Sexual Modes Questionnaire

Sexual Modes Questionnaire

PEDRO J. NOBRE,Universidade de Trás-os-Montes e Alto Douro, Portugal

JOSÉ PINTO-GOUVEIAUniversidade de Coimbra, Portugal

The Sexual Modes Questionnaire (SMQ; Nobre & Pinto-Gouveia, 2003) is a measure designed to assess the interaction among cognitions, emotions, and sexual responses.

Description

The SMQ is a self-report measure, with a male and a female version that can be used in both clinical and nonclinical samples. It is composed of three interdependent subscales: the Automatic Thought (AT) subscale, the Emotional Response (ER) subscale, and the Sexual Response (SR) subscale.

Automatic Thought Subscale

The AT subscale is composed of 30 items (male) or 33 items (female) developed to evaluate automatic thoughts and images experienced by the participants during sexual activity. Thoughts included in the scale were selected based on their theoretical and clinical relevance. For the male version we generated items pertaining to sexual performance thoughts (especially the erectile response), thoughts of potential failure, sexually negative or conservative thoughts toward sexuality, and thoughts about the negative impact of age on sexual functioning. We generated items for the female version to assess failure and disengagement thoughts, low body-image thoughts, sexual abuse thoughts, thoughts about a partner’s lack of affection, and sexual passivity and control thoughts (Nobre & Pinto-Gouveia, 2003).

Emotional Response Subscale

The ER subscale is composed of 30 items (male) or 33 items (female) that assess emotions that the respondents experience during sexual activity. Respondents are given a list of 10 emotions (worry, sadness, disillusion, fear, guilt, shame, anger, hurt, pleasure, satisfaction) to select from in evaluating their responses to the AT items.

Sexual Response Subscale

The SR subscale is composed of 30 items (male) or 33 items (female) that assess subjective sexual responses pertaining to the items of the AT subscale.

Response Mode and Timing

Using Likert-type scales, the participants may respond to the SMQ using paper and pencil or computer. Respondents begin with the AT subscale by rating how frequently they experience each of the automatic thoughts during sexual activity (from 1 = Never to 5 = Always). Respondents then check from the list of 10 emotions (worry, sadness, disillusion, fear, guilt, shame, anger, hurt, pleasure, satisfaction) those that they usually experience whenever they engage in each automatic thought. Finally respondents rate the inten- sity of their subjective sexual arousal (from 1 = Very Low to 5 = Very High) when related to their previous thoughts and emotions.

Scoring

Both versions (male and female) of the AT subscale were submitted to factor analysis (Nobre & Pinto-Gouveia, 2003). We conducted a principal component analysis with varimax rotation of the female version, identifying six fac- tors accounting for 53.1% of the total variance: (a) Sexual Abuse Thoughts, (b) Failure and Disengagement Thoughts, Partner’s Lack of Affection, (d) Sexual Passivity and Control, (e) Lack of Erotic Thoughts, and (f) Low Self Body-Image Thoughts (see Table 1).

TABLE 1

Factors Item Number

Minimum

Maximum

Sexual Abuse

Thoughts 1, 2, 3, 4, 6, 15, 32, 33

8

40

Failure/

Disengagement

Thoughts 19, 22, 26, 30

4

20

Partner’s Lack of

Affection 7, 12, 24, 27, 28

5

25

and Control 10, 14, 17, 21, 23, 29

6

30

Thoughts 5, 8, 11, 25, 31

5

25

Low Self Body-

Items, Minimums, and Maximums of Female AT Factors and Totals

Sexual Passivity Lack of Erotic

Image Thoughts 9, 16, 20 3 15

Factors Item Numbers Minimum Maximum

Failure Anticipation

Thoughts

1, 2, 3, 4, 6, 7, 16

7

35

Erection Concern

Thoughts

5, 8, 9, 10, 11, 12, 29

7

35

Age and Body-

Related Thoughts

19, 21, 22, 28

4

20

Negative Thoughts

Toward Sex

20, 23, 24, 25, 30

5

25

Lack of Erotic

Thoughts

14, 17, 18, 26

4

20

Total

27

135

Note. Items 14, 17, 18, and 26 are scored in reverse order.

