A New Measure of Sexual Satisfaction: Bi-national Validation of The New Sexual Satisfaction Scale (NSSS)

Štulhofer, A.*, Buško, V.**, Brouillard, P.***, Kuljanić, K.****

*Sexology Unit, Dept. of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb

**Dept. of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb***A&M University at Corpus Christi, TX

****Gynecology and Obstetrics Ward, University Hospital, Rijeka

8th Alps-Adria Psychology Conference, October 2-4, 2008, Ljubljana, Slovenia

How (scholarly) important is sexual satisfaction?

• Standard social science justification– Marital stability– Sexual satisfaction=“intimate glue”

• Sexological justification– Sexual rights paradigm– Sexual health paradigm

• “Postmodern” real life justification– Sexual satisfaction=measure of individual

success

What the world needs now is not another sexual satisfaction scale… - OR?

• Existing instruments– General (one or two-item) measures– Ad hoc measures (Hudson et al, 1981 /Index of Sexual

Satisfaction/; Young & Luquis, 1998; Snell, 1993)– Gender-specific m. (Pinney et al., 1987 /Pinney Inventory/;

Meston & Trapnell, 2005 /Sexual Satisfaction Scale for Women/)– Relationship-specific m. (Lawrance & Byers, 1995 /Interpersonal

Exchange Model of Sexual Satisfaction/)– Sexual health or combined satisfaction-distress measures

(clinical relevance is emphasized; Golombok & Rust, 1986 /G-R Inventory/; Meston & Trapnell, 2005)

– Hetero-specificity? (Unknown)

• Our rationale…

Conceptual framework: Revisiting sex therapy

• The majority of existing scales do not have a clear theoretical/conceptual anchorage

• A somewhat paradoxical approach: starting from a negative perspective (What is behind the lack of sexual satisfaction? Which factors negatively affect sexual health?)

• Sex therapy and counseling literature as the starting point

In

divid

ual V

isor

1 SEXUAL SENSATIONS- quality of touch/feel- quality of sexual arousal- frequency of arousal- quality of orgasm- frequency of orgasm2 SEXUAL PRESENCE/AWARENESS- feeling of letting oneself go- being focused- sexual reaction toward partner

Interp

ersonal V

isor

3 SEXUAL EXCHANGE- receiving pleasure- giving pleasure- partner's sexual availability- partner's sexual initiative- partner’s sexual creativity- balance between giving and receiving4 EMOTIONAL CONNECTEDNESS/CLOSENESS- trust- emotional opening up- partner’s emotional surrender- emotional closeness in sex- sex is contributing to the emotional bond

Rep

ortorialV

isor

5 SEXUAL ACTIVITY- variety- frequency- intensity (passion)- duration- sexual experimentation

Conceptual framework: Basic dimensions and related categories

Participants and data collection

• Online questionnaire (using a US-based commercial Internet surveying tool)

• Mostly network-based or referral sampling• Data collected between November 2007 and May 2008• The samples:

– Croatian students (2 samples; n=544+219 /test-retest/)– Croatian adults (n=729)– Croatian non-heterosexual adults (n=360)– Croatian clinical sample (n=54)– US students (n=356)– US adults (n=212)

Scale development• Initial pool of 35 items (Likert-type scale: 1=completely

dissatisfied / 5=completely satisfied)• 1st step: PCA procedure extracted 5-6 factors with

Eigenvalue >1• 2nd step: forced two-factor solution (oblimin rotation with

Kaiser normalization)• 54-58% total item variance explained; factor

correlation=.52-.61• Final selection of items (k=20, 10 per component) was

guided by factor loadings and content overlap (redundancy)

STUDENT SAMPLES COMMUNITY SAMPLES

CRO US CRO US

I1 .44 -.42 .48 .57

I2 .82 .73 .81 .86

I3 .88 .82 .76 .76

I4 .86 .83 .86 .82

I5 .81 .84 .83 .90

I9 .49 .66 .62 .65

I10 .47 .42 -.41 -.54 .44

I11 .48 -.54 -.65 .60

I12 .91 -.88 -.96 .94

I13 .72 -.64 -.62 .55

I14 .84 -.89 -.84 .68

I15 .74 -.65 -.82 .66

I16 .94 -.96 -.96 .95

I17 .72 -.80 -.72 .85

I18 .96 -.82 -.95 .88

I19 .53 -.50 .45 -.45 .49

I20 .56 -.40

I22 .51 -.45 -.52 .74

I23 .47 -.50 .67

I24 .72 .83 .77 .77

I25 .43 .55 .46 .43

I26 .45 .49 .56 .46 .42

I27 .61 .57 .78 .74

I28 .59 .64 .70 .71

I29 .46 .53 -.42 .43

I30 .59 -.67 -.69 .72

I31 .60 -.58 -.50 .62

I32 .80 .72 .66 .62

I33 .41 .40 .45 .58 .46

I34 .60 .62 .70 .59

Two facets of sexual satisfaction

• Ego-centered vs. Partner- (and sexual activity) centered dimension

• Both factors contain items related to all five conceptual dimensions

The New Sexual Satisfaction Scale (NSSS)EGO-CENTERED

SUBSCALE

PARTNER-CENTERED

SUBSCALE

The intensity of my sexual arousal X

The quality of my orgasms X

My “letting go” and surrender to sexual pleasure during sex X

My focus/concentration during sexual activity X

The way I sexually react to my partner X

My body’s sexual functioning X

My emotional opening up in sex X

My mood after sexual activity X

The frequency of my orgasms X

The pleasure I provide to my partner X

The balance between what I give and receive in sex X

My partner’s emotional opening up during sex X

My partner’s initiation of sexual activity X

My partner’s ability to orgasm X

My partner's surrender to sexual pleasure (“letting go”) X

The way my partner takes care of my sexual needs X

My partner’s sexual creativity X

My partner’s sexual availability X

The variety of my sexual activities X

The frequency of my sexual activity X

ReliabilityEGO-

CENTEREDSUBSCALE

PARTNER-CENTEREDSUBSCALE

FULLSCALE

CRO student sampleall (n = 544)women (n = 359)men (n = 185)

