Sexual Problems Self-Assessment Questionnaire

Abstract

The Sexual Problems Self-Assessment Questionnaire (SPSAQ) is a specialized, 73-item clinical evaluation tool designed primarily for use in Sex Therapy settings. Its main objective is to provide a comprehensive, yet brief, assessment of an adult client’s subjective levels of sexual and relational satisfaction, particularly when presenting with sexual difficulties. Unlike traditional diagnostic instruments, the SPSAQ was developed from the classification system presented in the influential work, A New View of Women’s Sexual Problems (Kaschak & Tiefer, 2001), which adopts a multidimensional approach to client experience.

The instrument is structured around five key domains, expanding upon the initial “New View” nosology to include concerns relevant to both men and women. The SPSAQ is intended for clinical use to quickly identify domains of distress, allowing clinicians to focus initial interviews efficiently. While highly valuable in clinical practice, the SPSAQ was not initially designed as a research tool and, consequently, lacks systematic data regarding its formal reliability and validity beyond initial clinical application and refinement.

Keywords

Sexual Problems Self-Assessment Questionnaire, SPSAQ, Sex Therapy, Sexual Satisfaction, Relationship Satisfaction, New View Nosology, Clinical Assessment, Sexual Dysfunction, Psychological Factors, Physical Factors.

Authors

Elizabeth Rae Larson (Seattle Institute for Sex Therapy, Education and Research), Malcolm H. McKay (Private Practitioner).

Purpose

The fundamental purpose of the Sexual Problems Self-Assessment Questionnaire (SPSAQ) is to facilitate a rapid and comprehensive clinical evaluation of sexual and relationship satisfaction levels in adult clients, especially couples seeking Sex Therapy. The instrument shifts the focus from narrow, symptom-specific complaints—which often dominate initial client presentation—to broader, underlying factors influencing sexual distress.

The SPSAQ is instrumental in the early stages of therapy, providing practitioners with immediate feedback regarding the client’s subjective state of relational and sexual satisfaction across various domains. For couples, scoring forms are designed to compare each partner’s responses, highlighting potential discrepancies or shared areas of concern, thereby streamlining the clinical interview process.

Construct

The SPSAQ measures the subjective perception of sexual and relational satisfaction based on a multidomain model derived from the New View of Women’s Sexual Problems (Kaschak & Tiefer, 2001). This nosology offers a broader description of client experience compared to the more medically focused categories found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

The 73 items of the SPSAQ are organized into five primary domains, ensuring coverage of diverse factors impacting sexuality in both male and female clients. The domains assessed are:

• Socio-Cultural, Political, or Economic Factors
• Relationships
• Psychological Factors
• Physical Factors (a shortened version of the original “Medical and Physiologic Factors”)
• Overall Satisfaction (an expanded domain including Sex Life and Emotional Intimacy)

Validity

Formal, systematic validation data for the SPSAQ have not been gathered, as the instrument was initially developed as a clinical aid rather than a research measure. However, item content underwent rigorous clinical validation during its development phase.

The instrument was initially tested on long-term therapy clients, primarily couples, who provided feedback on its user-friendliness and brevity. Following initial administration to new clients, clinical interviews were conducted to identify items that were vaguely worded or confusing, leading to subsequent rewording or removal of problematic items. This process ensured that the scale possessed high face validity and clinical utility, effectively capturing the subjective experiences it aimed to assess.

Reliability

The authors explicitly state that no systematic assessment of reliability has been undertaken for the Sexual Problems Self-Assessment Questionnaire (SPSAQ). Therefore, established psychometric measures such as test-retest reliability, internal consistency, or inter-rater reliability are not available for this instrument.

Factor Analysis

No formal factor analysis has been conducted or reported for the SPSAQ. Given that the instrument was developed based on the conceptual domains of the New View of Women’s Sexual Problems nosology rather than empirical factor extraction, and noting the absence of systematic reliability or validity studies, the underlying factor structure remains clinically assumed rather than statistically confirmed.

Instrument

Test Type: Clinical Self-Assessment Questionnaire / Diagnostic Aid

Format: 73 items utilizing a hidden 100-point continuum, which functions as a Likert-type scale. Responses typically range from “Yes” to “No” or “Very” to “Not at all.” The direction of the high score is varied by the wording of the statements (affirmatively or negatively).

Language Available: English (implied by source content)

Population Group: Adults presenting for Sex Therapy, including individuals and couples.

Age Group: Adult population (specific age range not provided).

Population Details: Clients presenting with sexual difficulties or relationship issues affecting sexual satisfaction. The scale was developed to be inclusive of both male and female sexual concerns.

