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Article

Sexual Desire and Erotic Fantasies Questionnaire: Validation of the Erotic Fantasy Inventory Scale (SDEF3) in Italian Adults

by
Filippo Maria Nimbi
1,*,
Roberta Galizia
1,
Lilybeth Fontanesi
2,
Seray Soyman
1,
Emmanuele Angelo Jannini
3,
Chiara Simonelli
1 and
Renata Tambelli
1
1
Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, 00185 Rome, Italy
2
Department of Psychological, Health and Territorial Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy
3
Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
*
Author to whom correspondence should be addressed.
Healthcare 2023, 11(6), 880; https://doi.org/10.3390/healthcare11060880
Submission received: 21 December 2022 / Revised: 3 March 2023 / Accepted: 15 March 2023 / Published: 17 March 2023
(This article belongs to the Special Issue Psychology in Sex and Gender)

Abstract

:
Background: Erotic fantasies are the most common sexual experiences and provide valuable clinical material for understanding individual and relational emotional dynamics. The primary objective of this study is to validate the Sexual Desire and Erotic Fantasies questionnaire (SDEF) Part 3–Inventory of Erotic Fantasies. This questionnaire was designed to be a sex-positive and inclusive measure of the content of erotic fantasies, accessible to individuals of all gender identities, sexual orientations, relationship/romantic status, and sexual behaviors. Methods: The SDEF3 was completed by 1773 Italian participants (1105 women, 645 men, and 23 participants identifying as other genders). Two factorial structures were presented and discussed: a 20-dimension structure for clinical and explorative use and a 6-dimension structure for research purposes. Results: The six-factor version was preferred due to its robust statistical properties and its ability to differentiate between sexually clinical and functional men and women, based on cut-off scores from the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Differences in the frequency of themes in fantasies between gender and sexual orientation were reported and discussed. Conclusions: The current study indicates that the SDEF3 is a valuable and comprehensive measure for assessing various scenarios related to fantasizing activity. It has potential applications in both clinical practice and scientific research.

1. Introduction

Sexual fantasies (SF) are usually defined as subjective mental imagery and thoughts that are erotic or arousing to the individual while awake [1]. SF are usually used to arouse the individual and are distinct from daydreaming, which is a spontaneous and fanciful series of thoughts not connected to immediate reality and the need for satisfaction [2]. Erotic fantasizing is regarded as the most common sexual experience among humans [3,4]. Across studies, about 90–97% of the general population report having SF and use them to stimulate their desire and intensify their arousal [1,5,6,7,8,9,10]. Fantasizing is typically referred to as a positive experience that can incentivize sexual response, pleasure, and satisfaction [4,11,12,13,14]. Sharing SF within a relationship may increase the positive perception of the relationship and foster intimacy [14]. However, SF may also represent a negative experience when perceived as unwanted and distressful for the individual [7,15]. SF should not be interpreted as a direct sign of real interest in the behaviors [16,17]. In this sense, some studies have focused on paraphilic interests and kinky SF to evaluate psychosocial factors associated with paraphilias, sexual violence, and deviance. The literature agrees that having SF related to paraphilic themes in the general population is neither rare nor directly connected to committing a crime [18,19]. The presence of paraphilic interests does not seem to be problematic per se (in line with DSM and ICD criteria); having a variety of different SF, rather than specific contents, seems to be a good marker of higher desire/arousal rates and better sexual health outcomes [7,17]. Historically, the literature has emphasized gender differences, with men reporting more SF about partner diversity, visually explicit descriptions, and dominating behaviors, whereas women report more about romance and submission [1,3].
A more complex and nuanced picture of gender differences has emerged from recent studies [7,8,9,10,17,20,21,22], accounting for individual variability and different sexual orientations and identities. In this sense, many studies [8,23,24,25,26,27,28,29] have attempted to categorize SF and create clusters focusing on erotic scenarios that refer to similar patterns (e.g., situations, sexual practices, and objects), following the evolution of the most common SF contents in different societies and cultures.
Focusing on validated measures of erotic fantasies, a masterful contribution dates back to the “Daydreaming inventory for married women” by Hariton and Singer [23]. In their study, the authors explored the incidence of 15 SF in a group of partnered women; however, despite the great contribution to the research, a real adaptation of the tool for the general population was never reported, making the tool obsolete today even for married women.
The Sex Fantasy Questionnaire (SFQ) [25,26] is among the most used questionnaires assessing the content of SF. With 40 items, it describes four dimensions: Exploratory (e.g., group sex, mate-swapping), Intimate (e.g., kissing, oral sex, masturbation), Impersonal (e.g., sex with strangers, voyeurism, fetish), and Sadomasochistic (e.g., whipping and spanking, being forced to have sex). Although it has been widely used, the SFQ misses some relevant updates to reflect contemporary erotic imageries. In fact, a recent study [7] has suggested a modified version of the SFQ. No validation study of this SFQ modified version is available in the literature, although a suggested six-factor structure was proposed by Dyer et al. [30] and used by Allen et al. [31].
O’Donohue et al. [27] created the Paraphilic Sexual Fantasy Questionnaire (PSFQ) to investigate sexual fantasies corresponding to paraphilic interests in accordance with DSM IV criteria, and tested it on a group of convicted male child molesters. Starting from Wilson’s work [25], the PSFQ includes 162 items on topics such as consenting adult partners, masturbation, bondage, sadism, masochism, rape, pedophilia, and other paraphilias. However, both Wilson’s SFQ [25] and O’Donohue et al.’s PSFQ [27] measures have been criticized as too vague, deficient in reliability, and too focused on paraphilias [32].
More recently, Bogaert et al. [28] presented a new measure named (again) Sexual Fantasy Questionnaire (SFQ) composed of 62 items including relevant themes extracted from the literature (e.g., irresistibility, commitment vs. non-commitment, explicitness, roughness/coercion, romantic gestures/situations, and dominance/submission). The participants were asked to indicate their arousal to the items on a 7-point scale (1 = not at all exciting to 7 = extremely exciting). All the items are formulated in heterosexual wording, and participants are asked to substitute the most appropriate pronouns in case they do not find themselves in the formulation. This makes the questionnaire easy to administer, yet at the same time requires an adaptation effort on the part of the participant, which could be tiring and disrespectful.
Two of the most updated measures of SF and related behaviors were developed by Brown and colleagues [33] using a modern statistical approach in a large nonclinical convenience sample of people from the U.S., Canada, U.K., and Ireland. Both measures showed paraphilic and normophilic interests, with higher scores in men and non-heterosexual participants. However, among the limitations of these measures, interests related to pedophilia, fetishism, and other less common paraphilias were not retained in the final version of the measure.
On the Italian population, Panzeri et al. [29,34] validated the Erotic Imagery Questionnaire (EIQ), an 81-item questionnaire exploring five factors: transgressive themes, emotional romantic topics, dominance/submission, variety of partners, and explicit sexual images. Despite the acknowledgement of the thematic updates, Nese et al. [22] suggested that the EIQ dimensions collect sexual fantasies based on general characteristics, with the limitation that very diverse fantasies may collide in the same statistical dimension. This makes the operationalization of the dimensions on a clinical and research level very difficult. The labels used to explain the themes are not accurate enough to offer a good description of the sexual fantasy content. Therefore, Nese et al. [22] call for the need for a measure that is easier to use and interpret.
On a general level, the content of sexual fantasies is difficult to measure and categorize, as it relies on self-reports that are influenced by social desirability and other variables [32]. These measurement challenges, also considering data representability and questionnaire reliability, have contributed to the debate on how best to assess sexual fantasies in sex research [35]. Keeping in mind that the self-report limitation cannot currently be overcome in this field, except by associating measures of social desirability during the assessment, available tools present some other relevant problems. Sexual fantasies are extremely important and useful clinical material, irrespective of the approach, that allows experiencing and being aware of individual and relational emotional dynamics [12]. In this sense, an inventory that is up-to-date and comprehensive can be a useful support to the clinician, both as a stimulus that can be used within individual or couple therapies, and as a tool to elicit reflections, comparisons, and open communication on intimate topics. The aforementioned questionnaires, as well as other questionnaires in the literature, represent diversified attempts to categorize complex and ever-changing erotic scenarios across time and cultures. Firstly, questionnaires on the contents of SF do not always pursue the same goal [22]: some of them focus on the frequency of SF, others evaluate the arousing potential of the presented scenarios, while others focus on how typical/pathological the contents might be. Another limitation, according to Cartagena-Ramos et al. [36], is that questionnaires on SF are not often applied to different sociocultural contexts than that of their authors, with significant issues regarding the replicability of the results and reliability. Moreover, many measures are limited to the heterosexual cisgender population, failing to capture other possible sexual identities (gender, sexual orientation, and other expressions) and behaviors [9,10].

