Validity evidence and norms of the Spanish version of the Hurlbert Index of Sexual Fantasy

429 Most people admit that they engage in fantasies during sexual activity (Moyano & Sierra, 2014). Sexual fantasies are thoughts or mental images with sexual content that affect emotions and physiological state (Perla, Sierra, Vallejo-Medina, & GutiérrezQuintanilla, 2009). The lack of sexual fantasies has been associated with inhibition of sexual desire (Boncinelli, Gaci Scaletti, Nanini, Daino, & Genazzani, 2013; Santos-Iglesias, Calvillo, & Sierra, 2013), whereas the experience of sexual fantasies has been associated with better sexual functioning (Birnbaum, Kanat-Maymon, Mizrahi, Recanati, & Orr, 2019; Moyano, Byers, & Sierra, 2016). According to Sierra, Santos-Iglesias, Vallejo-Medina, and Moyano (2014), the study of sexual fantasies includes three different dimensions: (1) attitude towards sexual fantasies, (2) daydream or ability to develop sexual cognitions, and (3) type of experienced fantasy. Regarding the last one, Moyano and Sierra (2014) valued fantasies as positive or negative sexual cognitions. The use of sexual fantasies in sexual therapy is common (see Newbury, Hayter, Wylie, & Riddell, 2012). Therefore, before identifying the most adequate sexual fantasies for a patient, it is essential to evaluate and, if necessary, modify the attitude towards sexual fantasies (Sierra, Santos-Iglesias et al., 2014). Comparing different population groups (e.g., men and women) requires instruments with invariant structures to minimize evaluation biases (Muñiz, Elosua, & Hambleton, 2013). Given the relevance of this issue the human sexuality area (see Sakaluk, 2019), in recent years there has been an increasing interest to examine the factorial invariance of scales to evaluate erotophilia (Arcos-Romero, Calvillo, Granados, Álvarez-Muelas, & Sierra, 2020), sexual assertiveness (Sierra, Santos-Iglesias, & VallejoMedina, 2012), subjective orgasm experience (Arcos-Romero & Sierra, 2019), sexual satisfaction (Calvillo, Sánchez-Fuentes, Parrón-Carreño, & Sierra, 2019), and sexual double standard (Álvarez-Muelas, Gómez-Berrocal, Vallejo-Medina, & Sierra, ISSN 0214 - 9915 CODEN PSOTEG Copyright © 2020 Psicothema www.psicothema.com Validity evidence and norms of the Spanish version of the Hurlbert Index of Sexual Fantasy Juan Carlos Sierra, Ana Isabel Arcos-Romero, and Cristóbal Calvillo Universidad de Granada, Centro de Investigación Mente, Cerebro y Comportamiento (CIMCyC) Abstract Resumen Background: Sexual fantasies are described as thoughts or mental images with sexual content. The Hurlbert Index of Sexual Fantasy (HISF) evaluates the positive attitude towards sexual fantasies. The objective of this study was to provide validity evidence of the Spanish version of the HISF and to present its standard scores. Method: The sample was composed of 3,458 adults from the general Spanish population (1,641 men; 1,817 women), distributed across age groups (18-34, 35-49, and over 50 years old). Results: The unifactorial structure of the Spanish version of the HISF showed strict measurement invariance across sex, age range, and education level. Positive attitudes towards sexual fantasies signifi cantly correlated with erotophilia, sexual assertiveness, sexual desire, and sexual functioning. Also, the scale was useful for differentiating between individuals with sexual functioning diffi culties and individuals with no diffi culties. Finally, the standard scores were obtained based on sex and age range. Conclusions: The Spanish version of the HISF is a reliable, valid, and invariant scale for assessing a positive attitude towards sexual fantasies in people with different sociodemographic characteristics. Keywords: Sexual fantasies, attitude, Hurlbert Index of Sexual Fantasy, validity evidence, norms. Evidencias de validez y baremos de la versión española del Hurlbert Index of Sexual Fantasy. Antecedentes: las fantasías sexuales constituyen pensamientos o imágenes mentales con contenido sexual. El Hurlbert Index of Sexual Fantasy (HISF) evalúa la actitud positiva hacia las fantasías sexuales. El objetivo de este estudio fue aportar evidencias de validez a la versión española del HISF y presentar sus baremos. Método: la muestra estuvo compuesta por 3.458 adultos de la población española general (1.641 hombres, 1.817 mujeres), distribuidos en tres grupos de edad (18-34, 35-49 y 50 años o mayores). Resultados: la estructura unifactorial mostró nivel de invarianza estricta por sexo, rango de edad y nivel educativo. La actitud positiva hacia las fantasías sexuales correlacionó signifi cativamente con erotofi lia, asertividad sexual, deseo sexual y funcionamiento sexual. Además, la escala mostró capacidad para diferenciar entre individuos con y sin difi cultades en el funcionamiento sexual. Finalmente, se presentan las puntuaciones baremadas por sexo y rango de edad. Conclusiones: la versión española del HISF es una escala fi able, válida e invariante para evaluar la actitud positiva hacia las fantasías sexuales en personas con diferentes características sociodemográfi cas. Palabras clave: fantasías sexuales, actitud, Hurlbert Index of Sexual Fantasy, evidencias de validez, baremos. Psicothema 2020, Vol. 32, No. 3, 429-436 doi: 10.7334/psicothema2020.14 Received: January 15, 2020 • Accepted: February 2, 2020 Corresponding author: Juan Carlos Sierra Freire Facultad de Psicología Universidad de Granada 18011 Granada (Spain) e-mail: [email protected] Juan Carlos