Sexual Problems Self-Assessment Questionnaire

1. Abstract

The Sexual Problems Self-Assessment Questionnaire (SPSAQ) is a clinical self-report instrument designed by Elizabeth Rae Larson and Malcolm H. McKay to evaluate subjective sexual difficulties, relational distress, and sexual dissatisfaction among adult individuals and couples presenting for sex therapy. Grounded theoretically in the radical paradigm shift introduced by the Working Group on a New View of Women’s Sexual Problems (Kaschak & Tiefer, 2001) and later adapted to address both female and male sexual concerns (Klein & Morin, 2005; Larson, 2005), the SPSAQ departs radically from the strictly bio-medical, performance-based, and genital-reflex paradigms characteristic of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). Comprising 73 items organized across five foundational clinical domains—(1) Overall Satisfaction, (2) Socio-Cultural, Political, or Economic Factors, (3) Relationships, (4) Psychological Factors, and (5) Physical Factors—the SPSAQ assesses systemic, interpersonal, psychological, and physiological impediments to erotic well-being.

The assessment employs an electronic or pencil-and-paper interface utilizing a continuous 100-point visual analog/Likert-type continuum anchored primarily from “Yes” to “No” (or semantic equivalents such as “Very” to “Not at all”), wherein marks are digitally converted into numerical coordinates from 0 to 100, with higher scores reflecting greater subjective distress or dissatisfaction. Rather than functioning as a standardized, norm-referenced diagnostic psychometric tool, the SPSAQ operates as an idiographic, clinician-facilitated mapping instrument that prevents premature clinical narrowing and illuminates neglected systemic dynamics, such as partner discrepancies, emotional betrayal, traumatic history, and structural cultural mandates. Although formal classical test theory metrics (e.g., population-wide Cronbach’s alpha coefficients and confirmatory factor analysis fit indices) were deliberately eschewed during initial development in favor of immediate clinical utility and face validity, the instrument provides an exceptionally rich qualitative and quantitative profile of relational dynamics, making it an influential clinical assessment tool within contemporary integrative and feminist sexology.

2. Keywords

Sexual Problems Self-Assessment Questionnaire, SPSAQ, New View of Women’s Sexual Problems, sex therapy, sexual satisfaction, relational intimacy, psychosexual assessment, couple therapy, medicalization of sexuality, sexual distress, Leonore Tiefer, sexual health evaluation.

3. Authors

The Sexual Problems Self-Assessment Questionnaire was conceptualized, authored, and iteratively refined by:

• Elizabeth Rae Larson, Ph.D. — Affiliated with the Seattle Institute for Sex Therapy, Education and Research (100 NE 56th Street, Seattle, WA 98105; Email: [email protected]). Dr. Larson is a clinical sexologist, educator, and psychotherapist specializing in integrative couple sex therapy, feminist sex therapy approaches, and systemic interventions in psychosexual distress.
• Malcolm H. McKay, Ph.D. — Private Practitioner, Seattle, Washington. Dr. McKay specializes in clinical psychology, adult psychotherapy, and the treatment of complex sexual and relational dysfunctions within systemic and psychodynamic frameworks.

The authors developed the SPSAQ in collaborative consultation with key figures from the feminist sexology movement, most notably Leonore Tiefer, Ph.D., along with members of the New View Campaign listserv, and clinical sexologists including Marty Klein, Ph.D., Jack Morin, Ph.D., Gerald Weeks, Ph.D., Joy Davidson, Ph.D., and Marilyn McIntyre, Ph.D. Software interface design, digital implementation, and editorial contributions were provided by Laura Tsang, Ann Manly, and Ian Hagemann at the Seattle Institute for Sex Therapy, Education and Research.

