Sexual Inhibition/Sexual Excitation Scales

Abstract

The Sexual Inhibition/Sexual Excitation Scales (SIS/SES) represent a foundational psychometric instrument developed to operationalize and quantify individual propensities within the theoretical framework of the Dual Control Model of sexual response (Bancroft & Janssen, 2000). Grounded in neurobiological and evolutionary behavioral paradigms, the instrument conceptualizes human sexual responsiveness as the net outcome of two central neurophysiological mechanisms: an excitatory system that facilitates sexual arousal and an inhibitory system that suppresses it in the presence of physical, social, or performance-related threats. Comprising 45 self-report items formulated largely in an conditional (“if-then”) format, the SIS/SES yields three robust higher-order dimensions: Sexual Excitation (SES; 20 items), Sexual Inhibition Due to the Threat of Performance Failure (SIS1; 14 items), and Sexual Inhibition Due to the Threat of Performance Consequences (SIS2; 11 items).

Extensive psychometric investigations across diverse cohorts demonstrate solid construct, convergent, discriminant, and criterion-related validity. Internal consistency reliability remains strong across samples, with Cronbach’s alpha coefficients typically ranging from .87 to .89 for SES, .76 to .83 for SIS1, and .69 to .75 for SIS2. Test-retest reliability across multi-week intervals confirms temporal stability (.60 to .76). The instrument has demonstrated profound predictive utility across clinical and empirical sexology, differentiating individuals at risk for erectile dysfunction and arousal difficulties from those prone to sexual compulsivity, high-risk sexual behaviors, and sexual aggression. By providing an empirically substantiated assessment of excitatory and inhibitory vulnerabilities, the SIS/SES remains an indispensable tool for clinical assessment, biopsychosocial modeling, and translational sex research.

Keywords

Dual Control Model, Sexual Excitation Scale, Sexual Inhibition Scale, SIS/SES, Sexual Arousal, Erectile Dysfunction, Sexual Risk Taking, Psychometrics, Kinsey Institute, Sexual Health

Authors

The Sexual Inhibition/Sexual Excitation Scales were developed through a collaborative research program conducted at the Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University, Bloomington, along with international academic collaborators:

• Erick Janssen, Ph.D. — The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, Indiana, USA; currently affiliated with the Institute for Family and Sexuality Studies, Department of Neurosciences, University of Leuven (KU Leuven), Belgium. Correspondence: [email protected].
• John Bancroft, M.D., FRCP, FRCPsych — Former Director of The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, Indiana, USA; Clinical Psychiatrist and Medical Sexologist.
• Cynthia A. Graham, Ph.D. — Warneford Hospital, Oxford, England; currently Professor of Sexual and Reproductive Health, University of Southampton, UK.
• Deanna L. Carpenter, Ph.D. — Department of Psychology, Christopher Newport University, Newport News, Virginia, USA.

Purpose

The primary clinical and empirical purpose of the SIS/SES is to quantify an individual’s enduring trait propensities for sexual excitation and sexual inhibition. Historically, psychological theories of human sexuality frequently operated under unidimensional models, presuming that low sexual arousal reflected an absence of excitatory drive. The SIS/SES was designed to rectify this clinical and empirical shortcoming by operationalizing sexual responsiveness as a dynamic balance between independent neurobiological activating and braking systems. By measuring these systems independently, the scale clarifies why individuals exposed to identical sexual stimuli exhibit profoundly disparate behavioral, affective, and physiological outcomes.

In clinical settings, the SIS/SES serves as an essential diagnostic and case-conceptualization tool for sexual dysfunctions. Individuals presenting with psychogenic erectile disorder or female sexual interest/arousal disorder often display elevated scores on the inhibition dimensions (particularly SIS1), indicating that normal physiological arousal is actively interrupted by performance anxiety, distraction, or self-monitoring. Conversely, identifying individuals with high SES and low SIS2 provides clinicians with an etiology for hypersexuality, paraphilic behaviors, sexual compulsivity, and patterns of sexual infidelity. In behavioral health and epidemiology, the scale reliably predicts participation in high-risk sexual practices, such as condomless intercourse with anonymous partners, non-adherence to biomedical prevention regimens, and substance-involved sexual encounters.

