Sexual Self-Consciousness Scale

1. Abstract

The Sexual Self-Consciousness Scale (SSCS) is a 12-item psychometric instrument developed to assess individual differences in the dispositional propensity to experience self-consciousness and self-focused attention during sexual interactions. Grounded in cognitive-affective models of sexual dysfunction—most notably the pioneering theoretical paradigms of Masters and Johnson, David Barlow, and subsequent experimental sexological research—the scale conceptualizes attentional interference and self-monitoring as critical vulnerability factors that impede physiological sexual arousal. The SSCS comprises two psychometrically validated subscales of six items each: Sexual Embarrassment, which measures acute social-evaluative discomfort, shyness, and affective inhibition in erotic contexts, and Sexual Self-Focus, which captures introspective self-absorption, monitoring of bodily sensations, and preoccupation with one’s erotic demeanor. Endorsement is recorded on a 5-point Likert scale ranging from 0 (Strongly Disagree) to 4 (Strongly Agree), generating subscale scores from 0 to 24 and a composite score from 0 to 48.

Psychometric evaluations demonstrate that the SSCS possesses robust empirical characteristics. Factor analytic investigations using principal components analysis with direct oblimin rotation reveal an invariant two-component structure accounting for 53.7% of total variance. The instrument exhibits satisfactory to high internal consistency (Cronbach’s α = .84 for Sexual Embarrassment, α = .79 for Sexual Self-Focus, and α = .85 for the total 12-item scale) and demonstrates stable four-week test-retest reliability (r = .84, .79, and .79, respectively). Construct validity is evidenced by moderate to strong convergent correlations with the general Self-Consciousness Scale (SCS) and known-groups discriminant validity, wherein individuals diagnosed with sexual dysfunctions score significantly higher than sexually functional counterparts on both subscales. Consequently, the SSCS serves as an indispensable self-report instrument in clinical sexology, psychopathology research, and human sexuality laboratories.

2. Keywords

Sexual Self-Consciousness Scale, SSCS, sexual self-focus, sexual embarrassment, spectatoring, cognitive distraction, sexual dysfunction, genital arousal, psychometrics, sexology

3. Authors

The Sexual Self-Consciousness Scale was originally formulated in an exploratory framework by T. Hendriks (1997) and subsequently refined, standardized, and psychometrically validated by a collaborative research team from the Netherlands and Belgium:

• Jacques J. D. M. van Lankveld, Ph.D. — Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands. (Primary correspondence author; e-mail: [email protected]; currently affiliated with the Faculty of Psychology, Open University of the Netherlands).
• H. Sykora, M.D. / M.Sc. — Manë Center, Maasmechelen, Belgium.
• W. E. H. Geijen, M.Sc. — Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.

4. Purpose

The primary purpose of the Sexual Self-Consciousness Scale (SSCS) is to measure systematic individual differences in dispositional self-awareness, self-monitoring, and affective apprehension within sexual scenarios. In the discipline of sexology and clinical psychology, substantial empirical inquiry has demonstrated that sexual arousal is not exclusively an autonomic reflex; rather, it is intimately modulated by central cognitive and attentional mechanisms. When an individual engages in an intimate encounter, optimal physiological responsiveness (such as penile erection in men and vaginal lubrication or vasocongestion in women) necessitates focused processing of erotic stimuli. However, when an individual’s cognitive processing capacity is hijacked by self-scrutiny, performance fears, or hypervigilance regarding bodily functioning, sexual response is routinely impaired.

The SSCS was specifically designed to operationalize this cognitive-attentional vulnerability. Clinically, the scale facilitates targeted diagnostic assessments for individuals presenting with hypoactive sexual desire disorder, erectile dysfunction, female sexual arousal disorder, or dyspareunia. By delineating whether a patient’s sexual impediment is driven primarily by acute social evaluative anxiety (Sexual Embarrassment) or by an internalized, hyper-reflective cognitive surveillance of their somatic reactions and behavioral output (Sexual Self-Focus), clinicians can tailor cognitive-behavioral therapies (CBT), sensate focus protocols, and mindfulness-based interventions to the specific cognitive obstacle presenting in therapy.

