Table of Contents
Abstract
The Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15) is a specialized psychometric instrument designed to evaluate the multifaceted nature of Sexual Dysfunction in individuals diagnosed with Multiple Sclerosis (MS). Recognizing that sexual health is a critical component of overall well-being, this tool systematically captures the unique ways in which a chronic neurodegenerative disease disrupts Intimacy. It operates on a comprehensive theoretical framework that categorizes sexual issues into primary (neurological), secondary (physical/treatment-related), and tertiary (psychosocial) causes, offering a nuanced profile of a patient's sexual health.
The development and Cross-cultural adaptation of the MSISQ-15 into Spanish represents a significant advancement for health psychology and clinical practice in Spanish-speaking regions. Historically, Sexual Dysfunction in MS has been underreported and inadequately assessed due to patient embarrassment and a lack of targeted, culturally validated measurement tools. By providing a reliable, 15-item self-report measure, the MSISQ-15 empowers clinicians to initiate sensitive conversations, accurately diagnose the root causes of sexual distress, and tailor interventions accordingly.
In the broader field of psychometrics, the validation of the Spanish MSISQ-15 underscores the importance of disease-specific instruments. While generic sexual function scales exist, they often fail to capture the complex interplay of symptoms unique to MS, such as spasticity, fatigue, or disease-related depression. The robust psychometric properties of this adapted scale ensure that researchers and healthcare providers have a scientifically sound method to track disease progression, evaluate the efficacy of therapeutic interventions, and ultimately improve the Quality of life for individuals navigating the intersection of chronic illness and sexuality.
📊 Psychometric Scorecard
15
Multidimensional
0.89
0.970
📍 Spain
Authors
Purpose
The primary purpose of the MSISQ-15 is to provide a standardized, disease-specific measure of Sexual Dysfunction for individuals living with Multiple Sclerosis. In clinical environments, sexual health is frequently sidelined due to provider discomfort, time constraints, or the prioritization of other neurological symptoms. This scale bridges that critical communication gap by offering a brief, structured method for patients to report their intimate concerns. It is specifically designed to disentangle the complex web of MS symptoms, helping practitioners determine whether a patient's sexual difficulties stem from direct nerve damage, physical limitations, or psychological distress.
For researchers and clinicians, the availability of a validated Spanish version addresses a glaring deficit in cross-cultural neuro-rehabilitation tools. Prior to this adaptation, professionals in Spain lacked a tailored instrument to assess the full spectrum of MS-related sexual issues in both men and women. The MSISQ-15 not only facilitates epidemiological research on the prevalence of these dysfunctions but also serves as a vital outcome measure for clinical trials testing pharmacological or psychotherapeutic interventions aimed at restoring sexual well-being in this vulnerable population.
Construct
The psychological and physiological construct measured by the MSISQ-15 is MS-related Sexual Dysfunction, conceptualized through a tripartite model of chronic illness impact. This framework posits that sexual impairment in Multiple Sclerosis is rarely monolithic; rather, it is the cumulative result of three distinct but interacting dimensions. The first dimension, primary causes, directly reflects the neurodegenerative nature of the disease, capturing issues like altered genital sensation or neurologically mediated orgasmic dysfunction resulting from central nervous system lesions.
The second dimension encompasses secondary causes, which are the indirect physical consequences of the disease or its medical management. This includes symptoms such as profound fatigue, muscle spasticity, and bladder or bowel incontinence, which physically impede sexual activity. Finally, the tertiary dimension measures the psychosocial and emotional fallout of living with a chronic, unpredictable illness. This captures the psychological barriers to Intimacy, including diminished self-esteem, depression, anxiety, and shifts in relationship dynamics. By mapping the construct across these three domains, the MSISQ-15 aligns with the biopsychosocial model of health, offering a holistic view of human sexuality under the strain of chronic disease.
Validity
Construct validity for the Spanish MSISQ-15 was rigorously evaluated through convergent and divergent validation strategies. To establish convergent validity, researchers correlated the scale's scores with established measures of sexual function, specifically the Male Sexual Function (FSH) and Female Sexual Function-2 (FSM-2) questionnaires. The results yielded moderate negative correlations (r = -0.52 and r = -0.55, respectively), which is theoretically sound given that higher MSISQ-15 scores indicate greater dysfunction, while higher scores on the FSH/FSM-2 indicate better function. Notably, these correlations were strongest within the primary causes dimension, reinforcing that the scale accurately captures direct physiological sexual impairment.
Furthermore, the scale demonstrated expected associations with health-related Quality of life, showing a moderate inverse relationship (r = -0.39) with the MusiQoL assessment. Interestingly, divergent validity was supported by a lack of significant correlation with the Dyadic Adjustment Scale-13 (EAD-13). This finding is highly relevant to the broader literature, suggesting that while MS patients may experience profound Sexual Dysfunction, this does not automatically equate to relationship dissatisfaction, likely due to the protective buffering effects of partner support and adaptive coping mechanisms within the dyad.