Furthermore, the instrument addresses complex psychosomatic phenomena, including paradoxical sexual arousal under negative affective states. Research utilizing the SIS/SES has revealed that while anxiety and depression suppress sexual interest in the majority of individuals (mediated by high SIS), a meaningful subpopulation demonstrates increased sexual arousal and behavior during states of stress or depression (characteristic of high SES combined with low SIS1/SIS2). Thus, the purpose of the scale extends beyond classification into the fundamental elucidation of neuroadaptive individual differences across both normative and clinical human populations.

Psychological Construct

The SIS/SES measures three overarching, theoretically differentiated latent constructs that govern sexual responsiveness. These higher-order dimensions encompass specific lower-level behavioral and sensory facets:

1. Sexual Excitation (SES)

Sexual Excitation represents an individual’s underlying sensitivity to a wide spectrum of erotic, social, sensory, and cognitive stimuli that trigger sexual arousal. Rather than capturing momentary arousal, SES evaluates a stable behavioral disposition toward rapid, intense conditionability and activation of subjective and genital sexual states. The construct comprises 20 items organized into four lower-level subscales:

• SES_1 (Social Interactions and Visual Cues): Evaluates arousal elicited by interpersonal dynamics, eye contact, flirtation, attractive strangers, and social settings (e.g., Item 6: “When a sexually attractive stranger accidentally touches me, I easily become aroused”).
• SES_2 (Explicit Erotic Media and Viewing Sex): Assesses responsiveness to visual depictions of explicit sexual activities, erotic films, and observing others engaged in sexual intercourse (e.g., Item 1: “When I look at erotic pictures, I easily become sexually aroused”).
• SES_3 (Cognitive and Internal Fantasies): Taps into sexual arousal generated endogenously through imagery, past sexual memories, and intrinsic genital awareness (e.g., Item 25: “Just thinking about a sexual encounter I have had is enough to turn me on sexually”).
• SES_4 (Non-Sexual and Ambient Sensory Triggers): Reflects arousal triggered by general physical sensations, warm baths, lying in the sun, or wearing appealing attire (e.g., Item 4: “Sometimes I become sexually aroused just by lying in the sun”).

2. Sexual Inhibition 1: Threat of Performance Failure (SIS1)

SIS1 measures the propensity for sexual arousal to be diminished or extinguished by the perceived or anticipated threat of inadequate sexual performance. This system acts as an acute internal feedback monitor that terminates genital and subjective arousal when performance criteria are not met, when cognitive distraction intervenes, or when demands from a sexual partner generate distress. SIS1 consists of 14 items across three lower-level subscales:

• SIS1_1 (Distraction and Loss of Arousal): Captures the vulnerability of physiological arousal (erection or vaginal lubrication) to extraneous cognitive thoughts, physical disruption, or lack of tactile focus (e.g., Item 40: “When I have a distracting thought, I easily lose my erection/my arousal”).
• SIS1_2 (Partner Responsiveness and Evaluation): Measures the moderating effect of partner pleasure and responsiveness on maintaining personal arousal (e.g., Item 21: “If I am concerned about pleasing my partner sexually, I easily lose my erection/it interferes with my arousal”).
• SIS1_3 (Performance Expectations and Pressure): Gauges the inhibitory suppression caused by feeling expected to perform, experiencing worry about lubrication/erection, or auditory distractors (e.g., Item 20: “If I feel that I’m expected to respond sexually, I have difficulty getting aroused”).