1.1. The Current Study

The current study is inserted in this complex scenario as a part of a wider project aiming to provide an updated, extensive, and inclusive measure of SF that can be easily adapted to different cultural backgrounds and used in clinical work in a second phase of the project (cross-cultural validation). The project aims to analyze the psychometric properties of a composite measure for sexual desire called the “Sexual Desire and Erotic Fantasies questionnaire (SDEF)”. The SDEF is divided into three independent measures (1. Sexual Desire; 2. Use of Erotic Fantasies; and 3. Erotic Fantasies Inventory) [37,38] that can be used separately or together for a general overview of the desire function. The creation of the SDEF was driven by the need to have a tool able to explore different aspects of the desire experience rather than to improve the currently available measures. Especially, it was designed to be used in clinical settings for the investigation of key components that should be observed in the assessment of sexual dysfunctions and relational problems as highlighted by the major diagnostic classifications such as DSM-5 and ICD-11 [39,40].
In this paper, we will test and discuss the results of the validation study of the Sexual Desire and Erotic Fantasies questionnaire–Part 3 Erotic Fantasies Inventory (SDEF3), which focuses on the frequency of SF contents. The SDEF3 was created to explore a person’s erotic imaginative experience and to collect a wide range of erotic stimuli based on scientific literature. This variety is considered one of the strengths of the SDEF3, which may help clinicians to assess desire and/or sexual-related difficulties, and can also be used in research to deepen specific characteristics of SF. Furthermore, a sex-positive approach [41] was used to build the SDEF3 as a tool accessible to all individuals, regardless of their gender identities, sexual orientations, relational/romantic status, and sexual behaviors. Specifically, special attention was paid to writing items with inclusive language that is capable of describing different manifestations of human sexuality, such as non-penetrative sexual behaviors. This is particularly important in the Italian language, in which gender binary declinations can create difficulties and misinterpretations. In this sense, a sex-positive approach recognizes the tremendous cultural diversity in sexual practices, acknowledging substantial variations in personal meanings and preferences over time and space.

1.2. Aims

The main aim of the present study is to explore the factorial structure of the SDEF3 questionnaire and to discuss its psychometric properties. The first objective focuses on testing the internal reliability, construct, and discriminant validity of a 20-factor structure of the questionnaire. This large and descriptive model aims to illustrate clusters of SF that may vary together. The second objective is to test an alternative 6-factor structure of the SDEF3, which is more concise and has more rigorous statistical criteria, and a reduced number of domains. The internal reliability, construct and discriminant validity of the questionnaire will be evaluated. The third objective is to explore the characteristics of the SDEF3 six-factor structure, such as its association with sociodemographic variables, sexual functioning, and differences in gender and sexual orientation, in a group of Italian individuals.

2. Materials and Methods

A total of 1819 volunteers from the Italian general population participated in the SDEF validation study, of which 1135 were women, 661 were men, and 23 identified as other genders. Participants were recruited using a snowball technique and sharing advertisements on institutional websites and social networks such as Facebook, Instagram, and LinkedIn. The web survey was available on the Google.forms platform from January 2019 to December 2020. Participants provided informed consent before accessing the survey, and the questionnaire was anonymous with no remuneration provided. The institutional ethics committee of the Dept. of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Italy (protocol code 14) approved the study on 9th January 2019. The inclusion criteria were being at least 18 years old and holding Italian citizenship. The present study excluded 46 responses (2.53%) due to duplicated, falsified, or incomplete records. The final group comprised 1773 participants, including 1105 women, 645 men, and 23 other genders. To conduct explorative and confirmative factorial analysis, participants were randomly assigned to two different groups, balanced for gender, age, and sexual orientation (see Table 1). The same group of participants was also involved in the validation study of SDEF1 and SDEF2 [37,38].
In the current study, different measures were involved. Firstly, participants completed a brief sociodemographic questionnaire to provide information about age, gender, sexual orientation, marital and relationship status, children, education level, work status, religious and political orientation, and whether they were sexually active or not.
The Sexual Desire and Erotic Fantasies questionnaire (SDEF3–Part 3) is designed to measure the frequency of the most common SF. The items included in the SDEF3 were created by reviewing and selecting fantasy contents from relevant literature on fantasies and pornography trends [7,8,23,24,25,26,27,28,29,42,43] to offer an inclusive and updated list of erotic situations, practices, and objects. The authors developed 153 items during this process, paying particular attention to the use of inclusive language that could refer to any erotic activity, not only penetrative sex (e.g., kissing, body stimulation, oral sex, masturbation), and trying to be respectful of any gender identity and sexual orientation. Answers are rated using a 5-point Likert scale (from “never” to “always”) to indicate the frequency of SF related to the presented stimuli in the last six months (time frame chosen in line with DSM-5 criteria for desire-related disorders). Higher scores indicate a higher frequency of fantasies. At the end of the questionnaire, a part is left free for the person to indicate fantasies that have not been included in the previous items as open-ended questions. A pool of ten experts in the field of psychosexology and sexual medicine reviewed the content by inserting comments and suggestions into the text separately. The criteria used by the experts were content relevance and comprehension. Once all the comments from the experts had been collected, the authors revised each item by incorporating minor wording changes and merging or deleting 28 items that were redundant (e.g., ‘drinking urine’ or ‘receiving urine on the body’ has been merged into item 78 ‘urine’). The remaining 125-item version of the SDEF3 was pilot-tested with 20 volunteers to examine the general comprehension of the questionnaire and was then administered in the present study to test its psychometric characteristics. The final version is reported in Appendix A.
Sexual Desire Inventory–2 (SDI-2) [44]: The SDI-2 is a 14-item measure used to evaluate two dimensions of sexual desire: dyadic and solitary sexual desire. Higher scores indicate a higher level of sexual desire. The two-dimensional structure presents satisfying psychometric properties, as in the Italian version [45], with a Cronbach’s alpha coefficient in this study equal to 0.88 for dyadic and 0.91 for solitary sexual desire.
International Index of Erectile Function (IIEF) [46]: The IIEF is a widely used 15-item questionnaire for the evaluation of male erectile and sexual function. A general index of sexual function and five specific dimensions are calculated: sexual desire, erectile function, orgasmic function, satisfaction with intercourse, and overall satisfaction. Higher scores indicate better functioning. Psychometric studies have reported good reliability, validity, and discrimination between sexually dysfunctional and healthy people (clinical cut-off score <26). For this study, the IIEF was worded in a such way as to be completed by all cisgender men, regardless of their sexual orientation. The Cronbach’s alpha in this study ranged from 0.87 (orgasmic function) to 0.93 (overall satisfaction).
Female Sexual Function Index (FSFI) [47]: The FSFI is an established 19-item instrument providing information on general sexual functioning and six specific dimensions: sexual desire, sexual arousal, lubrication, orgasm, sexual pain, and sexual satisfaction. Higher scores indicate better functioning. The measure presents good test–retest reliability, internal consistency, validity, and discrimination between sexually dysfunctional and healthy people (clinical cut-off score <26.55), as in the Italian version [48]. For this study, the FSFI was worded in a such a way as to be completed by all cisgender women, regardless of their sexual orientation. The Cronbach’s alpha in this study ranged from 0.81 (sexual arousal) to 0.92 (sexual pain). The calculation of total FSFI/IIEF scores and relevant domain scores (on all but the desire domain) were limited to those who did not indicate a zero score (no sexual activity) on any of the FSFI/IIEF items.
Marlowe–Crowne Social Desirability Scale–Short Form (MCSDS-SF) [49]: The MCSDS-SF is a 13-item measure developed to assess socially desirable responses. Higher scores indicate a higher tendency to respond in a socially desirable way. The Cronbach’s alpha value for this measure was 0.91. The MCSDS-SF was used as a covariate in the analysis of the current study to limit the effects of social desirability.
Regarding statistical analyses, the psychometric properties of the SDEF3 were tested using different procedures. Construct validity was estimated at the item level using principal component analysis (PCA) to identify the underlying constructs of the questionnaires. In this phase, a direct oblimin rotation was used, and the number of factors selected was determined using parallel analysis in conjunction with the Guttman–Kaiser criterion, using Monte Carlo PCA for parallel analysis by Watkins [50]. After establishing a satisfactory model, a path diagram was drawn and tested using confirmatory factor analysis (CFA). Internal consistency was assessed using Cronbach’s alpha. Composite reliability (CR) and average variance extracted (AVE) values were examined. Pearson correlations (two-tailed), one-way and two-way multivariate analyses of covariance (MANCOVAs) were used to explore associations with erotic fantasy dimensions and sociodemographic variables, sexual functioning, gender, and sexual orientation differences in a group of Italian people. Age, relationship status, and social desirability effects were controlled using these as covariates in the MANCOVAs. PCA, Cronbach’s alpha values, Pearson correlations, and MANCOVAs were performed using IBM SPSS 27.0, and CFA was tested with IBM SPSS Amos 22 (Version22, IBM Corp, Armonk, NY, USA).

