Establishing dimensionality of sexual behaviours in patients with regional brain dysfunction

ABSTRACT

Objective: To develop a validated, caregiver-based measurement scale to assess sexual changes across several domains in a sample of 86 patients with penetrating traumatic brain injury (TBI) and 65 patients with neurodegeneration due to frontotemporal dementia and corticobasal syndrome.

Methods: A new measure, the Sexual Symptoms in Neurological Illness and Injury Questionnaire (SNIQ), was constructed. Dimensionality, monotonicity, item discrimination power, and scalability were evaluated using nonparametric Mokken item response theory (IRT) methodology.

Results: Three primary domains were established. The domains presented with sufficient reliability (rho .70 to .80), while meeting the Mokken IRT criteria of medium scalability. The domains were labeled ‘Prosocial sexual behaviour’ (H = .42), ‘Sexual interest’ (H = .50), and ‘Inappropriate sexual behaviour’ (H = .41). A fourth dimension emerged, ‘Detachment’ (H = .47), but with very few items.

Conclusions: Construct validity was established for groups of items pertaining to three unique aspects of sexuality. These findings support further use of the SNIQ in assessing and researching sexual behaviours in patients with dementia and brain injury.

KEYWORDS:

• Inhibition
• sexuality
• construct validity
• brain injury
• dementia

Acknowledgments

We thank the Vietnam War veterans and patients with neurodegenerative disorders who participated in the study. Further information on the Vietnam Head Injury Study can be obtained by contacting Jordan Grafman at [email protected]. We thank Sandi Bonifant for her work with the participants, and the National Naval Medical Center for use of their facilities. We thank Michael Tierney and all of the research coordinators who worked with the patients with neurodegenerative disease at NINDS.

Additional information

Funding

This work was supported by funding from the U.S. National Institute of Neurological Disorders and Stroke intramural research program and a project grant from the United States Army Medical Research and Material Command administered by the Henry M. Jackson Foundation (Vietnam Head Injury Study Phase III: a 30-year post-injury follow-up study, grant number DAMD17-01-1-0675). EDH is supported by NIH/NINDS grants R00NS060766 and R01NS076837 and the Irving Institute of Columbia University. The authors report no potential conflicts of interest.