4. Purpose

The primary clinical imperative driving the formulation of the Sexual Problems Self-Assessment Questionnaire (SPSAQ) was the critical recognition that individuals and couples presenting for psychosexual clinical intervention frequently exhibit severe “tunnel vision” or premature problem-narrowing. When clients initiate sex therapy, they almost universally frame their presenting complaints around narrow physiological, genital, or performance-related symptomatology—such as erectile dysfunction, rapid ejaculation, female orgasmic infrequency, or dyspareunia. In doing so, clients and conventional clinicians often miss the broader, complex matrix of contextual, interpersonal, historical, and sociopolitical determinants that actually generate, maintain, or exacerbate their distress. The SPSAQ was engineered to systematically broaden the diagnostic aperture, compelling clients and clinicians alike to evaluate the holistic ecosystem of their erotic and intimate lives.

From a diagnostic and clinical application perspective, the SPSAQ serves several critical functions:

• Comprehensive Intake Screening: Administered typically during the second or third session of therapy, the SPSAQ provides an immediate, multidimensional diagnostic landscape. By requiring the respondent to reflect on 73 discrete variables across multiple life spheres, it illuminates latent conflicts—such as unexpressed resentment over domestic labor, deep-seated religious guilt, history of unaddressed developmental trauma, or physical health issues—that might otherwise remain undetected until months into treatment.
• Couple Profile Comparison: In relational and couple sex therapy, both partners complete the instrument independently. A specialized couple summary scoring sheet juxtaposes both partners’ quantitative scores side-by-side. This reveals critical perceptual discrepancies: for example, where one partner perceives minimal relational conflict but extreme sexual dissatisfaction, the other may report high relational anxiety, severe feelings of unequal power, and moderate physical pleasure. Such comparisons immediately identify relational impasses and discrepancies in sexual desire, preferences, and emotional trust.
• De-Medicalization and Normalization: By explicitly foregrounding socio-cultural mandates, unrealistic media beauty ideals, economic stress, and lack of foundational sexual education alongside physical ailments, the SPSAQ clinically normalizes the patient’s experience. It reframes an alleged “individual biological pathology” into an understandable, biopsychosocial reaction to relational, cultural, or environmental stressors.
• Within-Subject Longitudinal Monitoring: Although constructed without standardized population norms, the SPSAQ yields sensitive within-subject numerical tracking metrics (scaled 0 to 100). Clinicians can readminister the questionnaire at mid-treatment or termination to quantitatively and qualitatively track symptomatic reduction, communicative expansion, and improvements in overall emotional and sexual satisfaction.

By moving beyond the traditional constraints of genital functioning, the SPSAQ provides mental health practitioners, marriage and family therapists, clinical sexologists, and medical providers with an empirically grounded, clinically responsive intake and diagnostic apparatus that honors the genuine lived complexity of human sexuality.

5. Psychological Construct

The core overarching construct measured by the SPSAQ is multidimensional subjective sexual and relational dissatisfaction. Rather than defining sexual functioning along a unidimensional axis of physiological adequacy (e.g., genital tumescence, vaginal lubrication, latency to orgasm), the SPSAQ operationalizes sexual well-being as an emergent property of systemic balance across five interconnected psychological and physiological domains. Each domain captures distinct theoretical facets of psychosexual distress:

1. Overall Satisfaction

This foundational subscale serves as a global barometer of psychosexual distress and relational happiness. It encompasses two core items measuring:

• Global Sex Life Satisfaction: The subjective evaluation of the quality, frequency, pleasure, and emotional resonance of one’s erotic engagements, divorced from strict normative performance standards.
• Emotional Intimacy Satisfaction: The perceived depth of affective connection, psychological safety, reciprocal vulnerability, and emotional closeness within the primary relationship.

