The Spanish Version of the International Index of Erectile Function: Adaptation and Validation.

BACKGROUND: The International Index of Erectile Function (IIEF) is a widely employed questionnaire in urology to assess erectile dysfunction (ED) in both clinical research and practice. OBJECTIVE: To translate and culturally adapt the Spanish version of the International Index of Erectile Function (IIEF) and to analyze its psychometric properties in Spanish men with erectile dysfunction (ED). METHODS: Firstly, direct and reverse translations were performed. Secondly, a pilot study was carried out on 23 patients with the lowest possible education level without being illiterate. Finally, 170 participants completed the IIEF. Test-retest reliability, internal consistency and construct validity (exploratory factor analysis) were assessed. Concurrent and divergent validity were evaluated with the Hospital Anxiety and Depression Scale (HADS) and the 12-item Short-Form Health Survey (SF-12), respectively. Discriminant validity (with and without anxiety or depression) was calculated using a receiver-operating characteristic curve analysis. RESULTS: High internal consistency (Cronbach's alpha = 0.968, total score) and moderate-to-excellent test-retest reliability were found. The factor analysis showed a two-factor structure (explained variance of 77.34%). Significant correlations of the IIEF total score (p < 0.01) and domains (p < 0.05) with HADS anxiety and depression scores were observed (concurrent validity), while non-significant correlations with SF-12 physical and mental summary scores were found (divergent validity). The IIEF total score could discriminate between participants with and without anxiety (p < 0.05) and depression (p < 0.01), with an optimal cut-off point of <39.50 for both anxiety (48.30% sensitivity and 78.75% specificity) and depression (50.00% sensitivity and 81.01% specificity). CLINICAL IMPLICATIONS: The psychometric properties of the IIEF have not been analyzed in Spanish people to date. Strengths and Limitations: The Spanish version of the IIEF was shown to be capable of discriminating between men with erectile dysfunction with and without depression or anxiety. There are some limitations to this study that should be noted. It was conducted on Spanish participants, and, thus, it should be employed with caution in other Spanish-speaking countries. This study was carried out on a selected population, and, therefore, the generalizability of its results to other populations might be limited. Moreover, a large majority of the participants (89.41%) had secondary or higher education. Future studies should be performed on a more general population with a varied geographical and educational background. CONCLUSIONS: The Spanish IIEF is a valid and reliable instrument for assessing erectile function among Spanish men with ED.

[Validation of the Spanish version of the Golombok Rust Inventory of Sexual Satisfaction]. / Validación de la versión española del Golombok Rust Inventory of Sexual Satisfaction.

INTRODUCTION: Self-reports are one of the most used techniques in the evaluation of human sexuality. For this reason, valid and reliable evaluation instruments are necessary for high quality studies. OBJECTIVE: The main purpose of this study was to translate and validate the Golombok Rust Inventory of Sexual Satisfaction for use in Spanish. METHOD: A sample of 1,265 subjects (1,007 men, 258 women) completed the Golombok Rust Inventory of Sexual Satisfaction questionnaire. Two independent translators performed the translation and a group of experts unified the versions. RESULTS: The items showed adequate correlation, both in the men's version (0.306-0.440), and in the women's version (0.355-0.652). Reliability is high in both versions (men: 0.864; women: 0.924). Factor analysis adjusts to the theoretical dimensions proposed by the authors of the questionnaire, explaining 57.75% of the variance in men, and 66.67% in women. CONCLUSIONS: The Spanish version of the Golombok Rust Inventory of Sexual Satisfaction has the necessary psychometric properties to be used both in the clinic and in research.

Creating and Validating the DESEA Questionnaire for Men and Women.

In clinical practice, it is essential to be able to identify hypoactive sexual desire disorder (HSDD), with its different severity levels and assess the influence the subject's relationship has on the issue. In order to do this, questionnaires are needed that comprise appropriate psychometric properties. We analyzed the psychometric properties and factorial structure of the Sexual Desire and Aversion (DESEA) questionnaire that evaluates sexual desire and interpersonal stress (relationship problems) in male and female couples. A pilot study was conducted with a group of 1583 people. Finally, it included 20,424 Spanish speakers who answered the questionnaire via an online link. The requirements for factor analysis were verified followed by the exploratory and confirmatory factor analysis. The Cronbach's alpha coefficient calculated the reliability of the test scores at 0.834 in the pilot group and 0.889 in the final group. A 3-factor factorial design explains the 62.08% variance. The KMO (Kaiser-Meyer-Olkin) test (p = 0.904), Bartlett's test of sphericity (126,115.3; p = 0.000010) and the matrix determinant (0.0020770) verified the appropriateness of the factor analysis. The results show that the DESEA questionnaire is a reliable and valid instrument for evaluating desire and interpersonal stress, both in women and men, in clinical and research contexts.