Sierra, Ana Isabel Arcos-Romero, and Cristóbal Calvillo 430 2019). To date, factorial invariance of the instruments to evaluate dimensions of sexual fantasy has not been analyzed. However, comparisons between men and women (Goldey, Avery, & van Anders, 2014; Moyano et al., 2016; Santos-Iglesias, Sierra, & Vallejo-Medina, 2013), different age range (Perla et al., 2009), and different education levels (Kasemy, Desouky, & Abdelrasoul, 2016; Moyano & Sierra, 2014) are common. One of the few instruments to evaluate attitude towards sexual fantasies is the Hurlbert Index of Sexual Fantasy (HISF; Hurlbert, 2011; Hurlbert & Apt, 1993), that was originally developed to evaluate thoughts and emotions associated with sexual fantasies. Its 25 items assess the individual propensity towards sexual fantasies. Hurlbert and Apt (1993) reported a Cronbach’s alpha of .82 and a test-retest reliability coeffi cient of .86 after one week. In Spain, Desvarieux, Salamanca, Ortega, and Sierra (2005) proposed a reduced ten-item version to specifi cally assess positive attitudes towards sexual fantasies; its Cronbach’s alpha was .85. This version presented adequate validity evidence, it was signifi cantly correlated with the frequency of sexual fantasies and sexual desire. Perla et al. (2009) confi rmed its good internal consistency reliability (Cronbach’s alpha: .92 in adults and .87 in adolescents). They also showed its convergent validity, the scale positively correlated with sexual daydreaming and erotophilia. Furthermore, scores in men were higher than in women. Differences across gender were later showed by Santos-Iglesias, Sierra et al. (2013), who also showed that men report positive attitudes towards sexual fantasies more frequently. Other studies have associated the Spanish version of the HISF with different related variables: sexual assertiveness, erotophilia, and sexual desire (Santos-Iglesias, Sierra et al., 2013), attitude towards masturbation (Sierra, Santos-Iglesias, & Monge, 2013), sexual daydreaming (Pérez-González, Moyano, & Sierra, 2011), sexual guilt (Sierra, Perla, & Santos-Iglesias, 2011), and sexual functioning (Sierra, Vallejo-Medina et al., 2014). The aim of the present study is to provide validity evidence and to present the standard scores for the Spanish version of the HISF (Desvarieux et al., 2005). First, the item analysis will be carried out. Also, the unidimensionality of the scale will be tested by analyzing its factorial invariance across population groups that have been compared in previous studies (i.e., sex, age range, and education level). Due to associations among related variables are essential to obtain validity evidence of an instrument (Muñiz & FonsecaPedrero, 2019), the association between positive attitudes towards sexual fantasies and erotophilia, sexual assertiveness, sexual desire, and sexual functioning will be analyzed. Furthermore, evidence of discriminant validity will be tested by comparing the mean scores of the HISF between a group of individuals with sexual functioning diffi culties and a group without these diffi culties. Finally, the standard scores of the HISF for the Spanish population will be presented. Method Participants The sample consisted of 3,458 heterosexual adults from the general Spanish population (1,641 men and 1,817 women), distributed into three age groups (18-34 years old; n = 1,321; 35-49 years old, n = 1,191; and 50 years old or older, n = 946). 52.5% of the participants reported having University studies. Inclusion criteria were being an adult (i.e., 18 years old or older), Spanish nationality, and heterosexual orientation. Table 1 presents the descriptive statistics of the evaluated sociodemographic and psychosexual variables. Instruments Sociodemographic and Sexual History Questionnaire. Includes information about sex, age, nationality, sexual orientation, education level, relationship, and sexual activity. Spanish version of the Hurlbert Index of Sexual Fantasy (HISF; Desvarieux et al., 2005; Hurlbert, 2011). It consists of ten items to evaluate the positive attitude towards sexual fantasies through a Likert scale from 0 (Never) to 4 (All of the time). Higher scores indicate more positive attitudes towards sexual fantasies. Short Spanish version of the Sexual Opinion Survey (SOS-6; Fisher, White, Byrne, & Kelley, 1988; Vallejo-Medina, Granados, & Sierra, 2014). Its six items evaluate erotophilia through a Likert scale from 1 (I strongly disagree) to 7 (I strongly agree),. Its Cronbach’s alpha reliability is .74 and its convergent validity is adequate. Higher scores indicate higher erotophilia. In the present study, Cronbach’s alpha coeffi cient was .72. Spanish version of the Sexual Assertiveness Scale (SAS; Morokoff et al., 1997; Sierra, Vallejo-Medina, & Santos-Iglesias, 2011). It consists of 18 items distributed into three factors: Sexual assertiveness to initiate sexual activities, Sexual assertiveness to refuse unwanted sexual contact, and STI-prevention. It uses a Likert scale from 0 (Never) to 4 (Always). It has shown evidence of good concurrent validity. Higher scores indicate higher sexual assertiveness. In this study, we considered sexual assertiveness to initiate sexual activities and sexual assertiveness to refuse unwanted sexual contact; the Cronbach’s alpha values were .72 and .76, respectively. Spanish version of the Sexual Desire Inventory (SDI; Moyano, Vallejo-Medina, & Sierra, 2017; Spector, Carey, & Steinberg, 2011). Its 13 items evaluate interest in sexual