2. Socio-Cultural, Political, or Economic Factors

This subscale assesses the structural, systemic, and environmental forces that constrain, distort, or inhibit healthy psychosexual expression. Grounded in feminist sociology and critical psychology, this dimension measures:

• Educational and Epistemic Deprivation: Subjective deficits in comprehensive sexual education, lack of accurate anatomical knowledge across the lifespan, and an impoverished linguistic vocabulary to articulate physical and emotional sexual states.
• Healthcare and Safety Access Barriers: Institutional barriers to reproductive healthcare, family planning, STI screening, and specialized resources for survivors of domestic violence or sexual assault.
• Cultural Ideology and Normative Oppression: Internalized shame, anxiety, and distress stemming from failure to conform to culturally dominant beauty standards, narrow bodily ideals, or rigid gender-role scripts.
• Identity, Moral, and Value Conflicts: Internalized homophobia, sexual orientation distress, guilt surrounding erotic fantasies, and irreconcilable friction between personal erotic values and those enforced by religious institutions, peer groups, or dominant cultural paradigms.
• Economic, Domestic, and Occupational Exhaustion: Chronic depletion of sexual desire, physical energy, and erotic space resulting from work-related stress, parental duties, economic survival pressures, and unequally distributed domestic labor.

3. Relationships

Human sexual expression within couples is profoundly mediated by interpersonal safety, attachment security, and communication. This dimension captures relational determinants of sexual inhibition, aversion, and avoidance, including:

• Betrayal and Interpersonal Mistrust: Lingering affective residue from emotional affairs, infidelities, dishonesty, or fundamental interpersonal disillusionment.
• Fear, Intimidation, and Coercion: Covert or overt relational terror, physical intimidation, or history of partner abuse that precludes somatic vulnerability.
• Power Asymmetries and Negative Communication: Unequal decision-making power, weaponized communication styles (e.g., contempt, stone-walling, hypercriticism), and inability to negotiate boundaries safely.
• Desire and Behavioral Discrepancies: Incongruencies between partners regarding preferred sexual frequency, initiation patterns, erotic activities, and reciprocal sensitivity to sexual boundaries.
• Secondary Relational Interference: The erosion of sexual connection due to mundane domestic conflicts (finances, schedules, in-laws), profound existential trauma (infertility, loss of a child), or partner psychiatric/medical distress.

4. Psychological Factors

This dimension examines individual intrapsychic mechanisms, mental health conditions, and developmental trauma histories that disrupt erotic functioning. Key facets include:

• Trauma Sequelae: Somatic shutdown, dissociative tendencies, or sexual aversion directly linked to developmental, emotional, physical, or sexual trauma.
• Attachment Insecurities: Fears of engulfment, abandonment, vulnerability, or rejection that prompt avoidance of erotic contact.
• Affective Distress: Depressive anhedonia, generalized anxiety, panic responses during physical intimacy, and sexual guilt.
• Performance and Consequence Anxiety: Acute cognitive interference surrounding fears of pain, unintended pregnancy, disease transmission, or partner dissatisfaction.
• Dysregulated Erotic Behaviors: Compulsive sexual behaviors that induce personal distress, feelings of loss of control, or shame.

5. Physical Factors

Acknowledging that somatic health directly interacts with psychological and relational variables, this domain captures the biological, physiological, and medical realities affecting sexual experience, including:

• Chronic Illness and Neurological Conditions: The debilitating impact of conditions such as diabetes, multiple sclerosis, epilepsy, Parkinson’s disease, arthritis, and systemic lupus erythematosus.
• Reproductive, Surgical, and Endocrine Events: The somatic sequelae of hysterectomy, oophorectomy, prostate cancer therapies, hormonal interventions, pregnancy, childbirth, and menopause.
• Somatic Pain Syndromes: Dyspareunia, vaginismus, vulvodynia, and unclassified genital pain during arousal, intercourse, or orgasm.
• Lifestyle and Environmental Toxicants: Substance dependence, tobacco use, alcohol misuse, neurotoxic solvent exposures, and sedentary lifestyles.

6. Theoretical Framework

The theoretical architecture of the SPSAQ is explicitly rooted in the New View of Women’s Sexual Problems, a paradigm articulated by feminist psychologist Leonore Tiefer, Ellyn Kaschak, and the New View Working Group (2001). The New View emerged as a direct, politically conscious critique of the prevailing psychiatric and medical nosology embodied in the American Psychiatric Association’s DSM-IV and the classic Masters and Johnson / Helen Singer Kaplan Human Sexual Response Cycle (HSRC).

