Sex Anxiety Inventory

1. Abstract

The Sex Anxiety Inventory (SAI), developed by Louis H. Janda and Kevin E. O’Grady in 1980, is a foundational psychometric instrument designed to evaluate generalized, dispositional sexual anxiety. Operating as a unidimensional self-report measure, the SAI addresses the cognitive, affective, and conditioned emotional responses individuals experience across an array of sexual contexts, ranging from solitary masturbation and erotic media consumption to intimacy initiation, partner communication, non-traditional behaviors, and sexual intercourse. The instrument comprises 25 forced-choice dyadic items, wherein each item pairs a non-anxious or sexually adaptive statement with an anxiety-keyed statement. Respondents are required to select the alternative that most accurately reflects their personal beliefs, feelings, or behavioral tendencies, yielding a total score between 0 and 25.

Extensive psychometric investigations have established the SAI as an empirically robust measurement tool within clinical sexology, relationship therapy, and social psychology. Internal consistency estimates across collegiate and clinical samples consistently demonstrate high reliability, with Cronbach’s alpha values regularly exceeding .85 and test-retest coefficients over multi-week intervals demonstrating strong temporal stability (typically ranging from .84 to .89). Construct validity is evidenced by significant convergent associations with related constructs such as sexual guilt (notably the Mosher Sex Guilt Inventory), erotophobia (Byrne’s Sexual Opinion Survey), generalized trait anxiety (Spielberger’s State-Trait Anxiety Inventory), and social evaluative fear. Conversely, the instrument exhibits discriminant validity against unrelated dimensions of psychopathology and general intelligence. Factor analytic evaluations reveal a dominant general factor reflecting subjective apprehension, somatic tension, and moralized distress surrounding sexual intimacy. This article provides a comprehensive academic analysis of the SAI’s development, theoretical architecture, dimensional psychometrics, clinical utility, and administration protocols.

2. Keywords

Sex Anxiety Inventory, sexual anxiety, erotophobia, psychometrics, sex guilt, sexual functioning, forced-choice format, Louis H. Janda, clinical sexology, sexual inhibition

3. Authors

The Sex Anxiety Inventory was conceptualized, operationalized, and validated by psychologists Louis H. Janda and Kevin E. O’Grady:

• Louis H. Janda, Ph.D.: Associate Professor Emeritus of Psychology at Old Dominion University in Norfolk, Virginia, United States. Dr. Janda has authored numerous peer-reviewed articles, psychological tests, and books focusing on clinical assessment, human sexuality, abnormal psychology, and personality dynamics. His scholarship pioneered empirical methodologies for measuring previously obscure affective reactions to sexual stimuli.
• Kevin E. O’Grady, Ph.D.: Professor Emeritus of Psychology at the University of Maryland, College Park, Maryland, United States. Dr. O’Grady is an authority in psychometrics, multivariate quantitative analysis, and behavioral research methodology. His collaborative work on the SAI provided rigorous structural equation modeling, exploratory factor analysis, and measurement validation frameworks.

Correspondence regarding the foundational validation studies of the SAI has historically been directed through the Department of Psychology at Old Dominion University and the academic literature published in the Journal of Consulting and Clinical Psychology.

4. Purpose

The primary purpose of the Sex Anxiety Inventory is to quantify the degree to which an individual experiences an conditioned, generalized emotional response of dread, nervousness, tension, or apprehension in reaction to sexual cues, behaviors, and interpersonal scenarios. In the mid-twentieth century, clinical sexology lacked psychometrically vetted, brief, and objective scales capable of capturing sexual apprehension independently of confounding variables such as moralistic guilt, generalized neuroticism, or physiological sexual dysfunction. Historically, affective distress surrounding sex was either conflated with moral-religious scruples (as measured by Mosher’s inventories) or viewed merely as a symptom of broad neurotic distress. Janda and O’Grady recognized the necessity for a targeted instrument capable of capturing the pure affective-anxious continuum of sexual functioning.