activity across three dimensions: Partner-focused dyadic sexual desire, Dyadic sexual desire for an attractive person, and Solitary sexual desire. Different assessment scales are used for each question (e.g., 0 = Not at all to 7 = Many times per day; 0 = No desire to 8 = Strong desire). Its internal consistency reliability ranges from .80 to .93 (Cronbach’s alpha), depending on gender and age group. It has shown evidence of convergent validity. Higher scores indicate higher sexual desire. In the present study, Cronbach’s alpha values were .86 for Partnerfocused dyadic sexual desire, .89 for Dyadic sexual desire for an attractive person, and .92 for Solitary sexual desire. Spanish version of the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ; Fava, Rankin, Alpert, Nierenberg, & Worthington, 1998; Sierra, Vallejo-Medina, SantosIglesias, & Lameiras-Fernández, 2012). It consists of fi ve items that evaluate general sexual functioning over the previous month in terms of desire, excitation, orgasm, erection (in men), and sexual satisfaction. It uses a Likert scale from 0 (Totally absent) to 4 (Normal). Its Cronbach’s alpha reliability is .90 in men and .93 in women. The scale has shown adequate evidence of convergent validity. Higher scores indicate better sexual functioning. In this study, Cronbach’s alpha value was .89 for men (fi ve items) and .93 for women (four items). Procedure Participants were recruited from the general Spanish population. To obtain a balanced proportion of men and women, Evidencias de validez y baremos de la versión española del Hurlbert Index of Sexual Fantasy 431 a quota convenience sampling method was used. The sample was distributed incidentally across three age groups (18-34, 35-49, and 50 years old or older). The assessment was conducted in different public places (e.g., public libraries, classrooms, social centers, health centers) by well-trained researchers. Once the questionnaire was completed, it was returned in a sealed envelope. Participants signed an informed consent in which anonymity, confi dentiality, and the exclusive use of test scores for only research purposes were guaranteed. They completed the questionnaires on their own. Ethical approval was obtained from the Ethics Committee of Human Research of the University of Granada. Data analysis Missing data analysis showed percentages of missing values that did not exceed 2% in the items of all the used scales. The missing values were replaced using the estimation method of the median of nearby points. First, the item analysis was carried out. Second, the unidimensionality of the scale was tested by analyzing its factorial invariance across groups using the lavaan package (version 0.6-3; Rosseel, 2012) included in the R statistical software (version 3.4.4; R Core Team, 2016) and its integrated RStudio interface (version 1.1.447; RStudio Team, 2018). Groups were analyzed by sex, age range, and education level. The progressive invariance of the one-factor model was tested at different levels. The following indicators were used to evaluate the model fi t: CFI and TLI > .90 and RMSEA < .08 (Hu & Bentler, 1999), and the difference between CFI comparative index values (Bentler, 1990). The difference between the models nested at different levels was considered; thus, if the discrepancy in the CFI value were higher than .01 in favor of the least restrictive model, the most restrictive model would be rejected (Cheung & Rensvold, 2002). Then, using Student’s t-test, differences across sex in the mean scores of the observed variables were examined. Due to the signifi cant differences found in most of the psychosexual variables, we decided to carry out the rest of the analyses separately for men and women. To test the validity evidence based on correlations with related variables, we examined the bivariate correlation matrix between positive attitudes towards sexual fantasies and erotophilia, sexual assertiveness, sexual desire, and sexual functioning. Then, multiple linear regression models were tested to explain sexual functioning based on positive attitudes towards sexual fantasies, erotophilia, and sexual assertiveness. Furthermore, a Student’s t-test was used to examine the differences in mean scores of the HISF between a group of individuals with diffi culties in the dimensions of general sexual functioning (MGH-SFQ) and a group of individuals without these diffi culties. Based on the scores from the items of the MGH-SFQ, we considered individuals with diffi culties who showed scores from 0 to 2 (Markedly diminished to Moderately diminished); individuals with no diffi culties showed scores equal to 4 (Normal). Participants whose scores were equal to 3 (Minimally diminished) were excluded from this analysis. Finally, the norms of the HISF differentiated by sex and age range were obtained. Histograms, skewness, and kurtosis were observed. Considering the normal distribution of the sub-samples of men and women, we decided to use the direct scores of the scale. Table 1 Descriptive statistics of the sociodemographic and psychosexual variables Total (N = 3,458) Men (n = 1,641) Women (n = 1,817) t / χ2 Socio-demographic Age (M, SD) 39.02 (13.31) 39.20 (13.20) 38.88 (13.42) 0.69 Age range (n, %) 18-34 y/o 35-49 y/o ≥ 50 y/o 1,321 (38.2%) 1,191 (34.4%) 946 (27.4%) 626 (38.1%) 556 (33.9%) 459 (28%) 695 (38.2%) 635 (34.9%) 487 (26.8%) 0.72 Education level (n, %) University Non-university 1,815 (52.5%) 1,643 (47.5%) 831 (50.6%) 810 (49.4%) 984 (54.2%) 833 (45.8%) 4.27 Relationship (n, %) Yes No 3,378 (97.7%) 80 (2.3%) 1,615 (98.4%) 26 (1.6%) 1,763 (97%) 54 (3%) 7.35*** Sexual activity (n, %) Yes No 3,369 (97.4%) 89 (2.6%) 1,608 (98%) 33 (2%) 1,761 (96.9%) 56 (3.1%) 3.95* Psychosexual variables M (SD) M (SD) M (SD) t d HISF Sexual fantasies (positive attitude) 28.46 (8.57) 30.73 (3.34) 26.41 (9.08) 15.46*** 0.63 SOS Erotophilia 34.12 (7.20) 35.38 (6.27) 32.92 (7.80) 9.46*** 0.35 SAS Sexual assertiveness (initiation) Sexual assertiveness (refusal) 14.01 (4.92) 13.59 (5.69) 14.38 (4.34) 11.48 (5.55) 13.68 (5.37) 15.51 (5.10) 4.22*** -22.16*** 0.14 -0.76 SDI Partner-focused sexual desire Sexual desire (attractive person) Sexual desire (solitary) 39.94 (9.02) 7.29 (4.77) 13.39 (8.65) 41.87 (7.36) 8.64 (4.55) 15.76 (7.91) 38.19 (9.98) 6.06 (4.63) 11.25 (8.72) 12.41*** 16.50*** 15.95*** 0.42 0.56 0.54 MGH-SFQ General sexual functioning 18.15 (3.47) 13.13 (4.42) Note: There is no data for the total sample for the variable “General sexual functioning (MGH-SFQ)” because this variable is different in men (5 items) and women (4 items). ***p < .001; *p < .05 Juan Carlos Sierra, Ana Isabel Arcos-Romero, and Cristóbal Calvillo 432 Results Item analysis The mean scores of the HISF items were higher than the theoretical midpoint of the scale (i.e., 2). The lowest mean was in item 4 (M = 2.41) and its standard deviation was the highest (SD = 1.47). Item 1 showed the highest mean (M = 3.34) and median (Mdn = 4). The discrimination index for each item was higher than the minimum criterion .30 (Johnson & Wichern, 2002), ranging from .56 (item 4) to .76 (item 9). Internal consistency reliability, estimated by ordinal alpha, was .94 for the total sample; this value failed to improve with the elimination of any of the ten items (Table 2). Furthermore, the Test Information Function of the HISF (Figure 1) showed that the maximum value reached was above 15 and the most stable measurements fl uctuated between -2 and +1. Values different from those indicated, whether lower or higher, suggested that the results would present more errors. Factorial invariance The unidimensional model fi tting indicated that the values associated with CFI allowed for the acceptance of the factorial equivalence for all the examined groups. Results showed strict measurement invariance across sex [RMSEA = .050 (.045–.055); CFI = .987], age range [RMSEA = .052 (.047–.056); CFI = .984], and education level [RMSEA = .031 (.026–.036); CFI = .996]. Fit indices and invariance indicators for the unifactorial model are displayed in Table 3. Sex differences No signifi cant differences across sex were found in mean age, age range, and education level. Results showed a higher Table 2 Item analysis of the Spanish version of the HISF M (SD) Median Skewness Kurtosis Discrimination index Ordinal α if item deleted Item 1. Considero saludables las fantasías sexuales (I think sexual fantasies are healthy) 3.34 (0.92) 4 -1.48 1.90 .63 .93 Item 2. Disfruto con las fantasías sexuales (I enjoy fantasizing about sex) 3.11 (1.05) 3 -1.14 0.69 .75 .92 Item 3. Me agrada compartir mis fantasías sexuales con mi pareja (I feel comfortable sharing my sexual fantasies with my partner) 2.84 (1.21) 3 -0.79 -0.38 .65 .93 Item 4. Disfruto de mis fantasías sexuales cuando me masturbo (I enjoy using my sexual fantasies during masturbation) 2.41 (1.47) 3 -0.44 -1.19 .56 .94 Item 5. Me excito fácilmente cuando pienso en el sexo (I am easily aroused by thoughts of sex) 2.67 (1.08) 3 -0.58 -0.27 .69 .93 Item 6. Me divierte escuchar las fantasías sexuales de mi pareja (I enjoy hearing my partner’s sexual fantasies) 2.90 (1.21) 3 -0.93 -0.12 .72 .93 Item 7. Los pensamientos sexuales entran en mi mente con facilidad (Thoughts about sex enter my mind without much effort) 2.51 (1.13) 3 -0.34 -0.60 .69 .93 Item 8. Creo que las fantasías sexuales incrementan el interés sexual (I believe sexual fantasy enhances sex) 3.14 (0.96) 3 -1.12 1.02 .69 .93 Item 9. Me excitan las fantasías sexuales de mi pareja (I fi nd my partner’s sexual fantasies to be exciting) 2.78 (1.18) 3 -0.77 -0.25 .76 .93 Item 10. Disfruto experimentando mis fantasías sexuales durante las relaciones sexuales (I enjoy using my sexual fantasies during sex) 2.75 (1.19) 3 -0.68 -0.47 .71 .93 Figure 1. Test Information Function for HISF Evidencias de validez y baremos de la versión española del Hurlbert Index of Sexual Fantasy 433 percentage of women without a relationship and sexual activity. There were also signifi cant differences across sex among the psychosexual variables; men showed higher mean scores in all of them, except for sexual assertiveness to refuse sexual contact (Table 1). Validity evidence based on correlations with related variables In both men and women, positive attitudes towards sexual fantasies positively correlated with erotophilia, sexual assertiveness to initiate sexual activities, partner-focused sexual desire, sexual desire for Table 3 Fit indices and invariance indicators for the unifactorial model Model RMSEA ∆RMSEA 90% CI RMSEA CFI ∆CFI RMSR CMIN/DF df Rχ2∆Rχ2p Sex (men; women) 1. Confi gural .036 NA .030-.042 .996 NA .033 3.216 52 609.923 NA <.001 2. Weak .033 -.003 .027-.039 .996 0 .034 2.891 61 374.876 -235.047 <.001 3. Strong .049 .016 .044-.054 .989 -.007 .045 5.204 70 733.045 358.169 <.001 4. Strict .050 .01 .045-.055 .987 -.002 .050 5.322 80 761.621 28.576 <.001 Age range (18-34; 35-49; ≥ 50 y/o) 1. Confi gural .053 NA .047-.058 .990 NA .048 4.196 93 1127.765 NA <.001 2. Weak .051 -.002 .046-.056 .988 -.002 .052 3.996 111 700.751 -427.015 <.001 3. Strong .050 -.001 .045-.055 .987 -.001 .054 3.888 129 788.612 87.861 <.001 4. Strict .052 .002 .047-.056 .984 -.003 .062 4.059 149 862.115 73.503 <.001 Education level (university; non-univers.) 