From an empirical research perspective, the SSCS serves as a critical moderating and mediating variable in human sexual psychophysiology experiments. Laboratory investigations utilizing vaginal photoplethysmography or penile plethysmography frequently investigate the interaction between state attentional manipulations (e.g., exposing participants to performance demands or visual feedback) and trait dispositions. Studies by van Lankveld and colleagues (2004, 2008) and Meston (2006) demonstrate that experimentally induced self-directed attention differentially interacts with the personality trait of sexual self-consciousness to inhibit genital arousal, while leaving subjective sexual excitement comparatively unaltered. Thus, the SSCS bridges psychophysiological laboratory paradigms and applied clinical psychopathology, providing an empirical index for investigating the cognitive mechanisms underlying sexual health and dysfunction.

5. Psychological Construct

The overarching psychological construct quantified by the SSCS is sexual self-consciousness, defined as a stable cognitive disposition characterized by excessive inward focus on one’s physical appearance, internal sensations, erotic performance, and partner appraisal during intimate interactions. The construct draws direct structural lineage from general personality constructs of self-consciousness, specifically the public and private dimensions formalized by Allan H. Buss, Arnold Fenigstein, and Michael Scheier (1975). However, general trait self-consciousness is insufficient to capture domain-specific erotic distress; the SSCS isolates these phenomena as they manifest uniquely within romantic and erotic contexts.

The SSCS divides this broad construct into two primary, interrelated, yet psychometrically and clinically distinct dimensions:

1. Sexual Embarrassment

The Sexual Embarrassment subscale measures the affective-evaluative aspect of sexual self-consciousness. It encapsulates acute feelings of shyness, awkwardness, vulnerability, and exposure in sexual situations. Individuals who score high on this subscale report profound hesitation in sexually “letting themselves go,” experience an agonizing sense of being scrutinized or judged by their partner, and endorse intense discomfort during erotic intimacy. Examples of items reflecting this dimension include: “It takes quite some time for me to overcome my shyness in sexual situations” and “When I see myself during sex, I am irritatingly aware of myself.” Psychologically, sexual embarrassment operates as an inhibitory emotional state that triggers defensive avoidance, autonomic sympathetic activation, and subjective distress, which directly interferes with the parasympathetic dominance typically required for early stages of physiological sexual arousal.

2. Sexual Self-Focus

The Sexual Self-Focus subscale taps into the cognitive-introspective and self-monitoring dimension of sexual self-consciousness. This facet represents heightened perceptual vigilance directed toward one’s ongoing bodily sensations, sexual behavior, and internal somatic processing, alongside an ongoing mental rehearsal of how one is perceived by the partner. Rather than reflecting purely negative emotional distress, this dimension reflects an intrusive meta-cognitive surveillance during intimacy. Exemplary statements include: “I pay much attention to my sexual thoughts and feelings” and “During sex, I pay much attention to what happens inside my body.” Although self-focus can theoretically be neutral or hedonistic, within sexual contexts it frequently consumes working memory and central executive resources, depriving the central nervous system of the cognitive bandwidth required to process relevant erotic stimuli.

6. Theoretical Framework

The theoretical framework underpinning the SSCS synthesizes cognitive models of anxiety, attentional capacity theories, and established sexological models of performance anxiety. The primary foundational pillars comprise:

Masters and Johnson’s ‘Spectatoring’ Hypothesis

In their seminal work, William H. Masters and Virginia E. Johnson (1970) posited that a critical factor in the pathogenesis and maintenance of sexual difficulties is the adoption of a third-person, evaluative perspective during erotic activity—a phenomenon they famously termed “spectatoring.” Rather than immersing themselves in sensory, erotic, and relational stimuli, the individual mentally steps outside their own body to observe, monitor, and critique their performance and physical reactions. Spectatoring introduces severe performance anxiety, transforms intimacy into an evaluative test, and systematically blocks the autonomic processes that regulate sexual arousal.

