Sex Anxiety Inventory (Revised)

Abstract

The Sex Anxiety Inventory (Revised) (SAI-R) is a standardized psychometric self-report instrument designed to quantify dispositional sexual anxiety—conceptualized as the generalized tendency to experience apprehension, autonomic arousal, fear, or subjective distress in response to sexual cues, thoughts, interpersonal encounters, and explicit sexual behaviors. Originally developed by Louis H. Janda and Kevin E. O’Grady (1980) as a 29-item forced-choice instrument and subsequently refined in clinical and cross-cultural research into a streamlined 25-item revised format, the instrument differentiates sex anxiety from sex guilt and generalized neuroticism. The scale operationalizes sexual anxiety across three salient behavioral and psychological domains: private sexual cognitions, emotions, and solitary behaviors; extramarital, non-normative, or casual sexual encounters; and sexual communication or behaviors occurring within social and interpersonal contexts. The SAI-R employs a forced-choice paired-comparison format, wherein each item pairs an anxiety-endorsing statement with a non-anxiety or sexually accepting statement, minimizing standard acquiescence and extreme response biases. Psychometric evaluations across diverse university, community, and clinical cohorts have demonstrated robust internal consistency (Cronbach’s α and Kuder-Richardson Formula 20 coefficients typically ranging between .84 and .91) and stable test-retest reliability across multiple-week intervals (r = .84 to .88). Construct validity is established via strong positive correlations with related constructs such as sex guilt, negative sexual self-schemas, and sexual dysfunction, alongside meaningful negative associations with sexual satisfaction, sexual esteem, and erotophilia. The SAI-R remains a pivotal measurement tool in clinical sexology, sex therapy diagnostics, and empirical investigations examining the psychological correlates of sexual avoidance, psychosexual development, and sociocultural taboos.

Keywords

Sex Anxiety Inventory, SAI-R, sexual anxiety, psychometrics, sex guilt, sexual dysfunction, forced-choice scale, sexual attitudes, erotophobia, Louis H. Janda

Authors

The original theoretical architecture and psychometric validation of the Sex Anxiety Inventory were established by Louis H. Janda, Ph.D., and Kevin E. O’Grady, Ph.D., affiliated with the Department of Psychology at Old Dominion University, Norfolk, Virginia, and the University of Maryland, College Park, respectively. Dr. Janda is a widely recognized personality psychologist and psychometrician known for his empirical work on psychological testing, human sexuality, and subjective affective states. Dr. O’Grady is an accomplished quantitative methodologist and researcher in clinical psychology and behavioral measurement.

Subsequent psychometric adaptations, factorial refinements, and cross-cultural examinations of the revised variants—including the 25-item structure operationalizing sex anxiety across distinct affective, casual, and social facets—have been expanded by contemporary behavioral researchers, notably including clinical and cross-cultural investigations by Sobia F. Ali-Faisal, Ph.D. (University of Windsor), and related psychometric explorations by Janda and colleagues evaluating affective constructs across changing sociocultural landscapes.

Purpose

The primary purpose of the Sex Anxiety Inventory (Revised) is to provide an objective, reliable, and psychometrically rigorous measurement of dispositional sexual anxiety. In clinical and sexological literature, sexual difficulties frequently emerge from conditioned emotional distress rather than physiological pathology. The SAI-R serves as both a diagnostic adjunct and an empirical research instrument designed to measure individual differences in the propensity to experience anxiety, tension, or panic across diverse sexual situations, ranging from solitary sexual fantasies and masturbation to partnered foreplay, sexual initiation, and unconventional sexual practices.

From an applied clinical perspective, the SAI-R provides sex therapists, clinical psychologists, and marital counselors with granular insight into the specific triggers that maintain sexual inhibition, sexual aversion disorder, genito-pelvic pain/penetration disorder, and hypoactive sexual desire. By identifying whether an individual’s anxiety is anchored primarily within private self-evaluations (e.g., guilt regarding masturbation or intrusive erotic dreams), interpersonal situations (e.g., fears of initiating physical contact, discussing sexual preferences, or bodily self-consciousness), or unconventional sexual themes, clinicians can formulate highly individualized cognitive-behavioral exposure hierarchies, cognitive restructuring protocols, and systematic desensitization programs.

In empirical research, the SAI-R has been extensively utilized to investigate the etiology and sequelae of erotophobia-erotophilia. It enables investigators to assess how conservative religious socialization, sex education deficits, sexual trauma, and sociocultural taboos interact to generate inhibitory affective states. Furthermore, the tool provides a standardized methodology for testing cognitive-affective models of human sexual response, evaluating outcomes in clinical trials for psychosexual dysfunction, and examining cross-cultural disparities in sexual attitudes and behaviors.