The SAI was constructed to fulfill multiple critical applications in empirical research and clinical practice:

• Clinical Diagnosis and Treatment Planning: In clinical settings, excessive sexual anxiety is a principal etiological agent in psychogenic sexual dysfunctions, including erectile dysfunction, premature ejaculation, vaginismus, dyspareunia, and hypoactive sexual desire disorder. Masters and Johnson famously characterized “spectatoring”—the hypervigilant self-monitoring of sexual performance—as an anxiety-fueled cognitive intrusion that disrupts autonomous physiological arousal. The SAI allows sex therapists and clinical psychologists to establish a baseline measure of sexual apprehension before initiating cognitive-behavioral interventions, systematic desensitization, or sensate focus exercises, and subsequently track treatment progression.
• Empirical Research on Interpersonal Dynamics and Relationship Quality: In social and personality psychology, the SAI serves as a metric to examine how individual differences in sexual fear influence mate selection, communication openness between partners, romantic satisfaction, and the trajectory of long-term intimacy. High scores on the SAI correlate with avoidance of sexual communication, resistance to initiating intimacy, and elevated marital distress.
• Sex Education and Public Health Initiatives: The inventory aids researchers in evaluating the efficacy of sexual health curricula, erotophobia-reduction workshops, and affirmative educational programs. By evaluating whether pedagogical interventions decrease irrational fears and increase comfort with sexual anatomy, contraception, and communication, the SAI acts as an outcome metric for institutional psychoeducational interventions.

By implementing a forced-choice format, the instrument intentionally forces respondents to weigh competing affective dispositions, thereby mitigating common self-report biases such as acquiescence bias and extreme response styles, which frequently distort traditional Likert ratings on sensitive themes.

5. Psychological Construct

The psychological construct assessed by the Sex Anxiety Inventory is dispositional sexual anxiety, conceptualized as a chronic, stable tendency to respond with negative affect, somatic tension, apprehension, and avoidance behaviors to sexual stimuli, anticipation of sexual encounters, and direct participation in erotic acts. Rather than reflecting an acute state of momentary nervousness, the SAI taps into a trait-like personality dimension that influences cognitive appraisal across multiple domains of human sexuality.

Although the SAI was designed to yield a unidimensional composite score representing overall sex anxiety, psychometric analysis and content mapping delineate five primary behavioral and psychological manifestations embedded within the construct:

5.1. Erotic Stimuli and Media Exposure

This component taps into emotional distress, visceral discomfort, and nervousness elicited by exposure to sexually explicit representations, off-color humor, and erotic literature or media (e.g., items reflecting buying pornographic material, viewing explicit films, or hearing dirty jokes). Individuals high in sexual anxiety appraise such stimuli as threatening, intrusive, or inherently shameful, triggering involuntary avoidance or acute cognitive dissonance.

5.2. Interpersonal and Initiatory Intimacy

This facet assesses the social-evaluative fears intrinsic to courting, flirting, dating, and initiating physical touch. Items capturing reactions to meeting attractive individuals, navigating mutual flirtation, and making overt sexual advances evaluate performance-related apprehension and fear of negative evaluation or rejection by a prospective or current partner.

5.3. Solitary and Private Sexual Behaviors

Sexual anxiety does not manifest solely in relational settings; it frequently contaminates intrapsychic and autoerotic processes. This dimension encompasses affective responses to masturbation, sexual daydreams, nocturnal emissions or sex dreams, and spontaneous sexual arousal. High-anxiety respondents experience guilt-adjacent worry, psychological discomfort, or somatic jitteriness immediately following autoerotic thoughts or masturbatory release, viewing their endogenous sexual drives as volatile or morally hazardous.

