The FSFI was developed for assessing women clinically diagnosed with FSAD. The present study examined the reliability and validity of the FSFI for use among women with a primary clinical diagnosis of FOD or HSDD. Inter-item correlations of .83 and higher were observed for all of the domain scores among women with FOD and for control women. These high correlations are comparable to those reported by Rosen et al. (2000)
for women with FSAD (.82 and higher) and for control women (.89 and higher). Among women with HSDD, internal consistency was in the acceptable range for all of the domains (.74 and higher), with the exception of the desire composite. The moderate alpha value of .58 suggests that the two-item FSFI desire composite may not be a reliable indicator of sexual desire among this population.
Correlations between the Locke-Wallace Marital Adjustment Test and FSFI domains scores were modest in magnitude for women with FOD, for women with HSDD, and for controls. Correlations with the total FSFI scores were in the low moderate range for the control women (r
= .52) and were very low for women with FOD (r
= .22) and with HSDD (r
= .16). These correlations are almost identical to those reported by Rosen et al. (2000)
for women with FSAD (r
= .22) and for controls (r
= .53). Also consistent with that reported by Rosen et al. (2000)
, the satisfaction domain showed the strongest association with marital adjustment for each of the participant groups. Lowest marital adjustment associations were with the FSFI pain domain for women with FOD and for controls and with the orgasm and lubrication domains for women with HSDD. The statistical dissociation between FSFI scores and the related construct of marital adjustment lends support for the construct validity of the FSFI among these groups of women.
Significant differences between women with FOD and controls and between women with HSDD and controls were noted for each of the FSFI domains and for the total scores. As one might have expected, the largest differences between women with FOD and controls were noted for the domains of orgasm and arousal (effect sizes estimated using Cohen’s D = 1.69, 1.58, respectively), and the largest differences between women with HSDD and controls were seen for the domains of arousal and desire (effect sizes estimated using Cohen’s D = 1.85, 1.69, respectively). The ability of the FSFI to differentiate between clinical and nonclinical groups of women lends support for the discriminant validity of the FSFI among these groups of women.
In conclusion, the findings from this study indicate that the FSFI is a reliable and valid measure of sexual functioning for women with FOD and HSDD. This is the first study to validate a measure of sexual functioning on a sample of women with a primary clinical diagnosis of FOD and on a sample of women with a primary clinical diagnosis of HSDD. Future research is needed to examine the sensitivity of the FSFI for detecting treatment-induced changes among these populations of women.