An index of negative automatic thoughts may be calculated by summing all automatic thought items (thoughts related to erotic cues were scored in reverse order).

An index for each emotional response may be calculated based on the following formula: total number of each emotion endorsed / total number of emotions endorsed. The emotional response index ranges from 0.0 to 1.0.

An index of sexual response may be calculated based on the following formula: sum of the sexual response for each item / total number of sexual response items endorsed. The sexual response index ranges from 1 to 5.

Reliability

Internal consistency of both male and female AT subscales was assessed using Cronbach’s α for the total scales and for each factor separately. Results were high for male and female total scales (α = .88 and .87, respectively), showing the general consistency of the measures (Nobre & Pinto-Gouveia, 2003). The internal consistency of the specific dimensions within each factor indicated Cronbach’s α statistics ranging from .71 to .80 for the female version and from .69 to .83 for the male version (Nobre & Pinto- Gouveia, 2003).

We assessed test-retest reliability of both male and female AT subscales by computing Pearson product-moment cor- relation between two consecutive administrations with a 4-week interval. Results from the female version show the stability of the measure across time, with a high correlation for the total scale (= .95, < .01) and correlations from the specific dimensions ranging from = .52, < .05 to r = .90, < .01. Results from the male version show a more moderate Pearson product-moment correlation between the two consecutive administrations (= .65, = .08), with correlations for the several specific dimensions ranging from = .20, < .05 to = .95, < .01 (Nobre & Pinto-Gouveia, 2003).

Validity

Convergent Validity

Convergent validity of the SMQ was assessed through the relationship with validated measures of sexual functioning in men (International Index of Erectile Function [IIEF]; Rosen et al., 1997) and women (Female Sexual Function Index [FSFI]; Rosen et al., 2000). Several statistically significant correlations were found between both versions of the SMQ and the FSFI and IIEF, indicating that thoughts and emotions during sexual activity are closely linked to sexual response. The FSFI presented high negative correlations with the AT subscale, particularly with Sexual Abuse Thoughts (F1), Failure and Disengagement Thoughts (F2), and Lack of Erotic Thoughts (F5). The IIEF showed significant negative correlations with the AT subscale, particularly with Failure Anticipation Thoughts (F1), Erection Concern Thoughts (F2), and Lack of Erotic Thoughts (F5; Nobre & Pinto-Gouveia, 2003).

Correlations between the ER subscale and the male and female sexual function indices were also statistically significant. The FSFI was strongly negatively correlated with the emotions of sadness, guilt, and anger, and positively correlated with pleasure. For males, there were higher correlations between the IIEF and sadness, disillusionment, pleasure, and satisfaction (Nobre & Pinto-Gouveia, 2003, 2006).

Discriminant Validity

We conducted a discriminant validity analysis, using a clinical group (men and women with sexual dysfunction) and a control group (matched men and women without sexual dysfunction). Our results indicated significant differences in the automatic thoughts, emotions, and sexual responses of clinical and control group participants of both sexes. The women in the clinical group presented significantly higher scores on Failure and Disengagement Thoughts (F2), Lack of Erotic Thoughts (F5), and the total scale. The men in the clinical group presented significantly higher scores (com- pared to the control group) on Failure Anticipation (F1), Erection Concern (F2), and Lack of Erotic Thoughts (F5; Nobre & Pinto-Gouveia, 2003, 2008).

Other Information

For more information regarding the SMQ and permission for its use, please contact Pedro J. Nobre.

The items presented below are a list of thoughts one can have during sexual activity. In the first column, please indicate the frequency with which you experience these thoughts by circling a number (1—Never to 5—Always). Next, indicate the types of emotions you typically experience when having these thoughts by marking an X in the columns for the appropriate emotions. Finally, in the last col- umn, for each thought experienced indicate the intensity of your typical sexual response (arousal) while you are having that thought by circling a number (1—Very Low to 5—Very High).

NOTE: For thoughts that you indicate as never experiencing, you do not need to fill out the emotion or sexual response column.

