Development of Multiple Sclerosis Intimacy and Sexuality Questionnaire
Sanders, Audrey Sorgen
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The purpose of the present study was to develop a valid and reliable self-report questionnaire to assess the perceived influence of Multiple Sclerosis [MS] symptoms on sexual activity and satisfaction and the perceived influence of MS symptoms on the overall quality of intimate relationships. This instrument was called the Multiple Sclerosis Intimacy and Sexuality Questionnaire [MSISQ]. The initial item pool consisted of 72 items reflecting primary, secondary, and tertiary sexual dysfunction. The MSISQ was revised by eliminating items assessing the impact of MS symptoms on the overall quality of intimate relationships because they were redundant with items assessing the impact of MS symptoms on sexual activity and satisfaction. Factor analysis, reliability analysis, and item analysis demonstrated that the MSISQ could be further shortened without diminishing the statistical integrity of the instrument. Hence, it was shortened to a 19-item questionnaire [MSISQ-19]. The MSISQ-19 demonstrated differential validity for men and women. Primary, secondary, and tertiary sexual dysfunction subscales exist for females, but the scale is a unidimensional measure of sexual dysfunction in males. Reliability analyses provided evidence for high internal consistency for the MSISQ-19 in the total sample and for the three subscales in the female subsample. The MSISQ-19 demonstrated concurrent validity with measures of: (1) marital satisfaction, specifically satisfaction with affective' communication, problem solving communication, and sexual dissatisfaction, (2) neurological impairment and level of disability in MS, (3) psychological distress and well-being, and (4) global sexual dysfunction in MS. In addition, a comparison of the distribution of scores of the MSISQ-19 and the Sexual Function Scale (SFS) of the Minimal Record of Disability (MRD) in MS demonstrated that the MSISQ-19 was more sensitive to moderate and high levels of sexual difficulty. Study limitations, theoretical, clinical, and research implications, and directions for further research are discussed.