The Female Sexual Function Index (FSFI): Cross-Validation and Development of Clinical Cutoff Scores

epartment of Psychiatry, Robert Wood Johnson Medical School, University of Medicine & Dentistry of New Jersey, Piscataway, NJ 08854, USA.
Journal of Sex and Marital Therapy (Impact Factor: 1.27). 01/2005; 31(1):1-20. DOI: 10.1080/00926230590475206
Source: PubMed

ABSTRACT The Female Sexual Function Index (FSFI) is a brief multidimensional scale for assessing sexual function in women. The scale has received initial psychometric evaluation, including studies of reliability, convergent validity, and discriminant validity (Meston, 2003; Rosen et al., 2000). The present study was designed to crossvalidate the FSFI in several samples of women with mixed sexual dysfunctions (N = 568) and to develop diagnostic cut-off scores for potential classification of women's sexual dysfunction. Some of these samples were drawn from our previous validation studies (N = 414), and some were added for purposes of the present study (N = 154). The combined data set consisted of multiple samples of women with sexual dysfunction diagnoses (N = 307), including female sexual arousal disorder (FSAD), hypoactive sexual desire disorder (HSDD), female sexual orgasm disorder (FSOD), dyspareunia/vaginismus (pain), and multiple sexual dysfunctions, in addition to a large sample of nondysfunctional controls (n = 261). We conducted analyses on the individual and combined samples, including replicating the original factor structure using principal components analysis with varimax rotation. We assessed Cronbach's alpha (internal reliability) and interdomain correlations and tested discriminant validity by means of a MANOVA (multivariate analysis of variance; dysfunction diagnosis x FSFI domain), with Bonferroni-corrected post hoc comparisons. We developed diagnostic cut off scores by means of standard receiver operating characteristics-curves and the CART (Classification and Regression Trees) procedure. Principal components analysis replicated the original five-factor structure, including desire/arousal, lubrication, orgasm, pain, and satisfaction. We found the internal reliability for the total FSFI and six domain scores to be good to excellent, with Cronbach alpha's >0.9 for the combined sample and above 0.8 for the sexually dysfunctional and nondysfunctional samples, independently. Discriminant validity testing confirmed the ability of both total and domain scores to differentiate between functional and nondysfunctional women. On the basis of sensitivity and specificity analyses and the CART procedure, we found an FSFI total score of 26.55 to be the optimal cut score for differentiating women with and without sexual dysfunction. On the basis of this cut-off we found 70.7% of women with sexual dysfunction and 88.1% of the sexually functional women in the cross-validation sample to be correctly classified. Addition of the lubrication score in the model resulted in slightly improved specificity (from .707 to .772) at a slight cost of sensitivity (from .881 to .854) for identifying women without sexual dysfunction. We discuss the results in terms of potential strengths and weaknesses of the FSFI, as well in terms of further clinical and research implications.

