The Female Sexual Function Index (FSFI): A Multidimensional Self ...

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204 R. Rosen et al. for subjects who have had some level of sexual activity during the measurement period. Also, a score of zero in a domain total indicates that no sexual activity has been reported, but conveys no further meaningful information about the specific domain. Dependence on sexual activity did affect the original items relating to psychological distress, which were not included in the final questionnaire due to ambiguity in their interpretation. However, it should be noted, that while distress is an important component in the diagnosis of female sexual dysfunction, the evaluation of pharmaceutical agents will focus on perceptions of sexual responsiveness (e.g., level of arousal and lubrication) and global satisfaction as the clinical outcomes. The specific issue of distress in the diagnosis of female sexual dysfunction is currently being examined by a consensus panel of the American Foundation of Urological Diseases, and will be the subject of a future publication. CONCLUSIONS The FSFI, a 19-item questionnaire, has been developed as a brief, multidimensional self-report instrument for assessing the key dimensions of sexual function in women. It is psychometrically sound, easy to administer, and has demonstrated ability to discriminate between clinical and nonclinical populations. The questionnaire described was designed and validated for assessment of female sexual function and quality of life in clinical trials or epidemiological studies. Its further use in these areas remains to be investigated. REFERENCES American Psychiatric Association. (1994). DSM-IV: Diagnostic and statistical manual of mental disorders (4th ed., pp. 493–518). Washington, DC: American Psychiatric Association. Derogatis, L. R., & Melisaratos, N. (1979). The DSFI: a multidimensional measure of sexual functioning. J. Sex Marital Ther. 5: 244–281. Hoon, E. F., Hoon, P. W., & Wincze, J. P. (1976). An inventory for the measurement of female sexual arousability. Arch. Sex. Behav. 5: 291–300. International Consensus Development Conference on Female Sexual Dysfunctions: Definitions and Classifications (in press). Boston, MA 1998. J. Urology. Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States. JAMA 281: 537–544. Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The Social Organization of Sexuality. Chicago: University of Chicago Press. Masters, W. H., & Johnson, V. E. (1966). Human sexual response. Boston: Little Brown. 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.
Female Sexual Function Index Rosen, R. C., Taylor, J. F., Leiblum, S. R., & Bachmann, G. A. (1993). Prevalence of sexual dysfunction in women: results of a survey of 329 women in an outpatient gynecological clinic. Journal of Sex & Marital Therapy, 19: 171–188. Spector, I. P., & Carey, M. P. (1990). Incidence and prevalence of the sexual dysfunctions: a critical review of the empirical literature. Arch. Sex. Behav, 19: 389–408. Taylor, J. F., Rosen, R. C., & Leiblum, S. R. (1994). Self-report assessment of female sexual function: psychometric evaluation of the brief index of sexual functioning for women. Arch. Sex. Behav. 23: 627–643. World Health Organization. (1992). ICD-10: International Statistical Classification of Diseases and Related Health Problems. World Health Organization: Geneva. Zuckerman, M. (1973). Scales for sex experience for males and females. J. Consul. Clin Psychol. 41: 27–29. Appendix A—Female Sexual Function Index (FSFI)* Question Response Options Q1: Over the past 4 weeks, how often did you feel sexual desire or interest? Q2: Over the past 4 weeks, how would you rate your level (degree) of sexual desire or interest? Q3. Over the past 4 weeks, how often did you feel sexually aroused (“turned on”) during sexual activity or intercourse? Q4. Over the past 4 weeks, how would you rate your level of sexual arousal (“turn on”) during sexual activity or intercourse? Q5. Over the past 4 weeks, how con fident were you about becoming sexually aroused during sexual activity or intercourse? Q6. Over the past 4 weeks, how often have you been satisfied with your arousal (excitement) during sexual activity or intercourse? Response Options 5 = Almost always or always 4 = Most times (more than half the time) 3 = Sometimes (about half the time) 2 = A few times (less than half the time) 1 = Almost never or never 5 = Very high 4 = High 3 = Moderate 2 = Low 1 = Very low or none at all 0 = No sexual activity 5 = Almost always or always 4 = Most times (more than half the time) 3 = Sometimes (about half the time) 2 = A few times (less than half the time) 1 = Almost never or never 0 = No sexual activity 5 = Very high 4 = High 3 = Moderate 2 = Low 1 = Very low or none at all 0 = No sexual activity 5 = Very high confidence 4 = High confidence 3 = Moderate confidence 2 = Low confidence 1 = Very low or no confidence 0 = No sexual activity 5 = Almost always or always 4 = Most times (more than half the time) 3 = Sometimes (about half the time) 2 = A few times (less than half the time) 1 = Almost never or never 205
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