent is with his or her own sexual life).

The intercorrelations among the subscales are provided in Table 1.

 

The MMCS1: The Multidimensional Measure of Comfort With Sexuality

For each item please check () the box that best represents your answer.

  1. I am completely comfortable knowing and interacting with Strongly Disagree D D D D D D Strongly Agree people whose sexual activities significantly differ from my own.

  2. I would be completely comfortable talking to a friend Strongly Disagree D D D D D D Strongly Agree about sexual problems I was having with my lover.

  3. I have lived my sex life in a way that is consistent with Strongly Disagree D D D D D D Strongly Agree my moral beliefs.

  4. I would be comfortable telling a good friend about sexual Strongly Disagree D D D D D D Strongly Agree experiences I have had which I consider to be out of the norm.

  5. Talking about the details of my own sexual experiences Strongly Disagree D D D D D D Strongly Agree would be embarrassing, even with friends.

  6. I could be comfortable interacting with a person who I Strongly Disagree D D D D D D Strongly Agree thought might be having a sexual relationship with their sibling.

  7. Talking about my personal sexual views is as natural as Strongly Disagree D D D D D D Strongly Agree talking about current events.

  8. I enjoy the opportunity to share my personal views Strongly Disagree D D D D D D Strongly Agree about sexuality.

  9. My sexual experiences and explorations are a positive, Strongly Disagree D D D D D D Strongly Agree on-going part of who I am.

  10. I am comfortable with my sexual activities, both past Strongly Disagree D D D D D D Strongly Agree and present.

  11. Having a lot of sexually active bisexual friends would Strongly Disagree D D D D D D Strongly Agree make me feel uncomfortable.

  12. I am ashamed of my past sexual conduct. Strongly Disagree D D D D D D Strongly Agree

  13. I am comfortable talking about my sexual views, my Strongly Disagree D D D D D D Strongly Agree sexual fantasies, and sexual experiences that I have had.

  14. My past sexual experiences and explorations have been Strongly Disagree D D D D D D Strongly Agree very worthwhile.

  15. I would be comfortable talking about my sexual fantasies Strongly Disagree D D D D D D Strongly Agree in a small group.

  16. It is disturbing for me to think about my past sexual experiences. Strongly Disagree D D D D D D Strongly Agree

  17. I would be comfortable having a close friend who was Strongly Disagree D D D D D D Strongly Agree engaging in homosexual activities.

  18. I could comfortably interact with an adult who I thought might Strongly Disagree D D D D D D Strongly Agree have had a sexual encounter with a pubescent 12-year-old.

  19. I am comfortable talking about my sexual views with Strongly Disagree D D D D D D Strongly Agree people I do not know well.

  20. I would never maintain a friendship with someone who Strongly Disagree D D D D D D Strongly Agree engaged in sexual activity with animals.

  21. The sexual activities I have engaged in are completely Strongly Disagree D D D D D D Strongly Agree and perfectly natural.

  22. I would be repulsed and appalled if a 21-year-old friend Strongly Disagree D D D D D D Strongly Agree told me they recently had oral sex with a 13-year-old.

  23. It would not bother me if I knew that a good friend Strongly Disagree D D D D D D Strongly Agree enjoys anal stimulation during masturbation.

  24. I am comfortable discussing my sexual fantasies with Strongly Disagree D D D D D D Strongly Agree close friends.

  25. I would be perfectly comfortable working with a person who I Strongly Disagree D D D D D D Strongly Agree knew enjoys spanking during sexual activity with their sex partner.

  26. A person can be a good friend of mine, even if they Strongly Disagree D D D D D D Strongly Agree enjoy sadomasochism with their sex partners.

  27. I can freely discuss sexual topics in a small group of peers. Strongly Disagree D D D D D D Strongly Agree

  28. I would find it awkward knowing that a friend’s favorite Strongly Disagree D D D D D D Strongly Agree sexual activity was anal sex.

  29. If I had my life to live over, I would relive most of my Strongly Disagree D D D D D D Strongly Agree past sexual experiences.

  30. I think it is good for people to experiment with a wide Strongly Disagree D D D D D D Strongly Agree range of sexual practices.