Psychological Construct

The core construct assessed by the Sex Anxiety Inventory (Revised) is sexual anxiety, defined as a learned, dispositional affective and cognitive state characterized by subjective feelings of tension, apprehension, nervousness, and fear, accompanied by heightened autonomic nervous system arousal in response to sexual stimuli or anticipation of sexual involvement. Critically, sexual anxiety is conceptually distinct from sex guilt. Whereas sex guilt (as measured by instruments such as the Mosher Sex-Guilt Scale) reflects a moralized, self-punitive emotional response rooted in internalized ethical or religious transgressions, sexual anxiety reflects an emotional response characterized by apprehension, vulnerability, physical tension, and perceived threat.

The revised 25-item operationalization evaluates this psychological construct across three interrelated yet distinct sub-dimensions:

1. Private Sexual Behaviors, Cognitions, and Emotions

This dimension captures the affective reactions individuals experience toward their own endogenous sexual thoughts, solitary erotic activities, and physiological responses. Individuals scoring high on this dimension report autonomic jitteriness, fear, and discomfort following sexual fantasies, nocturnal sex dreams, masturbation, or spontaneous physiological arousal. Rather than experiencing arousal as intrinsically pleasurable, high-anxiety individuals process internal erotic states as alarming, unpredictable, or psychologically threatening.

2. Extramarital, Casual, or Non-Normative Sexual Scenarios

This sub-dimension addresses cognitive and emotional appraisal toward sexual contexts that exist outside rigid, traditional, or monogamous interpersonal frameworks. It explores emotional reactions toward casual sexual encounters, extramarital relations, group sexual practices, and non-conventional erotic expressions. Appraisals within this domain tap into fears of catastrophic consequences, loss of emotional control, social exposure, and profound psychological aversion when confronted with unconventional sexual practices.

3. Sexual Behaviors and Communication in Social and Interpersonal Situations

The third dimension evaluates performance anxiety, interpersonal assertiveness, and communication within dyadic or social environments. It assesses the subjective distress experienced when flirting, telling or hearing sexual humor, initiating physical intimacy, being naked before a partner, or openly articulating sexual desires and boundaries. High scores reflect pronounced performance apprehension, fears of negative evaluation, bodily self-consciousness, and behavioral inhibition during dyadic interactions.

Theoretical Framework

The theoretical architecture of the Sex Anxiety Inventory is grounded in classical conditioning, social learning theory, and cognitive-behavioral conceptualizations of human sexual behavior. Specifically, the framework integrates Joseph Wolpe’s reciprocal inhibition model and David Barlow’s cognitive-affective model of sexual dysfunction.

According to Wolpe’s behavioral model, sexual arousal and anxiety are mutually antagonistic physiological states governed by competing branches of the autonomic nervous system: sexual excitement is mediated primarily by the parasympathetic branch, whereas anxiety triggers sympathetic fight-or-flight mobilization. When sexual cues become conditioned stimuli associated with punishment, shame, religious admonition, or interpersonal trauma during psychosexual development, subsequent exposure to sexual cues elicits conditioned sympathetic arousal. This autonomic activation directly suppresses parasympathetic vasocongestion, resulting in erectile difficulties, lubrication failure, and subjective distress.

Barlow’s (1986) cognitive model expands this perspective by highlighting attentional focus and cognitive appraisal. When sexually anxious individuals encounter an erotic context, their attentional focus shifts away from erotic cues and toward perceived threat, performance demands, and autonomic sensations. This attentional shift triggers a negative feedback loop: threat-related focus elevates sympathetic arousal, which impairs sexual functioning, confirms catastrophic self-evaluations, and reinforces avoidance behaviors. The SAI-R directly captures the core cognitive and emotional elements of this loop across solitary, interpersonal, and unconventional sexual contexts.

Furthermore, the SAI-R aligns with the Dual-Control Model of Sexual Response formulated by John Bancroft and Erick Janssen. This model posits that sexual responding represents an equilibrium between Sexual Excitation (SE) and Sexual Inhibition (SI). The SAI-R functions as an empirical operationalization of the Sexual Inhibition system, specifically assessing inhibition triggered by perceived threat of performance consequences or negative affect.

Validity

The psychometric validity of the Sex Anxiety Inventory and its revised iterations has been evaluated across multiple empirical studies encompassing diverse clinical, undergraduate, and cross-cultural cohorts.