Efectos del consumo de drogas y de la ansiedad en la eyaculación precoz en una muestra de drogodependientes españoles / Effects of drug use and anxiety on premature ejaculation in a sample of Spanish drug addicts

Introducción: La eyaculación precoz puede deberse a múltiples factores y uno de ellos puede ser el consumo de drogas. Objetivos: El objetivo principal de este estudio es conocer cómo afecta el consumo de drogas a la respuesta eyaculatoria, teniendo en cuenta las diferentes sustancias de consumo, el nivel de ansiedad y el tiempo de abstinencia. Método: Se utilizaron 2 muestras, una correspondiente a hombres que han tenido un historial de consumo de sustancias adictivas (n=925) y otra de hombres no consumidores (n=82). Ambas muestras fueron seleccionadas de 28 centros de tratamiento. Se utilizaron los cuestionarios Golombok Rust Inventory of Sexual Satisfaction (GRISS) y el Cuestionario de Ansiedad Estado Rasgo (STAI). Resultados: Los resultados muestran que los hombres con historia de consumo obtienen porcentajes mayores en eyaculación precoz frente a los no consumidores (44,3>15,9%) y puntuaciones medias también mayores en ansiedad (estado=19,83>11,89; rasgo=25,66>12,39), siendo dichas diferencias estadísticamente significativas (p=0,000). Los resultados confirman que el período de abstinencia no mejora la respuesta eyaculatoria y tener pareja no funciona como factor de protección en la eyaculación precoz. Conclusiones: Los hombres con historia de consumo de drogas tienen más probabilidad de padecer eyaculación precoz y más ansiedad, que no mejora en el período de abstinencia, lo que incita a pensar que los consumidores de drogas tienen rasgos de personalidad que predisponen la eyaculación precoz y/o que los daños neurológicos ocasionados por la drogas contribuyen a disminuir la latencia intravaginal eyaculatoria, cuestiones que deben ser estudiadas en próximas investigaciones

Introduction: Premature ejaculation may be due to many factors and one of them may be drug use. Aims: The main objective of this study is to show how drug abuse affects the ejaculatory response, keeping in mind the different substances consumed, the level of anxiety and the period of withdrawal. Method: Two samples were used, one for men who were addicted to drugs (N=925) and one of non-consumers (N=82). Both samples were selected from 28 treatment centers. The Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire and the State Anxiety Trait Questionnaire (STAI) were used. Results: The results show that men with a history of consumption obtain higher percentages in premature ejaculation compared to non-users (44.3%> 15.9%) and also higher mean scores in anxiety (State Anxiety=19.83>11, 89; Trait Anxiety=25.66>12.39). These differences were statistically significant (P=.000). The results confirm that the withdrawal period does not improve ejaculatory response and having a partner does not work as a protective factor in premature ejaculation. Conclusions: Men with a history of drug use are more likely to suffer from premature ejaculation and higher levels of anxiety, which does not improve during the period of withdrawal, leading to the belief that drug users have personality traits that facilitate premature ejaculation and/or that the neurological damages caused by the drugs contribute to a decrease in the intravaginal ejaculatory latency, issues that should be studied in future investigations

[Effects of drug use and anxiety on premature ejaculation in a sample of Spanish drug addicts]. / Efectos del consumo de drogas y de la ansiedad en la eyaculación precoz en una muestra de drogodependientes españoles.

