The Erectile Performance Anxiety Index: scale development and psychometric properties

J Sex Med. 2013 Dec;10(12):3019-28. doi: 10.1111/jsm.12305. Epub 2013 Aug 23.


Introduction: Erectile dysfunction is a highly publicized and prevalent condition with marked adverse effects on men's social, emotional, and quality of life. Although several instruments have emerged for assessing erectile dysfunction and its impact on men's quality of life, none of the existing instruments provide a specific assessment of men's erectile performance anxiety.

Aim: This article reports on the development and psychometric evaluation of the Erectile Performance Anxiety Index (EPAI)--a 10-item self-report scale designed to fill an important gap in the assessment of male erectile dysfunction.

Methods: A total of 207 men ranging in age from 18 to 79 took part in the study. All subjects completed an online battery consisting of the EPAI, along with measures of related sexual functioning, social anxiety, state anxiety, and depressive symptoms. A small subset of study participants (N = 42) completed the EPAI a second time for determining test-retest reliability.

Main outcome measure: Test-retest reliability was determined by Pearson's product-moment correlations. Internal reliability was assessed using Cronbach's alpha. Factor validity was evaluated by a maximum likelihood factor analysis with oblique rotation. Convergent and discriminant validity was assessed by comparing the strength of association between the EPAI and measures varying in their hypothesized shared variance with the construct of erectile performance anxiety.

Results: The EPAI demonstrated excellent internal consistency, with Cronbach's alpha = 0.93 and excellent test-retest reliability (r = 0.85) over an average period of 3.5 weeks. Results of an exploratory factor analysis revealed a one-factor solution that accounted for 63% of the total variance. Preliminary evidence supports the convergent and discriminant validity of the EPAI.

Conclusion: Results support the use of the EPAI as a reliable, valid, and efficient instrument for the assessment of erectile performance anxiety. Potential research and clinical applications are discussed.

Keywords: Assessment; Assessment Scale; Erectile Dysfunction; Erectile Performance Anxiety; Screening.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Erectile Dysfunction / psychology
  • Humans
  • Male
  • Middle Aged
  • Penile Erection / psychology*
  • Performance Anxiety / psychology*
  • Psychometrics / methods*
  • Young Adult