Sexual Modes Questionnaire: Measure
Assess the Interaction AmongCognitions, Emotions, and Sexual Response
Pedro J. Nobre
Universidade de Trás-os-Montes e Alto Douro, Miranda do Douro, Portugal
Universidade de Coimbra, Portugal
The goal of the present article is to present a new measure developed to assess cognitive and emotional factors of sexu-al function. This instrument was developed especially to test some hypotheses derived from Beck's new theoretical concep-tualization (the modes theory; A. T. Beck, 1996). This model, characterized by its systemic and integrated approach, consti-tutes a remarkable development from a linear to a network perspective of the cognitive-emotional-behavioral processes. Thenew concept of mode, as a composite of schemas (cognitive, emotional, and behavioral) interacting together, is theoretical-ly sound and supported by recent research findings from clinical and experimental sets (see A. T. Beck,
for a revision).Our aim is to develop a new measure specifically created to assess these integrated and interdependent processes in the fieldof sexuality. The Sexual Modes Questionnaire (SMQ; male and female versions) is a combined measure constituted by threeinterdependent subscales: automatic thoughts, emotions, and sexual response presented during sexual activity. Psychometricstudies showed good reliability and validity results in both versions, and high correlations between several dimensions ofthe three subscales support the concept of mode and its interactional
Moreover, the capacity showed by the SMQto discriminate between sexually functional and dysfunctional subjects and its high correlations with measures of sexualfunctioning emphasize the role of cognitive-emotional processes on sexual problems, supporting the clinical value of themeasure.
Recently, a growing body of research on the role of cog-nitions and emotions in sexual response has emerged. Infact, since Barlow's formulation on cognitive-affectivefactors of sexual dysfunction (Barlow, 1986; Cranston-Cuebas & Barlow, 1990; Sbrocco & Barlow, 1996), sever-al laboratory and clinical studies were conducted to analyzethe role of some cognitive and emotional dimensions in thesexual health field. Cognitive distraction (J. G. Beck,Barlow, Sakheim, & Abrahamson, 1987; Dove &Wiederman, 2000; Elliot & O'Donohue, 1997; Farkas,Sine,& Evans, 1979; Geer & Fuhr, 1976; Przybyla &Byrne, 1984), efficacy expectancies (Bach, Brown, &Barlow, 1999; Creti & Libman, 1989; Palace, 1995), causalattributions (Fichten, Spector, & Libman, 1988; Weisberg,Brown, Wincze, & Barlow, 2001), and perfectionism
This research was partially supported by a grant from PRODEP. The authorswould like to thank to Allen Gomes, M.D., Hospitals da Universidade deCoimbra, Portugal, for making possible the collection of the clinical sample andalso for his comments and suggestions. Thanks also to D. Rijo, M.A., C.Salvador, M.A., M. Lima, Ph.D., Faculdade de Psicologia, Universidade deCoimbra, Portugal; A. Gomes, M.A., L. Fonseca, M.A., A. Carvalheira, M.A., J.Teixeira, M.D., G. Santos, M.D., J. Quartilho, M.D., Ph.D., P. Abrantes, M.D.,and A. Canhao, M.D., Hospitais da Universidade de Coimbra, for their sugges-tions and help in sample collection. H. Ramsawh, M.A., L. Scepkowski, M.A.,and M. Santos, B.A., Center for Anxiety and Related Disorders, BostonUniversity, for reviewing the English version of the measures. John Wincze,Ph.D., Brown University and Center for Anxiety and Related Disorders, BostonUniversity, for his review and suggestions on a previous version of the paper.Thanks also to participants who volunteered to participate in the study.Address correspondence to Pedro Nobre, Rua Amorim de Carvalho, 97,4460SENHORA DA HORA, PORTUGAL; e-mail: firstname.lastname@example.org.
(DiBartolo & Barlow, 1996) are among the most studiedcognitive dimensions in sexual functioning. In general,results from these studies support the main role performedby cognitive factors in sexual dysfunction processes.For the present discussion cognitive distraction studiesassume a central role. Research with both male andfemale samples suggests that distraction from sexual cuesduring sexual activity decreases subjective and physio-logical arousal in both males and females (J. G. Beck etal., 1987; Dove & Wiederman, 2000; Elliot &O'Donohue, 1997; Farkas et al., 1979; Geer & Fuhr,1976;Przybyla & Byrne, 1984). These psychophysiolog-ical studies support several clinical suggestions that dys-functional subjects, when in sexual situations, focus theirattention on negative thoughts rather than on sexuallyerotic thoughts. In males, these thoughts are mostly relat-ed to performance concerns (erection concerns), antici-pating failure and its consequences (Hawton, 1985;Wincze & Barlow, 1997; Zilbergeld, 1999), whereasfemales orient their attention to self-body-image con-cerns, sexual performance concerns, and failure thoughts(Dove & Wiederman, 2000; Hawton, 1985). Despite theselaboratory findings and clinical suggestions, there is stilla lack of naturalistic empirical studies investigating thecognitive content of sexually dysfunctional males andfemales during sexual activity. With the exception of theDove and Weiderman study (2000), which indicates anegative impact of distraction thoughts (sexual perfor-mance and bodily appearance) on female sexual function-ing, there is no published data about cognitive content
The Journal of
Volume 40, Number 4, November 2003: pp. 368-382368