Abstract
The purpose of the present study was to develop a reliable and valid 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), with primary, secondary, and tertiary sexual dysfunction subscales. Reliability analyses provided evidence for high internal consistency for the total MSISQ-19 (α = .91) and for the primary(α = .82), secondary (α = .85) and tertiary (α = .87) subscales. 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.
Similar content being viewed by others
REFERENCES
Anderson, D.W., Ellenberg, J.H., Leventhal, C.M., Reingold, S.C., Rodriguez, M., & Silberberg, D.H. (1992). Revised estimate of the prevalence of multiple sclerosis in the United States. Annals of Neurology, 31, 333–336.
Kunz, J.R. & Finkel, A.J. (1987). The American Medical Association Family Medical Guide. Random House, Inc., New York.
Clayman, C.B. (1989). The American Medical Association Encyclopedia of Medicine. Random House, Inc., New York.
Smith, C.R., Samkoff, L.M., & Scheinberg, L.C. (1993). Clinical features, assessment, and differential diagnosis of multiple sclerosis. In U. Halbreich (Ed.), Multiple Sclerosis: A Neuropsychiatric Disorder. American Psychiatric Press, Washington D.C.
Foley, F.W. & Iverson, J. (1992). Sexuality and MS. In R.C. Kalb and L.C. Scheinberg (Eds.), M.S. & The Family. Demos Publications, New York.
Foley, F. W. & Sanders, A. (May, 1997). Sexuality, multiple sclerosis, and women. MS Management, 4 (1), 1–10.
Mattson, D., Petrie, M., Srivastava, D.K., & McDermott, M. (1995). Multiple sclerosis: sexual dysfunction and its response to medications. Archives of Neurology, 52, 862–868.
Valleroy, M.L., & Kraft, G.H. (1984). Sexual dysfunction in multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 65, 125–128.
Barrett, M. (1991). Sexuality and Multiple Sclerosis. The Multiple Sclerosis Society of Canada, Toronto, Ontario.
Delisa, J.A., Miller, R.M., Mikulic, M.A., & Hammond, M.C. (1985). Multiple sclerosis: Part II. Common functional problems and rehabilitation. American Family Physician, 32 (5), 127–132.
Foley, F.W., Dince, W., Bedell, J.R., LaRocca, N.G., Kalb, R., Caruso, L.S., Smith, C.R., & Shnek, Z.M. (1994). Psychoremediation of communication skills for cognitively impaired persons with multiple sclerosis. Journal of Neurologic Rehabilitation, 8, 165–179.
Weiss, J. (1992). Multiple sclerosis: will it come between us? Sexual concerns of clients and their partners. Journal of Neuroscience Nursing, 24 (4), 190–193.
White, D.M., Catanzaro, M.L., & Kraft, G.H. (1993). An approach to the psychological aspects of multiple sclerosis: a coping guide for healthcare providers and families. Journal of Neurological Rehabilitation, 7, 43–52.
Kalb, R.C., La Rocca, N.G., & Kaplan, S.R. (1987). Sexuality. In L.C. Scheinberg & N.J. Holland (Eds.), Multiple Sclerosis: A Guide for Patients and their Families. Raven Press.
Ivers, R.R. & Goldstein, N.P. (1963). Multiple sclerosis: A current appraisal of symptoms and signs. Mayo Clinic Proceedings, 38, 457–466.
Kurtzke, J.F., Beebe, G., Nagler, B., Auth, T., Kurland, L.T., & Nefzger, M.D. (1968). Study on the natural history of multiple sclerosis. 4. Clinical features of the onset bout. Acta Neurologica Scandinavica, 44, 467–499.
Ghezzi A., Malvestiti, G.M., Baldini, S., Zaffaroni, M., & Zibetti, A. (1995). Erectile impotence in multiple sclerosis: A neurophysiological study. Journal of Neurology, 242, 123–126.
Lilius, H.G., Valtonen, E.J., & Wikstrom, J. (1976a). Sexual problems in patients suffering from multiple sclerosis. Journal of Chronic Diseases, 29, 643–647.
Lilius, H.G., Valtonen, E.J., & Wikstrom, J. (1976b). Sexual problems in patients suffering from multiple sclerosis. Scandinavian Journal of Social Medicine, 4, 41–44.
McCabe, M. P., McDonald, E., Deeks, A. A., Vowels, L.M., & Cobain, M.J. (1996). The impact of multiple sclerosis on sexuality and relationships. The Journal of Sex Research, 33 (3), 241–248.
Barak, Y., Achiron, A., Elizur, A.A., Gabbay, U., Noy, S., & Sarova-Pinhas, I. (1996). Sexual dysfunction in relapsing-remitting multiple sclerosis: magnetic resonance imaging, clinical, and psychological correlates. Journal of Psychiatry and Neuroscience, 21 (4), 255–258.
Schover, L.R., Thomas, A.J., Lakin, M.M., Montague, D.K., & Fischer, J. (1988). Orgasm phase dysfunction in multiple sclerosis. The Journal of Sex Research, 25 (4), 548–554.
Hulter, B.M. & Lundberg, P.O. (1995). Sexual function in women with advanced multiple sclerosis. Journal of Neurology, Neurosurgery, & Psychiatry, 59, 83–86.
