Sexual Desire and the Female Sexual Function Index (FSFI): A Sexual Desire Cutpoint for Clinical Interpretation of the FSFI in Women with and without Hypoactive Sexual Desire Disorder

New England Research Institutes, Inc., Watertown, MA 02472, USA.
Journal of Sexual Medicine (Impact Factor: 3.15). 09/2010; 7(9):3096-103. DOI: 10.1111/j.1743-6109.2010.01871.x
Source: PubMed


A validated cutpoint for the total Female Sexual Function Index scale score exists to classify women with and without sexual dysfunction. However, there is no sexual desire (SD) domain-specific cutpoint for assessing the presence of diminished desire in women with or without a sexual desire problem.
This article defines and validates a specific cutpoint on the SD domain for differentiating women with and without hypoactive sexual desire disorder (HSDD).
Eight datasets (618 women) were included in the development dataset. Four independent datasets (892 women) were used in the validation portion of the study.
Diagnosis of HSDD was clinician-derived. Receiver-operator characteristic (ROC) curves were used to develop the cutpoint, which was confirmed in the validation dataset.
The use of a diagnostic cutpoint for classifying women with SD scores of 5 or less on the SD domain as having HSDD and those with SD scores of 6 or more as not having HSDD maximized diagnostic sensitivity and specificity. In the development sample, the sensitivity and specificity for predicting HSDD (with or without other conditions) were 75% and 84%, respectively, and the corresponding sensitivity and specificity in the validation sample were 92% and 89%, respectively.
These analyses support the diagnostic accuracy of the SD domain for use in future observational studies and clinical trials of HSDD.

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Available from: Michael Sand, Feb 13, 2014
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    • "Combined with the conceptual problems discussed earlier, it appears that the measurement of desire by the FSFI is neither reliable nor valid. Despite these problems, researchers have specifically recommended the FSFI as a measure for female sexual desire (Gerstenberger et al., 2010). "
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    ABSTRACT: The Female Sexual Function Index (FSFI; Rosen et al., 2000 ) and International Index of Erectile Function (IIEF; Rosen et al., 1997 ) are two of the most widely used measures of sexual dysfunction. However, they have potential measurement and psychometric flaws that have not been addressed in the literature. This article examines the measurement capabilities of these measures based on data collected from an online study in 2010. A convenience sample of 518 sexually active adults (65% female) drawn from the general community were included in the analyses. Both measures displayed critical theoretical and measurement problems for the assessment of sexual problems beyond sexual arousal, and for the sexual desire domains in particular. Based on these results, we encourage clinicians and researchers to think critically about whether the FSFI and IIEF are appropriate measures for their practice and research. In particular, these measures are inappropriate for use among individuals who are not currently sexually active, and research with a focus other than sexual arousal should consider supplementary measures of sexual function. The psychometric properties of these measures should be reassessed in clinical samples, but the theoretical issues with the measures raised in this article are relevant across clinical and research contexts.
    The Journal of Sex Research 07/2014; 51(5):485-91. DOI:10.1080/00224499.2013.876607 · 2.53 Impact Factor
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    • "We suggest that this shows an overall increase in sexual function, rather than a response of sexual desire specifically, and do not follow how these results testify to the criterion validity of the desire domain. Gerstenberger et al. (2010) developed a cut-off score to ascertain the presence or absence of HSDD, which was shown to have good sensitivity and specificity. Regarding our critique of this cut-off, Rosen raised many concerns about the sample we used that were acknowledged as limitations in our original paper. "
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    ABSTRACT: This is a response to the commentary by Rosen, Revicki, and Sand (201429. Rosen , R. C. , Revicki , D. A. , & Sand , M. ( 2014 ). Commentary on “Critical flaws in the FSFI and the IIEF.” Journal of Sex Research , 51 , 492 – 497 . doi: 10.1080/00224499.2014.894491 [Taylor & Francis Online], [PubMed], [Web of Science ®]View all references) on our original article titled “Critical Flaws in the Female Sexual Function Index and the International Index of Erectile Function” (Forbes, Baillie, & Schniering, 20148. Forbes , M. K. , Baillie , A. J. , & Schniering , C. A. ( 2014 ). Critical flaws in the Female Sexual Function Index and the International Index of Erectile Function . Journal of Sex Research , 51 , 485 – 491 . doi: 10.1080/00224499.2013.876607 [Taylor & Francis Online], [PubMed], [Web of Science ®]View all references). We address his criticisms and clarify our points further using existing research. We conclude that there are a number of evident limitations to these popular measures, and suggest that researchers and clinicians familiarize themselves with the aim and scope of each measure before use.
    The Journal of Sex Research 07/2014; 51(5):498-502. DOI:10.1080/00224499.2014.895795 · 2.53 Impact Factor
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    • "En lo que concierne a la función sexual, tres presentaron puntuación del IFSF compatible con riesgo para disfunción sexual mientras una de ellas presentó puntuación compatible con función sexual normal. En el análisis del IFSF por dominios , sólo la puntuación relativa al dominio del dolor coital fue superior a 5, lo que indica que esas pacientes no presentan dolor durante las relaciones sexuales (Tabla 2), ya que la puntuación ≤5 demuestra riesgo para disfunción sexual de aquel dominio (Gerstenberger et al., 2010). "
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