3. Sexual Inhibition 2: Threat of Performance Consequences (SIS2)

SIS2 operationalizes the propensity for sexual arousal to be suppressed in response to external threats and dangerous real-world consequences associated with sexual activity. Rooted in defensive harm avoidance and social boundary maintenance, SIS2 terminates arousal when engagement risks social sanction, physical harm, or moral violation. It comprises 11 items distributed across three subscales:

• SIS2_1 (Risk of Discovery and Social Exposure): Assesses inhibition triggered by the possibility of being seen, overheard, or interrupted during sexual intimacy (e.g., Item 12: “If I am having sex in a secluded, outdoor place and I think that someone is nearby, I am not likely to get very aroused”).
• SIS2_2 (Disease and Pregnancy Vulnerabilities): Measures inhibitory suppression resulting from the threat of sexually transmitted infections (STIs), non-use of condoms, or unintended pregnancy (e.g., Item 27: “If I realize there is a risk of catching a sexually transmitted disease, I am unlikely to stay sexually aroused”).
• SIS2_3 (Physical Pain and Norm Violations): Captures inhibition caused by anticipated pain, feeling rushed, or discovering that a partner is inappropriate due to age or other constraints (e.g., Item 31: “If I think that having sex will cause me pain, I will lose my erection/my arousal”).

Theoretical Framework

The SIS/SES is grounded directly in the Dual Control Model of sexual response, advanced by John Bancroft and Erick Janssen (2000). The model draws upon principles of evolutionary biology, central nervous system neurophysiology, and behavioral learning theory. Its fundamental premise is that sexual responding is regulated by an adaptive balance between central excitatory (activating) and central inhibitory (braking) mechanisms within the human brain.

From an evolutionary standpoint, high sexual excitation is biologically advantageous because it promotes mating, reproductive success, and genetic propagation. However, unconstrained sexual behavior entails severe evolutionary risks, including predation during vulnerability, transmission of infectious pathogens, maternal morbidity, social ostracism, and violent conflict within social hierarchies. Consequently, natural selection preserved complex neurobiological braking mechanisms (sexual inhibition) designed to abort or suppress sexual engagement when environmental, physiological, or social threats are detected. In this evolutionary matrix, SIS1 protects against repeated performance failure and personal reproductive inefficiency, whereas SIS2 protects against physical danger, infectious pathology, and social ruin.

Neurobiologically, the dual control model parallels Jeffrey Gray’s Reinforcement Sensitivity Theory (RST), which differentiates the Behavioral Approach System (BAS) from the Behavioral Inhibition System (BIS). However, Bancroft and Janssen demonstrated that general approach and avoidance traits do not fully explain sexual responding; rather, sex-specific neural circuits exist. Sexual excitation is primarily mediated by mesolimbic and central dopaminergic pathways, oxytocin, melanocortins, and noradrenergic signaling, which lower sensory thresholds and promote genital vasocongestion. In contrast, sexual inhibition is mediated by central serotonergic transmission, endocannabinoids, and sustained alpha-adrenergic sympathetic discharge, which constricts peripheral vasculature, terminates erection/lubrication, and dampens erotic processing. The Dual Control Model posits that individual differences in baseline neurochemical tone, receptor sensitivities, and early conditioning determine a person’s characteristic location along the independent SES, SIS1, and SIS2 continuums.

Validity

The validity of the SIS/SES has been rigorously verified across clinical, non-clinical, heterosexual, and sexual minority populations of both men and women. Factorial, convergent, discriminant, and criterion-related validity evidence is extensive:

Factorial and Construct Validity

Using a facet design methodology (Shye & Elizur, 1994), Janssen et al. (2002a) initially identified 10 primary factors through exploratory factor analysis in 408 sexually functional heterosexual men. Higher-order factor analyses demonstrated that a single excitation factor (SES; accounting for 4 subscales) and two distinct inhibition factors (SIS1 and SIS2; each accounting for 3 subscales) best represented the latent structure, accounting for 60% of total variance. Confirmatory factor analysis (CFA) across diverse validation samples confirmed that the three-factor model yielded good fit across independent groups of men (CFA samples: N = 459 and N = 313) and an acceptable fit in women (N = 1,067; Carpenter et al., 2008).