1. Confi gural .019 NA .010-.026 .999 NA .023 1.595 50 329.225 NA .005 2. Weak .024 .005 .018-.030 .998 -.001 .028 1.989 59 262.939 -66.286 <.001 3. Strong .025 .001 .019-.031 .997 -.001 .030 2.056 68 305.338 42.399 <.001 4. Strict .031 .006 .026-.036 .996 -.001 .040 2.634 78 396.228 90.89 <.001 Note: In bold: level of invariance accepted for each group. RMSEA: Root Mean Square Error of Approximation; ΔRMSEA: Increase of Root Mean Square Error of Approximation; 90% CI RMSEA: 90% confi dence interval for RMSEA; CFI: Comparative Fit Index; ΔCFI: Increase of Comparative Fit Index; RMSR; Root Mean Square Residual; CMIN/DF: Chi Square per degree of freedom; df: difference test; Rχ2: Chi Square robust estimator; ΔRχ2: Increase of Chi Square robust estimator Table 4 Bivariate correlation matrix for positive attitude towards sexual fantasies and the examined variables in men and women 12345678 1. HISF (Fantasies)–.54*** .32*** -.12*** .54*** .25*** .41*** .32*** 2. SOS (Erotophilia).64*** – .22*** -.04 .37*** .23*** .44*** .23*** 3. SAS (Initiation) .54*** .46*** – .04 .29*** .05 .11*** .18*** 4. SAS (Refusal).16*** .18*** .23*** – -.08** -.01 -.02 .01 5. SDI (Partner).63*** .48*** .47*** .17*** – .10*** .23*** .51*** 6. SDI (Attractive person).30*** .31*** .14*** .08*** .24*** – .42*** .04 7. SDI (Solitary).44*** .49*** .25*** .05*.29*** .40*** – .16*** 8. MGHSFQ (Sexual functioning).41*** .29*** .30*** .16*** .66*** .10*** .17*** – Note: In bold: correlations between positive attitude towards sexual fantasies and all the variables. Values above the diagonal are based on men’s scores. Values below the diagonal are based on women’s scores. ***p < .001; **p < .01; *p < .05 Table 5 Linear regression models for explaining general sexual functioning (MGH-SFQ) in men and women Men Predictors BSDβtR 2F Positive attitude towards sexual fantasies .13 .02 .26 8.48*** .114 46.97 Erotophilia .04 .02 .07 2.21* Sexual assertiveness (initiation) .07 .02 .09 3.43** Sexual assertiveness (refusal) .02 .02 .04 1.39 Women Positive attitude towards sexual fantasies .18 .02 .37 11.49*** .196 93.70 Erotophilia -.01 .02 -.01 -0.27 Sexual assertiveness (initiation) .07 .02 .09 3.20** Sexual assertiveness (refusal) .08 .02 .09 3.81*** Note: ***p < .001; **p < .01; *p < .05 Juan Carlos Sierra, Ana Isabel Arcos-Romero, and Cristóbal Calvillo 434 an attractive person, solitary sexual desire, and sexual functioning. However, positive attitudes towards sexual fantasies were positively associated with sexual assertiveness to refuse sexual activity only in women; this association was negative in men (Table 4). Multiple linear regression models showed that the positive attitude towards sexual fantasies was the most signifi cant variable on general sexual functioning in both men (B = .13) and women (B = .18). Sexual functioning was signifi cantly explained by positive attitudes towards sexual fantasies, erotophilia, and sexual assertiveness. These variables explained 11.4% of the variance of the sexual functioning in the model for men (F = 46.97, p <.001) and 19.6% in the model for women (F = 93.70; p <.001) (Table 5). Considering the dimensions of the MGH-SFQ, we compared mean scores of the HISF between a group of individuals with diffi culties in sexual functioning and a group without these diffi culties. Results showed that the Spanish version of the HISF had the ability to signifi cantly discriminate between both groups; individuals with no diffi culties reached higher scores in positive attitudes towards sexual fantasy (Table 6). Standard scores Finally, the norms of the Spanish version of the HISF were calculated. Table 7 presents the standard scores differentiated by sex and age groups. In order to propose useful standard scores with homogeneous groups, we established three age groups (1834, 35-49, and 50 years old and older) based on the levels proposed by Arnett (2000), that depend on the subjective perception of the period of adulthood. Other sexual health measurement instruments also present their standard scores using these age ranges (e.g., Arcos-Romero & Sierra, 2019; Moyano et al., 2017; SantosIglesias, Vallejo-Medina, & Sierra, 2014; Sierra, Santos-Iglesias et al., 2012; Vallejo-Medina et al., 2014). Discussion Sexual attitudes are associated with sexuality in general (e.g., erotophilia) or specifi c, toward some specifi c sexual behavior Table 6 Differences in means of the HISF between a group of individuals with no diffi culties and a group of individuals with diffi culties in the dimensions of the sexual functioning (MGH-SFQ) Men Women Groups n M SD t d n M SD t d Sexual desire No diffi culties 1,288 31.72 6.80 10.02*** 0.66 1,201 28.31 8.18 12.24*** 0.70 Diffi culties 218 26.48 8.90 454 21.92 9.92 Sexual excitation No diffi culties 1,270 31.88 6.66 9.16*** 0.79 1,217 28.40 7.91 14.34*** 0.87 Diffi culties 192 25.56 9.20 411 20.48 10.22 Orgasm No diffi culties 1,359 31.67 6.63 8.59*** 0.86 1,257 28.47 8.00 15.31*** 0.98 Diffi culties 143 24.62 9.59 352 19.56 10.06 Erection No diffi culties 1,375 31.60 6.75 7.64*** 0.87 ––––– Diffi culties 107 24.50 9.44 – – – Sexual satisfaction No diffi culties 1,226 31.58 6.92 6.63*** 0.52 1,262 28.13 8.15 13.01*** 0.82 Diffi culties 221 27.52 8.62 366 