Under the traditional Masters-Johnson-Kaplan paradigm, human sexuality was conceptualized as a universal, linear, tripartite biological progression: Desire → Arousal → Orgasm (followed by Resolution). Consequently, the DSM-IV classified sexual dysfunctions almost exclusively as mechanistic breakdowns at specific points along this physiological continuum (e.g., Hypoactive Sexual Desire Disorder, Female Sexual Arousal Disorder, Male Erectile Disorder, Inhibited Orgasm). The New View Working Group forcefully argued that this bio-medical model possessed fatal conceptual flaws:

• False Equivalence of Male and Female Sexuality: The linear physiological model assumed that female sexual experience mirrors male genital hydraulics, ignoring decades of empirical evidence demonstrating that female desire is frequently non-linear, responsive, relational, and deeply dependent on context (a model later famously expanded by Rosemary Basson).
• De-Contextualization and Erasure of Meaning: The DSM framework reduced human sexual experience to genital blood flow and muscular contractions. It treated an inability to achieve orgasm during unarousing, coerced, or emotionally hostile intercourse as an “individual physiological dysfunction” rather than a healthy, expected somatic refusal.
• Commodification and Medicalization: The pharmaceutical revolution in sexual medicine following the 1998 approval of sildenafil (Viagra) established an intense commercial incentive to reduce all sexual dissatisfaction to biochemically correctable cellular mechanisms, pathologizing normal human variation and ignoring relational inequality.

In response, Kaschak and Tiefer (2001) proposed a revolutionary classification system that redefined sexual problems as: “discontent or dissatisfaction with any emotional, physical, or relational aspect of sexual experience.” They grouped all sexual problems into four expansive, non-hierarchical, socio-ecological categories: (a) Socio-cultural, political, or economic factors; (b) Partner and relationship factors; (c) Psychological factors; and (d) Medical/physiologic factors.

Larson and McKay took this theoretical manifesto and converted it into an actionable, clinical self-assessment instrument. Furthermore, recognizing that men are equally victimized by mechanistic, performance-obsessed cultural mandates (e.g., the “manhood machine” scripts of constant readiness, emotional detachment, and penile performance), Larson (2005), along with Klein and Morin (2005), expanded the New View nosology into a unified clinical framework applicable to all genders. The original medical category was broadened into “Physical Factors” to accommodate subjective somatic sensations, bodily perceptions, and lifestyle interactions, and an “Overall Satisfaction” domain was added to anchor clinical change. Thus, the theoretical foundation of the SPSAQ bridges feminist structural critique, systemic family therapy theory, and integrative biopsychosocial clinical sexology.

7. Validity

The psychometric evaluation of the SPSAQ must be understood within its explicit design parameters: the instrument was engineered specifically as an idiographic clinical assessment and diagnostic interview facilitation system, rather than a nomothetic, standardized psychometric test intended for population-based epidemiological research. Consequently, its validation trajectory differs fundamentally from traditional standardized psychological scales.

Face Validity and Content Validity

Content validity represents the strongest psychometric asset of the SPSAQ. The item pool was not generated in an ivory-tower isolation; rather, it was derived directly from the theoretical taxonomy established by the multi-disciplinary New View Working Group (comprising leading clinical psychologists, sociologists, physicians, and sex educators). To ensure comprehensive domain coverage, the preliminary items underwent extensive expert peer review. Dr. Leonore Tiefer and members of the international New View listserv systematically audited item phrasing, clarity, and conceptual fidelity. Clinical sexologists including Dr. Jack Morin, Dr. Marty Klein, and Dr. Gerald Weeks provided extensive feedback, ensuring that male-specific sexual vulnerabilities, couple dynamic complexities, and systemic relationship realities were thoroughly captured. Consequently, the instrument exhibits near-unrivaled qualitative content validity in assessing the multifaceted biopsychosocial universe of adult sexual presentation.