3. Results

Table 1 shows the sociodemographic data for the variables assessed in the study organized for the total group (n = 1773) and for the two subgroups randomly extracted to run exploratory and confirmatory factorial analyses separately (Group 1 n = 887; and Group 2 n = 886).

3.1. Testing the SDEF 20-Factor Structure

Group 1 was used to test the factorial structure of the SDEF3 with principal component analyses (PCAs). After excluding open-ended qualitative items (121, 122, 123, 124 and 125), PCAs were run on the remaining 120 items of the SDEF3 using a direct oblimin rotation. A Kaiser–Meyer–Olkin value of 0.92 supported the adequacy of the sample. The significance of the Bartlett test of sphericity (χ2 = 100,659.879; p < 0.001) meant that item correlations were large enough to conduct PCAs.
Based on eigenvalues higher than 1, 20 components were identified, accounting for 64.34% of the total variance. Item selection was based on loadings higher than 0.3 on respective factors. A total of 23 items loaded below 0.3 in all factors or loaded higher than 0.3 in more than one factor. Thus, they were excluded from the following analyses. Appendix B presents the retained 97 items’ component loadings. Factors highlighted are:
  • F1. Physical Characteristics: Dimension collecting physical characteristics culturally attributed to being beautiful/handsome, attractive, and sexy, such as athletic/thin body, young age, etc.
  • F2. Group sex: Dimension collecting different sexual scenarios having more than one sexual partner involved.
  • F3. Romantic: Dimension gathering romantic scenarios and actions such as kissing, hugging, massage, and looking after/being looked after by a partner.
  • F4. Vanilla Sex: Dimension collecting a range of common sexual practices such as petting, oral sex, masturbation, and vaginal sex.
  • F5. Masochism: Dimension describing a range of torture, humiliating and painful practices received by the participant from other partners.
  • F6. Sadism: Dimension gathering a range of torture, humiliating and painful practices performed by the participant on other partners.
  • F7. Taboo: Dimension gathering taboo scenarios such as having sex with animals, children, corpses, and people with disabilities.
  • F8. Anal Sex and Toys: Dimension collecting a range of activities involving anal play and sex toys.
  • F9. Incestuous/Older people: Dimension collecting fantasies around family members, pregnant women, elderly people, and obese people.
  • F10. Soft Fetish: Dimension describing a range of fetishes such as foot, hair, saliva, sweat and other parts of the body.
  • F11. Risk of Being Caught: Dimension regarding open air scenarios or places in which is easy to be caught by others while having sex.
  • F12. Past Experience: Dimension describing fantasies involving memories of past sexual experiences and former partners.
  • F13. Seduction and Infidelity: Dimension regarding themes in which seduction and betrayal of a relationship are central in the erotic scene.
  • F14. Exhibitionism and Voyeurism: Dimension that describes the activity of watching or being spied on while naked or engaging in sexual activity.
  • F15. Bondage: Dimension describing a range of practices involving the action of tying/being tied up and blindfolded.
  • F16. Sexual Abuse: Dimension regarding scenarios involving non-consensual sexual activities.
  • F17. Sex work: Dimension gathering scenarios where sex is bought or sold, including playing in a porn movie.
  • F18. Ejaculation Emission: Dimension collecting groups of fantasies in which the person ejaculates on the partner.
  • F19. Receiving Ejaculation: Dimension collecting groups of fantasies in which the person receives the ejaculation of the partner.
  • F20. Dirty Fetish: Dimension describing liquids fetishes such as urine, excrement, and vomit.
To validate the 20-factor structure, a CFA was run on Group 2 to measure model fit, comparison, and parsimony indices, following the procedure used by Nimbi et al. [51,52]. The figure of the model was not reported for simplicity. The maximum likelihood estimation method was used, and pathways of error variance between items inside the same factor were inserted to increase model fit. The χ2 value for the model was significant (χ2 = 18,012.66, p < 0.001), and the RMSEA was 0.043 (90% CI = 0.042–0.043). Other fit indices evaluated included GFI (0.79), NFI (0.82), and CFI (0.86). Moderate fit was reached in all measures except for the χ2 value, which is sensitive to large sample sizes (n > 200).
Regression coefficients for this model ranged from 0.27 to 0.94 and were all statistically significant (p < 0.001). MacDonald’s omega coefficients for internal consistency were satisfactory, ranging from 0.65 (F9. Incestuous/Older people) to 0.91 (F18. Ejaculation Emission). The composite reliability (CR) for each construct was above or close to the expected threshold of 0.70 (F1 = 0.83; F2 = 0.86; F3 = 0.85; F4 = 0.84; F5 = 0.82; F6 = 0.59; F7 = 0.82; F8 = 0.76; F9 = 0.65; F10 = 0.67; F11 = 0.85; F12 = 0.73; F13 = 0.73; F14 = 0.76; F15 = 0.85; F16 = 0.67; F17 = 0.34; F18 = 0.81; F19 = 0.82; F20 = 0.67). F6 and F17 showed a low CR. The average variance extracted (AVE) value for each factor was below the expected threshold of 0.50 for most of the factors (F1 = 0.33; F2 = 0.48; F3 = 0.45; F4 = 0.45; F5 = 0.44; F6 = 0.23; F7 = 0.47; F8 = 0.39; F9 = 0.28; F10 = 0.3; F11 = 0.6; F12 = 0.41; F13 = 0.41; F14 = 0.45; F15 = 0.58; F16 = 0.4; F17 = 0.14; F18 = 0.59; F19 = 0.61; F20 = 0.41), except for F11, F15, F18, and F19.
Intercorrelations between the 20 factors for the total group (n = 1773) are reported in Table 2. The 20-factor structure presented some strengths, such as the ability to describe different scenarios of erotic fantasies, and important weaknesses, such as fair psychometric characteristics, which will be discussed later. Therefore, the 20-factor structure was discarded, and it was decided to test a structure with six factors.

3.2. Testing the SDEF3 Six-Factor Structure

In line with the objectives of this study, a more robust factorial structure using more rigorous criteria for factor extraction was tested. A new set of PCAs was run on the 120 quantitative items of the SDEF3 using a direct oblimin rotation. Monte Carlo parallel analysis identified six components accounting for 47.9% of the total variance. Item selection was based on loadings higher than 0.4 on respective factors. A total of 54 items loaded below 0.4 in all factors or loaded higher than 0.4 in more than one factor. Thus, they were excluded from the following analyses. Appendix C presents the retained 66 items’ component loadings. The factors highlighted were:
  • F1. Physical and Contextual: A dimension that collects a series of physical characteristics inspired by common culturally widespread canons of beauty (e.g., athletic/thin body, tall, young age) and places or scenarios considered erotically stimulating and representative in mainstream pornography (e.g., outdoor sex, seduction, having sex at work).
  • F2. BDSM: A dimension collecting different sexual scenarios that recall BDSM and bondage practices, sadomasochistic activities, fetishism, and similar.
  • F3. Taboo: A dimension gathering taboo scenarios such as having sex with animals, children, relatives, corpses, and rape among others.
  • F4. Bottom: A dimension collecting a range of common sexual practices in which the person plays the role of receiving the practice (bottom/passive) with a partner who plays a more leading/active role.
  • F5. Top: A dimension collecting a range of common sexual practices in which the person plays the role of doing the practice (leader/active) with a partner who plays a more passive/bottom role of receiving it.
  • F6. Romantic: A dimension gathering romantic scenarios and actions such as kissing, hugging, massage, and looking after/being looked after by a partner.
To validate the six-factor structure identified with the PCA, a CFA was run on Group 2 measuring model fit, comparison, and parsimony indices. For simplicity, the figure of the model is not reported. The maximum likelihood estimation method was used. To increase model fit, pathways of error variance between items inside the same factor were inserted. The χ2 value for the model was significant (χ2 = 12,067.76, p < 0.001). RMSEA was 0.046 (90% CI = 0.045–0.047). Other fit indices evaluated included GFI (0.87), NFI (0.89), and CFI (0.91). A better fit was reached in all measures except for the χ2 value due to its sensitivity to large sample sizes (n > 200) compared to the 20-factor structure.
Regression coefficients for this model ranged from 0.37 to 0.88 and were all statistically significant (p < 0.001). Internal consistency was assessed: MacDonald’s omega coefficients were satisfactory (F1 = 0.88; F2 = 0.9; F3 = 0.8; F4 = 0.85; F5 = 0.87; F6 = 0.83); the CR for each construct was above the expected threshold of 0.70 (F1 = 0.88; F2 = 0.88; F3 = 0.85; F4 = 0.85; F5 = 0.86; F6 = 0.87); the AVE value for each factor was below the expected threshold of 0.50 (F1 = 0.28; F2 = 0.37; F3 = 0.32; F4 = 0.43; F5 = 0.47; F6 = 0.49).

