Synopsis of the Derogatis Sexual Functioning Inventory

DSFI

Author
Derogatis, Leonard R.

Title
Derogatis Stress Profile (DSP®)

Source
Clinical Psychometric Research Inc.,
1228 Wine Spring Lane,
Towson, MD 21204
Author
Derogatis, Leonard R.

Title
Derogatis Stress Profile (DSP®)

Source
Clinical Psychometric Research Inc.,
1228 Wine Spring Lane,
Towson, MD 21204

Instrument Development
Year Developed: 1975, 1978
Primary Measurement Constructs: The DSFI measures constructs believed to be
fundamental to successful sexual functioning (e.g. drive, body image, sexual satisfaction) and in
addition, measures several basic indicators of general well-being (e.g. affects balance and
psychological distress).

Description
The Derogatis Sexual Functioning Inventory (DSFI) is an “omnibus” self-report inventory
designed to measure the quality of the current sexual functioning of an individual. The DSFI is
multidimensional in nature because of the comprehensive study of sexual functioning has
revealed it to be a highly multidetermined behavior. Although apparently straightforward,
successful human sexual functioning rests on a complex interplay of endocrine, emotional,
cognitive and experiential factors, that precludes the simple enumeration of sexual episodes, or
orgasms as a meaningful form of measuring quality of sexual functioning.

The individual respondent is the basis for evaluation by the DSFI in part because it represents
the most parsimonious and straightforward unit to work with, and also because regardless of
context, quality of sexual functioning is ultimately appreciated by the individual. Current
sexual functioning is the conceptual continuum for the DSFI because it comes closest to the
central evaluative question in the clinical assessment of sexual disorder: “What is the current
level and nature of the patient’s sexual functioning.” By quantifying the principal dimensions of
the patient’s sexual experience in profile form, an insight is gained into both the nature and
magnitude of the individual’s sexual dysfunction.

The DSFI is comprised of 10 substantive dimensions that are judged to reflect the principal
components of sexual behavior. The conceptual basis for the DSFI was outlined by Derogatis in
1976, and several subsequent monographs have been published on the instrument (Derogatis,
1980; Derogatis & Melisaratos, 1979). Of the 10 subtests constituting the DSFI, two of them,
Psychological Symptoms and Affects are themselves complete, multidimensional tests. The
Brief Symptom Inventory (BSI) (Derogatis, 1993) and the Derogatis Affects Balance Scale (ABS)
(Derogatis, 1975; Derogatis & Rutigliano, 1996) provide measurement of psychological distress
and mood and affects, respectively.

Since its introduction in the mid-1970’s, the DSFI has been utilized as an outcome measure in
approximately 50 empirical studies of sexual functioning (see Bibliography). In most instances,
dimension or global score measures from the instrument have proven sufficiently sensitive to
discriminate differences in the groups under study. Discriminations have ranged from relatively
large effect sizes (e.g. comparisons of gender dysphoric patients with normal heterosexuals) to
much more demanding discriminations (e.g. sexual functioning in diabetic vs normal women,
inflatable vs non-inflatable prostheses in penile implant surgery).

DSFI Dimension & Global Score Descriptions

Information – Consists of a 26 item subtest in true-false format which measures the level
of accurate information possessed by the respondent concerning the physiology, anatomy and
other aspects of sexual functioning. A single information score is determined as the sum of the
number of correct responses.

Experiences – Is measured via a list of 24 sexual behaviors ranging from very
fundamental behaviors to various forms of sexual intercourse and oral-genital activities. The
respondent indicates which behaviors he/she has experience lifetime, and which experiences
have occurred during the past 60 days. The Experiences score is the sum of lifetime
experiences.

Drive – Is reflected in a composite summary measure of libidinal erotic interests
expressed in the 5 behavioral domains of sexual intercourse, masturbation, kissing and petting,
sexual fantasy and ideal frequency of intercourse. The respondent indicates the frequencies of
these behaviors during the current period. A single Drive score is developed by summing across
domains.

Attitudes – Based upon work showing liberal and conservative sexual attitudes to be
predictive of quality of sexual functioning, this subtlest is comprised of 30 items (15 liberal
items and 15 conservative items) represented on 5-point Likert scales. The respondent indicates
the degree to which he/she is in agreement with each item. Liberal, Conservative and Total
Attitude scores are generated.

Psychological Symptoms – Psychological distress is measures by the 53 items of the Brief
Symptom Inventory (BSI). Each symptom of the BSI is represented on a 5-point scale from “not
at all” (0) to “extremely” (4). Scores are summed across items to achieve a single Symptoms
score. The BSI may optionally be scored for the 9 dimensions (e.g. Depression, Anxiety) and
Global Scores that underlie the items of the BSI.

Affects – Is also a complete multidimensional test termed the Derogatis Affects Balance
Scale (DABS). The DABS measures affect and mood through 40 adjective items endorsed by
the respondent. Twenty items represent positive affects and 20 items reflect negative affects.
Scores include a Positive Affects Total, a Negative Affects Total and the overall Affects Balance
Index. The latter is used as the affects measure for the DSFI.