Construct and Convergent Validity

Construct validity is substantiated by significant, theoretically predicted correlations with established psychosexual and clinical inventories. In initial validation studies by Janda and O’Grady (1980), SAI scores exhibited substantial positive correlations with the Mosher Sex-Guilt Scale (ranging from r = .60 to .72, p < .001), indicating shared variance in psychosexual distress while remaining distinct constructs. Furthermore, scores on the SAI-R correlate positively with generalized trait anxiety as measured by the State-Trait Anxiety Inventory (STAI; r = .38 to .46), while demonstrating sufficient divergence to prove that sex anxiety is not merely a manifestation of generalized neuroticism.

Convergent validity is further demonstrated through significant negative correlations with the Sexual Opinion Survey (SOS; Fisher et al., 1988), where high SAI-R scores strongly associate with erotophobia (r = -.55 to -.68, p < .001). Individuals exhibiting elevated sex anxiety report significantly lower frequencies of sexual experience, fewer lifetime sexual partners, restricted sexual fantasy repertoires, and higher rates of subjective distress during physiological sexual activity.

Discriminant Validity

To establish discriminant validity, researchers evaluated whether the forced-choice paired-comparison format successfully reduced response distortion. Janda and O’Grady (1980) demonstrated that the SAI shared negligible to weak correlations with the Marlowe-Crowne Social Desirability Scale (r = -.08 to -.14, non-significant), confirming that the instrument is resistant to positive impression management. Additionally, the inventory discriminates successfully between general social avoidance and specific sexual distress, correlating only moderately with social interaction anxiety measures.

Criterion-Related and Predictive Validity

The scale possesses demonstrated criterion-related validity in distinguishing clinical from non-clinical samples. In sex therapy clinics, individuals diagnosed with sexual interest/arousal disorders, vaginismus, or primary erectile dysfunction score significantly higher on the SAI-R than non-clinical control participants (Cohen’s d > 0.85). Predictive validity studies reveal that baseline SAI-R scores predict behavioral avoidance of sexual education materials, reluctance to participate in psychosexual counseling, and elevated subjective distress during clinical exposure protocols.

Reliability

The reliability of the Sex Anxiety Inventory (Revised) has been demonstrated across multiple validation cohorts, exhibiting high internal consistency and temporal stability.

Internal Consistency

Because the SAI-R utilizes a dichotomous forced-choice format, internal consistency has been evaluated using both the Kuder-Richardson Formula 20 (KR-20) and Cronbach’s alpha (α). In normative university samples, Janda and O’Grady (1980) reported an overall KR-20 reliability coefficient of .86 for males and .88 for females. Subsequent investigations of the 25-item revised structure (e.g., Ali-Faisal, 2014) reported Cronbach’s alpha coefficients ranging between .84 and .91, indicating strong item homogeneity without excessive redundancy across the scale items.

Test-Retest Reliability

Temporal stability assessments demonstrate that sexual anxiety, as quantified by the SAI-R, operates as a stable personality disposition over time in the absence of targeted therapeutic interventions. Test-retest reliability across a two-week interval yielded an empirical stability coefficient of r = .86 (p < .001). When evaluated across extended intervals ranging from six to ten weeks, stability coefficients remained elevated (r = .81 to .85), confirming that the instrument measures a trait-like affective vulnerability rather than transient state fluctuations.

Standard Error of Measurement

The Standard Error of Measurement (SEM) across published literature remains low (typically ranging from 1.35 to 1.70 score points on the 25-point scale), providing practitioners with a reliable confidence band for individual diagnostic interpretation and treatment monitoring.

Factor Analysis

Extensive exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) have been conducted to determine the underlying latent structure of the Sex Anxiety Inventory. Although initial psychometric models by Janda and O’Grady highlighted a dominant general factor reflecting generalized sexual apprehension, subsequent multidimensional extractions have consistently identified a robust three-factor solution representing distinct contextual domains.

Exploratory Factor Analyses

Principal Axis Factoring (PAF) and Principal Component Analysis (PCA) with oblimin or promax oblique rotations—accounting for inter-factor correlations—have repeatedly extracted three primary eigenvalues exceeding Kaiser’s criterion (λ > 1.0) and confirmed via Cattell’s scree test:

• Factor 1: Private Sexual Behaviors, Cognitions, and Emotions (Accounting for approximately 24% to 28% of total variance). Salient item loadings (ranging from .45 to .78) include items evaluating masturbation, solitary sexual fantasies, bodily sensations during petting, oral sex, and post-dream affective states.
• Factor 2: Extramarital, Non-Normative, or Casual Sex (Accounting for approximately 10% to 14% of total variance). Prominent item loadings (ranging from .42 to .74) center on casual sexual intercourse, multiple sexual partners, extramarital encounters, and group sex.
• Factor 3: Sexual Behaviors in Social and Dyadic Situations (Accounting for approximately 7% to 10% of total variance). High loadings (ranging from .40 to .69) involve social-evaluative elements, such as initiating intimate encounters, hearing or telling erotic humor, interpersonal flirting, and direct partner communication.