5.4. Physical and Genital Intimacy

The core physiological domain pertains to direct sensual and genital contact, including passionate kissing, petting, oral sex, and sexual intercourse. Highly anxious individuals report feeling tense, terrified, apprehensive, or “out of control” during these activities. This manifestation closely aligns with the classical conditioning models of phobic avoidance, wherein tactile stimulation and physiological arousal trigger sympathetic nervous system overdrive rather than parasympathetic relaxation and sexual excitation.

5.5. Non-Traditional, Unconventional, and Taboo Sexual Behaviors

This dimension gauges panic or intense apprehension surrounding behaviors outside strict normative boundaries, such as group sex, homosexual encounters, experimenting with alternative sexual positions, having intercourse with the lights illuminated, or contemplating extramarital relationships. While conservative socio-cultural attitudes may dictate cognitive disapproval of these actions, the SAI specifically measures the affective terror or dread that contemplating or engaging in them provokes.

6. Theoretical Framework

The conceptual scaffolding of the Sex Anxiety Inventory is rooted in the synthesis of classical and operant conditioning paradigms, social learning theory, and dual-control models of sexual response.

6.1. Behavioral and Conditioning Formulations

In accordance with behavioral learning theory (Pavlovian conditioning), sexual stimuli—originally neutral or naturally reinforcing—can acquire aversive properties through pairing with punishment, parental condemnation, religious castigation, or traumatic experiences during early psychosexual development. When an adolescent is repeatedly chastised or made to feel deeply ashamed for autoerotic exploration or sexual curiosity, unconditioned stimuli of familial anger and social rejection produce conditioned emotional responses of terror and apprehension. Consequently, subsequent erotic cues automatically evoke sympathetic nervous system arousal (e.g., tachycardia, muscle tension, autonomic arousal) interpreted subjectively as anxiety. Through operant conditioning (Skinnerian mechanisms), avoidance of sexual contexts is reinforced via negative reinforcement: escaping or refusing intimacy terminates the unpleasant state of conditioned sexual anxiety.

6.2. Cognitive-Affective Processing and Byrne’s Erotophobia-Erotophilia Framework

The theoretical conceptualization of the SAI heavily intersects with Donn Byrne’s construct of erotophobia-erotophilia. Byrne posited that individuals develop a learned disposition to respond to erotic cues along a continuous affective dimension ranging from negative affect and avoidance (erotophobia) to positive affect and approach (erotophilia). Janda and O’Grady’s work refined this paradigm by focusing explicitly on the anxiety-fear axis rather than broad evaluative affect. Anxious individuals exhibit automatic attentional biases toward perceived threats within the sexual arena. When faced with sexual intimacy, their cognitive apparatus initiates catastrophic appraisals (“I will fail,” “This is terrifying,” “I will lose control”), directly inhibiting the parasympathetic autonomic pathways necessary for sustained sexual arousal.

6.3. The Dual Control Model of Sexual Response

Modern sexological theory contextualizes the SAI within the Dual Control Model developed by John Bancroft and Erick Janssen. This neurobiological and psychological model asserts that sexual response depends upon a dynamic equilibrium between the Sexual Excitation System (SES) and the Sexual Inhibition System (SIS). Individuals scoring high on the Sex Anxiety Inventory exhibit heightened sensitivity within the Sexual Inhibition System, particularly SIS1 (inhibition due to performance failure threat) and SIS2 (inhibition due to consequences such as physical danger, social censure, or moral contamination). The SAI measures the cognitive-affective manifestations of a hyperactive sexual inhibition system, delineating individuals whose neurochemical and cognitive thresholds for sexual shutdown are activated at minimal levels of erotic stimulation.

7. Validity

The psychometric validity of the Sex Anxiety Inventory has been extensively established across multiple empirical investigations, encompassing construct, convergent, discriminant, and criterion-related methodologies.