Gender Role Definition – Consistent with the concept that masculinity and femininity are
components of all individuals’ gender role definitions, the two primary components of gender
role are each measured in terms of 15 adjective items which the respondent endorses in varying
degrees. A Masculinity score, Femininity score and Gender Role Definition score are
determined.

Fantasy – This subtlest consists of 20 major sexual themes that have been culled from
research on normal sexual fantasies as well as fantasies arising from clinical variations on
routine sexual behaviors. The Fantasy score consists of a simple summation of the items
endorsed.

Body Image – Body image has been demonstrated to be an integral aspect of self-concept,
and as such, is an important determinant of successful sexual functioning. It is measured in the
DSFI in terms of 15 items, 10 common and 5 gender-keyed, that reflect the individual’s level of
appreciation of his/her body. A single Body Image score is developed.

Sexual Satisfaction – Is itself multidimensional in nature, being comprised of a number of
distinct components (e.g. frequency of intercourse, quality of communication, quality of orgasm,
etc.). Ten true-false items comprise the Satisfaction subtlest, each reflecting whether or not the
respondent is satisfied with that specific aspect of his/her sexual functioning. A single
Satisfaction score is calculated as a sum of endorsements indicating satisfaction with a particular
component.

SFI: The DSFI Total Score – The Sexual Functioning Index (SFI) is the Total or Global
Summary Score of the DSFI. It is calculated as a direct unweighted linear combination of the 10
subtest or principal dimension scores. Since subtlest scores are calculated along very different
score continua and some are gender-keyed (i.e., distinct for men and women), subtest scores are
first transformed to area T-scores (µ = 50; SD = 10) before being summed to achieve the SFI.
Since the transformation is a normalizing, area (under the curve) type, the actuarial
characteristics of the resulting standardized distribution are retained.

GSSI: The Global Sexual Satisfaction Index – The GSSI is the second global measure of
the DSFI, and quite different in nature from the SFI or DSFI total score. While the DSFI Total
Score reveals the respondent’s quality of sexual functioning in psychometric terms, the GSSI
reflects the individual’s subjective perception of his/her sexual behavior. The GSSI represents
quality of sexual functioning on a 9-point scale anchored at the lower extreme by (0), “could not
be worse” to (8), “could not be better” at the upper limit. Each scale point is characterized by a
descriptive phrase and the respondent is provided an opportunity to globally summarize his/her
perception of the quality of sexual behavior in straightforward terms.

Normative Population
Norms for the DSFI were developed based on a sample of 230 individuals in attendance at
university continuing education classes. The majority of the sample were white (80%) and
middle-aged, (X ? 32) with some college education. Approximately 60% of the sample were
married at the time of assessment, with the majority (75%) coming from middle class and
upper middle class background.

Instrument Type
Clinical/Research Self-Report Inventory

Languages Available
Arabic, Chinese, English, French, French Canadian, Indian, Korean, Norwegian, Spanish and
Turkish.

Item Format
The DSFI is composed of 254 items, arranged into 10 subtests. Formats vary from simple
endorsements of “yes” – “no”, to multiple point Likert scales.

Psychometrics
Published studies by both the author of the scale and numerous other investigators suggest the
DSFI is highly reliable and is a valid measure of the construct of sexual functioning. Derogatis
& Melisaratos (1979) report internal consistency reliability coefficients based on an N of 325
between .60 and .97, and test-retest coefficiencies across a 14-day interval ranging
predominantly from the high .70’s to the low .90’s. Howell, Reynolds, Thase, et al (1987) also
reported test-retest coefficients over a 14-day period and all coefficients were ? .70. Over four
dozen published studies currently exist using the DSFI as a measure of functional discrimination
and outcomes in a broad variety of medical treatment populations (see Bibliography). The
majority show the DSFI to be highly sensitive to naturally occurring and disease-induced
interference with sexual functioning, as well as positive treatment effects.

How to Obtain
The DSFI is distributed exclusively by Clinical Psychometric Research Inc., 1228 Wine Spring
Lane, Towson, MD 21204. Phone 1-800-245-0277; 1-410-321-6165; FAX 1-410-321-6341.

Copyright Owner
Leonard R. Derogatis, Ph.D.

Principal Citations

Derogatis, L.R. (1975). Derogatis Sexual Functioning Inventory (DSFI): Preliminary Scoring
Manual. Baltimore, MD. Clinical Psychometric Research.

Derogatis, L.R. & Mellisaratos, N. (1979). The DSFI: A Multidimensional Measure of Sexual
Functioning. J. of Sex & Marital Therapy, 5, 244-281.

Derogatis, L.R., Lopez, M.C. & Zinzeletta, E.M. (1988). Clinical Applications of the DSFI in the
Assessment of Sexual Dysfunctions. In R. Brown & E. Roberts (Eds.), Advances in the
Understanding and Treatment of Sexual Disorders, New York, PNA Publishing.

Conte, H.R. (1989). Development and Use of Self-Report Techniques for Assessing Sexual
Function: A Review and Critique. Archives of Sexual Behavior, 12, 555-576.

Derogatis, L.R., Schmidt, C.W., Fagan, P.J. & Wise, T.N. (1989). Subtypes of Anorgasmia Via
Mathematical Taxonomy. Psychosomatics, 30, 166-173.