INTRODUCTION: Premature ejaculation may be due to many factors and one of them may be drug use. AIMS: The main objective of this study is to show how drug abuse affects the ejaculatory response, keeping in mind the different substances consumed, the level of anxiety and the period of withdrawal. METHOD: Two samples were used, one for men who were addicted to drugs (N=925) and one of non-consumers (N=82). Both samples were selected from 28 treatment centers. The Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire and the State Anxiety Trait Questionnaire (STAI) were used. RESULTS: The results show that men with a history of consumption obtain higher percentages in premature ejaculation compared to non-users (44.3%> 15.9%) and also higher mean scores in anxiety (State Anxiety=19.83>11, 89; Trait Anxiety=25.66>12.39). These differences were statistically significant (P=.000). The results confirm that the withdrawal period does not improve ejaculatory response and having a partner does not work as a protective factor in premature ejaculation. CONCLUSIONS: Men with a history of drug use are more likely to suffer from premature ejaculation and higher levels of anxiety, which does not improve during the period of withdrawal, leading to the belief that drug users have personality traits that facilitate premature ejaculation and/or that the neurological damages caused by the drugs contribute to a decrease in the intravaginal ejaculatory latency, issues that should be studied in future investigations.

[Guide for the classification of clinical research articles for the International Journal of Andrology]. / Guía para la clasificación de artículos de investigación clínica para la Revista Internacional de Andrología.

The classification of knowledge is essential for understanding between researchers and the advancement of science. In this article a brief classification of clinical research methods is presented. The advantages that researchers use the same nomenclature are recalled, which enables improved communication among researchers, facilitates replication of studies and searches in databases, and helps to establish the aspects that can affect the different research models. They are grouped into four broad categories: epidemiological articles, articles of qualitative methodology, mixed methodology articles and review articles.

Guía para la clasificación de artículos de investigación clínica para la Revista Internacional de Andrología / Guide for the classification of clinical research articles for the International Journal of Andrology

La clasificación del conocimiento es fundamental para el entendimiento entre los investigadores y el avance de la ciencia. En el presente artículo se presenta una breve clasificación de los métodos de investigación clínica. Se recuerdan las ventajas que presenta el hecho de que los investigadores utilicen una misma nomenclatura: mejora la comunicación entre los investigadores, facilita la replicabilidad de los estudios y la búsqueda de artículos en las bases de datos, y ayuda a conocer los aspectos que pueden afectar a los diferentes modelos de investigación. Se agrupan en 4 grandes categorías: artículos epidemiológicos, artículos de metodología cualitativa, artículos de metodología mixta y artículos de revisión

The classification of knowledge is essential for understanding between researchers and the advancement of science. In this article a brief classification of clinical research methods is presented. The advantages that researchers use the same nomenclature are recalled, which enables improved communication among researchers, facilitates replication of studies and searches in databases, and helps to establish the aspects that can affect the different research models. They are grouped into four broad categories: epidemiological articles, articles of qualitative methodology, mixed methodology articles and review articles

Cuestionario de Ansiedad Estado Rasgo (STAI): análisis psicométrico y funcionamiento en una muestra de drogodependientes y controles / State Trait Anxiety Inventory (STAI): Psychometric Analysis and Functioning in a Sample of Drug Addicts and Controls

Resumen La presente investigación pretende evaluar las propiedades psicométricas del cuestionario STAI en población drogodependiente y comparar sus resultados con población no clínica. Se realizó un muestreo por conglomerados en 28 centros de tratamiento para las adicciones, repartidos en 27 provincias españolas. La muestra final estuvo compuesta por 1054 personas consumidoras de sustancias y 211 no consumidoras. El análisis de la fiabilidad mostró adecuada validez interna. El análisis de los ítems indica la necesidad de revisar dos de los ítems cuando se utiliza en población con historial de consumo de sustancias adictivas. Los resultados muestran que las personas con un historial de drogodependencia obtuvieron una puntuación media superior a las personas no drogodependientes, que las mujeres consiguieron una puntuación media superior a los hombres y que las personas que habían consumido sustancias depresoras lograron una puntuación superior a las que habían consumido sustancias estimulantes. Las diferencias fueron estadísticamente significativas.

Abstract This investigation intends to assess the psychometric properties of the questionnaire STAI in a sample of drug abusers versus a non-clinic sample. It was carried out a sampling for conglomerates in 28 treatment centers for addiction, distributed in 27 Spanish provinces. The sample was composed by 1054 subjects who had a history of substance use and 211 with no history of substance abuse. The analysis of reliability showed an internal appropriate validity. The items analysis shows the necessity to revise two items when the questionnaire is used with drug abusers population. The results show that people with a history of consumption obtained a higher mean score than those who had not used substances, women obtained a higher mean score than males, and that people who had used depressants obtained a score higher than those who had consumed stimulants. The differences were statistically significant.

