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
    • "bal score for overall sexual function in women , normative scores only exist for the IIEF erectile function domain ( Rosen, Revicki , & Sand , 2014 ). A cut - off score of 25 was used for the erectile dysfunction domain of the 15 - item IIEF ( Rosen et al . , 1997 ) ; and a cut - off score of 5 for the hypoactive sexual desire domain of the FSFI ( Gerstenberger et al . , 2010 ) and of 29 for the overall female sexual dysfunction basedon a prevalence study ( Veronelli et al . , 2009 ) and the FSFI mean score in the current sample . We found the internal reliability for the total IIEF / FSFI scores and the erectile function domain to range from good to excellent , with Cronbach alpha ' s >0 . 9 , and D0 . 8 fo"
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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.
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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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