7.1. Convergent Validity

During its initial validation, Janda and O’Grady (1980) administered the SAI alongside existing measures of personality, guilt, and anxiety. Convergent validity was robustly supported by strong, statistically significant correlations with the Mosher Sex Guilt Inventory (correlations generally ranging between r = .55 and r = .70 across diverse collegiate cohorts). While sex guilt and sex anxiety share substantial variance, subsequent structural modeling confirmed they represent distinct psychological phenomena: guilt predominantly reflects self-punitive, moral-evaluative transgressions of internalized standards, whereas anxiety reflects an immediate, somatic, and dread-based apprehension regarding prospective or ongoing sexual behaviors.

Significant positive associations have also been documented between the SAI and general measures of anxiety, such as the State-Trait Anxiety Inventory (STAI) (r values typically between .30 and .45) and the Taylor Manifest Anxiety Scale. Furthermore, when correlated with Byrne’s Sexual Opinion Survey (SOS), the SAI shows strong inverse relationships (r values ranging from -.60 to -.75), confirming that individuals with high sex anxiety are strongly erotophobic, displaying widespread aversion to sexual topics, behaviors, and materials.

7.2. Discriminant Validity

Discriminant validity has been demonstrated by showing negligible to weak correlations between the SAI and variables that should theoretically remain unrelated to sexual anxiety. The scale correlates minimally with non-evaluative cognitive intelligence, broad socio-economic indicators, and non-affective demographic variables. Although slightly correlated with general trait anxiety, the shared variance remains low enough (under 20%) to confirm that the SAI does not merely measure non-specific neuroticism or generalized negative affectivity, but instead captures an idiosyncratic, domain-specific psychological construct.

7.3. Criterion and Predictive Validity

Criterion-related validity is evidenced by the SAI’s power to predict real-world behavioral outcomes and clinical presentations:

• Behavioral Avoidance: In laboratory analog experiments, high scorers on the SAI demonstrate avoidance behaviors when presented with opportunities to interact with explicit visual materials or discuss sexual themes, displaying pronounced behavioral latency and autonomic agitation.
• Sexual History and Activity: Empirical studies consistently indicate that individuals with elevated SAI scores report significantly fewer lifetime sexual partners, delayed age of first intercourse, lower frequencies of solitary masturbation, and restricted repertoires of consensual sexual behaviors.
• Clinical Differentiation: The SAI reliably differentiates between clinical populations presenting with psychogenic sexual dysfunctions (e.g., lifelong vaginismus, performance-induced erectile dysfunction) and sexually functional control subjects. Clinical cohorts display SAI scores significantly higher (typically 1.5 to 2 standard deviations above the mean) than functional peers, confirming the instrument’s clinical diagnostic sensitivity.

8. Reliability

The Sex Anxiety Inventory exhibits solid psychometric reliability across diverse populations, manifesting robust internal consistency and temporal stability over extended intervals.

8.1. Internal Consistency

In the original normative sample of 170 undergraduate students (consisting of both male and female cohorts) analyzed by Janda and O’Grady (1980), the instrument demonstrated high internal consistency. The calculated Cronbach’s alpha coefficient for the total scale was .86 for males and .88 for females, reflecting a cohesive set of items measuring a common construct. Subsequent independent cross-validation studies published across subsequent decades (such as replications compiled in Fisher, Davis, Yarber, & Davis, 2010) have yielded comparable coefficients, consistently ranging from .84 to .90 across academic, clinical, and community-dwelling demographics.

8.2. Test-Retest Reliability

Because sexual anxiety is conceptualized as an enduring personality trait rather than a transient emotional state, the SAI must demonstrate temporal stability over time. In validation trials evaluating non-clinical cohorts across a 2-week to 4-week retest window, the test-retest correlation coefficient was calculated at r = .85 (p < .001). Longer-term assessments over a 3-month period under conditions devoid of psychotherapeutic intervention have sustained stability coefficients between .78 and .83, indicating that the forced-choice responses reflect stable cognitive-emotional traits rather than daily affective fluctuations.

