Jewish General Hospital Sexual Self-Monitoring Form: Diary Evaluation of Sexual Behavior and Satisfaction

Abstract

The Jewish General Hospital (JGH) Sexual Self-Monitoring Form is a structured, daily diary instrument designed to systematically evaluate the frequency, variability, and quality of sexual behavior and satisfaction in both individuals and couples. Consisting of eight core questions, the measure requires respondents to track 18 specific individual or interpersonal sexual activities, record the occurrence and context of orgasm, and rate their satisfaction regarding the sexual experience, affection received, and feelings toward their partner. Originally developed as a clinical tool, the JGH-SSMF was adapted for research, particularly in evaluating treatment outcomes in sex therapy and assessing sexual dysfunctions, such as those associated with antidepressant use.

Keywords

Sexual Self-Monitoring, Sexual Behavior, Sexual Satisfaction, Sex Therapy, Sexual Dysfunctions, Daily Diary, Clinical Instrument, Treatment Outcome, Interrater Reliability.

Authors

Eva Libman (SMBD-Jewish General Hospital and McGill University), Ilana Spector (SMBD-Jewish General Hospital and McGill University), Yitzchak Binik (McGill University and Royal Victoria Hospital), William Brender (SMBD-Jewish General Hospital), Catherine S. Fichten (SMBD-Jewish General Hospital, Dawson College, and McGill University).

Purpose

The primary purpose of the JGH Sexual Self-Monitoring Form is to provide granular, daily data on the frequency and quality of a wide spectrum of sexual behaviors for both individuals and couples. Unlike traditional retrospective questionnaires, the diary format is designed to capture temporal stability and variability in sexual activity with high precision, making it an ideal tool for tracking immediate behavioral changes.

Initially utilized as a clinical instrument for monitoring therapeutic progress and tailoring interventions, the form was later modified for use in sex therapy research. Its research applications include evaluating treatment outcomes, assessing the impact of specific therapeutic interventions (process studies), and monitoring client compliance with treatment protocols. Furthermore, the scale is useful for obtaining descriptive and normative information, especially regarding sexual dysfunctions, such as those arising as a side effect of antidepressant use (Serretti & Chiesa, 2009).

Construct

The JGH Sexual Self-Monitoring Form primarily measures the construct of Sexual Self-Monitoring, encompassing the daily self-reported frequency and subjective quality of specific sexual activities. It captures both individual (e.g., fantasies, masturbation) and interpersonal behaviors in a structured format, allowing researchers and clinicians to track subtle daily fluctuations in activity and affect.

Secondary constructs evaluated include affective responses to sexual experiences, satisfaction with received affection, and general feelings toward one’s partner. The structured format allows for the calculation of objective metrics, such as the orgasm ratio (success/experience ratio), providing a quantitative measure of sexual function and satisfaction over time. This metric can be adapted to assess other specific sexual functions, such as erection quality or speed of ejaculation, depending on the focus of interest.

Validity

Formal, systematic validity information has not been extensively obtained, as the measure was originally developed as a clinical instrument (Burstein et al., 1985) rather than a dedicated research tool. However, subsequent studies have provided evidence supporting its clinical utility and non-redundancy with other measures.

Research has demonstrated that sexual self-monitoring using the JGH-SSMF adds unique and useful information beyond that gathered by traditional retrospective questionnaire methods (Fichten, Libman, & Brender, 1986). Its effectiveness in determining differences in treatment compliance that predict successful therapy outcome supports its criterion validity in clinical settings (Fichten et al., 1983, 1986). It is also effective in highlighting differences between treatments and demonstrating pre- to post-therapy changes in sexual behavior frequency and satisfaction.

Reliability

Although the JGH-SSMF lacks comprehensive, systematically obtained reliability data typical of standardized research tools, the general methodology of sexual diaries is recognized for its excellent temporal stability (White et al., 1990). Specific reliability evidence for the JGH-SSMF derives mainly from clinical research applications.

Key findings indicate high degrees of concordance between partners’ behavioral frequency ratings, offering preliminary evidence for adequate interrater reliability. Furthermore, studies examining the potential for reactivity—where the act of recording behavior changes the behavior itself—suggest preliminary evidence for the nonreactivity of sexual self-monitoring with this instrument (Fichten et al., 1988; Takefman & Brender, 1984). Researchers acknowledge, however, that future studies should continue to assess potential reactivity, given findings using other similar measures (Ochs et al., 1993).

Factor Analysis

Formal factor analytic studies establishing underlying latent structures are not detailed in the available documentation. However, for research scoring purposes, the authors recommend clustering the 18 sexual activities into specific groupings to simplify data analysis and calculate mean scores over longer periods (e.g., monthly averages) to normalize weekly variability in sexual encounters. These recommended groupings are:

• Individual Sexual Activities: Includes dreams, fantasies, masturbation, and reading and viewing erotica.
• Affectional Display: Covers hugging, kissing, and receiving and giving nongenital manual or oral caresses.
• Couple Sexual Noncoital Activities: Encompasses receiving and giving genital manual or oral stimulation, and anal activities.
• Intercourse: Tracked as a distinct category, often central to assessing treatment for orgasmic dysfunction.

Instrument

Test Type: Daily Self-Monitoring Diary / Behavioral Assessment Tool

Format: Structured Daily Self-Report Form (8 main questions covering 18 specified activities, utilizing checklists and Likert-type scales ranging from 5 to 10 points for subjective ratings).

Language Available: English; French (Hôpital Général Juif [HGJ] Formulaire d’Enregistrement Quotidien des Activités Sexuelles).