Sexual Pain Disorders in Spanish Women Drug Users.

BACKGROUND: The impact of pain in sexuality, couple relationships and the quality of life is very well known. OBJECTIVES: The relationship between substance abuse and the presence of sexual pain disorder is assessed, together with anxiety and sexual attitudes . METHOD: Two samples were selected. One sample for women with a history of substance abuse (n = 129), and another one of women nonconsumers (n = 129). The Golombok Rust Inventory of Sexual Satisfaction (GRISS), the Sexual Opinion Survey (SOS) and the State Trait Anxiety Inventory (STAI) questionnaires were used. RESULTS: The results indicate that women consumers obtained a higher mean scores in sexual pain disorder (4.88 > 2.89, that is 65.12%), plus higher mean scores on state anxiety (23.82 > 14.56) and trait anxiety (30.93 > 16.95), and lower average figure in erotophilia (84.93 < 95.81). It was also verified that the period of abstinence does not improve sexual response. CONCLUSIONS: Substance consumption affects sexual response in women negatively. Sexual response does not improve with abstinence period.

Sexual pain disorders.

PURPOSE OF REVIEW: The purpose of this review was to assess recent research (the last 18 months) and its impact on understanding sexual pain disorders relevant to daily clinical practice. RECENT FINDINGS: It has been highlighted that sexual pain is related to the number of tender points, pressure pain threshold, more deliberate fear and less global positive affective associations with sexual stimuli, episiotomy, attachment styles, drug abuse and the influence of ambivalence over emotional expression in couples.The efficacy of a multidisciplinary vulvodynia programme of treatment, another type of therapy based on the fear-avoidance and pain self-efficacy model and a novel cognitive-behavioral couple therapy has been stated. SUMMARY: There is a gradual advance in the knowledge of sexual pain disorder etiology. At the same time different therapeutics strategies have been increasing, but it is necessary to introduce guidelines on the basis of the evidence to approach with efficacy this severe disorder. VIDEO ABSTRACT: http://links.lww.com/YCO/A31.

SOSPECHA (Sexual Opinion Survey en Población Española Con Historial de Adicciones) / SOSPECHA (Sexual Opinion Survey in a Spanish Population With a History of Addiction)

Introducción: Las actitudes sexuales son un aspecto importante que evaluar en terapia sexual y en el trabajo con personas con problemas de adicciones; por ese motivo, es necesario contar con instrumentos adecuados para su medida. Objetivos: Adaptación del cuestionario Sexual Opinion Survey a una población española con historial de adicciones, analizando su estructura factorial y su fiabilidad; comparar los resultados obtenidos en el cuestionario entre población con historial de adicciones y población sin historial de consumo de sustancias. Método: La muestra fue seleccionada de 28 centros de tratamiento, repartidos en 27 provincias españolas, mediante muestreo por conglomerados, formándose 2 grupos, uno experimental (personas drogodependientes) y otro control (personas no dependientes), contándose con una muestra de 1.054 personas para el primero y de 211 para el segundo. Resultados: Se encontraron 5 factores para la estructura del grupo control y 6 factores para el grupo experimental. Conclusiones: Se confirman 2 de las 3 hipótesis, según las cuales, las personas del grupo control y del grupo experimental tendrán una estructura factorial diferente en el cuestionario, y las personas del grupo control serán más erotofílicas que las personas del grupo experimental; además, se observa la tendencia de los hombres a puntuar más alto de media en el cuestionario que las mujeres, aunque sin llegar a ser una diferencia estadísticamente significativa, resultados que no concuerdan con los obtenidos en investigaciones previas, donde se señalaba que los varones eran bastante más erotofílicos que las mujeres, lo que hace pensar que en los 24 años transcurridos desde el desarrollo del Sexual Opinion Survey, las actitudes sexuales de las mujeres han cambiado, asemejándose más a los hombres (AU)

