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The New Sexual Satisfaction Scale and its short form

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Handbook of
Sexuality-Related
Measures
Fourth Edition

Edited by

Robin R. Milhausen, John K. Sakaluk, Terri D. Fisher,

Clive M. Davis, and William L. Yarber
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Fourth edition published 2020

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Professor Aleksandar Stulhofer - University of Zagreb
21 Pleasure, Satisfaction, and Orgasm
The New Sexual Satisfaction Scale and Its
Short Form
Pamela Brouillard, Texas A&M University-Corpus Christi
Aleksandar Štulhofer,1 University of Zagreb
Vesna Buško, University of Zagreb
The New Sexual Satisfaction Scale (NSSS; k = 20) and
its short form (NSSS-S; k = 12) are multi-dimensional
self-report scales designed to measure sexual satisfaction
in both clinical and non-clinical samples. The conceptual
framework of the NSSS derives from the sexuality coun-
seling and psychotherapy literature, focuses on multiple
aspects of sexual satisfaction, and is gender, sexual orien-
tation and relationship status neutral (Štulhofer, Buško, &
Brouillard, 2010, 2011).
Development
Initial bicultural construction and validation of the NSSS
were carried out in Croatia and the United States using
seven independent samples with over 2,000 participants
aged 18–55 years.
Principal components analysis was carried out on an ini-
tial pool of 35 Likert-type items generated by the proposed
five-dimensional conceptual framework. Oblimin method
extraction and rotation suggested a forced two-factor solu-
tion which proved stable across the samples. Using both
statistical and content-related characteristics, 20 items
were retained from the initial set creating two 10-item sub-
scales: The Ego-Centered subscale and the Partner/Sexual
Activity-Centered subscale. The short version or NSSS-S
was subsequently developed in order to facilitate the use of
the NSSS in clinical and non-clinical studies and demon-
strates reliability and validity comparable to the full scale
instrument (Štulhofer et al., 2011).
The NSSS-S was recently validated in Spanish (Strizzi,
Fernández-Agis, Alarcón-Rodriguez, & Parrón-Carreño,
2016), Portuguese (Pechorro, Pascoal, Neves, Almeida, &
Vieira, 2016), and German samples (Hoy, Strauß, Kröger,
& Brenk-Franz, 2019). For a Portuguese validation of the
1
Address correspondence to: astulhof@ffzg.hr
495
full NSSS, see Pechorro et al. (2015). Both translated meas-
ures were found to have sound psychometric properties and
yielded a two-factor solution—also reported in an online
study carried out in the USA (N = 425; Mark, Herbenick,
Fortenberry, Sanders, & Reece, 2014).
Response Mode and Timing
For each item, respondents are asked to rate their level of
satisfaction with their sex life in the preceding 6 months
using the following 5-point Likert type scale: 1 (not at all
satisfied), 2 (a little satisfied), 3 (moderately satisfied), 4
(very satisfied), 5 (extremely satisfied).
Scoring
The Ego-Centered subscale (Items 1–10), Partner and
Activity-Centered subscale (Items 11–20), NSSS (Items
1–20), and NSSS-S (Items 2–3, 5–6, 8, 10–12, 14, 17, 19–20)
are computed by summing the related items, with higher
scores representing higher levels of sexual satisfaction.
Reliability
Internal consistency in bicultural student and community
samples, and a sample of Croatian non-heterosexual men
and women was high for the full scale (Cronbach’s α =
.94–.96), its two subscales (α = .91–.93 and α = .90–.94,
respectively), and the short version (α = .90–.93; Štulhofer
et  al., 2010, 2011). No substantial gender-specific or
sexual orientation-specific differences were observed. In
the Spanish sample, internal consistency of the NSSS-S
was satisfactory both for the overall scale (α = .92) and its
subscales (α = .88 and .87). Similar findings were reported
in the Portuguese validation study (Pechorro et al., 2016),
 Review Copy – Not for Redistribution - 26/06/2019
Professor Aleksandar Stulhofer - University of Zagreb
496 Handbook of Sexuality-Related Measures
in which Cronbach’s alpha was .94 for the scale and .92
and .89 for its subscales, and in the Mark et al. (2014) study
(α = .91 for the full scale).
Test–retest reliability of the NSSS and NSSS-S was
shown to be satisfactory in a sample of Croatian stu-
dents (N = 219) over a one-month period, with somewhat
stronger associations reported among women (Štulhofer
et al., 2010). A comparable value (.81) was reported in the
Mark et al. (2014) study, in which test–retest reliability of
the NSSS-S was assessed after two months.
Validity