3.3. SDEF3 Six-Factor: Testing Validity Evidence Based on the Relationship with Other Variables

Based on the total group (n = 1773), intercorrelations between the six factors were all statistically significant (Table 3). Table 3 also reports Pearson’s correlations with SDI-2, FSFI, and IIEF scores to verify associations with desire and other sexual domains. Focusing on an SDEF3 six-factor description, associations with sociodemographic variables were explored. Table 4 reports Pearson’s correlations with age, being in a relationship, education level, political and religious attitudes, having sexual intercourse (being sexually active), and social desirability. Different erotic contents were shown to be significantly associated with sociodemographic variables such as age, relationship status, having children, education level, having sexual intercourse, and political and religious attitudes.
Due to the importance highlighted in the current results and similar constructs in literature, age, relationship status, and social desirability were considered as covariates in the following analyses aiming to explore possible differences in the contents of erotic fantasies among genders and sexual orientations [9,10]. Due to the limited number of transgender/gender-nonconforming, asexual, and pansexual participants, the following analyses focused on people identifying themselves as women and men (gender) and heterosexual, bisexual, or homosexual (sexual orientation).
A two-way MANCOVA (having age, being in a relationship, and social desirability as covariates) was run to highlight gender and sexual orientation differences on SDEF3 factors. Gender and sexual orientation were considered as independent variables, while SDEF3 dimensions were put as dependent ones. Findings are reported in Table 5, showing significant results for gender, sexual orientation, and gender X sexual orientation (Figure 1).
To explore whether the SDEF3 six dimensions were able to differentiate between clinical scores of FSFI and IIEF, two one-way MANCOVAs (having age, being in a relationship, and social desirability as covariates) were run to highlight sexual functioning differences on SDEF3 factors. Reaching a clinical score of FSFI for women and IIEF for men was considered as an independent variable, while SDEF3 dimensions were put as dependent ones. Findings are reported in Table 6, showing significantly higher SF in all SDEF3 dimensions for participants with FSFI and IIEF functional scores compared with those with clinical scores, except for F3 in both genders. These results seem to suggest the ability of the SDEF3 to discriminate among sexually functional and dysfunctional men and women.

4. Discussion

The current study aimed to test the psychometric properties of a self-administered measure of sexual fantasies (SF). Two structures were tested: a 20-factor structure that was able to describe a wide variety of erotic themes with fair psychometric characteristics, and a 6-factor structure with more reliable psychometrics.
The 20-factor version included 97 items explaining 64.34% of the total variance. The strengths of this version concern the possibility of describing a great variety of themes and scenarios that could be useful in clinical and explorative/descriptive contexts. Therapists may use the list of SF (dimensions and items) to help their patients reflect on their erotic repertoire, identify which elements they like or dislike, and communicate with their partners [12,52]. Having more awareness of one’s fantasies might be useful for dealing with desire issues and other problems in the sexual and relational sphere [14]. This allows, especially in the clinical setting, for discussing together how the individual or the partners communicate sexually about wishes, boundaries, and how sexuality is negotiated [52]. Furthermore, it may be easier to collect relevant information about SF by avoiding direct disclosure during the clinical interview. However, it should be noted that any form of categorization of fantasies, as with other natural phenomena, results in a simplification of reality and a loss of information [53]. Therefore, the SDEF3 should be considered a starting point to stimulate creativity and free-thinking, rather than a rigid model to follow. As critical elements of the 20-dimension version, we underline the low statistical power of some psychometric indexes, especially the AVE. Furthermore, using a tool that includes 20-dimensions could be difficult to operationalize in research for qualitative studies. For this reason, the 20-factor structure is not reliable enough to be recommended for scientific use. In the process of this study, it was essential to test a different (six-factor) structure based on more rigorous and stable statistical criteria.
The six-factor structure includes 66 items that explain 47.9% of the total variance. It provides general categories that may be comparable to those used in other studies [8,25,26,28,29]. Although having a categorization based on six dimensions can be reductive compared to the 20 previously presented, it may allow for an easier operationalization of SF. In this sense, the relevance of these broad categories was explored in relation to sociodemographic and sexual functioning variables.
Regarding associations with sociodemographic data, physical and contextual, BDSM, and romantic fantasies showed lower frequency with aging, being in a relationship, having children, and higher education levels. A major political involvement (regardless of the type of party) seemed to relate to a higher frequency of physical and contextual, BDSM, and top fantasies. Religiousness seemed to be connected to reporting fewer SF of any kind. Social desirability showed a relationship with all SDEF3 dimensions except for romantic fantasies, which might be intended as more “morally” acceptable as an expression of love and intimacy [54]. These results are in line with previous studies [55,56,57,58].
Sexual intercourse frequency showed a significant relationship with BDSM, bottom, and top fantasies. As expected [14], all the erotic dimensions were linked to a higher level of desire reported, both at the dyadic level and regarding masturbation, with the only exception of romantic fantasies, which do not seem to characterize solitary sexual activity. Regarding other phases of sexual response and satisfaction, in women, BDSM, bottom, and top fantasies seem to relate to higher FSFI scores, while in men, only top fantasies show a positive correlation with the IIEF scores. These results are not surprising and are in line with leading western gender scripts [28,58].
Moreover, for a clinical application of these results, it should be noted that the presence of specific SF could be a central expression of functional and satisfying sexuality. On the other hand, a problem in sexual functioning may also negatively influence fantasizing activity [53,59]. Therefore, in the case of sexual difficulties, the area of desire and fantasies should be investigated by the clinician for a deeper insight into the problem.
Regarding gender differences in fantasizing, controlling age, relationship status, and social desirability’s effects, men significantly reported a higher frequency of physical and contextual, taboo, and top fantasies than women. No differences were found regarding other SDEF3 domains. In line with other studies [7,22,25,29,60,61], gender differences in SF were expected, although the effect size was small (physical and contextual, taboo fantasies) to medium (top fantasies). Wilson [25] showed that men reported about twice more SF than women, especially in exploratory and impersonal categories, according to the fact that men’s SF seemed to be more explicit (and pornographic) than women’s. Joyal et al. [7] highlighted how men usually reported more different themes than women. In any case, we should consider that in the almost 35 years since Wilson’s studies, many things could have changed in line with the sociocultural evolution on sexuality that favors a greater openness to these issues and influences what we find to be erotic and what we fantasize about [41].
Considering sexual orientation, heterosexual participants seem to report significantly lower scores on physical and contextual, BDSM, and bottom fantasies compared to bisexual and homosexual participants. Moreover, bisexual participants reported a higher frequency of BDSM fantasies than homosexual participants. Intersecting gender and sexual orientation, gay men reported a higher frequency of physical and contextual and bottom fantasies and lower rates of top fantasies compared to other men, while bisexual women reported a higher frequency of physical and contextual, BDSM, bottom, and top fantasies compared to other women. Heterosexual and lesbian women reported lower scores in most of the domains assessed, supporting the idea expressed by Nese et al. [22] that they (1) may report fewer sexual fantasies in general, (2) may express less diversified contents (mainly romantic ones), and (3) the contents of their fantasies might be poorly represented by the items used in this study. In any case, these results are extremely important as they add data to the scarce literature on sexual minorities, especially bisexual men and lesbian women [9,10,62].
Another important result regards the ability of the SDEF3 six-factor solution to differentiate between sexually dysfunctional and functional women and men. Table 6 shows how groups of women and men having clinical scores on the FSFI and IIEF [46,47] got significantly lower scores in all the SDEF3 domains except for taboo fantasies. These results are in line with the idea that SF do not compensate for sexual deficiencies [1,14]. However, future studies should explore whether both the frequency and content of SF may compensate for the overall relational distress rather than for sexual dissatisfaction per se [14]. In any case, the literature agrees that SF are typically involved in the promotion of sexual arousal, pleasure, and satisfaction [1,4,8,11,12,13,14].
As shown by the current results, more frequent fantasizing is associated with higher scores on desire, arousal, orgasm, and satisfaction. To promote relationship intimacy and improve sexual functioning, many clinicians propose SF training to their patients [12,14,63]. Sexual fantasizing may offer individuals/couples a space to work on sexual communication, creating an opportunity to learn to talk about themes, possible experiences, and desires that are typically welcomed by patients [53].
The present research has some limitations that should be highlighted for the reader. (i) Participants were selected using a “snowball” technique; therefore, it is not possible to generalize the results to the Italian population, despite the large number of participants involved in the current study. (ii) The SDEF3 was created as an inventory of themes and fantasy scenarios selected among the most common and frequent ones in the literature. In this sense, they may have guided the participants in their choices, limiting free expression or facilitating falsification. Therefore, any assertion on people’s real fantasizing activity should be made with extreme caution. To limit this bias, the study used a large group of participants, giving them the possibility to report themes or scenarios not covered by the questionnaire with open answers and a social desirability measure that was assessed. However, the group assessed showed limited gender diversity. (iii) Test–retest reliability was not assessed in the current study. For that reason, further studies should be conducted to replicate the present findings and extend the psychometric understanding of the SDEF3. Moreover, future studies should consider extending the evaluation of SF to different sexual identities and orientations beyond binarism. Multicultural studies on the SDEF3 psychometric properties and, more generally, on SF to explore differences and similarities between countries are also needed, highlighting the importance of capturing potential changes over time linked to sociocultural factors [22,61].