Introduction: Sexual attitudes are an important aspect of therapeutic work, especially in persons with addictions. Consequently, it is important to have appropriate assessment instruments that can be used in this population. Objective: One of the goals of the present work was to adapt the Sexual Opinion Survey (SOS) to a Spanish population with a history in addictive behavior and to analyze its factorial structure and reliability. Another goal was to compare the results of the questionnaire obtained in this population with those of another population with no history of addiction. Method: The sample was selected from 28 treatment centers, distributed in 27 Spanish provinces, through conglomerate sampling. There were two groups: an experimental group (with 1054 persons with addictions) and a control group (211 persons with no addictions). Results: Five factors were found for the structure of the control group and six factors for that of the experimental group. Conclusions: The results of this study confirmed two of the three initial hypotheses. The control group and experimental group have a different factorial structure and people in the control group have a higher level of erotophilia. We also observed a tendency for men to have higher mean questionnaire scores than women, but these differences were not statistically significant. These results do not agree with those obtained in previous investigations, which indicated that men were more erotophilic than women, suggesting that, in the 24 years since the development of the SOS, sexual attitudes among women have changed and now more closely resemble those of men (AU)

Aspectos psicosociales del manejo de la disfunción eréctil / Psycosocial features of the management of erectile dysfunction

OBJETIVO: La sexualidad en general y la respuesta eréctil en particular no son ajenas a aspectos psico-socio-culturales y de pareja.Poner de relieve aquellos aspectos psicológicos y de pareja que interfieren en la erección y asimismo señalar las pautas de intervención en terapia de pareja que mejores resultados obtienen en el tratamiento de la disfunción eréctil.MÉTODOS: Se ha hecho una revisión de la literatura en torno a los aspectos psicológicos y sociales según los hábitos de vida actual en relación a la fisiología de la respuesta eréctil, además de revisar los distintos modelos de tratamiento en pareja.RESULTADOS/CONCLUSIONES: La separación del binomio reproducción-placer conseguido en los años 50 ha permitido una reivindicación progresiva por parte de la mujer de su necesidad de ser satisfecha, constituyendo uno de los motivos que han dado lugar al fenómeno de la “ansiedad de ejecución, que junto con otros hábitos tóxicos (tabaco, alcohol, drogas, vida sedentaria, etc.) facilitan la aparición de disfunción eréctil. Cuando los factores psicológicos forman parte importante del problema, la terapia sexual de pareja combinada con inhibidores de la fosfodiesterasa cinco constituye la estrategia terapéutica de elección(AU)

OBJECTIVES: Sexuality on the whole and erectile response particularly are not alien to psychosocial and couple features. We review al psychological and couple features that interfere on erection and also point out the interventional directions of couple therapy that give the best results in the treatment of erectile dysfunction.METHODS: We performed a bibliographic review about the psychological and social features under the current way of life in relation to erectile response physiology, in addition to review different models of couple therapy.RESULTS/CONCLUSIONS: The separation of the couple reproduction-pleasure achieved in the 50`s enabled a progressive claim from women of their need to be satisfied, representing one of the reasons that led to the phenomenon of “performance anxiety” that, altogether with some toxic habits (Tobacco consumption, alcohol, drugs, sedentary life, etc) help the appearance of erectile dysfunction. When psychological factors are an important part of the problem, couple sexual therapy in combination with phosphodiesterase 5 inhibitors is the therapy of choice(AU)

[Validation of the Spanish version of the SEAR (Self-Esteem And Relationship Questionnaire) for men with erectile dysfunction]. / Validación de la versión española del cuestionario SEAR (Self-Esteem And Relationship Questionnaire) para varones con disfunción eréctil.