.91

.91

.92

.92

.91

.93

.94

.94

.95

CRO community sampleall (n = 729)women (n = 471)men (n = 258)

.92

.92

.91

.94

.94

.93

.95

.95

.94

CRO non-heterosexual sampleall (n = 360)women (n = 102)men (n = 258)

.92

.92

.92

.94

.94

.93

.95

.95

.95

US student sampleall (n = 356)women (n = 246)men (n = 110)

.91

.91

.93

.92

.91

.94

.95

.94

.96

US community sampleall (n = 212)women (n = 138)men (n = 74)

.93

.93

.92

.92

.90

.94

.94

.94

.95

Construct validity

*p < .05; **p < .01; ***p < .001

EGO-CENTEREDSUBSC.(k = 10)

PARTNER-C. SUBSC. (k = 10)

FULL SCALE(k = 20)

CRO US CRO US CRO US

r (n)

Life satisfaction .28***(531)

.21***(290)

.24***(527)

.25***(290)

.28***(523)

.25***(284)

Sexual boredom -.49***(522)

-.37***(285)

-.44***(519)

-.35***(285)

-.51***(515)

-.39***(279)

Intimacy .41***(525)

.43***(288)

.41***(521)

.43***(288)

.44***(517)

.47***(282)

Partner communication about sex .19***(531)

.16**(290)

.18***(537)

.15*(290)

.20***(523)

.18**(284)

Currently in a relationship .25***(531)

.21***(290)

.32***(527)

.16**(290)

.30***(523)

.20**(284)

Satisfaction with one's sex life .63***(531)

.44***(271)

.61***(527)

.54***(271)

.67***(523)

.53***(265)

Temporal stabilityWomen(n=116)

Men(n=103)

All(n=219)

M1a

(SD)

M2b

(SD)

r M1a

(SD)

M2b

(SD)

r M1a

(SD)

M2b

(SD)

r

EGO-CENTEREDSUBSCALE

38.99(6.60)

39.87(7.03)

.84* 40.26(8.23)

41.40(7.33)

.72* 39.59(7.43)

40.59(7.20)

.78*

PARTNER-CENTEREDSUBSCALE

41.72(6.15)

41.71(7.18)

.73* 38.10(9.38)

37.98(8.23)

.73* 40.02(8.02)

39.95(8.20)

.74*

FULLSCALE

80.66(11.84)

81.71(13.43)

.81* 78.34(16.70)

79.33(15.22)

.74* 79.57(14.35)

80.60(14.31)

.76*

M1 = 1st measurement mean, M2 = 2nd measurement mean; *p <.001

Clinical applicationEGO-

CENTEREDSUBSCALE

PARTNER-C.SUBSCALE

FULL SCALE

M (SD)

Students with self-reported sexualdifficulties (n=265)

Students without self-reported sexualdifficulties (n=279)

37,28 (7.90)

42,48 (6,39)

38,72 (8,07)

41,56 (7,00)

76,18 (14,52)

84,01 (12,30)

tdfCohen’s d

-8,30* 492,56-0,72

-4,32*506,67-0,38

-6,64*(496,77)

-0,58

Clinical sample (n=54)Community sample (n=729)

30.39 (8.87)39.71 (7.34)

29.96 (8.24)38.97 (8.62)

59.84 (12.95)78.90 (14.40)

tdfCohen’s d

-7.33* 55.17-1.14

-7.74*740

-1.07

-8.64*709

-1.39

p<.001

Study limitations

• Theoretical framework was not confirmed– Size of the initial pool of items?– Initial “dichotomization” of items?– Presence of 5 dimensions in each factor; high

correlation between the NSSS (k=20) and a short version (k=12) constructed following the conceptual framework (r=.98-.99)

• Sampling bias and systematic overestimation of sexual satisfaction levels

Conclusion and further steps• The NSSS appears to be valid and cross-culturally applicable scale

for measuring sexual satisfaction/content• Sociocultural “determinants” of sexual satisfaction (the US vs.

Croatia):CRO_sat > US_satCRO_FEM_sat = CRO_MALE_satUS_FEM_sat > US_MALE_satCRO_ADULT_sat > CRO_STUD_satUS_ADULT_sat < US_STUD_satFEM_ego_sat < or = FEM_partner_satMALE_ego_sat > MALE_partner_sat

• NSSS is applicable regardless of gender, relationship status, or sexual orientation

• More thorough clinical assessment is needed (an on-going study on couples participating in an assisted reproduction program /infertility treatment/)

• Exploring variation in the NSSS scores associated with the type, dynamics, and “locus” of sexual problem/dysfunction

Thank you...