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    • "To measure sexual function of female teachers, we use the Female Sexual Function Index (FSFI) — a multidimensional self report instrument — introduced by [14]. To characterize whether a participant suffer from sexual disorder or not, we use criteria suggested by [15], that the FSFI total score of 26.55 is the optimal cut-off score for differentiating women with and without sexual dysfunction. "
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    ABSTRACT: This research is aimed to find out whether sexual dysfunction affects female teachers performance in fulfilling pedagogical tasks. Eighty-four female teachers who work at 12 elementary schools in the city of Bandar Lampung, Lampung Province, Indonesia became the participants in this study. To assess the teacher's sexual quality, we used the Female Sexual Function Index (FSFI), a brief questionnaire designed to measure sexual functioning in women with focus on sexual desire, sexual arousal, lubrication, orgasm, satisfaction, and pain. To measure the quality of a teacher, two pupils were asked to become respondents and fill out a Likert Scale questionnaire containing both positive and negative quality indicators of the teacher. The positive indicators consist of punctual, prepared, approachable, respectful and professional, while the negative ones include bad tempered, rude, insulting, arrogant and domineering. Mann-Whitney comparison test and Spearman Rank Correlation were performed in data analysis. The results showed that 39 (46%) of the participant categorized as teachers without sexual disorder (total FSFI score of 29.1±1.33) and the other 45 (54%) categorized as teachers with sexual disorders (total FSFI score of 21.48 ± 2.84). Compared with the teacher without sexual dysfunction, teachers with sexual disorders tend to be less diligent (P <0.05), less prepared for class (P <0.001), less friendly (P <0.001) and less appreciative students (P <0.01). In addition, teachers with sexual problems tend to be more hothead (P< 0.001), rude (P<0.001) and domineering (P<0.01). As the conclusion, sexual dysfunction potentially affects teaching performance of the female teachers.
    11/2014; 2(2 6):244-247. DOI:10.12691/ajphr-2-6-5
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    • "With regard to sexual function, we adopted the validated system; Female Sexual Function Index (FSFI) [6]. With regard to correction of vaginal width, we adopted a five score scale as follows: very satisfied (5), satisfied (4), neutral (3), dissatisfied (2), or completely dissatisfied (1). "
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    ABSTRACT: Abstract Recently, there has been growing interest in female genital plastic surgery. To the authors' knowledge, no studies have adopted elastic silicone thread for vaginal rejuvenation. This study introduces clinical experience over 4 years with vaginal rejuvenation using elastic silicone thread to specifically assess the overall patient satisfaction (sexual function and correction of the vaginal width). It is hypothesised that this novel surgical method can improve sexual function. Between 2007-2011, 180 patients underwent vaginal rejuvenation using elastic silicone thread performed by the authors at a single institution. Patients with persistent feeling of a wide vagina and/or a decreased ability to reach orgasm were included. Patients were excluded from the study if they were unavailable for follow-up, or if they had been diagnosed with any gynecologic diseases. To measure the 15 degree of improvement with regard to sexual function, this study adopted the validated system; Female Sexual Function Index (FSFI). 92.8% (167/180) of the patients were satisfi ed with outcome with regard to feelings of correction of vaginal width. Vaginal rejuvenation using elastic silicone thread significantly improved postoperative outcomes, resulting in improved sexual function, with a focus on improving the FSFI score. This is especially prominent in FSFI orgasm subscore. However, a prospective multicentre study would be beneficial to provide patients with the best possible management.
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    • "Total scores range from 2 to 36 and higher scores represent better sexual function. The FSFI has been found to have discriminant validity in discriminating between women with and without sexual complaints (Meston, 2003; Rosen et al., 2000; Wiegel, Meston, & Rosen, 2005). Cronbach's alpha in the current sample for the total FSFI was 0.894. "
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    ABSTRACT: a b s t r a c t At least a third of women across reproductive ages experience low sexual desire and impaired arousal. There is increasing evidence that mindfulness, defined as non-judgmental present moment awareness, may improve women's sexual functioning. The goal of this study was to test the effectiveness of mindfulness-based therapy, either immediately or after a 3-month waiting period, in women seeking treatment for low sexual desire and arousal. Women participated in four 90-min group sessions that included mindfulness meditation, cognitive therapy, and education. A total of 117 women were assigned to either the immediate treatment (n ¼ 68, mean age 40.8 yrs) or delayed treatment (n ¼ 49, mean age 42.2 yrs) group, in which women had two pre-treatment baseline assessments followed by treatment. A total of 95 women completed assessments through to the 6-month follow-up period. Compared to the delayed treatment control group, treatment significantly improved sexual desire, sexual arousal, lubri-cation, sexual satisfaction, and overall sexual functioning. Sex-related distress significantly decreased in both conditions, regardless of treatment, as did orgasmic difficulties and depressive symptoms. Increases in mindfulness and a reduction in depressive symptoms predicted improvements in sexual desire. Mindfulness-based group therapy significantly improved sexual desire and other indices of sexual response, and should be considered in the treatment of women's sexual dysfunction.
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