Barlow’s Cognitive-Affective Model of Sexual Dysfunction

David H. Barlow (1986) substantially advanced this conceptualization by establishing a comprehensive cognitive-affective paradigm of sexual functioning. According to Barlow’s model, sexually functional individuals respond to sexual cues with positive affect, focal attention on erotic stimuli, and parasympathetic arousal, creating a positive feedback loop that intensifies sexual response. Conversely, individuals vulnerable to sexual dysfunction process sexual demands as evaluative threats. This triggers negative affect, sympathetic hyperarousal, and a disastrous attentional shift away from erotic stimuli toward non-erotic, self-evaluative cues (e.g., worries about losing an erection, body shame, or fear of disappointing a partner).

Attentional Resource Allocation and Limited Processing Capacity

Modern cognitive psychopathology emphasizes that human working memory and attentional bandwidth are finite. As outlined by Meston (2006) and van Lankveld et al. (2004, 2008), the brain cannot simultaneously process rich erotic visual, tactile, and contextual cues while dedicating substantial cognitive capacity to introspective rumination and self-monitoring. When dispositional sexual self-consciousness is high, attentional resources are monopolized by internal states (e.g., somatic monitoring, fear of negative evaluation). Consequently, insufficient cognitive resources remain available to appraise the erotic stimulus itself, blunting downstream neurovascular responses in genital tissue. The SSCS directly operationalizes this cognitive bottleneck, providing a measurement framework for exploring how trait self-focus undermines sexual arousal.

7. Validity

The validation of the SSCS was thoroughly established by van Lankveld, Geijen, and Sykora (2008) across several methodological dimensions using a sample of 282 clinical and non-clinical participants (253 providing full demographic and psychometric datasets; 171 women, 82 men; age range 16–75 years):

Construct and Known-Groups Validity

Known-groups validity was established by comparing sexually functional participants with an identified subsample of 61 sexually dysfunctional participants (42 women, 19 men) diagnosed via clinical screening. Sexually dysfunctional individuals scored significantly higher than functional individuals on both subscales:

• Sexual Embarrassment: Functional M vs. Dysfunctional M, yielding a robust main effect of group, F(1, 235) = 10.98, p = .001.
• Sexual Self-Focus: Dysfunctional individuals exhibited significantly elevated cognitive self-focus compared to functional peers, F(1, 235) = 8.97, p < .005.

Furthermore, demographic analyses revealed significant main effects of sex on Sexual Embarrassment, F(1, 235) = 12.07, p = .001, with women reporting higher embarrassment than men, whereas Sexual Self-Focus showed no sex differences. Participants without a partner also reported significantly higher Sexual Embarrassment, F(1, 235) = 8.26, p < .005, than individuals in steady relationships. In repeated MANCOVAs controlling for relationship duration, these group and sex differences remained statistically robust.

Convergent and Divergent Validity

Construct validity was further evaluated through bivariate correlations with theoretically relevant external measures:

• Convergence with General Self-Consciousness: In line with theoretical expectations, both SSCS subscales demonstrated medium-to-large positive correlations with the subscales of the general Self-Consciousness Scale (Fenigstein et al., 1975), validating that the SSCS taps into the broad disposition of self-consciousness while applying it to sexual interactions.
• Divergence with General Psychological Distress: Divergent validity was examined against the Symptom Checklist-90 (SCL-90). The Sexual Self-Focus subscale demonstrated low to moderate correlations (.20 > r > .24, p < .05) with general psychological distress subscales, confirming that cognitive self-monitoring during sex is distinct from general psychiatric symptomatology. Conversely, Sexual Embarrassment correlated moderately to strongly with SCL-90 distress markers (e.g., r = .36 with Somatic Complaints, r = .49 with Depression), reflecting the pronounced negative affect and emotional dysregulation intertwined with sexual shame.