Never Seldom Sometimes Often

Male version

Example: Imagine that the thought “Making love is wonderful” comes to your mind very often whenever you are engaged in a sexual activity, that this idea is accompanied by pleasurable emotions, and that your sexual arousal becomes very high. In this case your answer should be:

Thoughts

Emotions

Sexual

Response

Type of Thoughts

Frequency

Types of Emotions

Intensity

1. These movements and positions are fabulous
2. This time I cannot disappoint my partner
3. She will replace me with another guy
4. I’m condemned to failure
5. I must be able to have intercourse
6. This is not going anywhere
7. I’m not satisfying her
8. I must achieve an erection
9. I’m not penetrating my partner
10. My penis is not responding
11. Why isn’t this working?
12. I wish this could last longer
13. What is she thinking about me?
14. These movements and positions are fabulous
15. What if others knew I’m not capable . . . ?
16. If I fail again I am a lost cause
17. I’m the happiest man on earth
18. This is turning me on
19. If I don’t climax now, I won’t be able to later
20. She is not being as affectionate as she used to
21. She doesn’t find my body attractive anymore
22. I’m getting old
23. This is disgusting
24. This way of having sex is immoral unnatural
25. Telling her what I want sexually would be
26. She is really turned on
27. I must show my virility
28. It will never be the same again
29. If I can’t get an erection, I will be embarrassed
30. I have other more important matters to deal with

Female Version

The items presented below are a list of thoughts one can have during sexual activity. In the first column, please indicate the frequency with which you experience these thoughts by circling a number (1—Never to 5—Always). Next, indicate the types of emotions you typically experience when having these thoughts by marking an X in the columns for the appropriate emotions. Finally, in the last column, for each thought experienced indicate the intensity of your typical sexual response (arousal) while you are having that thought by circling a number (1—Very Low to 5—Very High).

NOTE: For thoughts that you indicate as never experiencing, you do not need to fill out the emotion or sexual response column.

Example: Imagine that the thought “Making love is wonderful” comes to your mind often whenever you are engaged in a sexual activity, that this idea is accompanied by pleasurable emotions, and that your sexual arousal becomes very high. In this case your answer should be:

Thoughts

Emotions

Sexual

response

Type of Thoughts

Frequency

Types of Emotions

Intensity

1. He is abusing me
2. How can I get out of this situation?
3. He only wants to satisfy himself
4. Sex is all he thinks about
5. The way he is talking turns me on
6. He is violating me
7. This way of having sex is immoral
8. These movements and positions are fabulous
9. I’m getting fat/ugly
10. If I let myself go he is going to think I’m promiscuous
11. Making love is wonderful
12. He is not being as affectionate as he used to be
13. I’m not satisfying my partner
14. I must not show that I’m interested
15. This is disgusting
16. I’m not as physically attractive as I used to be
17. I should not take the lead in sexual activity
18. He only cares about me when he wants sex
19. I’m not getting turned on
20. I’m not feeling physically attractive
21. These activities shouldn’t be planned ahead of time
22. I can’t feel anything
23. I don’t want to get hurt emotionally
24. Why doesn’t he kiss me?
25. My body turns him on
26. When will this be over?
27. If only he’d whisper something romantic in my ear
28. He only loves me if I’m good in bed
29. I should wait for him to make the first move
30. I am only doing this because he asked me to
31. I’m the happiest woman on earth
32. I have other more important matters to deal with
33. If I refuse to have sex, he will cheat on me

References

Nobre, P. J., & Pinto-Gouveia, J. (2003). Sexual Modes Questionnaire: Measure to assess the interaction between cognitions, emotions and sexual response. The Journal of Sex Research, 40, 368–382.

Nobre, P. J., & Pinto-Gouveia, J. (2006). Emotions during sexual activity: Differences between sexually functional and dysfunctional men and women. Archives of Sexual Behavior, 35, 8–15.

Nobre, P. J., & Pinto-Gouveia, J. (2008). Differences in automatic thoughts presented during sexual activity between sexually functional and dysfunctional males and females. Journal of Cognitive Therapy and Research, 32, 37–49.

Rosen, R. C., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., et al. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex & Marital Therapy, 26, 191–208.

Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997). The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49, 822–830.