Clinical Validation and Usability Testing

Initial clinical validation was conducted naturalistically within the clinical practice of the Seattle Institute for Sex Therapy, Education and Research. Long-term therapy clients—predominantly couples undergoing active treatment for diverse psychosexual complaints—were invited to complete the computerized and paper-and-pencil drafts of the SPSAQ. The senior authors monitored client comprehension, user-friendliness, and emotional response. Across these developmental cohorts, clients consistently reported that the instrument was intuitive, cathartic, and surprisingly brief given its breadth (typically taking 12 to 25 minutes). Clinicians noted “no surprises” when comparing client quantitative profiles to their known clinical histories, confirming exceptional clinical-phenomenological congruence.

Iterative Item Refinement

Following successful preliminary clinical deployment with established clients, the SPSAQ was introduced as a standard intake measure for consecutive new clients. Post-assessment clinical debriefings revealed that certain items produced ambiguous or inaccurate endorsements due to linguistic complexity, compound phrasing, or double-barreled structures. Items demonstrating elevated rates of client misinterpretation or clinical confusion were systematically reworded, simplified, or dropped from the final 73-item inventory.

Empirical Limitations in Nomothetic Validity

As documented transparently by Larson and McKay, no formal quantitative validation studies—such as convergent validity correlations against legacy measures (e.g., the Female Sexual Function Index [FSFI] or the International Index of Erectile Function [IIEF]), discriminant validity studies against general depressive or anxiety inventories (e.g., BDI-II, GAD-7), or predictive/criterion validity testing—have been conducted on large non-clinical populations. The authors explicitly emphasize that the SPSAQ is a clinical heuristic: scores reflect the subjective perceptions and affective states of clients at the exact moment of testing, and must never be interpreted as objective, bio-pathological symptom markers.

8. Reliability

In accordance with classical test theory, psychological instruments traditionally require rigorous demonstration of internal consistency reliability (e.g., Cronbach’s alpha, McDonald’s omega) and temporal stability (test-retest reliability). In the developmental trajectory of the SPSAQ, no systematic, large-sample statistical assessment of reliability was conducted.

Several theoretical and methodological factors account for this deliberate design choice:

• Emergent and Heterogeneous Item Architecture: Many subscales within the SPSAQ—particularly the Physical Factors and Socio-Cultural, Political, or Economic Factors domains—function as formative or index indicators rather than reflective latent constructs. For instance, in the physical health domain, endorsing a history of multiple sclerosis or prostate cancer does not presuppose endorsing headaches, arthritis, or involuntary vaginismus. In such index measures, high internal consistency (Cronbach’s alpha) is neither mathematically expected nor psychometrically desirable, as items represent independent, non-redundant environmental and somatic life events.
• Dynamic Relational Sensitivity: The SPSAQ is designed to be highly sensitive to the fluid, fluctuating affective states inherent to couples in acute distress. Relational trust, perceived partner hostility, communication resentment, and sexual satisfaction can shift markedly following an acute marital argument or, conversely, following a therapeutic breakthrough. Consequently, conventional high test-retest reliability across multi-week intervals would paradoxically indicate clinical insensitivity to meaningful therapeutic change.
• Within-Subject Idiographic Tracking: The authors provided a test-retest clinical scoring summary protocol (accessible via clinical supplementary materials) specifically designed for idiographic tracking. In clinical practice, the tool demonstrated strong within-subject reliability in capturing longitudinal patterns of therapeutic growth, stability, or relapse when interpreted by trained clinicians across consecutive therapy sessions.

9. Factor Analysis

To date, no formal exploratory factor analysis (EFA) or confirmatory factor analysis (CFA) has been published in peer-reviewed psychometric literature for the 73-item SPSAQ. The five-domain structural organization of the questionnaire was not mathematically derived through post-hoc principal component extraction or latent structural equation modeling; rather, it was established a priori via deductive conceptual mapping grounded in the theoretical framework of the New View of Women’s Sexual Problems (Kaschak & Tiefer, 2001; Klein & Morin, 2005).