Convergent & Discriminant Validation Correlations
| Reference Instrument | Correlation Coefficient (r) |
|---|---|
| Male Sexual Function (FSH) | r=-0.52 |
| Female Sexual Function-2 (FSM-2) | r=-0.55 |
| Multiple Sclerosis International Quality of life Questionnaire (MusiQoL) | r=-0.39 |
Reliability
The internal consistency of the Spanish adaptation of the MSISQ-15 was evaluated using the ordinal alpha coefficient, a robust metric specifically recommended for scales utilizing categorical or Likert-type response formats. The overall scale demonstrated excellent reliability, yielding an ordinal alpha of 0.89. This value comfortably exceeds the standard psychometric threshold of 0.70, indicating a high degree of interrelatedness among the 15 items and confirming that they reliably measure the overarching construct of Sexual Dysfunction.
Reliability was also strong at the subscale level, which is crucial for clinicians who wish to interpret the primary, secondary, and tertiary dimensions independently. The primary causes dimension achieved an alpha of 0.85, the secondary causes dimension scored 0.81, and the tertiary causes dimension reached 0.87. These consistent metrics across all domains suggest that the translation and cultural adaptation process successfully preserved the psychometric integrity of the original English instrument, ensuring minimal measurement error when deployed in Spanish-speaking clinical settings.
Factor Analysis
To verify the underlying structure of the Spanish MSISQ-15, researchers conducted a Confirmatory Factor Analysis (CFA). Given the ordinal nature of the item responses, the analysis appropriately utilized the Weighted Least Squares Mean and Variance adjusted (WLSMV) estimation method. This approach is highly sensitive to categorical data and provides more accurate parameter estimates than traditional maximum likelihood methods when dealing with Likert scales.
The CFA results strongly supported the retention of the original three-factor model (primary, secondary, and tertiary causes). The model demonstrated excellent fit to the data, evidenced by a Comparative Fit Index (CFI) of 0.97 and a Tucker-Lewis Index (TLI) of 0.96, both of which easily surpass the stringent 0.95 threshold indicative of a well-fitting model. Additionally, the Root Mean Square Error of Approximation (RMSEA) was calculated at 0.07 (95% CI [0.052–0.082]), which falls within the acceptable range for complex multidimensional models. These indices collectively confirm that the theoretical architecture of the original scale remains structurally sound and culturally relevant in the Spanish context.
Subscales
| Subscale | Items | Description |
|---|---|---|
| Primary causes | Measures Sexual Dysfunction stemming directly from central nervous system damage, such as altered genital sensation or neurological orgasmic difficulties. | |
| Secondary causes | Evaluates physical barriers to sexual activity caused by the disease or its treatments, including fatigue, spasticity, and incontinence. | |
| Tertiary causes | Assesses the psychosocial and emotional impacts of the disease on Intimacy, such as depression, loss of self-esteem, and relationship role changes. |
Instrument
| Test Type | Self-report questionnaire |
| Format | 15 items |
| Language | Spanish |
| Population | Clinical patients, Adults |
Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 Items
Items are currently not available
The individual items of this scale are not publicly available. Researchers interested in using this instrument should contact the original authors directly to request the scale materials.
Sample
The study included a total of 208 participants diagnosed with Multiple Sclerosis. The sample was recruited from various Multiple Sclerosis associations across Spain.
Permissions & Test Year
The authors obtained permission to use the required questionnaires from the respective copyright holders.
Test Year: 2023
Cite This Paper
Antonio Esteve Ríos, María José Cabañero-Martínez, Silvia Escribano, Frederick Foley, Sofía García-Sanjuán (2023). Multiple Sclerosis Intimacy and Sexuality Questionnaire-15. PeerJ. https://doi.org/10.7717/peerj.15138
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Cite this article
Mohammed looti (2026). Multiple Sclerosis Intimacy and Sexuality Questionnaire-15. PSYCHOLOGICAL SCALES. Retrieved from https://scales.arabpsychology.com/s/multiple-sclerosis-intimacy-and-sexuality-questionnaire-15/
Mohammed looti. "Multiple Sclerosis Intimacy and Sexuality Questionnaire-15." PSYCHOLOGICAL SCALES, 14 Aug. 2026, https://scales.arabpsychology.com/s/multiple-sclerosis-intimacy-and-sexuality-questionnaire-15/.
Mohammed looti. "Multiple Sclerosis Intimacy and Sexuality Questionnaire-15." PSYCHOLOGICAL SCALES, 2026. https://scales.arabpsychology.com/s/multiple-sclerosis-intimacy-and-sexuality-questionnaire-15/.
Mohammed looti (2026) 'Multiple Sclerosis Intimacy and Sexuality Questionnaire-15', PSYCHOLOGICAL SCALES. Available at: https://scales.arabpsychology.com/s/multiple-sclerosis-intimacy-and-sexuality-questionnaire-15/.
[1] Mohammed looti, "Multiple Sclerosis Intimacy and Sexuality Questionnaire-15," PSYCHOLOGICAL SCALES, vol. X, no. Y, ص Z-Z, August, 2026.
Mohammed looti. Multiple Sclerosis Intimacy and Sexuality Questionnaire-15. PSYCHOLOGICAL SCALES. 2026;vol(issue):pages.