BACKGROUND AND OBJECTIVE: The aim was to validate the Spanish version of the Self-Esteem and Relationship Questionnaire (SEAR), specific for patients with erectile dysfunction (ED), and based on the concept of self-esteem, for use in research and clinical practice in Spain. PATIENTS AND METHOD: Observational, prospective, multisite, study comparing patients with ED (IIEF questionnaire score < 26 points), with a score (3/4) 16 points in the Self-Esteem domain of the SEAR questionnaire and undergoing treatment with sildenafil (group A), and healthy control subjects without ED. Patients with ED were assessed at baseline and after 3 months' treatment. RESULTS: Among 586 evaluable subjects (504 patients with ED and 82 health subjects) the questionnaire showed: a) adequate feasibility with a percentage of patients without response < 5%; b) adequate reliability with Cronbach alpha coefficients for the total and all domains (Sexual-Relationship, Confidence, Self-Esteem, and Overall-Relationship), of SEAR questionnaire, respectively: 0.92, 0.89, 0.84, 0.75, and 0.82 un patients, and 0.86, 0.80, 0.73, 0.56 and 0.74 un healthy subjects; c) adequate discriminatory validity between patients and healthy subjects (Mann-Whitney test, p < 0.0001), and between patients with vaying degrees of ED (Kruskall-Wallis test, p < 0.05); d) adequate convergent/divergent validity (correlations > 0.5 with the IIEF questionnaire and r > 0.3 and < 0.5 with Mental Health domain score of SF-12 questionnaire); e) adequate construct validity, obtaining 2 domains: Sexual-Relationship, and Confidence, and f) adequate sensitivity to clinical changes (SES: 2.1/SRM: 1.5/SEM: 4.4/MID: 13.1). Mark scores were estimated. CONCLUSIONS: The Spanish version of the SEAR questionnaire showed adequate and similar psychometric properties to those shown with the original English version.

Validación de la versión española del cuestionario SEAR (Self-Esteem And Relationship Questionnaire) para varones con disfunción eréctil / Validation of the Spanish version of the SEAR (Self-Esteem And Relationship Questionnaire) for men with erectile dysfunction

Fundamento y objetivo: Validar la versión española del cuestionario específico para disfunción eréctil SEAR (Self-Esteem And Relationship Questionnaire), centrado en el concepto de autoestima, para su uso en la investigación y/o práctica clínica en España. Pacientes y método: Estudio observacional, prospectivo, multicéntrico y comparativo entre pacientes con disfunción eréctil (DE) ­puntuación inferior a 26 puntos en cuestionario IIEF (Índice Internacional de Función Eréctil)­ y con ¾ 16 puntos o menos en la dimensión Autoestima del cuestionario SEAR, en tratamiento con sildenafilo (grupo A), y sujetos controles sanos sin DE (grupo B). Se evaluó a los pacientes con DE en la visita basal y a los 3 meses de tratamiento. Resultados: El cuestionario mostró en 586 sujetos valorables (504 pacientes con DE y 82 sujetos sanos): a) adecuada factibilidad, con porcentaje de pacientes sin respuesta inferior al 5%; b) adecuada fiabilidad, con coeficientes alfa de Cronbach para SEAR total y dimensiones Relaciones sexuales, Autoconfianza, Autoestima y Relaciones en General, respectivamente de 0,92, 0,89, 0,84, 0,75 y 0,82 en los pacientes, y de 0,86, 0,80, 0,73, 0,56 y 0,74 en sujetos sanos; c) adecuada validez discriminante entre pacientes y sujetos sanos (prueba Mann-Whitney p 0,5 con cuestionario IIEF, y r 0,3 con escala Salud Mental del cuestionario SF-12); e) adecuada validez de constructo, encontrando las dimensiones Relaciones Sexuales y Autoconfianza, y f) adecuada sensibilidad para detectar cambios clínicos (tamaño del efecto estandarizado: 2,1; respuesta media estandarizada: 1,5; error estándar de medida: 4,4; diferencia mínimamente importante: 13,1). Se estimaron las puntuaciones de referencia. Conclusiones: La versión española del cuestionario SEAR mostró propiedades psicométricas adecuadas y similares a las de la versión original en inglés

Background and objective: The aim was to validate the Spanish version of the Self-Esteem and Relationship Questionnaire (SEAR), specific for patients with erectile dysfunction (ED), and based on the concept of self-esteem, for use in research and clinical practice in Spain. Patients and method: Observational, prospective, multisite, study comparing patients with ED (IIEF questionnaire score 0.5 with the IIEF questionnaire and r > 0.3 and < 0.5 with Mental Health domain score of SF-12 questionnaire); e) adequate construct validity, obtaining 2 domains: Sexual-Relationship, and Confidence, and f) adequate sensitivity to clinical changes (SES: 2.1/SRM: 1.5/SEM: 4.4/MID: 13.1). Mark scores were estimated. Conclusions: The Spanish version of the SEAR questionnaire showed adequate and similar psychometric properties to those shown with the original English version