If a contemporary psychometrician were to conduct exploratory and confirmatory factor analyses on a large, diverse normative cohort using the SPSAQ, the theoretical structure suggests the following latent considerations:

• Multilevel Factor Architecture: A bifactor or higher-order structural equation model would likely be required. A general latent factor of “Global Relational-Sexual Distress” would likely account for shared variance across the Overall Satisfaction, Relationships, and Psychological Factors items, while discrete group factors would capture specific variance attributable to cultural/educational deficits, traumatic sequelae, and somatic illness.
• Item-Category Mismatches in Linear Factor Models: Because the instrument integrates continuous visual analog scales (0–100 Likert-type responses) with categorical/dichotomous medical checklist items (e.g., presence/absence of diabetes, hysterectomy, prostate surgery, smoking status), standard Pearson correlation-based factor analysis would produce substantial distortion. Appropriate psychometric modeling would necessitate robust weighted least squares estimators (WLSMV) capable of simultaneously handling continuous, ordinal, and dichotomous indicators.
• Factor Independence: The Physical Factors items would almost certainly fail to form a unidimensional latent factor, given the clinical independence of varied medical conditions. In contrast, the Relationships and Psychological Factors subscales would be expected to demonstrate robust factor loadings (> .60) on latent constructs representing Interpersonal Alienation, Fear of Intimacy, and Erotic Shame.

10. Instrument / Measurement Tool

The SPSAQ is a comprehensive clinical self-report inventory consisting of 73 operational items. Below are the structural specifications and operational guidelines of the tool:

• Test Type: Multi-domain clinical self-assessment inventory; couple diagnostic profile tool.
• Target Population: Adult individuals and couples (heterosexual, same-sex, or diverse sexual orientations and gender identities) presenting for sex therapy, relationship counseling, or clinical sexual health evaluation.
• Item Count: 73 total items, accompanied by demographic queries (gender, age, relationship duration) and clinical feedback routing headers.
• Domain Breakdown:
  • Overall Satisfaction: 2 global anchor items (Sex Life Satisfaction, Emotional Intimacy Satisfaction).
  • Socio-Cultural, Political, or Economic Factors: 18 items measuring educational deficits, structural barriers, body image standards, and socio-economic fatigue.
  • Relationships: 14 items evaluating partner betrayal, fear, power dynamics, negative communication, and sexual discrepancies.
  • Psychological Factors: 7 items addressing trauma history, fear of intimacy, anger, affective distress, and compulsive sexual patterns.
  • Physical Factors: 32 items capturing systemic medical conditions, cancer/surgical histories, hormonal use, pain during arousal/orgasm, substance use, and lifestyle factors.
• Response Modality: Continuous visual analog / hidden 100-point Likert-type continuum. In the computer-administered software version, respondents use a keyboard and mouse to mark an indicator along a continuous visual dotted line anchored by semantic poles (predominantly “Yes” on one end and “No” on the other, or “Very” to “Not at all”, “Daily” to “Rarely”, and “Too Thin” to “Too Fat”). Paper-and-pencil administrations require respondents to place an “X” along the dotted continuum.
• Polarity Balancing: The left-to-right directionality of distress is intentionally varied across items by phrasing certain statements affirmatively and others negatively, mitigating unreflective acquiescence or habitual straight-line response sets.
• Skip Logic and Agency: In accordance with trauma-informed and feminist clinical ethics, respondents are fully empowered to mark “Skip” on any item or alter responses freely prior to submitting the final questionnaire.
• Administration Time: Typically 12 to 25 minutes for the computerized version; immediate automated scoring and printout generation.
• Scoring and Quantification Rules:
  • The underlying software maps the respondent’s mark along the continuous dotted line to an integer coordinate ranging from 0 to 100.
  • The scoring algorithm automatically standardizes directional polarity so that higher numerical values consistently reflect greater problem severity, higher distress, or greater dissatisfaction (0 = optimal functioning / no distress; 100 = maximum severity / acute distress).
  • For couple evaluations, individual scores are transcribed onto a synchronized Couple’s Scoring Form, providing an immediate visual profile comparing partner scores across all 73 dimensions.
  • Medical and surgical checklists are scored categorically to flag organic comorbidities requiring physician referral.