Test Methodology: The SPSAQ is typically administered by computer, allowing respondents to complete the assessment via keyboard and mouse, resulting in an immediate printout of results. Completion time ranges from 12 to 25 minutes. Although computer-administered, client responses and identifying data are generally not electronically stored in the clinical setting; a printed answer sheet is provided to the clinician for interview notes.

Scoring: The computer program translates the mark along the Likert-type scale continuum into a numerical score ranging from 0 to 100. Higher scores indicate areas of greater perceived distress or problem areas. Scoring forms are available for individuals and for couples (listing comparative scores).

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: [email protected] (Elizabeth Rae Larson)

Correspondence Address: Elizabeth Rae Larson, Seattle Institute for Sex Therapy, Education and Research, 100 NE 56th Street, Seattle WA 98105.

Permissions & Fee and Test Year

The SPSAQ is described as a “work in progress” and part of a research and development project; thus, it is noted that there are no scoring norms available. The instrument was developed by the Seattle Institute for Sex Therapy, Education and Research, with initial development and presentation occurring around 2005–2006. Permissions for use should be directed to the corresponding author, Elizabeth Rae Larson. Information regarding specific licensing fees is not provided in the source material.

Reference’s

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Marty Klein and Jack Morin (2005), in applying the “New View” nosology to a unified classification of women’s and men’s sexual problems, expanded the original Medical category to a more inclusive Physical Factors which we found more descriptive of respondents’ subjective reports.

Kaschak, E., & Tiefer, L. (2001). A new view of women’s sexual problems. Binghamton, NY: The Haworth Press.

Klein, M., & Morin, J. (2005, July). The new view: Men are from earth, women are from earth. Paper presented at the New View Conference, Montreal, Canada.

Larson, E. R. (2005, May). Using the New View of Women’s Sexuality in clinical practice. Paper presented at the meeting of the Western Region of the Society for the Scientific Study of Sexuality, San Francisco, CA.

Larson, E. R., & McKay, M. H. (2006, November). Use of the New View diagnostic system in couple sex therapy. Paper presented at the Annual Meeting of the Society for the Scientific Study of Sexuality, Las Vegas, NV.

Items of the Sexual Problems Self-Assessment Questionnaire

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

1. 1. This questionnaire is part of a research and development project; it is unfinished and there are no scoring norms. It is being explored as a tool to aid in making a comprehensive assessment of sexual issues in women and men.

   2. This information is intended for two uses:

      1. Feedback to your educator or clinician; and

      2. Data to a research project to measure the effectiveness of this questionnaire.

         Your answers might be shared anonymously with scientific, educational, or clinical professionals.

   3. If you are a client or patient, know that you have the right to decline to answer all or part of the questionnaire and it will not negatively affect standard practice of treatment.

GENERAL QUESTIONS

1. FEEDBACK

   1. Are you taking this survey to provide feedback to your service provider?

           Yes  No

   2. Enter service provider’s name:

   3. Please create your code number with the first letter of your mother’s maiden name and the last four digits of your Social Security Number. Or you may, instead, create another 5-character code that you will remember.

   4. To assist us in long-term research, do you agree to have a second report sent to Seattle Institute?

           Yes  No

2. DEMOGRAPHICS

   1. Sex:      Female        Male       Other

   2. Age             

   3. Are you in a relationship?             

   4. If so, how long?                             

3. INSTRUCTIONS AND SAMPLE QUESTION

   Answer each question by placing an “X” on the dotted line at the place that best describes how you feel.

   Example: 1. I feel I have adequate access to chocolate.

   Yes……………………………………………………………….X. No

4. OVERALL SATISFACTION

   1. In general, I am satisfied with my sex life. Very. Not at all

   2. In general, I am satisfied with the emotional intimacy in my life. Very. Not at all

1. SOCIO-CULTURAL, POLITICAL, OR ECONOMIC FACTORS

   1. I feel uninformed about sexuality due to inadequate sex education. Yes. No

   2. I think my vocabulary is adequate to describe subjective or physical sexual experience.

   3. I have adequate information about human sexual biology and women’s changes with age.

   4. I have adequate information about human sexual biology and men’s changes with age.

   5. I think I lack information about how gender roles influence men’s and women’s sexuality.

   6. I have adequate access to information and services for birth control.

   7. I have adequate access to information and services for prevention and treatment of sexually transmitted infections.

   8. I have adequate access to information and services for rape or sexual trauma.

   9. I have adequate access to information and services for domestic violence.

   10. I avoid having sex or experience distress during sex because I feel I don’t live up to the ideals of my culture regarding sexuality or desirability.