Convergent and Discriminant Validity

Studies evaluating associations between the SIS/SES and general personality measures show that while the scales correlate systematically with broad temperamental constructs, they possess substantial domain specificity:

• Behavioral Activation (BAS): SES correlates positively and moderately with the Carver & White BAS scales, specifically BAS Reward Responsiveness (r = .37, p ≤ .01 in men; r = .11 in women), BAS Drive (r = .25, p ≤ .01 in men; r = .15 in women), and BAS Fun Seeking (r = .25, p ≤ .01 in men; r = .27, p ≤ .01 in women). SIS1 and SIS2 correlate negatively with BAS Fun Seeking (e.g., SIS2-Fun Seeking: r = -.31 in women, r = -.17 in men).
• Behavioral Inhibition (BIS) and Harm Avoidance: SIS2 correlates significantly with Carver & White’s BIS (r = .21, p ≤ .01 in men; r = .17 in women) and with the Multidimensional Personality Questionnaire (MPQ) Harm Avoidance scale (r = .26, p ≤ .01 in men; r = .23 in women), demonstrating appropriate convergent alignment with harm-monitoring systems.
• Domain-Specific Sexuality Measures: SES correlates strongly with positive erotophilic attitudes as assessed by the Sexual Opinion Survey (SOS; r = .58 in women, r = .42 in men) and unrestricted sociosexuality on the Sociosexual Orientation Inventory (SOI; r = .38 in women, r = .20 in men). SIS2 correlates negatively with both SOS (r = -.33 in women, r = -.28 in men) and SOI (r = -.47 in women, r = -.33 in men).
• Discriminant Independence: SES and the two inhibition scales display near-zero inter-correlations (SES & SIS1: r = -.07; SES & SIS2: r = -.11), confirming that excitation and inhibition represent orthogonal dimensions rather than opposite ends of a single continuum. The modest correlation between SIS1 and SIS2 (r = .28) supports their separation into performance-specific versus consequence-specific braking systems.
• Social Desirability: Correlations with the 5-item Social Desirability Scale (SDSR-5) were minimal to modest (-.23 to .16), confirming that the instrument is not an artifact of impression management.

Criterion-Related and Predictive Validity

In psychophysiological laboratory paradigms (Janssen et al., 2002b), men with higher SES scores demonstrated faster rates of penile tumescence during erotic film exposure, whereas those high on SIS1 exhibited rapid detumescence when cognitive distraction or performance-demand instructions were introduced. In epidemiologic studies, low SIS2 scores independently predict elevated numbers of lifetime sexual partners, failure to use condoms during casual sex, and high rates of sexually transmitted infection diagnoses, confirming the real-world predictive validity of the SIS2 brake.

Reliability

The SIS/SES demonstrates consistent internal reliability and temporal stability across research cohorts of varying ages and biological sexes:

Internal Consistency

Across the three original male validation samples published by Janssen et al. (2002a):

• Sexual Excitation (SES; 20 items): Cronbach’s α values were .89 (Sample 1, N = 408), .89 (Sample 2, N = 459), and .88 (Sample 3, N = 313).
• Sexual Inhibition 1 (SIS1; 14 items): Cronbach’s α values were .81 (Sample 1), .78 (Sample 2), and .83 (Sample 3).
• Sexual Inhibition 2 (SIS2; 11 items): Cronbach’s α values were .73 (Sample 1), .69 (Sample 2), and .75 (Sample 3).

In a large-scale comparative study involving 1,067 heterosexual women (Carpenter et al., 2008), the corresponding Cronbach’s alpha coefficients remained robust: .87 for SES, .76 for SIS1, and .70 for SIS2, confirming that the scale retains adequate to high internal consistency regardless of gender.