  31. Talking to a sexuality researcher about my sexual Strongly Disagree D D D D D D Strongly Agree history would be easy for me.

  32. I would continue to accept a 21-year-old friend who I Strongly Disagree D D D D D D Strongly Agree discovered was sexually involved with an elderly person.

The MMCS1-S: The Multidimensional Measure of Comfort With Sexuality Short Form

For each item please check () the box that best represents your answer.

1. I am completely comfortable knowing and interacting with people whose sexual activities significantly differ from my own.

Strongly Disagree D

D

D

D

D

Strongly Agree

2. I enjoy the opportunity to share my personal views about sexuality

Strongly Disagree D

D

D

D

D

Strongly Agree

3. My sexual experiences and explorations are a positive, on-going part of who I am.

Strongly Disagree D

D

D

D

D

Strongly Agree

4. I am comfortable with my sexual activities, both past and present

Strongly Disagree D

D

D

D

D

Strongly Agree

5. I am comfortable talking about my sexual views, my sexual fantasies, and sexual experiences that I have had.

Strongly Disagree D

D

D

D

D

Strongly Agree

6. My past sexual experiences and explorations have been very worthwhile.

Strongly Disagree D

D

D

D

D

Strongly Agree

7. It would not bother me if I knew that a good friend enjoys anal stimulation during masturbation.

Strongly Disagree D

D

D

D

D

Strongly Agree

8. I can freely discuss sexual topics in a small group of peers.

Strongly Disagree D

D

D

D

D

Strongly Agree

9. I think it is good for people to experiment with a wide range of sexual practices.

Strongly Disagree D

D

D

D

D

Strongly Agree

Possible cover page for use with the MMCS1

Thank you for filling out the attached questionnaire. Your responses to this questionnaire are anonymous. Do not put your name on these sheets.

InstructionsThis is not a test. It is a survey about attitudes and sexuality. You will not have to reveal any details about sexual experiences you may have had. There are no correct or incorrect answers. Please answer all of the questions and answer each question truthfully. Your honest answer to each question is the best answer.

Thank you for your participation!

Sincerely,

[fill in name of researcher] Principal Investigator

If you have any questions about this research and would like to contact me, I can most easily be reached by [fill in: e-mail, phone, postal mail] at:

[fill in contact information]

Possible demographics page for use with the MMCS1

What is your age?              What is your sex?                        

What is your race/ethnicity (if you are mixed race, please check all that apply):

White/Caucasian Black/African American Other (please specify:

Asian/Pacific Islander Hispanic/Latino                                 

How open about sexual issues were your parents while you were growing up? Not Open D D D D D D Very Open

How open was your family about nudity while you were growing up? Not Open D D D D D D Very Open

How would you describe your social views?

Conservative D D D D D D Liberal

To what extent are you sexually aroused by people of the other sex? Not At All D D D D D D Very Much

To what extent are you sexually aroused by people of the same sex? Not At All D D D D D D Very Much

How do you rate your sex drive (libido)?

Very Mild D D D D D D Very Strong

With how many people of the other sex have you had sexual experiences

(e.g., masturbating with them, oral sex, anal sex, penis-vagina intercourse)?                     

With how many people of the same sex have you had sexual experiences (e.g., masturbating with them, oral sex, anal sex)?                  

How many sexual experiences have you had with people of the other sex?

None 1 or 2 3 to 5 6 to 10 11 to 20 21+

Of those, approximately how many times have you engaged in coitus (i.e., penis-vagina intercourse)?

None 1 or 2 3 to 5 6 to 10 11 to 20 21+

How many sexual experiences have you had with people of the same sex?

None 1 or 2 3 to 5 6 to 10 11 to 20 21+

In a typical month, how many times do you masturbate?          How frequently do you attend religious services?

Never 1–4 times/year 5–12 times/year

2–3 times/month Once a week More than once a week

 

Reference

 

Tromovitch, P. (2000). The Multidimensional Measure of Comfort With Sexuality (MMCS1): The development of a multidimensional objec- tive measure of comfort with sexuality for use in sexuality education and research (Doctoral dissertation, University of Pennsylvania). Dissertation Abstracts International, 61, 2277.