20.57 10.23 Note: ***p < .001 Table 7 Standard scores of the HISF in men and women of different age groups Men (n = 1,641) Women (n = 1,817) Age 18-34 y/o (n = 626) 35-49 y/o (n = 556) ≥ 50 y/o (n = 459) 18-34 y/o (n = 695) 35-49 y/o (n = 635) ≥ 50 y/o (n = 487) Ordinal α .91 .92 .93 .90 .93 .94 M32.40 30.70 28.50 29.20 27.20 21.40 SD 6.40 7.30 8.00 7.00 8.50 10.30 Min 020 500 Max 40 40 40 40 40 40 Percentile 113 10 4 10 5 0 520 16 14 16 12 2 10 24 20 18 20 15 7 15 26 23 21 22 18 9 20 28 25 22 23 20 12 25 29 27 24 25 22 14 30 30 28 25 26 23 16 35 31 29 26 27 24 18 40 32 30 27 28 26 19 45 33 31 28 29 26 21 50 34 32 29 30 28 23 55 34 33 30 31 29 24 60 35 34 31 32 30 25 65 36 35 32 33 31 26 70 37 36 34 34 32 28 75 37 36 35 34 34 29 80 38 37 36 35 36 31 85 39 38 38 36 37 32 90 40 40 38 38 38 35 95 40 40 40 40 40 37 99 40 40 40 40 40 40 Note: Ordinal α: reliability coeffi cient; M: mean; SD: standard deviation; Min.: minimum; Max.: maximum. Men: skewness = -.93; kurtosis = .89; Women: skewness = -.68; kurtosis = .07 Evidencias de validez y baremos de la versión española del Hurlbert Index of Sexual Fantasy 435 (e.g., sexual fantasies). Attitude towards sexual fantasies is a good indicator of sexual health (Santos-Iglesias, Sierra et al., 2013; Sierra, Vallejo-Medina et al., 2014), thus it is important to use measurement instruments with adequate psychometric properties. The aim of this study was to provide validity evidence of the Spanish version of the Hurlbert Index of Sexual Fantasy (HISF; Desvarieux et al., 2005) and to present its standard scores for the Spanish population. The Spanish version of the HISF has shown excellent internal consistency reliability; an ordinal alpha of .94 was obtained for the total sample. This value is higher than those reported by Desvarieux et al. (2005), Perla et al. (2009) and Santos-Iglesias, Sierra et al. (2013). Also, excellent reliability coeffi cients were obtained in the three established age groups, ranged between .91 and .93 in men and between .90 and .94 in women. Regarding the analysis of the Information Function of the HISF, the results are positive, the range of values with accurate scores has an adequate amplitude. The one-factor structure of the HISF showed strict factorial invariance across sex, age range, and education level, which allows us for a comparison of scores between people with these sociodemographic characteristics. Evaluation bias (Muñiz et al., 2013; Muñiz & Fonseca-Pedrero, 2019) is minimized in comparisons across sex, age, and education level. This issue is important because many studies in human sexuality make comparisons among population groups, especially between men and women. We can conclude that the higher frequency of positive attitudes towards sexual fantasies in men compared to women in the present study (and in previous studies, e.g., Perla et al., 2009; Santos-Iglesias, Sierra et al., 2013) is not due to measurement bias of the HISF. Similar to Perla et al. (2009) and Santos-Iglesias, Sierra, et al. (2013), positive attitudes towards sexual fantasies were correlated with erotophilia in both men and women. As expected, the propensity to positively respond to sexual stimuli was related to higher positive attitudes towards sexual fantasies. In both sexes, positive attitudes towards sexual fantasies have also been correlated with sexual assertiveness to initiate sexual activity, in accordance with Santos-Iglesias, Sierra, et al. (2013). However, sexual assertiveness to refuse unwanted sexual activity was negatively associated with positive attitudes towards sexual fantasies in men. That is to say, men who reported more positive attitudes towards sexual fantasies are less assertive in rejecting unwanted sexual contact. This result could be associated with the differences across sex found in these variables, indicating that, although men report more positive attitudes towards sexual fantasies than women, women report more assertiveness to reject unwanted sexual activity. This could be an expression of traditional gender roles in which women tend to limit their sexual activities more frequently (Simon & Gagnon, 2003). Regarding sexual desire, our results indicate that positive attitudes towards sexual fantasies are correlated with interest in sexual activities, whether in a relationship or alone (i.e., dyadic and solitary sexual desire), according to results reported by SantosIglesias, Sierra et al. (2013). Accordingly, Birnbaum et al. (2019) showed that sexual fantasies involving a partner are associated with signifi cantly higher levels of sexual desire in both sexes. The differences in the magnitude of the correlations between attitude towards sexual fantasies and partner-focused sexual desire and sexual desire for an attractive person are noteworthy in both men and women; this fact indicates that the two dimensions of sexual desire suggested by Moyano et al. (2017) are relatively different constructs. Also, positive attitudes towards sexual fantasies have been associated with better sexual functioning in both sexes. Regression models tested to explain sexual functioning indicate that positive attitudes towards sexual fantasies have more relevance than erotophilia and sexual assertiveness. As expected, positive attitudes towards sexual fantasies are associated with better sexual functioning. The same result has already been advanced by Sierra, Vallejo-Medina, et al. (2014) in women, among whom this association was found to increase with age. The relevance of