   11. I feel anxiety or shame about my body, sexual attractiveness, or sexual responses.

   12. I feel confusion or shame about my sexual orientation or identity.

   13. I feel confusion or shame about my sexual fantasies, desires, and preferences.

   14. I feel that there are conflicts between my sexual values and those of my partner.

   15. I feel that there are conflicts between my sexual values and those of my peer group.

   16. I feel that there are conflicts between my sexual values and those of the mainstream culture.

   17. I feel a lack of interest, fatigue, or lack of time for sex due to family, work, or other obligations.

   18. I feel inhibited about communicating preferences or initiating, pacing, or shaping sexual activities.

2. RELATIONSHIPS

   1. I currently experience sexual inhibition, avoidance, or distress because of betrayal by or dislike of my partner. Yes. No

   2. I currently experience sexual inhibition, avoidance, or distress because I fear my partner.

   3. I currently experience sexual inhibition, avoidance, or distress because of abuse by my partner.

   4. I currently experience inhibition, avoidance, or distress arising from unequal power between myself and my partner.

   5. I currently experience sexual inhibition, avoidance, or distress because of my partner’s negative communication patterns.

   6. I have experienced sexual inhibition, avoidance, or distress arising from betrayal, dislike, fear, or abuse in a previous relationship.

   7. There are discrepancies between myself and my partner in frequency of desire for sexual activity.

   8. There are discrepancies between myself and my partner in preferences for various sexual activities.

   9. I trust my partner to be sensitive to my wants.

   10. I have lost sexual interest as a result of conflicts with my partner over commonplace issues such as money, schedules, or relatives.

   11. I have experienced loss of sexual interest due to traumatic experiences, such as infertility or the death of a child.

   12. My partner’s health and/or sexual problems interfere with my sexual arousal, enjoyment, or spontaneity.

   13. I experience sexual aversion, mistrust, or inhibition of sexual pleasure due to my partner’s personality, such as problems with rejection, cooperation, closeness, or criticalness.

   14. I experience sexual aversion, mistrust, or inhibition of sexual pleasure due to my partner’s depression or anxiety.

3. PSYCHOLOGICAL FACTORS

   1. I experience inhibition of sexual pleasure or response that I believe is due to a history of physical, sexual, or emotional trauma. Yes. No

   2. I avoid sexual activity or fail to experience sexual pleasure because of fears of rejection or intimacy.

   3. I avoid sexual activity or fail to experience sexual pleasure because of anger toward my partner.

   4. I experience sexual aversion, mistrust, or inhibition of sexual pleasure due to depression or anxiety.

   5. I experience sexual inhibition due to fear of sexual acts or their possible consequences, for example pain during intercourse, pregnancy, sexually transmitted infections, etc.

   6. I limit my sexual feelings due to my fear of losing my partner.

   7. I engage in sexual behavior that feels inappropriate and out of control.

4. PHYSICAL FACTORS

1. I experience pain or lack of physical response during sexual activity due to medical condition(s) affecting my body. Yes. No

2. I believe my sexual experience and pleasure are limited by the following medical conditions (check all that apply):

   1.        Diabetes 5.    Headaches

   2.         Multiple Sclerosis 6.    Epilepsy

   3.         Parkinson’s Disease 7.    Arthritis

   4.         Lupus 8.    Other

3. (men) I have been treated for prostate cancer.    Yes   No

4. (women) I have had a hysterectomy or had my ovary(ies) removed.   Yes   No

5. I have taken female hormones (estrogen, progesterone, etc.) at some time in my life.    Yes   No

6. I have taken male hormones (testosterone, DHEA, etc.) at some time in my life.    Yes   No

7. I experience pain or lack of physical response during sexual activity due to the following medical conditions:

   1. Pregnancy Yes. No

   2. Childbirth

   3. Menopause

   4. Sexually Transmitted Disease

   5. Physical Injury

   6. Side effects of drugs, medications, or treatment for a medical condition.‌

   7. (women) Involuntary contractions of the vagina (vaginismus).

8. I am satisfied with my ability to control my ejaculation/orgasm.

9. I experience pain during arousal (erection, lubrication).

10. I experience pain during orgasm.

11. I experience pain during intercourse or other sexual contact for undiagnosed reasons.

12. I take medication/substance(s) (prescribed, herbal, or illegal) to enhance my sexual experience.

13. I lead a physically healthy lifestyle.

14. I smoke.

15. I drink more than 1 alcoholic beverage per day (women) or more than 2 drinks per day (men).

16. Regarding my weight, I am:

    Too Thin. Too Fat

17. I am exposed to solvents or volatile substances, e.g., exhaust, chemical odors, etc. Daily. Rarely

18. I regularly engage in vigorous physical exercise. Daily. Rarely