Population Group: Clinical populations (individuals and couples seeking sex therapy for sexual dysfunctions) and general populations for descriptive and normative studies.

Age Group: Typically sexually active adults and couples.

Population Details: The measure has been extensively used in studies focusing on treatment for secondary orgasmic dysfunction and erectile dysfunction, as well as assessing sexual side effects related to antidepressant use.

Test Methodology: Daily self-report, requiring respondents to complete the form individually. Completion time is typically less than 5 minutes per day.

Keywords

Sexual Quality of Life, Treatment Compliance, Orgasmic Ratio, Affective Response, Couple Behavior, Orgasmic Dysfunction, Erectile Dysfunction, Daily Monitoring.

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: [email protected]

Correspondence Address: Eva Libman, Behavioral Psychotherapy and Research Unit, Institute of Community and Family Psychiatry, SMBD-Jewish General Hospital, 4333 Cote St. Catherine Rd., Montreal, Quebec, Canada H3T 1E4.

Permissions & Fee and Test Year

The scale was initially developed as a clinical instrument around 1985 (Burstein et al., 1985) and has been used in research since at least 1983 (Fichten, Libman, & Brender, 1983). While the instrument is available in academic publications for research purposes, specific fee requirements or current licensing permissions must be obtained directly from the corresponding author, Eva Libman, or the Jewish General Hospital.

Reference’s

Arrington, R., Cofrancesco, J., & Wu, A. W. (2004). Questionnaires to measure sexual quality of life. Quality of Life Research, 13, 1643–1658.

Auerbach, R., & Kilmann, P. R. (1977). The effects of group systematic desensitization on secondary erectile failure. Behavior Therapy, 8, 330–339.

Burstein, R., Libman, E., Binik, Y., Fichten, C. S., Cohen, J., & Brender, W. (1985). A short-term treatment program for secondary orgasmic dysfunction. Psychological Documents, 15, 9. (Ms. No. 2688)

Fichten, C. S., Libman, E., & Brender, W. (1983). Methodological issues in the study of sex therapy: Effective components in the treatment of secondary orgasmic dysfunction. Journal of Sex & Marital Therapy, 9, 191–202.

Fichten, C. S., Libman, E., & Brender, W. (1986). Measurement of therapy outcome and maintenance of gains in the behavioral treatment of secondary orgasmic dysfunction. Journal of Sex & Marital Therapy, 12, 22–33.

Fichten, C. S., Libman, E., Takefman, J., & Brender, W. (1988). Self-monitoring and self-focus in erectile dysfunction. Journal of Sex & Marital Therapy, 14, 120–128.

Libman, E., Fichten, C. S., & Brender, W. (1984). Prognostic factors and classification issues in the treatment of secondary orgasmic dysfunction. Personality and Individual Differences, 5, 1–10.

Ochs, E. P., Meana, M., Mah, K., & Binik, Y. M. (1993). The effects of exposure to different sources of sexual information on sexual behavior: Comparing a “sex-expert system” to other educational material. Behavior Research Methods, Instruments and Computers, 25, 189–194.

Serretti, A., & Chiesa, A. (2009). Treatment-emergent sexual dysfunction related to antidepressants: A meta-analysis. Journal of Clinical Psychopharmacology, 29, 259–266.

Takefman, J., & Brender, W. (1984). An analysis of the effectiveness of two components in the treatment of erectile dysfunction. Archives of Sexual Behavior, 13, 321–340.

White, J. R., Case, D. A., McWhirter, D., & Mattison, A. M. (1990). Enhanced sexual behavior in exercising men. Archives of Sexual Behavior, 19, 193–209.

Items of the Jewish General Hospital Sexual Self-Monitoring Form: Diary Evaluation of Sexual Behavior and Satisfaction

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Jewish General Hospital Sexual Self-Monitoring Form

(please fill out alone)

NAME: DATE:

1. Sexual Activities (please check in column 1 if the activity occurred)

   	1	2		1	2
   	Check if Activity Occurred	Rate According to Scale A (1–10)		Check if Activity Occurred	Rate According to Scale A (1–10)
   Individual activities
   a) fantasies (daydreams)			j) breast caressing
   b) dreams			k) genital touching (giving)
   c) masturbation			l) genital touching (receiving)
   d) reading erotica			m) oral stimulation (giving)
   e) seeing erotica			n) oral stimulation (receiving)
   f) other (specify below)			o) anal stimulation (giving)
   Interpersonal activities			p) anal stimulation (receiving)
   g) kissing			q) mutual masturbation
   h) caressing—nongenital (giving)			r) intercourse
   i) caressing—nongenital (receiving)			s) other (specify below)

2. Please look at Scale A below and then rate each activity checked above. Write the rating in column 2 above.

   Scale A

   Very Unenjoyable

   1

   2

   3

   4

   5

   6

   7

   8

   9

   10

   Very Enjoyable

3. How did you feel about your sexual experience today? (Put X in box)

   Very Negative

   1

   2

   3

   4

   5

   Very Positive

4. Did you experience any orgasms?

5. If yes, during which activity?

6. How satisfied are you with the amount of affection you received today?

   Very Dissatisfied

   1

   2

   3

   4

   5

   Very Satisfied

7. In general, how did you feel about your partner today?

   Very Negative

   1

   2

   3

   4

   5

   Very Positive

8. Please add, in your own words, any important information or feelings concerning yourself, your marriage, your sex life, or any other issues you’d like to bring up in your session with your therapist.