Minderhoud, J.M., Leemhuis, J.G., Kremer, J., Laban, E., & Smits, P.M.L. (1984). Sexual disturbances arising from multiple sclerosis. Acta Neurologica Scandinavica, 70, 299–306.
Lundberg, P.O. (1981). Sexual dysfunction in female patients with multiple sclerosis. International Rehabilitation Medicine, 3 (1), 32–34.
Vickrey, B.G., Hays, R., Harooni, R., Myers, L.W., & Ellison, G.W. (1995). A health-related quality of life measure for multiple sclerosis. Quality of Life Research, 4, 187–206.
Haber, A. & LaRocca, N.G. (Eds.) (1985). Minimal Record of Disability for Multiple Sclerosis. National Multiple Sclerosis Society, New York.
Stenager, E., Stenager, E.N., Jensen, K., & Boldsen, J. (1990). Multiple Sclerosis: Sexual Dysfunctions. Journal of Sex Education & Therapy, 16 (4), 262–269.
Stenager, E., Stenager, E., & Jensen, K. (1996). Sexual function in multiple sclerosis. A 5-year follow-up study. The Italian Journal of Neurological Sciences, 17, 67–69.
Szasz, G., Paty, D., Lawton-Speert, S., & Eisen, K. (1984a). A sexual functioning scale in multiple sclerosis. Acta Neurologica Scandinavica, Suppl 101, 37–43.
Szasz, G., Paty, D., & Maurice, W.L. (1984b). Sexual dysfunctions in multiple sclerosis. Ann NY Academy of Science, 436, 443–452.
Glass, C. (1995). Addressing psychosexual dysfunction in neurological rehabilitation settings. Journal of Mental Health, 4, 251–260.
Nosek, M.A., Rintala, D.H., Young, M.E., Howland, C.A., Foley, C.C., Rossi, D., & Chanpong, G. (1996). Sexual functioning among women with physical disabilities. Archives of Physical Medicine and Rehabilitation, 77, 107–115.
Conte, H.R. (1983). Development and use of self-report techniques for assessing sexual functioning: a review and critique. Archives of Sexual Behavior, 12 (6), 555–576.
DuPont, S. (1995). Multiple sclerosis and sexual functioning—review. Clinical Rehabilitation, 9, 135–141.
Miller, D.M., Kalb, R.C., Daily, P., Soderberg, J., Choi, T. (1994). Counseling section. Journal of Neurological Rehabilitation, 8, 145–150.
Kurtzke, J.F. (1961). On the evaluation of disability in multiple sclerosis. Neurology, 11, 686–694.
Scheinberg, L., Feldman, F., Ratzker, P., LaRocca, N., Aisen, M., Giesser, B., & Smith, C. Self-Assessment of Neurological Impairment in Multiple Sclerosis. Paper presented at the Annual Meeting of the American Academy of Neurology, New Orleans, Louisiana, May 1986.
Kurtzke, J.F. (1983). Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS), Neurology, 33, 1444–1452.
Ratzker, P.K., Feldman, J.M., Scheinberg, L.C., LaRocca, N.G., Smith, C.R., Giesser, B.S., & Aisen, M.L. (1997). Self-assessment of neurologic impairment in MS. Journal of Neurological Rehabilitation, 11 (4), 207–211.
Snyder, D.K. (1981). Marital Satisfaction Inventory Manual. Western Psychological Services, Los Angeles.
Snyder, D.K., Wills, R.M., & Keiser, T.W. (1981). Empirical validation of the Marital Satisfaction Inventory: An actuarial approach. Journal of Consulting and Clinical Psychology, 49 (2), 262–268.
Berg, P. & Snyder, D.K. (September 1980). A multidimensional comparison of maritally and sexually dysfunctioned couples. Paper presented at the annual meeting of the American Psychological Association, Montreal, Canada.
Veit, C.T. & Ware, J.E. (1983). The structure of psychological distress and well-being in general populations. Journal of Consulting and Clinical Psychology, 51 (5), 730–742.
Weinstein, M.C., Berwick, D.M., Goldman, P.A., Murphy, J.M., & Barsky, A.J. (1989). A comparison of three psychiatric screening tests using receiver operating characteristic (ROC) analysis. Medical Care, 27 (6), 593–607.
Berwick, D.M., Murphy, J.M., Goldman, P.A., Ware, J.E., Barsky, A.J., & Weinstein, M.C. (1991). Performance of a five-item mental health screening test. Medical Care, 29 (2), 169–176.
Smeltzer, S.C. & Kelly, C.L. (1997). Multiple Sclerosis. In M.L. Sipski and C.J. Alexander (Eds.), Sexual Function in People with Disability and Chronic Illness. Aspen Publishers, Inc., Gaithersburg, Maryland.
Ferroni, P. & Taffe, J. (1997). Women's emotional well-being: The importance of communicating sexual needs. Sexual and Marital Therapy, 12 (2), 127–138.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sanders, A.S., Foley, F.W., LaRocca, N.G. et al. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19). Sexuality and Disability 18, 3–26 (2000). https://doi.org/10.1023/A:1005421627154
Issue Date:
DOI: https://doi.org/10.1023/A:1005421627154