Each month, questions with a common theme will be selected and answered comprehensively by one of our Steering Committee members. Previously answered questions will be archived each month for your reference. If you wish to submit a question, click here.

To view archived responses, click here.

This Month's Question:

The validated short form of the Psychological and Interpersonal Relationship Scales (SF-PAIRS) for erectile dysfunction (ED) screening, diagnosis, and management differs slightly from the original. What are the notable characteristics that differentiate the Psychological and Interpersonal Relationship Scales (PAIRS) from SF-PAIRS? How do these scales differ from the Self-Esteem and Relationship (SEAR) questionnaire and the International Index of Erectile Function (IIEF)?

Response by Raymond C. Rosen, PhD, Posted 04/06/06:

Outcomes studies traditionally have used self-report measures to provide information about patients’ erectile function,¹ treatment satisfaction,² or quality of life.³ Interest in studying the broader psychosocial facets of ED led to the development of scales and questionnaires that go beyond the assessment of erectile function to assess the psychological and interpersonal outcomes associated with ED treatment.³ Three self-report questionnaires – PAIRS,³ SF-PAIRS,⁴ and SEAR⁵– were developed and validated in conjunction with the use of phosphodiesterase type 5 (PDE5) inhibitors as ED therapy.

PAIRS provides researchers with a reliable, validated tool for assessing many of the broader mental and relational outcomes associated with ED and its treatment.^3,4 PAIRS measures facets of ED and treatment results that may affect what men believe about their ability to have satisfying sexual relationships with their partners.³ The self-reported information comprises 23 items in 3 domains: Sexual Self-Confidence, Spontaneity, and Time Concerns.³

The usefulness of PAIRS as an indicator of sexual and relationship satisfaction was indicated by an analysis of community sampling.⁴ Findings from 3 studies provided additional evidence of the validity of PAIRS and documented its sensitivity in differentiating between PDE5 inhibitors with long and short durations of action.⁴

The need for a brief version of PAIRS for use in shorter studies and in clinical settings by clinicians became apparent, however.⁴ In creating SF-PAIRS, the developers used the PAIRS questionnaire and internal consistency reliability analyses to identify 15 items in the 3 PAIRS domains: 3 of 6 items in Sexual Self-Confidence, 4 of 9 items in Spontaneity, and all 8 items in Time Concerns.⁴

Study results demonstrate that, overall, correlations are very high between PAIRS and SF-PAIRS for mean scores in the Sexual Self-Confidence and Spontaneity domains.⁴ One of the primary differences between PAIRS and SF-PAIRS is that the abbreviated Sexual Self-Confidence scale demonstrated less sensitivity between the long-acting and short-acting PDE5 inhibitors.⁴

The SEAR questionnaire is another scale designed to evaluate the psychosocial factors associated with ED.⁵ SEAR measures ED treatment responsiveness by measuring the patient’s self-reported responses to 14 items in 2 domains: 8 in Sexual Relationship and 6 in Confidence, with 2 subscales in the latter: Self-Esteem (4 items) and Overall Relationship (2 items). The objectives of SEAR are to address the multidimensional nature of ED and the emotional toll ED can take on a man, particularly on self-esteem.⁵

The use of PAIRS, SF-PAIRS, or SEAR is intended to complement other measures of treatment outcome, such as the IIEF,^3,5 which measures 15 items in 5 domains of sexual functionality.¹ Widely used to detect treatment-related functional changes in clinical trials on ED,⁶ the IIEF provides only cursory assessment of the nonerectile aspects of sexual response and only limited evaluation of the relationship with the sexual partner.¹ The shortened version of the IIEF, known as IIEF-5 or the Sexual Health Inventory for Men (SHIM), was developed for clinicians to measure the presence and severity of ED.⁷

SF-PAIRS offers clinicians a tool to evaluate, in the clinical setting, patients’ psychological and interpersonal outcomes after ED treatment.⁴ By using SF-PAIRS scores in combination with sexual functionality measures and information about the patient’s lifestyle and preference for a long- or short-acting PDE5 inhibitor, the clinician may better evaluate ED treatment options and assess results with increased sensitivity to the patient’s prior sexual routine and relationship.

References

1. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49:822-830.

2. Althof SE, Corry EW, Levine SB, et al. EDITS: development of questionnaires for evaluating satisfaction with treatments of erectile dysfunction. Urology.1999;53:793-799.

3. Swindle RW, Cameron AE, Lockhart DC, Rosen RC. The Psychological and Interpersonal Relationship Scales: assessing psychological and relationship outcomes associated with erectile dysfunction and its treatment. Arch Sex Behav. 2004;33:19-30.

4. Swindle R, Cameron A, Rosen R. A 15-item short form of the Psychological and Interpersonal Relationship Scales. Int J Impot Res. 2006;18:82-88.

5. Cappelleri JC, Althof SE, Siegel RL, Shpilsky A, Bell SS, Duttagupta S. Development and validation of the Self-Esteem and Relationship (SEAR) questionnaire in erectile dysfunction. Int J Impot Res. 2004;16:30-38.

6. Cappelleri JC, Rosen RC. The Sexual Health Inventory for Men (SHIM): a 5-year review of research and clinical experience. Int J Impot Res. 2005;17:307-319.

7. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11:319-326.

To view archived responses, click here.