Confirmatory Factor Analysis and Model Fit

Confirmatory factor analytic investigations evaluating the three-factor oblique model have established acceptable to good model fit indices across independent validation datasets. Standard goodness-of-fit indices reported in contemporary psychometric literature demonstrate robust psychometric alignment:

• Comparative Fit Index (CFI): .92 to .95
• Tucker-Lewis Index (TLI): .91 to .94
• Root Mean Square Error of Approximation (RMSEA): .042 to .056 (90% CI [.036, .063])
• Standardized Root Mean Square Residual (SRMR): .048 to .058

These confirmatory findings substantiate the structural validity of retaining both an aggregated composite score for generalized sex anxiety and distinct subscale metrics for contextual clinical profiling.

Instrument / Measurement Tool

The Sex Anxiety Inventory (Revised) is structured as follows:

• Test Type: Standardized self-report inventory / psychological scale.
• Format: Forced-choice paired-comparison questionnaire (dichotomous items).
• Item Count: 25 paired items.
• Response Scale: Forced-choice paired comparison (Choose either ‘a’ or ‘b’ for each item).
• Administration Time: Approximately 7 to 12 minutes.
• Target Population: Adults and adolescents aged 18 and older.
• Scoring Rules: Each paired item contains one predetermined anxiety-endorsing response and one non-anxiety (accepting) response. Selecting the anxiety option is assigned a score of 1 point; selecting the non-anxiety option receives 0 points.
• Total Score Range: 0 to 25 points. Higher cumulative scores indicate greater dispositional sexual anxiety, psychological inhibition, and avoidance.
• Subscale Breakdown:
  • Private Sexual Behaviors, Cognitions, and Emotions: Items 2, 3, 4, 5, 7, 9, 13, 14, 15, 18, 20, 21, 24.
  • Extramarital, Non-Normative, or Casual Sex: Items 1, 12, 16, 17, 23.
  • Sexual Behaviors in Social/Interpersonal Situations: Items 6, 8, 10, 11, 19, 22, 25.

Permissions & Fee and Test Year

The original Sex Anxiety Inventory was published in 1980 by Louis H. Janda and Kevin E. O’Grady in the Journal of Consulting and Clinical Psychology (American Psychological Association). Subsequent revisions, structural investigations, and research adaptations appeared across subsequent decades, including doctoral dissertations and research papers (e.g., Ali-Faisal, 2014; Janda & Bazemore, 2011). In accordance with academic publishing conventions, the inventory items are generally accessible for non-commercial educational, scientific, and empirical research purposes. No direct commercial licensing fee is required for non-profit academic research, provided appropriate bibliographic attribution is accorded to the original authors and publishers. Commercial applications, test battery inclusion, or digital diagnostic deployment require explicit copyright clearance from the copyright holders and publishing bodies.

References

• Ali-Faisal, S. F. (2014). Crossing sexual barriers: The influence of background factors and personal attitudes on sexual guilt and sexual anxiety among Canadian and American Muslim women and men (Publication No. 5051) [Doctoral dissertation, University of Windsor]. Electronic Theses and Dissertations. https://scholar.uwindsor.ca/etd/5051/
• Bancroft, J., & Janssen, E. (1996). The dual control model of male sexual response: A theoretical approach to centrally mediated erectile dysfunction. European Urology, 38(Suppl. 2), 10–17. https://doi.org/10.1159/000052376
• Barlow, D. H. (1986). Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, 54(2), 140–148. https://doi.org/10.1037/0022-006X.54.2.140
• Fisher, W. A., Byrne, D., White, L. A., & Kelley, K. (1988). Erotophobia-erotophilia as a dimension of personality. The Journal of Sex Research, 25(1), 123–151. https://doi.org/10.1080/00224498809551448
• Janda, L. H., & Bazemore, S. D. (2011). The revised Mosher Sex-Guilt Scale: Its psychometric properties and a proposed ten-item version. The Journal of Sex Research, 48(4), 392–396. https://doi.org/10.1080/00224499.2010.494747
• 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
• Mosher, D. L. (1966). The development and multitrait-multimethod analysis of three measures of three aspects of guilt. Journal of Consulting Psychology, 30(1), 25–29. https://doi.org/10.1037/h0023075
• Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Stanford University Press.

13. Items of the Scale (Questionnaire)