5. Conclusions

Erotic fantasizing activity remains a complex and largely unknown area of investigation; however, studies such as the present one may help take a small step forward. Specifically, the current study extends the current knowledge about the frequency of specific themes in SF and their connections with sexual functioning among genders and sexual orientations. This may be important not only for advances in research but also for improvements in clinical practice [9,10,11,12]. Sexual therapists should acknowledge the role played by SF and use specific techniques in their clinical practice to improve sexual functioning, sexual communication, relational intimacy, and satisfaction [12,41]. For this purpose, the SDEF3 six-factor solution could be a useful and valid measure to assess different expressions of erotic repertoires for clinical and research purposes. Moreover, we suggest assessing the SDEF3 six-factor solution in association with the SDEF1 and SDEF2 [37,38] in order to have a more complex view of the sexual phantasmatic experience and expression of individuals.

Author Contributions

F.M.N., E.A.J., C.S. and R.T. originated the idea and design for the current study. F.M.N., R.G. and S.S. conducted literature searches and provided summaries of previous research studies. F.M.N., R.G., L.F. and S.S.; followed the investigation process, and data collection. FMN wrote the first draft of the manuscript. F.M.N., E.A.J., C.S. and R.T. supervised the research process and the final draft of the manuscript. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Ethics Committee of the Dept. of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Italy (protocol code 14 of 9 January 2019).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Data is unavailable due to privacy or ethical restrictions. Any further request can be directed to the corresponding author.

Conflicts of Interest

The authors declare no conflict of interest.

Appendix A. SDEF–Sexual Desire and Erotic Fantasies Questionnaire–Part 3. Inventory of Erotic Fantasies

Below, you will find a list of scenarios and general elements that may be common in erotic fantasies. We kindly ask you to carefully read the list and indicate HOW OFTEN IN THE LAST SIX MONTHS IT HAPPENED TO YOU TO HAVE AN EROTIC FANTASY RELATED TO EACH ONE OF THE LISTED TOPICS. We apologize in advance if some topics or elements may cause any inconvenience or disturbance. If you wish, you can write down your considerations or any clarifications that you consider important alongside each erotic fantasy.
Table A1. SDEF–Sexual Desire and Erotic Fantasies Questionnaire.
Table A1. SDEF–Sexual Desire and Erotic Fantasies Questionnaire.
NErotic FantasyNeverRarelySometimesOftenAlwaysNotes and Considerations
1Being in a romantic scenario (candlelit dinner, sunset walk, etc.)01234
2Kissing a partner01234
3Caressing and hugging (cuddling)01234
4Receiving a massage01234
5Giving a massage01234
6Touching the breast/chest or stimulating the nipples01234
7Being masturbated by a partner01234
8Masturbating a partner01234
9Practicing oral sex (cunnilingus/fellatio/anilingus)01234
10Receiving oral sex (cunnilingus/fellatio/anilingus)01234
11Having vaginal intercourse with an insertive role (top/active; with penis or sex toys)01234
12Having vaginal intercourse with a receptive role (bottom/passive; with penis or sex toys)01234
13Practicing anal stimulation (fingers, sex toys, etc.)01234
14Receiving anal stimulation (fingers, sex toys, etc.)01234
15Having anal intercourse with an insertive role (top/active; with penis or sex toys)01234
16Having anal intercourse with a receptive role (bottom/passive; with penis or sex toys)01234
17Using sex toys or other common objects for sexual purposes01234
18Ejaculating on partner’s face and/or body01234
19Ejaculating inside the partner (vagina and/or anus)01234
20Ejaculating in partner’s mouth01234
21Receiving the partner’s ejaculation on the face and/or body01234
22Receiving the partner’s ejaculation in the vagina and/or anus01234
23Receiving the partner’s ejaculation in the mouth01234
24Squirting (expelling fluid from the female genitals during or before an orgasm)01234
25Looking after the partner (taking care)01234
26Letting yourself be looked after by the partner01234
27Seducing someone01234
28Being seduced by someone01234
29Cheating on your regular partner01234
30Having sexual activity on the phone01234
31Having virtual sexual activity (cams, chats, sex toys, etc.)01234
32Having sexual intercourse in a state of high disinhibition (including with the use of alcohol and/or drugs)01234
33Having sexual intercourse with an unconscious person (fainted or asleep)01234
34Having intercourse while unconscious (fainted or asleep)01234
35Sexually abusing someone (raping)01234
36Being sexually abused (being raped)01234
37Watching or spying on someone while she/he/they are naked01234
38Watching or spying on someone who is engaging in sexual activities01234
39Being watched or spied on while naked01234
40Being watched or spied on while engaging in sexual activities01234
41Rubbing an unaware person in a crowded place (subway, bus, concert, etc.)01234
42Making a porn video01234
43Paying for having sex01234
44Getting paid for having sex01234
45Engaging in sexual activities in a place where you risk getting caught01234
46Engaging in sexual activities in a public place (street, alley, municipal park, etc.)01234
47Engaging in sexual activities in a workplace (office, school, etc.)01234
48Engaging in sexual activities in a natural place (forest, beach, etc.)01234
49Remembering a past sexual experience01234
50Remembering a past experience that is not directly related to sexuality01234
51Remembering an erotic or pornographic scene from a movie, book, or comic01234
52Remembering a non-sexual scene from a movie, book, or comic01234
53Having sex with two people (threesome, ménage à trois)01234
54Having a sexual intercourse with a couple (whose members have a romantic relationship with each other)01234
55Having sex with twins01234
56Having sex with three or more people (orgy, group sex)01234
57Being the centre of attention in a group sex situation (gang bang/reverse gang bang)01234
58Having a sexual intercourse with your regular partner and another person01234
59Watching your regular partner having sex with another person/s01234
60Being watched by your regular partner while you are having sex with another person/s01234
61Blindfolding (depriving of sight)01234
62Being blindfolded (being blinded)01234
63Handcuffing, tying and/or gagging01234
64Being handcuffed, tied up and/or gagged01234
65Controlling the breath/suffocating the partner
66Being choked/controlled in the breath by the partner
67Hitting (spanking, slapping, whipping, etc.)01234
68Being hit (spanked, slapped, whipped, etc.)01234
69Inflicting painful practices and/or torturing01234
70Receiving painful practices and/or being tortured01234
71Dominating/mastering01234
72Being dominated/submissive01234
73Humiliating and/or insulting01234
74Being humiliated and/or insulted01234
75Use of specific materials or fabrics (leather, rubber, silk, fur, etc.) (specify which material in the notes)01234
76Saliva01234
77Sweat01234
78Urine01234
79Faeces01234
80Other bodily fluids (blood, vomit, mucus, flatulence, etc.) (specify which body fluid in the notes)01234
81Feet01234
82Hair01234
83Other body parts (specify which parts of the body in the notes)01234
84Having a different body from your own (specify in the notes)01234
85Engaging in sexual activity in the role of the opposite gender01234
86Engaging in sexual activity with a woman01234
87Engaging in sexual activity with a man01234
88Having sex with a transgender or transsexual person01234
89Engaging in sexual activity with your regular partner01234
90Engaging in sexual activity with a former partner (ex-partner)01234
91Engaging in sexual activity with a known person (friend, colleague, etc.)01234
92Engaging in sexual activity with a relative or another family member01234
93Engaging in sexual activity with an unknown person01234
94Engaging in sexual activity with a real celebrity (existing VIP) (specify which one in the notes)01234
95Engaging in sexual activity with a fictional character (film, cartoon, video game, etc.) (specify which one in the notes)01234
96Engaging in sexual activity with a person with one or more very large organs (penis, breasts, etc.) (specify which part of the body in the notes)01234
97Engaging in sexual activity with a person with one or more very small organs (penis, breasts, etc.) (specify which part of the body in the notes)01234
98Engaging in sexual activity with a pregnant woman01234
99Engaging in sexual activity with a very thin person01234
100Engaging in sexual activity with an overweight or obese person01234
101Engaging in sexual activity with a very tall person01234
102Engaging in sexual activity with a very short person01234
103Engaging in sexual activity with a very athletic/muscular person01234
104Engaging in sexual activity with a very hairy person01234
105Engaging in sexual activity with a shaved or hairless person01234
106Engaging in sexual activity with a person with many piercings and/or tattoos01234
107Engaging in sexual activity with a person of an ethnicity other than your own (Asian, Black, Caucasian, etc.)01234
108Engaging in sexual activity with a professional figure (doctor, military, businessman/businesswoman, etc.) (specify which in the notes)01234
109Engaging in sexual activity with a person wearing sexy clothes or lingerie01234
110Engaging in sexual activity with a person wearing sportswear (tracksuit, leggings, shorts, tank tops, sneakers etc.)01234
111Engaging in sexual activity with a much older person (MILF/DILF, etc.)01234
112Engaging in sexual activity with a much younger person (adult)01234
113Engaging in sexual activity with an elderly person01234
114Engaging in sexual activity with a teenager/adolescent01234
115Engaging in sexual activity with a child or pre-adolescent01234
116Engaging in sexual activity with a “virgin” person (who has never had sexual intercourse)01234
117Engaging in sexual activity with a person with physical disability (blind, paraplegic, amputee, etc.) (specify which in the notes)01234
118Engaging in sexual activity with a person with mental disability (mental retardation, etc.) (specify which in the notes)01234
119Engaging in sexual activity with an animal (specify which in the notes)01234
120Engaging in sexual activity with a corpse01234
This space is dedicated to other erotic fantasies that you may have and that were not described in the previous list.
Table A2. Questionnaire.
Table A2. Questionnaire.
NErotic FantasyNeverRarelySometimesOftenAlwaysNotes and Considerations
121 01234
122 01234
123 01234
(124) Which of YOUR erotic fantasies excite you the most?
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
(125) Which of YOUR erotic fantasies cause you discomfort?
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Table A3. SDEF3 6-factor solution scoring.
Table A3. SDEF3 6-factor solution scoring.
Factor6-Factor Solution Scoring
SDEF3–F1. Physical and ContextualMean score of items 27, 28, 45, 46, 47, 48, 53, 90, 91, 94, 96, 101, 103, 105, 106, 107, 108, 110, 111
SDEF3–F2. BDSMMean score of items 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73
SDEF3–F3. TabooMean score of items 33, 34, 35, 92, 98, 100, 113, 115, 117, 118, 119, 120
SDEF3–F4. BottomMean score of items 9, 12, 14, 16, 21, 22, 23, 36
SDEF3–F5. TopMean score of items 10, 11, 13, 15, 18, 19, 20
SDEF3–F6. RomanticMean score of items 1, 2, 3, 4, 5, 25, 26