Test-Retest Stability

Temporal stability was evaluated by administering the questionnaire twice to a sample of 50 men (mean retest interval: 7 weeks; Janssen et al., 2002a) and 51 women (mean retest interval: ~5 weeks; Carpenter et al., 2008):

• Men (7-week interval): Test-retest correlation coefficients were r = .76 for SES, r = .67 for SIS1, and r = .74 for SIS2.
• Women (5-week interval): Test-retest correlation coefficients were r = .70 for SES, r = .68 for SIS1, and r = .60 for SIS2 (after removing two extreme outliers).

These findings demonstrate that the propensities measured by the SIS/SES function as stable dispositional traits over time rather than fluctuating situational states.

Factor Analysis

The structural validation of the SIS/SES adhered to rigorous classical test theory and multidimensional modeling techniques:

Exploratory Factor Analysis (EFA)

Development began with a comprehensive item pool designed via facet theory (Shye & Elizur, 1994) covering diverse stimulus modalities (visual, tactile, auditory, cognitive) and response types (subjective arousal, genital vasocongestion). Principal components and exploratory factor analyses with oblique rotation in 408 sexually functional men resolved the items into 10 lower-level factors. A subsequent second-order factor analysis of these lower-level factors extracted three higher-order dimensions accounting for approximately 60% of the total variance:

• SES Factor: Captured all four excitation-related lower-level factors with primary factor loadings ranging from .60 to .90.
• SIS1 Factor: Captured three performance-failure inhibition subscales (distraction, partner response, performance anxiety) with loadings ranging between .60 and .85.
• SIS2 Factor: Captured three performance-consequence inhibition subscales (risk of being seen/heard, STD/pregnancy threats, pain/norm violations) with loadings ranging between .60 and .85.

Confirmatory Factor Analysis (CFA)

To verify the generalizability and replicability of the higher-order three-factor solution, multigroup confirmatory factor analyses were performed on two independent replication samples of men: a college-aged cohort (N = 459, mean age = 21 years) and an older adult cohort (N = 313, mean age = 46 years). The higher-order three-factor model showed stable goodness-of-fit metrics across both groups, substantiating measurement invariance across age brackets.

Subsequently, Carpenter et al. (2008) conducted CFA on data from 978 men and 1,067 heterosexual women. The structural model demonstrated an acceptable fit for female respondents, affirming that despite physiological differences in genital anatomy (accommodated via parallel item phrasing such as “erection” vs. “vaginal lubrication”), the underlying dual control mechanisms operate along identical psychometric dimensions across sexes.

Instrument / Measurement Tool

The SIS/SES is structured as follows:

