Introduction Over the past 20 years, the Female Sexual Function Index (FSFI) has been considered the gold standard for the measurement of sexual function in women, with over 1,000 published manuscripts citing the article. Despite the measure’s widespread usage and excellent psychometric properties, there has been some confusion over how to best implement and score the measure and interpret corresponding findings. Aim The aim of the current article is to provide guidance, drawing from 20 years of use, on how to best implement the FSFI in research settings and interpret results based on the validation studies that have been conducted to date. Methods The overview of scoring and interpretation procedures found in this article is drawn from a review of the published literature on the psychometric properties of the FSFI. Main Outcome Measure The measure of interest for the present review is the FSFI. Results This review article provides information about implementing, scoring, and interpreting the full-scale FSFI. Domain-level scoring and interpretation procedures are also discussed across the 5 domains of the FSFI: arousal, satisfaction, desire, pain, and lubrication. Additionally, guidance is provided for evaluating translated versions of the FSFI and using the measure to examine sexual function in culturally diverse populations. Clinical Implications Guidance on appropriately scoring and interpretating the FSFI has the potential to strengthen our empirical understanding of sexual function, and consequently, to guide theory-driven treatment development and clinical practice. Strength & Limitations The present review provides applied guidance for the appropriate use of the FSFI specifically, but does not cover other common measures of sexual function or adaptations of the original measure. Conclusion It is our hope that the guidance found in this review will ultimately lead to more rigorous and appropriate usage of the FSFI in research settings.

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Introduction Women’s sexuality is influenced by their perceptions of their bodies. Negative body appraisals have been implicated in the development and maintenance of sexual concerns in women with a history of childhood sexual abuse (CSA). The sexuality of these women is often expressed in extremes of approach and avoidant sexual tendencies, which have been related to the sexual inhibition and sexual excitation pathways of the dual control model. Aim To test the influence of body esteem on the sexual excitation and inhibition responses of women with and without a history of CSA. Methods One hundred thirty-nine women with CSA and 83 non-abused women reported on their abuse history, depressive symptomology, sexual response, and affective appraisals of their body. Main Outcome Measures Validated self-report measurements of sexual excitation and inhibition responses (Sexual Excitation/Sexual Inhibition Inventory for Women) and body esteem (Body Esteem Scale) were administered. Results Body esteem was significantly associated with sexual inhibition responses of women regardless of CSA history status but was significantly related only to the sexual excitation responses of women with a CSA history. Perceived sexual attractiveness was a unique predictor of sexual excitation in women with a history of CSA. Conclusion Women with a history of CSA have lower body esteem than non-abused women, particularly in self-perceived sexual attractiveness, and these perceptions appear to influence their sexual responses by acting on the sexual excitation and inhibition response pathways.

Many individuals who experience nonconsensual sexual experiences (NSEs) do not identify their experiences with common sexual violence labels (e.g., sexual assault, rape, or abuse), and cognitive mechanisms of identification have yet to be examined. Identification may involve the integration of the experience into sexual self-schemas, which would have implications for sexual well-being. Women were recruited through Amazon's Mechanical Turk (N = 818) to take part in an anonymous online study of sexual experiences. The current study assessed the relationship between textually derived sexual self-schemas and sexual function (measured by the Female Sexual Function Index) in women (M = 35.37 years, SD = 11.27) with NSEs who both did (identifiers, n = 305) and did not (non-identifiers, n = 176) identify with common sexual violence labels, in comparison with those with no NSEs (n = 337). Text analyses revealed nine sexual self-schema themes in participants' essays: Virginity, Openness, Erotophilia, NSEs, Romantic, Sexual Activity, Warmth, Relationships, and Reflection. Analyses demonstrated that identifiers reported significantly poorer sexual functioning and less use of both the Warmth and Openness themes than those with no NSEs. Identifiers also invoked the NSE theme more frequently than both those with no NSE histories and non-identifiers. While greater prominence of the Warmth theme was predictive of greater sexual functioning for both non-identifiers and those with no NSEs, this was not true for identifiers. Instead, the NSE theme was significantly predictive of lower sexual functioning in identifiers. The results suggest that NSE identification may result in greater internalization of the NSE into one's sexual self-schema and, in turn, predict decrements in sexual functioning. The results are discussed in relation to identification interpretation and clinical intervention.