11. Permissions & Fee and Test Year

The foundational conceptual development of the SPSAQ took place between 2001 and 2005, drawing directly upon the diagnostic taxonomy published by Ellyn Kaschak and Leonore Tiefer in 2001. Elizabeth Rae Larson and Malcolm H. McKay introduced the clinical instrument through scholarly presentations at the Western Regional and Annual Meetings of the Society for the Scientific Study of Sexuality (SSSS) in 2005 (San Francisco, CA) and 2006 (Las Vegas, NV). The full instrument, scoring rationale, and mock couple diagnostic profiles were published in chapter form in Handbook of Clinical Sexuality for Mental Health Professionals (edited by Stephen B. Levine, Candace B. Risen, & Stanley E. Althof, Routledge/Taylor & Francis, 2010).

Licensing, Fees, and Clinical Permissions:

• The SPSAQ was developed as a clinical service and research tool by the Seattle Institute for Sex Therapy, Education and Research. In clinical practice, the authors maintained strict confidentiality protocols: neither identifying patient details nor raw data were electronically warehoused on public servers.
• For clinical, instructional, and academic research purposes, the paper-and-pencil instrument and clinical scoring sheets have historically been made available to mental health professionals and clinical sexologists without licensing fees, provided proper academic citation and attribution are maintained.
• Clinicians, sex therapists, and psychological researchers wishing to utilize, electronically digitize, or adapt the SPSAQ for empirical research or institutional use should direct correspondence and permission requests to: Elizabeth Rae Larson, Ph.D., Seattle Institute for Sex Therapy, Education and Research, 100 NE 56th Street, Seattle, WA 98105 (Email: [email protected]).

12. References

The theoretical framework, clinical methodology, and psychometric background of the SPSAQ are grounded in the following academic literature:

• American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). American Psychiatric Association. https://doi.org/10.1176/ajp.152.8.1228
• Basson, R. (2000). The female sexual response: A different model. Journal of Sex & Marital Therapy, 26(1), 51–65. https://doi.org/10.1080/009262300278597
• Kaschak, E., & Tiefer, L. (Eds.). (2001). A new view of women’s sexual problems. The Haworth Press. https://doi.org/10.4324/9780203049105
• Klein, M., & Morin, J. (2005, July). The new view: Men are from earth, women are from earth. Paper presented at the New View Conference, Montreal, Canada.
• Larson, E. R. (2005, May). Using the New View of Women’s Sexuality in clinical practice. Paper presented at the meeting of the Western Region of the Society for the Scientific Study of Sexuality, San Francisco, CA.
• Larson, E. R., & McKay, M. H. (2006, November). Use of the New View diagnostic system in couple sex therapy. Paper presented at the Annual Meeting of the Society for the Scientific Study of Sexuality, Las Vegas, NV.
• Larson, E. R., & McKay, M. H. (2010). The Sexual Problems Self-Assessment Questionnaire (SPSAQ). In S. B. Levine, C. B. Risen, & S. E. Althof (Eds.), Handbook of clinical sexuality for mental health professionals (2nd ed., pp. 493–502). Routledge. https://doi.org/10.4324/9780203886168
• Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Little, Brown and Company.
• Tiefer, L. (2001). A new view of women’s sexual problems: Why new? Why now? The Journal of Sex Research, 38(2), 89–96. https://doi.org/10.1080/00224490109552077
• Working Group on a New View of Women’s Sexual Problems. (2001). A new view of women’s sexual problems. Women & Therapy, 24(1-2), 1–8. https://doi.org/10.1300/J015v24n01_01

13. Items of the Scale (Questionnaire)