Appendix B. Principal Component Analysis Matrix (n = 887)–SDEF3 20-Factor Solution Extracted from 97 Items of the 120-Pilot Tested Version

ItemFactors Extracted
F1F2F3F4F5F6F7F8F9F10F11F12F13F14F15F16F17F18F19F20
F1. Physical Characteristics
SDEF3_1050.654
SDEF3_1100.611
SDEF3_1010.610
SDEF3_1070.605
SDEF3_1030.574
SDEF3_1020.570
SDEF3_1060.561
SDEF3_0990.518
SDEF3_1120.492
SDEF3_0960.487
F2. Group sex
SDEF3_060 0.747
SDEF3_059 0.740
SDEF3_058 0.736
SDEF3_054 0.682
SDEF3_056 0.658
SDEF3_053 0.640
SDEF3_057 0.614
F3. Romantic
SDEF3_026 0.777
SDEF3_025 0.773
SDEF3_003 0.766
SDEF3_001 0.694
SDEF3_002 0.658
SDEF3_004 0.502
SDEF3_005 0.470
F4. Vanilla Sex
SDEF3_007 0.823
SDEF3_008 0.794
SDEF3_010 0.725
SDEF3_009 0.702
SDEF3_006 0.630
SDEF3_011 0.458
SDEF3_012 0.436
F5. Masochism
SDEF3_070 0.779
SDEF3_066 0.707
SDEF3_074 0.703
SDEF3_072 0.640
SDEF3_068 0.616
SDEF3_036 0.490
F6. Sadism
SDEF3_073 0.623
SDEF3_069 0.526
SDEF3_071 0.460
SDEF3_065 0.371
SDEF3_067 0.367
F7. Taboo
SDEF3_120 0.789
SDEF3_118 0.755
SDEF3_115 0.704
SDEF3_117 0.611
SDEF3_119 0.568
F8. Anal Sex and Toys
SDEF3_014 0.736
SDEF3_016 0.713
SDEF3_013 0.599
SDEF3_015 0.574
SDEF3_017 0.462
F9. Incestuous/Older people
SDEF3_113 0.718
SDEF3_100 0.599
SDEF3_092 0.481
SDEF3_111 0.437
SDEF3_098 0.35
F10. Soft Fetish
SDEF3_082 0.698
SDEF3_077 0.564
SDEF3_083 0.507
SDEF3_076 0.482
SDEF3_081 0.444
F11. Risk of Being Caught
SDEF3_046 0.818
SDEF3_045 0.814
SDEF3_047 0.726
SDEF3_048 0.725
F12. Past Experience
SDEF3_050 0.758
SDEF3_049 0.704
SDEF3_090 0.568
SDEF3_052 0.489
F13. Seduction and Infidelity
SDEF3_027 0.757
SDEF3_028 0.746
SDEF3_029 0.549
SDEF3_091 0.457
F14. Exhibitionism and Voyeurism
SDEF3_039 0.717
SDEF3_038 0.686
SDEF3_040 0.657
SDEF3_037 0.613
F15. Bondage
SDEF3_061 0.839
SDEF3_063 0.810
SDEF3_062 0.736
SDEF3_064 0.658
F16. Sexual Abuse
SDEF3_033 0.669
SDEF3_035 0.627
SDEF3_034 0.598
F17. Sex work
SDEF3_044 0.435
SDEF3_042 0.390
SDEF3_043 0.323
F18. Ejaculation Emission
SDEF3_020 0.792
SDEF3_018 0.754
SDEF3_019 0.751
F19. Receiving Ejaculation
SDEF3_023 0.812
SDEF3_021 0.777
SDEF3_022 0.749
F20. Dirty Fetish
SDEF3_079 0.779
SDEF3_080 0.599
SDEF3_078 0.523
Rotation method: direct oblimin.

Appendix C

Table A4. Principal Component Analysis Matrix (n = 887)–SDEF3 6-Factor Solution Extracted from 66 Items of the 120-Pilot Tested Version.
Table A4. Principal Component Analysis Matrix (n = 887)–SDEF3 6-Factor Solution Extracted from 66 Items of the 120-Pilot Tested Version.
ItemFactors Extracted
F1. Physical and ContextualF2. BDSMF3. TabooF4. BottomF5. TopF6. Romantic
SDEF3_0910.685
SDEF3_1080.647
SDEF3_1070.587
SDEF3_1100.569
SDEF3_1030.558
SDEF3_1110.550
SDEF3_0270.534
SDEF3_0960.533
SDEF3_0280.532
SDEF3_0470.511
SDEF3_0940.503
SDEF3_1060.501
SDEF3_1010.499
SDEF3_0900.471
SDEF3_0460.455
SDEF3_0450.449
SDEF3_0480.444
SDEF3_1050.442
SDEF3_0530.411
SDEF3_063 0.786
SDEF3_061 0.725
SDEF3_064 0.696
SDEF3_062 0.673
SDEF3_065 0.654
SDEF3_067 0.622
SDEF3_071 0.613
SDEF3_066 0.573
SDEF3_069 0.560
SDEF3_068 0.541
SDEF3_072 0.486
SDEF3_070 0.443
SDEF3_073 0.434
SDEF3_118 0.725
SDEF3_120 0.711
SDEF3_115 0.656
SDEF3_119 0.609
SDEF3_117 0.581
SDEF3_035 0.556
SDEF3_033 0.540
SDEF3_113 0.499
SDEF3_034 0.469
SDEF3_092 0.452
SDEF3_100 0.443
SDEF3_098 0.441
SDEF3_016 0.798
SDEF3_023 0.775
SDEF3_022 0.761
SDEF3_014 0.752
SDEF3_021 0.740
SDEF3_012 0.449
SDEF3_036 0.408
SDEF3_009 0.400
SDEF3_020 0.793
SDEF3_019 0.767
SDEF3_015 0.762
SDEF3_018 0.761
SDEF3_013 0.738
SDEF3_011 0.456
SDEF3_010 0.405
SDEF3_003 0.812
SDEF3_002 0.746
SDEF3_001 0.713
SDEF3_025 0.690
SDEF3_026 0.690
SDEF3_004 0.611
SDEF3_005 0.599
Rotation method: direct oblimin.