• Instrument Name: Sexual Inhibition/Sexual Excitation Scales (SIS/SES)
• Authors: Erick Janssen, John Bancroft, Cynthia A. Graham, and Deanna L. Carpenter
• Constructs Measured: Individual propensity for Sexual Excitation (SES), Sexual Inhibition due to Threat of Performance Failure (SIS1), and Sexual Inhibition due to Threat of Performance Consequences (SIS2)
• Administration Format: Self-report questionnaire (paper-and-pencil or secure computer/digital administration)
• Target Population: Adult men and women (normative, clinical, and research populations)
• Total Number of Items: 45 items
  • Sexual Excitation Scale (SES): 20 items (Items 1, 3, 4, 6, 7, 11, 13, 14, 16, 25, 26, 29, 30, 32, 35, 37, 38, 39, 43, 44)
  • Sexual Inhibition 1 (SIS1): 14 items (Items 5, 9, 10, 17, 19, 20, 21, 23, 33, 36, 40, 41, 42, 45)
  • Sexual Inhibition 2 (SIS2): 11 items (Items 2, 8, 12, 15, 18, 22, 24, 27, 28, 31, 34)
• Completion Time: Approximately 10 minutes
• Response Categories: 4-point Likert-type scale:
  • 1 = Strongly Agree
  • 2 = Agree
  • 3 = Disagree
  • 4 = Strongly Disagree
• Scoring and Transformation Rules:
  • To compute scores, all but two (Items 17 and 45) of the items first need to be reversed (1 = 4, 2 = 3, 3 = 2, 4 = 1).
  • Items 17 and 45 are positively phrased relative to inhibition and are NOT reversed.
  • Missing Value Replacement: Missing values can be replaced with the mean of the other items making up the lower-level factor to which the missing item belongs.
  • Protocols for Invalid Protocols: It is recommended that no scores are computed if more than 10 out of the 45 items are missing, and that missing values are assigned to SES if more than 5 SES items are missing, to SIS1 if more than 4 SIS1 items are missing, and to SIS2 if more than 3 SIS2 items are missing.
  • Scale Summation:
    • SES Total: Sum of recoded Items 1, 3, 4, 6, 7, 11, 13, 14, 16, 25, 26, 29, 30, 32, 35, 37, 38, 39, 43, and 44 (Theoretical range: 20 to 80; higher scores indicate greater excitatory arousability).
    • SIS1 Total: Sum of recoded Items 5, 9, 10, 19, 20, 21, 23, 33, 36, 40, 41, 42, and unrecoded Items 17 and 45 (Theoretical range: 14 to 56; higher scores indicate greater vulnerability to performance-related inhibition).
    • SIS2 Total: Sum of recoded Items 2, 8, 12, 15, 18, 22, 24, 27, 28, 31, and 34 (Theoretical range: 11 to 44; higher scores indicate greater inhibition related to threat of consequences).

Permissions & Fee and Test Year

The Sexual Inhibition/Sexual Excitation Scales were formally published in 2002 by Erick Janssen, Henk Vorst, Peter Finn, and John Bancroft in The Journal of Sex Research. The instrument was developed at The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University.

Licensing and Fees: There are no licensing fees attached to the use of the SIS/SES for non-commercial, academic, clinical, and scientific research purposes. The scale, along with specialized SPSS scoring syntax files, manual guidelines, and demographic norms, is maintained by the developers and hosted online through academic repositories (formerly accessible at http://www.indiana.edu/~sexlab and via correspondence with the primary author). Researchers and clinicians wishing to employ the instrument are encouraged to contact the corresponding author, Dr. Erick Janssen (The Kinsey Institute / University of Leuven; email: [email protected]), to request official scoring algorithms, adaptations, or translations.

References

• Bancroft, J., Graham, C. A., Janssen, E., & Sanders, S. A. (2009). The dual control model: Current status and future directions. The Journal of Sex Research, 46(2-3), 121–142. https://doi.org/10.1080/00224490902747222
• 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
• Carpenter, D. L., Janssen, E., Graham, C. A., Vorst, H., & Wicherts, J. M. (2008). Women’s scores on the Sexual Inhibition/Sexual Excitation Scales (SIS/SES): Gender similarities and differences. The Journal of Sex Research, 45(1), 36–48. https://doi.org/10.1080/00224490701808076
• Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6(2), 65–70. https://www.jstor.org/stable/4615733
• Janssen, E., & Bancroft, J. (2007). The dual control model: The role of sexual inhibition and excitation in sexual arousal and behavior. In E. Janssen (Ed.), The Psychophysiology of Sex (pp. 197–222). Indiana University Press.
• Janssen, E., Vorst, H., Finn, P., & Bancroft, J. (2002a). The Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales: I. Measuring sexual inhibition and excitation proneness in men. The Journal of Sex Research, 39(2), 114–126. https://doi.org/10.1080/00224490209552130
• Janssen, E., Vorst, H., Finn, P., & Bancroft, J. (2002b). The Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales: II. Predicting psychophysiological response patterns. The Journal of Sex Research, 39(2), 127–132. https://doi.org/10.1080/00224490209552131
• Shye, S., & Elizur, D. (1994). Introduction to Facet Theory: Content Design and Intrinsic Data Analysis in Behavioral Research. Sage Publications. https://doi.org/10.4135/9781412984652

Items of the Scale