8. Reliability

The psychometric evaluation of the SSCS demonstrates excellent internal consistency and temporal stability across diverse participant groups:

Internal Consistency

Internal consistency was calculated using Cronbach’s alpha (α) in the validation sample of 253 participants (van Lankveld et al., 2008):

• Total SSCS (12 items): α = .85 (indicative of high overall scale reliability).
• Sexual Embarrassment Subscale (6 items): α = .84 (demonstrating strong internal homogeneity).
• Sexual Self-Focus Subscale (6 items): α = .79 (demonstrating satisfactory internal reliability).

Multitrait scaling analysis (Hays & Hayashi, 1990) confirmed item-scale convergent validity (all items correlated strongly with their hypothesized subscale) and item-scale discriminant validity (each item correlated higher with its own subscale than with the competing subscale). The inter-subscale correlation was r = .44 (p < .001). Because this correlation is substantially lower than the respective internal consistency coefficients of each subscale, it provides empirical evidence that Sexual Embarrassment and Sexual Self-Focus measure related but psychometrically distinct constructs.

Test-Retest Reliability

Temporal stability was evaluated across a 4-week test-retest interval. The coefficients confirmed that the SSCS captures a stable personality disposition rather than transient situational fluctuations:

• Sexual Embarrassment Subscale: r = .84, p < .001.
• Sexual Self-Focus Subscale: r = .79, p < .001.
• Total SSCS Composite: r = .79, p < .001.

9. Factor Analysis

The dimensional structure of the SSCS was established through rigorous exploratory factor analysis. Initially, Hendriks (1997) selected 15 items designed to capture private and public self-consciousness, sexual anxiety, and discomfort. In the validation study by van Lankveld, Geijen, and Sykora (2008), these items were submitted to a principal components analysis (PCA). The initial extraction yielded two robust components with eigenvalues exceeding Kaiser’s criterion (> 1.0). Based on statistical item evaluation, subscale reliability, and multitrait scaling analysis, three underperforming items were removed, leaving a 12-item final inventory.

A final PCA with oblimin rotation (allowing the underlying dimensions to correlate) was executed on the 12 retained items. This confirmed a clean two-component solution without problematic cross-loadings (loadings < .40 were suppressed):

• Component 1 (Sexual Embarrassment): Eigenvalue = 4.58, accounting for 38.10% of the total variance. Primary item pattern loadings ranged from .57 to .84:
• Item 11 (“It takes quite some time for me to overcome my shyness in sexual situations”): .84
• Item 4 (“I quickly feel embarrassed in sexual situations”): .80
• Item 1 (“I feel uncomfortable in sexual situations”): .79
• Item 9 (“I find it difficult to sexually let myself go in front of the other person”): .76
• Item 10 (“When I see myself during sex, I am irritatingly aware of myself”): .60
• Item 12 (“I continuously feel being observed by the other person during sex”): .57
• Component 2 (Sexual Self-Focus): Eigenvalue = 1.87, accounting for 15.60% of the total variance. Primary item pattern loadings ranged from .55 to .73:
• Item 7 (“I am aware during sex of the impression I make on the other person”): .73
• Item 3 (“I pay much attention to my sexual thoughts and feelings”): .73
• Item 5 (“I often wonder during sex what the other person thinks of me”): .68
• Item 6 (“I am preoccupied by the way I behave sexually”): .68
• Item 8 (“During sex, I pay much attention to what happens inside my body”): .62
• Item 2 (“I often imagine how I behave during sex”): .55

Together, these two components explain 53.7% of the total variance, demonstrating a concise and statistically robust representation of the sexual self-consciousness domain.