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Figure 1. Diagrams of Gender X Sexual Orientation on SDEF3 six-factor solution (MANCOVAs) (n = 1729).
Figure 1. Diagrams of Gender X Sexual Orientation on SDEF3 six-factor solution (MANCOVAs) (n = 1729).
Healthcare 11 00880 g001
Table 1. Sociodemographic variables description.
Table 1. Sociodemographic variables description.
Variables Group 1
(n = 887)
Group 2
(n = 886)
Total Group
(n = 1773)
M ± ds (Min–Max)M ± ds (Min–Max)M ± ds (Min–Max)
Age 29.3 ± 10.42 (18–78)29.32 ± 10.28 (18–65)29.31 ± 10.35 (18–78)
n (%)n (%)n (%)
GenderFemale555 (62.57)550 (62.08)1105 (62.32)
Male320 (36.08)325 (36.68)645 (36.38)
Transgender3 (0.34)3 (0.34)6 (0.34)
Non-binary9 (1.01)8 (0.91)17 (0.96)
Sexual OrientationHeterosexual705 (79.48)703 (79.35)1408 (79.41)
Bisexual80 (9.02)82 (9.26)162 (9.14)
Homosexual89 (10.03)89 (10.05)178 (10.04)
Asexual10 (1.13)9 (1.02)19 (1.07)
Pansexual3 (0.34)3 (0.34)6 (0.34)
Marital StatusUnmarried763 (86.02)736 (83.07)1499 (84.55)
Married96 (10.82)125 (14.11)221 (12.46)
Separated24 (2.71)24 (2.71)48 (2.71)
Widowed4 (0.45)1 (0.11)5 (0.28)
Relationship StatusSingle333 (37.54)293 (33.07)626 (35.31)
Couple532 (59.98)576 (65.01)1108 (62.49)
Polyamory22 (2.48)17 (1.92)39 (2.2)
ChildrenNo787 (88.73)764 (86.23)1551 (87.48)
Yes100 (11.27)122 (13.77)222 (12.52)
Education LevelMiddle School19 (2.14)21 (2.37)40 (2.26)
High School286 (32.24)333 (37.58)619 (34.91)
University 443 (49.94)396 (44.7)839 (47.32)
PhD and Postgrad courses139 (15.67)136 (15.35)275 (15.51)
Work StatusStudent422 (47.58)414 (46.73)836 (47.15)
Employed241 (27.17)274 (30.93)515 (29.05)
Freelance150 (16.91)140 (15.8)290 (16.36)
Unemployed64 (7.22)56 (6.32)120 (6.77)
Retired10 (1.13)2 (0.23)12 (0.68)
Sexual Intercourse in LifeNever45 (5.07)54 (6.09)99 (5.58)
Yes842 (94.93)832 (93.91)1674 (94.42)
Sexual Intercourse in the last 6 monthsNo138 (15.56)110 (12.42)248 (13.99)
Yes749 (84.44)776 (87.58)1525 (86.01)
Table 2. Person’s correlation matrix among SDEF3 domains of the 20-factor solution.
Table 2. Person’s correlation matrix among SDEF3 domains of the 20-factor solution.
F1F2F3F4F5F6F7F8F9F10F11F12F13F14F15F16F17F18F19F20
F1. Physical Characteristics1.
F2. Group sex0.433 **1
F3. Romantic0.171 **0.0011
F4. Vanilla Sex0.263 **0.290 **0.444 **1
F5. Masochism0.224 **0.448 **0.075 *0.247 **1
F6. Sadism0.425 **0.424 **0.147 **0.303 **0.480 **1
F7. Taboo0.274 **0.189 **0.081 **0.058 †0.215 **0.254 **1
F8. Anal Sex and Toys0.317 **0.462 **0.134 **0.434 **0.389 **0.370 **0.129 **1
F9. Incestuous/Older people0.530 **0.383 **0.078 *0.174 **0.286 **0.308 **0.407 **0.270 **1
F10. Soft Fetish0.500 **0.329 **0.202 **0.266 **0.351 **0.447 **0.193 **0.356 **0.355 **1
F11. Risk of Being Caught0.363 **0.432 **0.176 **0.357 **0.378 **0.370 **0.115 **0.319 **0.279 **0.310 **1
F12. Past Experience0.380 **0.272 **0.284 **0.275 **0.201 **0.278 **0.163 **0.193 **0.269 **0.295 **0.296 **1
F13. Seduction and Infidelity0.443 **0.373 **0.220 **0.301 **0.208 **0.280 **0.128 **0.236 **0.338 **0.266 **0.389 **0.449 **1
F14. Exhibitionism and Voyeurism0.388 **0.580 **0.075 *0.250 **0.348 **0.344 **0.211 **0.409 **0.339 **0.349 **0.463 **0.217 **0.320 **1
F15. Bondage0.232 **0.401 **0.228 **0.399 **0.536 **0.533 **0.111 **0.354 **0.165 **0.298 **0.431 **0.240 **0.218 **0.305 **1
F16. Sexual Abuse0.279 **0.312 **0.074 *0.098 **0.303 **0.346 **0.423 **0.228 **0.347 **0.264 **0.252 **0.200 **0.223 **0.408 **0.205 **1
F17. Sex work0.434 **0.543 **0.075 *0.182 **0.367 **0.337 **0.260 **0.338 **0.385 **0.351 **0.381 **0.263 **0.316 **0.529 **0.268 **0.429 **1
F18. Ejaculation Emission0.485 **0.356 **0.133 **0.370 **0.054 †0.422 **0.109 **0.473 **0.318 **0.351 **0.268 **0.204 **0.241 **0.322 **0.167 **0.191 **0.290 **1
F19. Receiving Ejaculation0.125 **0.310 **0.177 **0.352 **0.479 **0.144 **0.087 **0.451 **0.121 **0.249 **0.336 **0.122 **0.152 **0.278 **0.340 **0.111 **0.236 **0.181 **1
F20. Dirty Fetish0.216 **0.289 **0.0070.0420.341 **0.297 **0.254 **0.288 **0.330 **0.414 **0.164 **0.085 **0.085 **0.298 **0.140 **0.213 **0.275 **0.182 **0.198 **1
Note: † = p < 0.05; * = p < 0.01; ** p < 0.001.
Table 3. Person’s correlation matrix between SDEF3 six-factor solution, SDI-2, FSFI and IIEF (n = 1773).
Table 3. Person’s correlation matrix between SDEF3 six-factor solution, SDI-2, FSFI and IIEF (n = 1773).
SDEF3
F1
SDEF3
F2
SDEF3
F3
SDEF3
F4
SDEF3
F5
SDEF3
F6
SDEF3–F1. Physical and Contextual1
SDEF3–F2. BDSM0.487 **1
SDEF3–F3. Taboo0.393 **0.324 **1
SDEF3–F4. Bottom0.34 **0.466 **0.173 **1
SDEF3–F5. Top0.465 **0.329 **0.268 **0.275 **1
SDEF3–F6. Romantic0.227 **0.199 **0.094 **0.206 **0.213 **1
SDI-2–Solitary Desire0.398 **0.25 **0.192 **0.265 **0.352 **−0.032
SDI-2–Dyadic Desire0.49 **0.291 **0.189 **0.324 **0.461 **0.265 **
FSFI–Sexual Desire0.347 **0.355 **0.11 **0.45 **0.362 **0.25 **
FSFI–Arousal0.0460.221 **0.0530.292 **0.241 **0.057
FSFI–Lubrication0.0150.159 **0.0340.244 **0.195 **0.048
FSFI–Orgasm−0.0140.117 **0.0260.239 **0.201 **0.037
FSFI–Satisfaction−0.0540.167 **0.0290.212 **0.194 **0.059 †
FSFI–Pain−0.0190.133 **0.0450.212 **0.184 **−0.01
FSFI–Total Score0.0330.208 **0.0520.305 **0.256 **0.067 †
IIEF–Sexual Desire0.220 **0.193 **0.092 †0.19 **0.315 **0.188 **
IIEF–Erectile Function0.0270.0750.04−0.0020.227 **0.067
IIEF–Orgasmic Function0.0360.062−0.0020.0390.23 **0.027
IIEF–Intercourse Satisfaction−0.0160.101 †0.0630.0760.248 **0.058
IIEF–General Satisfaction−0.0660.060.0460.0320.189 **0.075
IIEF–Total Score0.0230.098 †0.050.0450.291 **0.079 †
Note: † = p < 0.05; ** p < 0.001.
Table 4. Person’s correlation matrix between SDEF3 six-factor solution, sociodemographic variables and social desirability (MC-SDS) (n = 1773).
Table 4. Person’s correlation matrix between SDEF3 six-factor solution, sociodemographic variables and social desirability (MC-SDS) (n = 1773).
SDEF3
F1
SDEF3
F2
SDEF3
F3
SDEF3
F4
SDEF3
F5
SDEF3
F6
Age−0.138 **−0.166 **0.024−0.0180.119 **−0.12 **
Being in a Relationship−0.192 **0.015−0.0270.061 †0.026−0.058 †
Having Children−0.127 **−0.134 **0.016−0.053 †0.071 *−0.106 **
Education Level−0.099 **−0.083 **−0.05 †0.028−0.043−0.098 **
Political Conservativism (Right winged)−0.003−0.051 †0.014−0.054 †0.0380.058 †
Political Involvement0.107 **0.082 *0.042−0.010.157 **−0.034
Religious Education0.03−0.0170.025−0.0290.0330.069 *
Religiousness −0.097 **−0.151 **−0.006−0.099 **−0.067 *0.029
Religious Involvement−0.101 **−0.159 **−0.018−0.109 **−0.076 *0.03
Sexual Intercourse in Life0.076 *0.125 **0.0200.144 **0.116 **0.025
Sexual Intercourse in the last six months0.0390.174 **0.0390.175 **0.136 **0.028
Social Desirability (MC-SDS)−0.212 **−0.11 **−0.143 **−0.057 †−0.049 †−0.001
Note: † = p < 0.05; * = p < 0.01; ** p < 0.001.
Table 5. MANCOVAs having Gender and Sexual Orientation as independent variables and SDEF3 six-factor solution as dependent ones (n = 1729).
Table 5. MANCOVAs having Gender and Sexual Orientation as independent variables and SDEF3 six-factor solution as dependent ones (n = 1729).
Women (n = 1088)
M ± DS
Men (n = 641)
M ± DS
ΔF(1,1724)p95% CIPartial Eta2
Lower BoundUpper Bound
SDEF3–F1. Physical and Contextual1.09 ± 0.631.55 ± 0.720.4670.14<0.001−0.984−0.5650.039
SDEF3–F2. BDSM0.84 ± 0.790.86 ± 0.810.02-0.354−0.3060.211-
SDEF3–F3. Taboo0.07 ± 0.180.21 ± 0.360.1420.87<0.001−0.165−0.0110.012
SDEF3–F4. Bottom1.49 ± 0.961.09 ± 0.90.4-0.6−1.2420.655-
SDEF3–F5. Top1.04 ± 0.842.38 ± 0.971.34207.89<0.001−1.265−0.6740.108
SDEF3–F6. Romantic1.76 ± 0.931.79 ± 0.90.03-0.311−0.3010.309-
Heterosexual
(n = 1404)
M ± DS
Bisexual
(n = 152)
M ± DS
Homosexual
(n = 173)
M ± DS
Post Hoc
Bonferroni
F(1,1724)p95% CIPartial Eta2
Lower BoundUpper Bound
SDEF3–F1. Physical and Contextual1.2 ± 0.691.5 ± 0.631.57 ± 0.74He < Bi
He < Ho
7.64<0.001−0.407−0.1610.009
SDEF3–F2. BDSM0.79 ± 0.771.25 ± 0.961.01 ± 0.79He < Bi
He < Ho
Ho < Bi
12.52<0.001−0.354−0.0490.014
SDEF3–F3. Taboo0.12 ± 0.280.16 ± 0.270.16 ± 0.24--0.382−0.1650.011-
SDEF3–F4. Bottom1.24 ± 0.921.77 ± 0.971.82 ± 1.01He < Bi
He < Ho
37.48<0.001−1.461−1.1160.042
SDEF3–F5. Top1.48 ± 1.111.64 ± 0.961.89 ± 1.04--0.054−0.0720.597-
SDEF3–F6. Romantic1.78 ± 0.931.73 ± 0.881.75 ± 0.82--0.936−0.1260.233-
GenderSexual OrientationMSDF(1,1724)pPartial Eta2
SDEF3–F1. Physical and ContextualWomen
 