8.3. Split-Half Reliability and Standard Error of Measurement

Split-half reliability coefficients, corrected via the Spearman-Brown prophecy formula, consistently range from .83 to .87. The standard error of measurement (SEM) associated with the SAI is approximately 1.8 to 2.1 points on its 25-point scale. This relatively narrow SEM provides clinicians with confidence that an observed score reflects the respondent’s true score within a narrow confidence band, enabling reliable detection of clinically meaningful change following therapy.

9. Factor Analysis

The internal structural validity of the Sex Anxiety Inventory was investigated through rigorous exploratory and confirmatory factor analytic procedures during its development and in independent post-hoc psychometric reviews.

9.1. Exploratory Factor Analysis (EFA)

Janda and O’Grady (1980) conducted an exploratory factor analysis utilizing principal axis factoring and principal component analysis with both orthogonal (Varimax) and oblique rotations. The scree test and eigenvalue inspection (> 1.0 criterion) revealed a dominant first factor that accounted for the vast majority of common variance (over 30% of total variance in the unrotated solution). This large first factor demonstrated high loadings (> .45 to .75) across virtually all 25 items, supporting the authors’ theoretical decision to retain the SAI as an essentially unidimensional scale.

9.2. Secondary Factor Solutions

When multiple factors were rotated to inspect nuanced sub-dimensions, a multi-factor structure emerged that grouped items along distinct operational contexts:

• Factor 1: Direct Physical and Genital Contact: Heavy loadings from items evaluating oral sex (Item 4), petting (Item 7), sexual intercourse (Item 19), and undressing before a partner (Item 15).
• Factor 2: Taboo and Non-Normative Sexual Behaviors: Characterized by strong loadings on items involving group sex (Item 12), extramarital sex (Items 2 and 21), homosexual experiences (Item 17), and explicit pornography (Items 1 and 14).
• Factor 3: Initiatory and Social Interpersonal Assertiveness: Marked by high loadings on initiating sexual relationships (Item 3), meeting an attractive person (Item 5), flirting (Item 11/Item 25 variants), and telling/hearing jokes (Items 13 and 20).
• Factor 4: Autonomic and Intrapsychic Reactions: Items capturing the visceral, post-arousal emotional state, such as feeling jittery after sexual thoughts (Item 8), masturbatory worry (Item 9), and feeling out of control during arousal (Item 24).

Despite the presence of these clinically informative sub-clusters, the strong inter-factor correlations (typically ranging from r = .42 to .68) strongly support retaining the single composite score for standard clinical and psychometric assessment.

9.3. Confirmatory Factor Analysis (CFA) and Measurement Invariance

Subsequent confirmatory factor analyses of the forced-choice structure using item response theory (IRT) and structural equation modeling (SEM) for categorical indicators have supported a bifactor model or a hierarchical higher-order structure, where a single overarching general factor of Sex Anxiety accounts for the primary variance across items, alongside minor context-specific method factors. Fit indices for a dominant unidimensional model (adjusted for categorical data) consistently show adequate to strong model fit, with the Comparative Fit Index (CFI) exceeding .90 and the Root Mean Square Error of Approximation (RMSEA) remaining within acceptable ranges (< .06 to .08). Tests for gender invariance reveal that the items function largely equivalently across male and female respondents, although mean base scores differ between genders.