In support of convergent validity, associations between a
global (single-item) measure of sexual satisfaction and the
NSSS/NSSS-S scores were significant and strong in the ini-
tial studies (Štulhofer et al., 2010, 2011), the Portuguese study
(Pechorro et al., 2015), and the Mark et al. (2014) study.
The NSSS and NSSS-S were shown to be significantly
positively associated with a general measure of life satis-
faction (Štulhofer et al., 2010, 2011). Significant negative
correlations with the shortened Sexual Boredom Scale
scores (Watt & Ewing, 1996) and positive correlations
with relationship intimacy, partner communication about
sex, and relationship status were also found among both
Croatian and the U.S. male and female college students. In
addition, the NSSS-S was moderately correlated with the
General Measure of Relationship Satisfaction (Mark et al.,
2014). Portuguese versions of the NSSS and NSSS-S were
significantly correlated with sexual sensation seeking and
(negatively) with sexual boredom (Pechorro et al., 2015,
2016). A study focusing on avoidant and anxious attach-
ment styles and sexual satisfaction reported a significant
negative relationship between insecure attachment and the
NSSS scores (Khoury & Findlay, 2014).
Significant differences were found in the average NSSS
and NSSS-S scores between participants in a clinical sam-
ple of individuals undergoing sex therapy (N = 54; Mean
age = 34.6) and a large non-clinical community sample of
comparable age (Štulhofer et al., 2010, 2011). Participants
with sexual difficulties systematically reported lower
Exhibit
The New Sexual Satisfaction Scale
Thinking about your sex life during the last six months please rather your satisfaction with the follow aspects:
  1. The intensity of my sexual arousal.
  2. The quality of my orgasms.
  3. My “letting go” and surrender to sexual pleasure during sex.
  4. My focus/concentration during sexual activity.
  5. The way I sexually react to my partner.
  6. My body’s sexual functioning.
sexual satisfaction (Cohen’s d values ranged from –1.07
to –1.39). Discriminant analyses with the NSSS and
NSSS-S as independent variables—carried out to predict
membership in the clinical vs. nonclinical community
sample—correctly classified 80.3 percent and 79.6 per-
cent of cases, respectively.
References
Hoy, M., Strauß, B., Kröger, C., & Brenk-Franz, K. (2019). Überprüfung
der deutschen Kurzversion der „New Sexual Satisfaction Scale“
(NSSS-SD) in einer repräsentativen Stichprobe. Psychotherapie
Psychosomatik Medizinische Psychologie, 69, 129–135. https://doi.
org/10.1055/a-0620-0002
Khoury, C. B., & Findlay, B. M. (2014). What makes for good sex?
The associations among attachment style, inhibited communication
and sexual satisfaction. Journal of Relationships Research, 5, 1–11.
https://doi.org/10.1017/jrr2014.7
Mark, K., Herbenick, D., Fortenberry, J. D., Sanders, S., & Reece, M.
(2014). A psychometric comparison of three scales and a single-item
measure to assess sexual satisfaction. Journal of Sex Research, 51,
159–169. https://doi.org/10.1080/00224499.2013.816261.
Pechorro, P. S., Almeida, A. I., Figueiredo, C. S., Pascoal, P. M., Vieira,
R. X., & Neves, S. J. (2015). Validação portuguesa da Nova Escala de
Satisfação Sexual. Revista Internacional de Andrología: Salud Sexual y
Reproductiva, 13, 47–53. https://doi.org/10.1016/j.androl.2014.10.003
Pechorro, P. S., Pascoal, P. M., Neves, S. J., Almeida, A. I., & Vieira, R. X.
(2016). Propriedades psicométricas da versão portuguesa da Nova
Escala de Satisfação Sexual – versão curta. Revista Internacional de
Andrología: Salud Sexual y Reproductiva, 14, 94–100. https://doi.
org/10.1016/j.androl.2016.04.006
Strizzi, J., Fernández-Agis, I., Alarcón-Rodriguez, R., & Parrón-Carreño,
T. (2016). Adaptation of the New Sexual Satisfaction Scale-Short
Form into Spanish. Journal of Sex & Marital Behavior, 42, 579–588.
https://doi.org/10.1080/0092623X.2015.1113580
Štulhofer, A., Buško, V., & Brouillard, P. (2010). Development
and bicultural validation of the New Sexual Satisfaction Scale.
Journal of Sex Research, 47, 257–268. https://doi.org/10.1080/
00224490903100561
Štulhofer, A., Buško, V., & Brouillard, P. (2011). The New Sexual
Satisfaction Scale and its short form. In T. D. Fisher, C.M. Davis,
W.L. Yarber, & S. L. Davis (Eds.), Handbook of sexuality-related
measures (pp. 530–532). Thousand Oaks, CA: Sage.
Watt, J. D., & Ewing, J. E. (1996). Toward the development and valida-
tion of a measure of sexual boredom. Journal of Sex Research, 33,
57–66. https://doi.org/10.1080/00224499609551815
1 2 3 4 5
Not at all A Little Moderately Very Extremely
Satisfied Satisfied Satisfied Satisfied Satisfied
    