 
Men
Heterosexual
Bisexual
Homosexual
Heterosexual
Bisexual
Homosexual
1.05
1.46
1.03
1.48
1.64
1.78
0.62
0.61
0.6
0.73
0.71
0.68
6.910.0010.008
SDEF3–F2. BDSMWomen
 
 
Men
Heterosexual
Bisexual
Homosexual
Heterosexual
Bisexual
Homosexual
0.77
1.35
1.05
0.82
0.88
1
0.75
0.92
0.78
0.79
1
0.8
3.840.0220.004
SDEF3–F3. TabooWomen
 
 
Men
Heterosexual
Bisexual
Homosexual
Heterosexual
Bisexual
Homosexual
0.06
0.14
0.1
0.22
0.23
0.18
0.17
0.24
0.24
0.39
0.33
0.24
-0.118-
SDEF3–F4. BottomWomen
 
 
Men
Heterosexual
Bisexual
Homosexual
Heterosexual
Bisexual
Homosexual
1.47
1.81
1.15
0.79
1.63
2.07
0.95
0.97
0.88
0.66
0.96
0.95
54.91<0.0010.06
SDEF3–F5. TopWomen
 
 
Men
Heterosexual
Bisexual
Homosexual
Heterosexual
Bisexual
Homosexual
0.98
1.42
1.21
2.44
2.39
2.14
0.82
0.88
0.93
0.97
0.88
0.97
7.21<0.0010.008
SDEF3–F6. RomanticWomen
 
 
Men
Heterosexual
Bisexual
Homosexual
Heterosexual
Bisexual
Homosexual
1.77
1.71
1.79
1.8
1.83
1.74
0.95
0.85
0.7
1
0.87
0.9
-0.700-
Note: Age, Relationship Status, and Social Desirability were put as covariates.
Table 6. MANCOVAs having FSFI and IIEF clinical scores as independent variables and SDEF3 six-factor solution as dependent ones (n = 1455).
Table 6. MANCOVAs having FSFI and IIEF clinical scores as independent variables and SDEF3 six-factor solution as dependent ones (n = 1455).
WomenFSFI Functional Score
(n = 647)
M ± DS
FSFI Clinical Score
(n = 289)
M ± DS
ΔF(1,1083)p95% CIPartial Eta2
Lower BoundUpper Bound
SDEF3–F1. Physical and Contextual1.11 ± 0.631.07 ± 0.630.0416.76<0.0010.0850.2410.015
SDEF3–F2. BDSM0.95 ± 0.820.67 ± 0.730.2838.78<0.0010.220.4220.035
SDEF3–F3. Taboo0.08 ± 0.20.06 ± 0.160.02-0.156−0.0070.0410.002
SDEF3–F4. Bottom1.71 ± 0.941.17 ± 0.890.5485.14<0.0010.4490.6910.073
SDEF3–F5. Top1.21 ± 0.870.8 ± 0.740.4164.47<0.0010.3350.5510.056
SDEF3–F6. Romantic1.82 ± 0.921.68 ± 0.920.1410.810.0010.080.3170.01
MenIIEF Functional Score
(n = 430)
M ± DS
IIEF Clinical Score
(n = 89)
M ± DS
ΔF(1.636)p95% CIPartial Eta2
Lower BoundUpper Bound
SDEF3–F1. Physical and Contextual1.56 ± 0.721.51 ± 0.730.0512.6<0.0010.0190.0190.019
SDEF3–F2. BDSM0.9 ± 0.80.69 ± 0.810.2113.07<0.0010.1470.4960.020
SDEF3–F3. Taboo0.22 ± 0.350.2 ± 0.430.020.470.492−0.0520.1080.001
SDEF3–F4. Bottom1.11 ± 0.890.97 ± 0.950.144.090.0440.0060.4060.006
SDEF3–F5. Top2.46 ± 0.922.01 ± 1.120.4511.49<0.0010.1540.5770.018
SDEF3–F6. Romantic1.81 ± 0.911.71 ± 0.860.14.70.0310.0210.4230.007
Note: Age, Relationship Status, and Social Desirability were put as covariates.
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Nimbi, F.M.; Galizia, R.; Fontanesi, L.; Soyman, S.; Jannini, E.A.; Simonelli, C.; Tambelli, R. Sexual Desire and Erotic Fantasies Questionnaire: Validation of the Erotic Fantasy Inventory Scale (SDEF3) in Italian Adults. Healthcare 2023, 11, 880. https://doi.org/10.3390/healthcare11060880

AMA Style

Nimbi FM, Galizia R, Fontanesi L, Soyman S, Jannini EA, Simonelli C, Tambelli R. Sexual Desire and Erotic Fantasies Questionnaire: Validation of the Erotic Fantasy Inventory Scale (SDEF3) in Italian Adults. Healthcare. 2023; 11(6):880. https://doi.org/10.3390/healthcare11060880

Chicago/Turabian Style

Nimbi, Filippo Maria, Roberta Galizia, Lilybeth Fontanesi, Seray Soyman, Emmanuele Angelo Jannini, Chiara Simonelli, and Renata Tambelli. 2023. "Sexual Desire and Erotic Fantasies Questionnaire: Validation of the Erotic Fantasy Inventory Scale (SDEF3) in Italian Adults" Healthcare 11, no. 6: 880. https://doi.org/10.3390/healthcare11060880

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