10. Instrument / Measurement Tool

• Test Type: Self-report psychological questionnaire / psychometric rating scale.
• Target Population: Adolescents and adults (validated for ages 16 to 75) who are or have been sexually active.
• Item Count: 12 items.
• Subscales:
  • Sexual Embarrassment (6 items: Items 1, 4, 9, 10, 11, 12).
  • Sexual Self-Focus (6 items: Items 2, 3, 5, 6, 7, 8).
• Response Format: 5-point Likert scale:
  • 0 = Strongly Disagree
  • 1 = Disagree a Little
  • 2 = Neither Agree nor Disagree
  • 3 = Agree a Little
  • 4 = Strongly Agree
• Administration Time: Approximately 3 to 5 minutes.
• Scoring Instructions:
  • All items are positively keyed (there are no reverse-scored items).
  • Sexual Embarrassment Score: Sum of ratings on Items 1, 4, 9, 10, 11, and 12 (Range: 0 to 24).
  • Sexual Self-Focus Score: Sum of ratings on Items 2, 3, 5, 6, 7, and 8 (Range: 0 to 24).
  • Total SSCS Score: Sum of all 12 items (Range: 0 to 48).
  • Higher scores indicate higher levels of trait sexual self-consciousness, greater attentional interference, and heightened vulnerability to sexual dysfunction.

11. Permissions & Fee and Test Year

The Sexual Self-Consciousness Scale (SSCS) was developed between 1997 (initial conceptualization by T. Hendriks) and 2008 (formal empirical validation published in the Archives of Sexual Behavior). The copyright is held by Maastricht University, The Netherlands; J. J. D. M. van Lankveld, T. Hendriks, W. Geijen, & H. Sykora (2008).

The scale is available for academic, non-commercial research, and clinical use under standard scholarly fair-use conventions. Researchers and clinicians wishing to utilize the instrument in formal studies or clinical trials are advised to contact the primary corresponding author, Prof. Dr. Jacques van Lankveld ([email protected]), at the Department of Clinical Psychological Science, Maastricht University, to request formal permissions or check for updated language adaptations and clinical norm updates.

12. References

• 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
• Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
• Fenigstein, A., Scheier, M. F., & Buss, A. H. (1975). Public and private self-consciousness: Assessment and theory. Journal of Consulting and Clinical Psychology, 43(4), 522–527. https://doi.org/10.1037/h0076760
• Hays, R. D., & Hayashi, T. (1990). Beyond internal consistency reliability: Rationale and user’s guide for Multitrait Analysis Program on the microcomputer. Behavior Research Methods, Instruments, & Computers, 22(2), 167–175. https://doi.org/10.3758/BF03203140
• Hendriks, T. (1997). Een hypothetisch cognitief verklaringsmodel voor seksuele dysfuncties [A hypothetical cognitive explanatory model of sexual dysfunction] (Unpublished master’s thesis). Maastricht University, Maastricht, The Netherlands.
• Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Little, Brown and Company.
• Meston, C. M. (2006). The effects of state and trait self-focused attention on sexual arousal in sexually functional and dysfunctional women. Behaviour Research and Therapy, 44(4), 515–532. https://doi.org/10.1016/j.brat.2005.03.011
• van Lankveld, J. J. D. M., & Bergh, S. (2008). The interaction of state and trait aspects of self-focused attention affects genital, but not subjective, sexual arousal in sexually functional women. Behaviour Research and Therapy, 46(4), 514–528. https://doi.org/10.1016/j.brat.2008.01.011
• van Lankveld, J. J. D. M., Geijen, W., & Sykora, H. (2008). Reliability and validity of the Sexual Self-Consciousness Scale: Psychometric properties. Archives of Sexual Behavior, 37(6), 925–933. https://doi.org/10.1007/s10508-007-9263-6
• van Lankveld, J. J. D. M., van den Hout, M. A., & Schouten, E. G. (2004). The effects of self-focused attention, performance demand, and dispositional sexual self-consciousness on sexual arousal of sexually functional and dysfunctional men. Behaviour Research and Therapy, 42(8), 915–935. https://doi.org/10.1016/j.brat.2003.08.006

13. Items of the Scale (Questionnaire)