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ORIGINAL RESEARCH—PSYCHOLOGY: A New Evaluation Concept and Its Measurement: “Male Sexual Anticipating Cognitions”


Mireille Bonierbale, MD, University Hospital Ste Marguerite—Psychiatry and Medical Psychology Department, 270 Bd Sainte marguerite Cedex 09 Marseilles 13274, France. Tel/Fax: (33) 491-744-871; E-mail:


Context.  The development of sex-active drugs justifies the use of scales for evaluating changes induced by such forms of therapy. Among the tools available for evaluating erectile dysfunction (ED), the International Index of Erectile Function is the most widely used. Analysis of the scientific literature shows that these instruments remain primarily focused on functional aspects of ED. The vulnerability factors involved in ED are mainly based upon organic characteristics, e.g., age, cardiovascular diseases, or diabetes, but the psychological factors involved in the occurrence and maintenance of ED are less studied.

Objective.  This conclusion led us to develop a French self-administered instrument, based on patients’ subjective sexual experiences, to evaluate “male sexual anticipating cognitions,” using Apter's reversal theory as a framework.

Design, Setting, and Patients.  We present here the first stages of the development of this new instrument. We carried out semistructured, one-to-one interviews with patients with psychogenic ED and patients with mixed ED. Eighteen one-to-one interviews were held in several urologic/andrologic and psychiatric sexologist services. Interviews were continued until the required information was obtained. Analyses of the content were performed to generate items for the new instrument.

Results.  Dimensions isolated were those of (a) sexual beliefs; (b) metamotivational modes; and (c) dysfunctional coping. Pools of items are currently being analyzed by 108 experts (psychologists, sexologists, andrologists, urologists) to determine if additional items are required. The acceptability and the comprehensiveness of this preliminary questionnaire will be tested by 320 patients in a multicentric study, to produce a shorter questionnaire featuring the most relevant items. Once validated, this multidimensional instrument could be used to assess treatment efficacy of  the  mixed  and psychogenic components of ED. Bonierbale M, Clement A, Loundou A, Simeoni M-C, Barrau K, Hamidi K, Apter MJ, Lançon C, and Auquier P. A new evaluation concept and its measurement: “Male sexual anticipating cognitions.” J Sex Med 2006;3:96–103.