Sexual Modes Questionnaire (SMQ). Translation and psychometric properties of the italian version of the Automatic Thought Scale

Background: The Sexual Modes Questionnaire (SMQ) is a validated and widespread used tool to assess the association among negative automatic thoughts, emotions, and sexual response during sexual activity in men and women. Aim: To test the psychometric characteristics of the Italian version of the SMQ focusing on the Automatic Thoughts subscale (SMQ-AT). Methods: After linguistic translation, the psychometric properties (internal consistency, construct, and discriminant validity) were evaluated. 1,051 participants (425 men and 626 women, 776 healthy and 275 clinical groups complaining about sexual problems) participated in the present study. Outcomes: 2 confirmatory factor analyses were conducted to test the fit of the original factor structures of the SMQ versions. In addition, 2 principal component analyses were performed to highlight 2 new factorial structures that were further validated with confirmatory factor analyses. Cronbach α and composite reliability were used as internal consistency measures and differences between clinical and control groups were run to test the discriminant validity for the male and female versions. The associations with emotions and sexual functioning measures also are reported. Results: Principal component analyses identified 5 factors in the male version: erection concerns thoughts, lack of erotic thoughts, age- and body-related thoughts, negative thoughts toward sex, and worries about partner's evaluation and failure anticipation thoughts. In the female version 6 factors were found: sexual abuse thoughts, lack of erotic thoughts, low self-body image thoughts, failure and disengagement thoughts, sexual passivity and control, and partner's lack of affection. Confirmatory factor analysis supported the adequacy of the factor structure for men and women. Moreover, the SMQ showed a strong association with emotional response and sexual functioning, differentiating between clinical and control groups. Clinical Translation: This measure is useful to evaluate patients and design interventions focused on negative automatic thoughts during sexual activity and to develop multicultural research. Strengths and Limitations: This study reports on the translation and validation of the Italian version of a clinically useful and widely used measure (assessing automatic thoughts during sexual activity). Limits regarding sampling technique and use of the Automatic Thoughts subscale are discussed in the article. Conclusion: The present findings support the validity and the internal consistency of the Italian version of the SMQ-AT and allow the assessment of negative automatic thoughts during sexual activity for clinical and research purposes. Nimbi FM, Tripodi F, Simonelli C, Nobre P. Sexual Modes Questionnaire (SMQ): Translation and Psychometric Properties of the Italian Version of the Automatic Thought Scale. J Sex Med 2018;15:396–409