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Does the Female Sexual Distress Scale-Revised Cover the Feelings of Women with HSDD?


Leonard DeRogatis, Johns Hopkins Dept. of Psychiatry and Behavioral Sciences, Center for Sexual Medicine at Sheppard Pratt, 6501 N. Charles Street, Baltimore, MD 21285-6815, USA. Tel: (410) 938 4336; Fax: (410) 938 4340; E-mail:


Introduction.  Distress associated with low sexual desire is a key feature of hypoactive sexual desire disorder (HSDD). Accurate, reliable, and easy-to-use diagnostic tools to measure such distress are required. The Female Sexual Distress Scale-Revised (FSDS-R) has been shown to have good discriminant validity, test–retest reliability, and internal consistency in measuring sex-related personal distress in women with HSDD. However, the content validity (relevance, clarity, comprehensiveness) of the scale must also be established.

Aim.  The aim of this study was to assess the content validity of the FSDS-R and to examine the potential of Item 13 as a stand-alone measure of distress associated with decreased sexual desire.

Methods.  A single-visit content validation study was conducted in three centers in the United States. Women were screened for HSDD; those with HSDD completed the FSDS-R and then underwent debriefing to capture information on their perceptions of the instrument. Participants also rated the relevancy of every FSDS-R item, from 0 (“not at all relevant”) to 4 (“extremely relevant”).

Main Outcome Measures.  Female HSDD patients' ratings of the relevance and ease of understanding of the 13 items of the FSDS-R.

Results.  Twenty-five women with HSDD were interviewed. Mean relevancy ratings ranged from 1.96 (Item 9) to 3.33 (Item 13). Most participants (76–100%) found every item clear and easy to understand. Item 13 alone demonstrated good content validity, and 56% of participants felt that it covered all of their feelings about their low sexual desire.

Conclusions.  This study established the content validity of the FSDS-R and demonstrated that the FSDS-R total score is a relevant endpoint for women with HSDD. The tool's one item specific to low sexual desire (Item 13) was given the highest score and highest relevancy of all items, and over half the sample felt that it covered all of their feelings about their low sexual desire. DeRogatis L, Pyke R, McCormack J, Hunter A, and Harding G. Does the female sexual distress scale-revised© (FSDS-R©) cover the feelings of women with HSDD? J Sex Med 2011;8:2810–2815.