positive attitudes towards sexual fantasies in sexual functioning was confi rmed by the ability of the HISF scores to discriminate between individuals with and without diffi culties in the different dimensions of sexual functioning. Men and women with diffi culties in desire, excitation, orgasm, erection, and/or sexual satisfaction have signifi cantly lower HISF scores than individuals with normal sexual functioning. The standard scores for the Spanish population, differentiated by sex and age range, show that positive attitudes towards sexual fantasies decrease as age increases. It also occurs with other important dimensions of human sexuality, such as erotophilia (Vallejo-Medina, Granados et al., 2014), sexual assertiveness (Santos-Iglesias et al., 2014; Vallejo-Medina, Sierra, 2014; Sierra, Santos-Iglesias et al., 2012), or subjective orgasm experience (Arcos-Romero & Sierra, 2019). A possible explanation could be related to the dysfunctions of some aspects of sexual functioning as age increases (Sierra, Vallejo-Medina et al., 2012). As limitations, despite the use of a large sample, we used a probabilistic quota sampling that reduces the generalization of our results to the entire Spanish population. No evidence of test-retest reliability has been provided. Also, no control scale for the detection of random or dishonest responses has been used. As conclusions, we could highlight that this study provides validity evidence of the Spanish version of the HISF, which is a reliable, valid, and invariant scale to evaluate the positive attitude towards sexual fantasies in people with different sociodemographic characteristics. References Álvarez-Muelas, A., Gómez-Berrocal, C., Vallejo-Medina, P., & Sierra, J. C. (2019). Invariance of Spanish version of Sexual Double Standard Scale across sex, age, and education level. Psicothema, 31, 465-474. doi:10.7334/psicothema2019.102 Arcos-Romero, A. I., Calvillo, C., Granados, R., Álvarez-Muelas, A., & Sierra, J. C. (2020). The Spanish version of the Sexual Opinion Survey (SOS-6): Evidence of validity of a short version. International Journal of Psychological Research, 13, 40-49. doi:10.21500/20112084.4506 Arcos-Romero, A. I., & Sierra, J. C. (2019). Factorial invariance, differential item functioning, and norms of the Orgasm Rating Scale. International Journal of Clinical and Health Psychology, 19, 57-66. doi:10.1016/j. ijchp.2018.11.001 Juan Carlos Sierra, Ana Isabel Arcos-Romero, and Cristóbal Calvillo 436 Arnett, J. J. (2000). Emerging Adulthood a theory of development from the late teens through the twenties. The American Psychologist, 55, 469480. doi:10.1037/0003-066X.55.5.469 Bentler, P. M. (1990). Comparative fi t indexes in structural models. Psychological Bulletin, 107, 238-246. Birnbaum, G. E., Kanat-Maymon, Y., Mizrahi, M., Recanati, M., & Orr, R. (2019). What fantasies can do to your relationship: The effects of sexual fantasies on couple interactions. Personality and Social Psychology Bulletin, 45, 461-476. doi:10.1177/0146167218789611 Boncinelli, V., Gaci Scaletti, D., Nanini, C., Daino, D., & Genazzani, A. R. (2013). Sexual fantasies and female hypoactive desire. Sexologies, 22, 19-23. doi:10.1016/j.sexol.2012.08.004 Calvillo, C., Sánchez-Fuentes, M. M., Parrón-Carreño, T., & Sierra, J. C. (2020). Validation of the Interpersonal Exchange Model of Sexual Satisfaction Questionnaire in adults with a same-sex partner. International Journal of Clinical and Health Psychology, 20, 140-150. doi:10.1016/j.ijchp.2019.07.005 Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fi t indexes for testing measurement invariance. Structural Equation Modeling, 9, 233-255. doi:10.1207/S15328007SEM0902_5 Desvarieux, A. R., Salamanca, Y., Ortega, V., & Sierra, J. C. (2005). Validation of a Spanish version of Hurlbert Index of Sexual Fantasy: A measure of attitude toward sexual fantasies. Revista Mexicana de Psicología, 22, 529-539. Fava, M., Rankin, M. A., Alpert, J. E., Nierenberg, A. A., & Worthington, J. J. (1998). An open trial of oral sildenafi l antidepressant-induced sexual dysfunction. Psychotherapy and Psychosomatics, 67, 328-331. doi:10.1159/000012299 Fisher, W. A., White, L. A., Byrne, D., & Kelley, K. (1988). Erotophobiaerotophilia as a dimension of personality. The Journal of Sex Research, 25, 123-151. doi:10.1080/00224498809551448 Goldey, K. L., Avery, L. R., & van Anders, S. M. (2014). Sexual fantasies and gender/sex: A multimethod approach with quantitative content analysis and hormonal response. The Journal of Sex Research, 51, 917931. doi:10.1080/00224499.2013.798611 Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fi t indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55. doi:10.1080/10705519909540118 Hurlbert, D. F. (2011). Hurlbert Index of Sexual Fantasy. In T. D. Fisher, C. M. Davis, W. L. Yarber & S. L. Davis (Eds.), Handbook of sexuality– related measures (3th. ed., pp. 262). Abingdon: Routledge. Hurlbert, D. F., & Apt, C. (1993). Female sexuality: A comparative study between women in homosexual and heterosexual relationships. Journal of Sex & Marital Therapy, 19, 315-327. doi:10.1080/00926239308404375 Johnson, R. A., & Wichern, D. W. (2002). Applied Multivariate Statistical Analysis (5th ed.). New Jersey, NJ: Prentice-Hall. Kasemy, Z., Desouky, D. E., & Abdelrasoul, G. (2016). Sexual fantasy, masturbation and pornography among Egyptians. Sexuality & Culture, 20, 626-638. doi:10.1007/s12119-016-9346-1 