Sexuality and Disability

, Volume 18, Issue 1, pp 3–26 | Cite as

The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19)

  • Audrey Sorgen Sanders
  • Frederick W. Foley
  • Nicholas G. LaRocca
  • Vance Zemon


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.

multiple sclerosis sexual dysfunction measurement 


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  1. 1.
    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.Google Scholar
  2. 2.
    Kunz, J.R. & Finkel, A.J. (1987). The American Medical Association Family Medical Guide. Random House, Inc., New York.Google Scholar
  3. 3.
    Clayman, C.B. (1989). The American Medical Association Encyclopedia of Medicine. Random House, Inc., New York.Google Scholar
  4. 4.
    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.Google Scholar
  5. 5.
    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.Google Scholar
  6. 6.
    Foley, F. W. & Sanders, A. (May, 1997). Sexuality, multiple sclerosis, and women. MS Management, 4 (1), 1–10.Google Scholar
  7. 7.
    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.Google Scholar
  8. 8.
    Valleroy, M.L., & Kraft, G.H. (1984). Sexual dysfunction in multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 65, 125–128.Google Scholar
  9. 9.
    Barrett, M. (1991). Sexuality and Multiple Sclerosis. The Multiple Sclerosis Society of Canada, Toronto, Ontario.Google Scholar
  10. 10.
    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.Google Scholar
  11. 11.
    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.Google Scholar
  12. 12.
    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.Google Scholar
  13. 13.
    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.Google Scholar
  14. 14.
    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.Google Scholar
  15. 15.
    Ivers, R.R. & Goldstein, N.P. (1963). Multiple sclerosis: A current appraisal of symptoms and signs. Mayo Clinic Proceedings, 38, 457–466.Google Scholar
  16. 16.
    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.Google Scholar
  17. 17.
    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.Google Scholar
  18. 18.
    Lilius, H.G., Valtonen, E.J., & Wikstrom, J. (1976a). Sexual problems in patients suffering from multiple sclerosis. Journal of Chronic Diseases, 29, 643–647.Google Scholar
  19. 19.
    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.Google Scholar
  20. 20.
    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.Google Scholar
  21. 21.
    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.Google Scholar
  22. 22.
    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.Google Scholar
  23. 23.
    Hulter, B.M. & Lundberg, P.O. (1995). Sexual function in women with advanced multiple sclerosis. Journal of Neurology, Neurosurgery, & Psychiatry, 59, 83–86.Google Scholar
  24. 24.
    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.Google Scholar
  25. 25.
    Lundberg, P.O. (1981). Sexual dysfunction in female patients with multiple sclerosis. International Rehabilitation Medicine, 3 (1), 32–34.Google Scholar
  26. 26.
    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.Google Scholar
  27. 27.
    Haber, A. & LaRocca, N.G. (Eds.) (1985). Minimal Record of Disability for Multiple Sclerosis. National Multiple Sclerosis Society, New York.Google Scholar
  28. 28.
    Stenager, E., Stenager, E.N., Jensen, K., & Boldsen, J. (1990). Multiple Sclerosis: Sexual Dysfunctions. Journal of Sex Education & Therapy, 16 (4), 262–269.Google Scholar
  29. 29.
    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.Google Scholar
  30. 30.
    Szasz, G., Paty, D., Lawton-Speert, S., & Eisen, K. (1984a). A sexual functioning scale in multiple sclerosis. Acta Neurologica Scandinavica, Suppl 101, 37–43.Google Scholar
  31. 31.
    Szasz, G., Paty, D., & Maurice, W.L. (1984b). Sexual dysfunctions in multiple sclerosis. Ann NY Academy of Science, 436, 443–452.Google Scholar
  32. 32.
    Glass, C. (1995). Addressing psychosexual dysfunction in neurological rehabilitation settings. Journal of Mental Health, 4, 251–260.Google Scholar
  33. 33.
    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.Google Scholar
  34. 34.
    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.Google Scholar
  35. 35.
    DuPont, S. (1995). Multiple sclerosis and sexual functioning—review. Clinical Rehabilitation, 9, 135–141.Google Scholar
  36. 36.
    Miller, D.M., Kalb, R.C., Daily, P., Soderberg, J., Choi, T. (1994). Counseling section. Journal of Neurological Rehabilitation, 8, 145–150.Google Scholar
  37. 37.
    Kurtzke, J.F. (1961). On the evaluation of disability in multiple sclerosis. Neurology, 11, 686–694.Google Scholar
  38. 38.
    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.Google Scholar
  39. 39.
    Kurtzke, J.F. (1983). Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS), Neurology, 33, 1444–1452.Google Scholar
  40. 40.
    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.Google Scholar
  41. 41.
    Snyder, D.K. (1981). Marital Satisfaction Inventory Manual. Western Psychological Services, Los Angeles.Google Scholar
  42. 42.
    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.Google Scholar
  43. 43.
    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.Google Scholar
  44. 44.
    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.Google Scholar
  45. 45.
    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.Google Scholar
  46. 46.
    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.Google Scholar
  47. 47.
    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.Google Scholar
  48. 48.
    Ferroni, P. & Taffe, J. (1997). Women's emotional well-being: The importance of communicating sexual needs. Sexual and Marital Therapy, 12 (2), 127–138.Google Scholar

Copyright information

© Human Sciences Press, Inc. 2000

Authors and Affiliations

  • Audrey Sorgen Sanders
  • Frederick W. Foley
    • 1
  • Nicholas G. LaRocca
    • 2
  • Vance Zemon
    • 3
  1. 1.Ferkauf Graduate School of Psychology and Albert Einstein College of MedicineYeshiva UniversityBronx
  2. 2.National Multiple Sclerosis SocietyNew York
  3. 3.Ferkauf Graduate School of Psychology and Albert Einstein College of MedicineYeshiva UniversityBronx

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