10. Instrument / Measurement Tool

• Full Test Name: Sex Anxiety Inventory (SAI)
• Authors: Louis H. Janda, Ph.D., and Kevin E. O’Grady, Ph.D.
• Publication Date: 1980
• Construct Assessed: Dispositional, generalized sexual anxiety (conditioned negative affect and apprehension in response to sexual stimuli)
• Test Type: Self-report psychological scale, individual or group administration
• Format: Paper-and-pencil or computerized forced-choice questionnaire
• Number of Items: 25 forced-choice item dyads
• Response Scale: Forced-choice format (choose statement a or b for each pair)
• Target Population: Adolescents (typically 16+ with parental consent) and adults
• Administration Time: Approximately 5 to 10 minutes
• Scoring Rules:
  • One point (1) is scored for each anxiety-keyed response selected by the respondent.
  • Zero points (0) are assigned for selecting the non-anxious alternative.
  • Total scores range from 0 to 25.
  • Higher scores directly reflect greater dispositional sex anxiety.
  • The keyed anxiety responses correspond to the specific options identified with an asterisk (*) in the validation study: Item 1 (b), Item 2 (b), Item 3 (a), Item 4 (b), Item 5 (b), Item 6 (b), Item 7 (a), Item 8 (b), Item 9 (a), Item 10 (a), Item 11 (a), Item 12 (b), Item 13 (a), Item 14 (a), Item 15 (b), Item 16 (b), Item 17 (b), Item 18 (a), Item 19 (a), Item 20 (a), Item 21 (a), Item 22 (b), Item 23 (a), Item 24 (b), Item 25 (b).
• Normative Reference Ranges (General Interpretive Guidance):
  • 0 – 5: Minimal to very low sex anxiety (erotophilic, high comfort with sexual behaviors and concepts)
  • 6 – 11: Mild or average sex anxiety (typical within broader non-clinical community cohorts)
  • 12 – 17: Moderate sex anxiety (elevated apprehension; may contribute to periodic sexual reticence or mild dysfunction)
  • 18 – 25: High to severe sex anxiety (pronounced erotophobia; clinically significant distress, high risk for psychogenic sexual avoidance or dysfunction)

11. Permissions & Fee and Test Year

The Sex Anxiety Inventory was originally published in 1980 in the Journal of Consulting and Clinical Psychology, a journal owned and published by the American Psychological Association (APA). The full scale and its psychometric background were subsequently reprinted and documented in landmark compendia, notably the Handbook of Sexuality-Related Measures (Fisher, Davis, Yarber, & Davis, 1988, 2010, 2019; Routledge/Taylor & Francis).

In accordance with established academic conventions, the scale items and scoring directions were placed in the public scientific domain for non-commercial, scholarly, educational, and clinical research use. Qualified researchers, sexologists, psychologists, and clinicians may utilize the instrument without payment of royalties, provided that proper bibliographic citation is given to Janda and O’Grady (1980) and relevant copyright holders (such as the American Psychological Association where applicable). Commercial reproduction, incorporation into for-profit software packages, or wide-scale commercial redistribution requires formal written permissions from the copyright holders and original authors.

12. References

• Bancroft, J., & Janssen, E. (2000). The dual control model of male sexual response: A theoretical approach to centrally mediated erectile dysfunction. Neuroscience & Biobehavioral Reviews, 24(5), 571–579. https://doi.org/10.1016/S0149-7634(00)00024-5
• Byrne, D. (1977). The imagery of sex. In J. Money & H. Musaph (Eds.), Handbook of Sexology (pp. 327–350). Excerpta Medica.
• Fisher, T. D., Davis, C. M., Yarber, W. L., & Davis, S. L. (Eds.). (2010). Handbook of Sexuality-Related Measures (3rd ed.). Routledge. https://doi.org/10.4324/9780203844335
• Janda, L. H., & O’Grady, K. E. (1980). Development of a Sex Anxiety Inventory. Journal of Consulting and Clinical Psychology, 48(2), 169–175. https://doi.org/10.1037/0022-006X.48.2.169
• Masters, W. H., & Johnson, V. E. (1970). Human Sexual Inadequacy. Little, Brown and Company.
• Mosher, D. L. (1966). The development and multitrait-multimethod matrix analysis of three measures of three aspects of guilt. Journal of Consulting Psychology, 30(1), 25–29. https://doi.org/10.1037/h0023071
• Mosher, D. L. (1968). Measurement of guilt on the basis of a personality theory. Journal of Consulting and Clinical Psychology, 32(5), 585–595. https://doi.org/10.1037/h0026362
• Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press.

13. Items of the Scale