Question | Response options | |
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Q1: I feel content with the way my present sex life is. | 1 = Strongly disagree 2 = Disagree a little 3 = Neither agree or disagree 4 = Agree a little 5 = Strongly agree |
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Q2: I often feel something is missing from my present sex life. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q3: I often feel I don’t have enough emotional closeness in my sex life. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q4: I feel content with how often I presently have sexual intimacy (kissing, intercourse, etc.) in my life. | 1 = Strongly disagree 2 = Disagree a little 3 = Neither agree or disagree 4 = Agree a little 5 = Strongly agree |
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Q5: I don’t have any important problems or concerns about sex (arousal, orgasm, frequency, compatibility, communication, etc.). | 1 = Strongly disagree 2 = Disagree a little 3 = Neither agree or disagree 4 = Agree a little 5 = Strongly agree |
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Q6: Overall, how satisfactory or unsatisfactory is your present sex life? | 5 = Completely satisfactory 4 = Very satisfactory 3 = Reasonable satisfactory 2 = Not very satisfactory 1 = Not at all satisfactory |
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Q7: My partner often gets defensive when I try discussing sex. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a litte 1 = Strongly agree |
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Q8: My partner and I do not discuss sex openly enough with each other, or do not discuss sex often enough. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q9: I usually feel completely comfortable discussing sex whenever my partner wants to. | 1 = Strongly disagree 2 = Disagree a little 3 = Neither agree or disagree 4 = Agree a little 5 = Strongly agree |
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Q10: My partner usually feels completely comfortable discussing sex whenever I want to. | 1 = Strongly disagree 2 = Disagree a little 3 = Neither agree or disagree 4 = Agree a little 5 = Strongly agree |
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Q11: I have no difficulty talking about my deepest feelings and emotions when my partner wants me to. | 1 = Strongly disagree 2 = Disagree a little 3 = Neither agree or disagree 4 = Agree a little 5 = Strongly agree |
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Q12: My partner has no difficulty talking about their deepest feelings and emotions when I want him to. | 1 = Strongly disagree 2 = Disagree a little 3 = Neither agree or disagree 4 = Agree a little 5 = Strongly agree |
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Q13: I often feel my partner isn’t sensitive or aware enough about my sexual likes and desires. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q14: I often feel that my partner and I are not sexually compatible enough. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q15: I often feel that my partner’s beliefs and attitudes about sex are too different from mine. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q16: I sometimes think my partner and I are mismatched in needs and desires concerning sexual intimacy. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q17: I sometimes feel that my partner and I might not be physically attracted to each other enough. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q18: I sometimes think my partner and I are mismatched in our sexual styles and preferences. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q19: I’m worried that my partner will become frustrated with my sexual difficulties. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q20: I’m worried that my sexual difficulties will adversely affect my relationship. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q21: I’m worried that my partner may have an affair because of my sexual difficulties. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q22: I’m worried that my partner is sexually unfulfilled. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q23: I’m worried that my partner views me as less of a woman because of my sexual difficulties. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q24: I feel like I’ve disappointed my partner by having sexual difficulties. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q25: My sexual difficulties are frustrating to me. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q26: My sexual difficulties make me feel sexually unfulfilled. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q27: I’m worried that my sexual difficulties might cause me to seek sexual fulfillment outside my relationship. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q28: I’m so distressed about my sexual difficulties that it affects the way I feel about myself. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q29: I’m so distressed about my sexual difficulties that it affects my own well-being. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
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Q30: My sexual difficulties annoy and anger me. | 5 = Strongly disagree 4 = Disagree a little 3 = Neither agree or disagree 2 = Agree a little 1 = Strongly agree |
Scoring System | ||
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Domain | Questions | Score range |
Contentment | 1,2,3,4,5,6 | 6–30 |
Communication | 7,8,9,10,11,12 | 6–30 |
Compatibility | 13,14,15,16,17,18 | 6–30 |
Concern—Relational | 19,20,21,22,23,24 | 6–30 |
Concern—Personal | 25,26,27,28,29,30 | 6–30 |
Individual domain scores are computed by adding the scores of the individual items that comprise the domain. Full Scale Score = (Contentment + Communication + Compatibility + (Relational Concern + Personal Concern/2)).