    
    
    
    
    
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Professor Aleksandar Stulhofer - University of Zagreb
Pleasure, Satisfaction, and Orgasm 497

  7. My emotional opening up in sex.     

  8. My mood after sexual activity.     
  9. The frequency of my orgasms.     
10. The pleasure I provide to my partner.     
11. The balance between what I give and receive in sex.     
12. My partner’s emotional opening up during sex.     
13. My partner’s initiation of sexual activity.     
14. My partner’s ability to orgasm.     
15. My partner’s surrender to sexual pleasure (“letting go”).     
16. The way my partner takes care of my sexual needs.     
17. My partner’s sexual creativity.     
18. My partner’s sexual availability.     
19. The variety of my sexual activities.     
20. The frequency of my sexual activity.     

Interpersonal Exchange Model of Sexual Satisfaction

Questionnaire
Kelli-An Lawrance, Brock University
E. Sandra Byers,2 University of New Brunswick
Jacqueline N. Cohen, Nova Scotia Health Authority

The Interpersonal Exchange Model of Sexual Satisfaction
(IEMSS) Questionnaire assesses the components of
the IEMSS, a conceptual framework for understanding
sexual satisfaction within relationships. It addresses a
number of methodological limitations associated with
previous research on sexual satisfaction, namely use of
single-item measures with unknown reliability and valid-
ity, inclusion in multi-item scales of items that are used as
predictors of sexual satisfaction (e.g., sexual frequency),
and failure to validate measures for sexual-minority
individuals.
The IEMSS Questionnaire comprises three self-report
measures which assess the components of the model:
the Global Measure of Sexual Satisfaction (GMSEX), the
Global Measure of Relationship Satisfaction (GMREL),
and the Exchanges Questionnaire. The questionnaire also
includes a checklist of sexual rewards and costs (Rewards/
Costs Checklist; RCC). These components can be admin-
istered together or individually.
Development
Theory development preceded development of the IEMSS
Questionnaire. In keeping with definitions of subjective
well-being generally (Byers & Rehman, 2014), Lawrance
and Byers’s (1992, 1995) developed a conceptual definition
of sexual satisfaction that takes both affective and cogni-
tive factors into account. Specifically, they defined sexual
satisfaction as an affective response arising from one’s
subjective evaluation of the positive and negative dimen-
sions associated with one’s sexual relationship (Lawrance
& Byers, 1995, p. 268). In addition, they extended Social
Exchange Theory (Byers, & Wang, 2004) to sexual satis-
faction and developed the Interpersonal Model of Sexual
Satisfaction. The IEMSS proposes that sexual satisfac-
tion is influenced by (a) the balance of sexual rewards and
sexual costs in the relationship, (b) how these rewards and
costs compare to the expected levels of rewards and costs,
(c) the perceived equality of rewards and costs between
partners, and (d) the nonsexual aspects of the relationship
(Lawrance & Byers, 1995). Sexual rewards are exchanges
that people experience as pleasurable and gratifying; sexual
costs are exchanges that demand effort or cause pain, anxi-
ety, or other negative affect. Because sexual satisfaction
is a function of the history of sexual exchanges, repeated
assessments of these components provides a better indica-
tion of sexual satisfaction than does a single assessment
(Byers & MacNeil, 2006; Lawrance & Byers 1995).

2
Address correspondence to: byers@unb.ca

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