Morokoff, P. J., Quina, K., Harlow, L. L., Whitmire, L., Grimley, D. M., Gibson, P. R., & Burkholder, G. J. (1997). Sexual Assertiveness Scale (SAS) for women: Development and validation. Journal of Personality and Social Psychology, 73, 790-804. doi:10.1037/0022-3514.73.4.790 Moyano, N., Byers, E. S., & Sierra, J. C. (2016). Content and valence of sexual cognitions and their relationship with sexual functioning in Spanish men and women. Archives of Sexual Behavior, 45, 2069-2080. doi:10.1007/s10508-015-0659-1 Moyano, N., & Sierra, J. C. (2014). Positive and negative sexual cognitions: Similarities and differences between men and women from southern Spain. Sexual and Relationship Therapy, 29, 454-466. doi:10.1080/14 681944.2014.934667 Moyano, N., Vallejo-Medina, P., & Sierra, J. C. (2017). Sexual Desire Inventory: Two or three dimensions? The Journal of Sex Research, 54, 105-116. doi:10.1080/00224499.2015.1109581 Muñiz, J., Elosua, P., & Hambleton, R. K. (2013). International Test Commission Guidelines for test translation and adaptation: Second edition. Psicothema, 25, 151-157. doi:10.7334/psicothema2013.24 Muñiz, J., & Fonseca-Pedrero, E. (2019). Ten steps for test development. Psicothema, 31, 7-16. doi:10.7334/psicothema2018.291 Newbury, R., Hayter, M., Wylie, K. R., & Riddell, J. (2012). Sexual fantasy as a clinical intervention. Sexual and Relationship Therapy, 27, 358371. doi:10.1080/14681994.2012.733816 Pérez-González, S., Moyano, N., & Sierra, J. C. (2011). Sexual daydreaming: Its relationship to attitudes towards sexual fantasy and personality traits. Cuadernos de Medicina Psicosomática y Psiquiatría de Enlace, 99, 9-20. Perla, F., Sierra, J. C., Vallejo-Medina, P., & Gutiérrez-Quintanilla, R. (2009). Un estudio psicométrico de la versión española reducida del Hurlbert Index of Sexual Fantasy [A psychometric study of the reduced Spanish version of the Hurlbert Index of Sexual Fantasy]. Boletín de Psicología, 96, 7-16. R Core Team (2016). R: A language and environment for statistical computing [Computer software]. Vienna: R Foundation for Statistical Computing. Retrieved from https://www.R-project.org/ Rosseel, Y. (2012). lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48, 1-36. Retrieved from http://www. jstatsoft.org/v48/i02/ RStudio Team (2018). RStudio: Integrated Development for R. Boston, MA: RStudio Inc. Retrieved from http://www.rstudio.com/ Sakaluk, J. K. (2019). Expanding statistical frontiers in sexual science: Taxometric, invariance, and equivalence testing. The Journal of Sex Research, 56, 475-510. doi:10.1080/00224499.2019.1568377 Santos-Iglesias, P., Calvillo, G., & Sierra, J. C. (2013). A further examination of Levine’s model of sexual desire. Psychology & Sexuality, 4, 34-45. doi:10.1080/19419899.2011.576697 Santos-Iglesias, P., Sierra, J. C., & Vallejo-Medina, P. (2013). Predictors of sexual assertiveness: The role of sexual desire, arousal, attitudes, and partner abuse. Archives of Sexual Behavior, 42, 1043-1052. doi:10.1007/ s10508-012-9998-3 Santos-Iglesias, P., Vallejo-Medina, P., & Sierra, J. C. (2014). Equivalence and standard scores of the Hurlbert Index of Sexual Assertiveness across Spanish men and women. Anales de Psicología, 30, 232-237. doi:10.6018/analesp.30.1.143321 Sierra, J. C., Perla, F., & Santos-Iglesias, P. (2011). Sexual guilt in youngsters: The infl uence of attitudes and sexual experience. Revista Latinoamericana de Psicología, 43, 73-81. Sierra, J. C., Santos-Iglesias, P., & Monge, F. S. (2013). Inventario de Actitudes Negativas hacia la Masturbación: validez, fi abilidad y propuesta de una versión reducida para población adolescente [Negative Attitudes toward Masturbation Inventory: Validity, reliability, and proposal of a reduced version for adolescent population]. Revista Argentina de Clínica Psicológica, 22, 57-66. Sierra, J. C., Santos-Iglesias, P., & Vallejo-Medina, P. (2012). Evaluation of the factorial and metric equivalence of the Sexual Assertiveness Scale (SAS) by sex. Psicothema, 24, 316-322. Sierra, J. C., Santos-Iglesias, P., Vallejo-Medina, P., & Moyano, N. (2014). Autoinformes como instrumento de evaluación en Sexología Clínica [Self-reports as an evaluation instrument in Clinical Sexology]. Madrid: Síntesis. Sierra, J. C., Vallejo-Medina, P., & Santos-Iglesias, P. (2011). Psychometric properties of the Spanish version of the Sexual Assertiveness Scale (SAS). Anales de Psicología, 27, 17-26. Sierra, J. C., Vallejo-Medina, P., Santos-Iglesias, P., & Lameiras-Fernández, M. (2012). Validation of Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) in a Spanish population. Atención Primaria, 44, 516-526. doi:10.1016/j.aprim.2012.02.004 Sierra, J. C., Vallejo-Medina, P., Santos-Iglesias, P., Moyano, N., Granados, M. R., & Sánchez-Fuentes, M. M. (2014). Sexual functioning in the elderly: Infl uence of age and psychosexual factors. Revista Internacional de Andrología, 12, 64-70. doi:10.1016/j.androl.2013.10.002 Simon, W., & Gagnon, J. H. (2003). Sexual scripts: Origins, infl uences and changes. Qualitative Sociology, 26, 491-497. doi:10.1023/ B:QUAS.0000005053.99846.e5 Spector, I. P., Carey, M. P., & Steinberg, L. (2011). Sexual Desire Inventory. In T. D. Fisher, C. M. Davis, W. L. Yarber & S. L. Davis (Eds.), Handbook of Sexuality-Related Measures (3th. ed., pp. 192195). London: Sage. Vallejo-Medina, P., Granados, M. R., & Sierra, J. C. (2014). Proposal and validation of a short version of the Sexual Opinion Survey in the Spanish population. Revista Internacional de Andrología, 12, 47-54. doi:10.1016/j.androl.2013.04.004