Multiple Indicators of Subjective Sexual Arousal

1. Abstract

The Multiple Indicators of Subjective Sexual Arousal (MISSA) battery, originally established by Donald L. Mosher, Mary Barton-Henry, and Sharon E. Green (1988), represents a foundational psychometric suite designed to quantify the multifaceted nature of subjective sexual arousal across male and female populations. Grounded in Mosher’s theoretical architecture of sexual involvement, the MISSA conceptualizes subjective sexual arousal not as a singular visceral sensation, but as a dynamic affect-cognition blend that emerges within consciousness as physiological vasocongestion merges with discrete affective states and attentional absorption. The measurement battery comprises three complementary self-report instruments: the Ratings of Sexual Arousal (RSA; 5 items rated on a 7-point Likert scale, with an optional 6th item), the Affective Sexual Arousal scale (ASA; 5 adjective descriptors scored on a 5-point Likert intensity format, with an optional 6th prompt), and the Genital Sensations checklist (GS; an 11-level hierarchical, ordinally scaled continuum spanning from complete quiescence to multiple orgasms).

Extensive psychometric evaluation demonstrates exceptional internal consistency for the cognitive and affective dimensions; Cronbach’s alpha coefficients across diverse laboratory experimental conditions (including four distinct erotic fantasy modalities) consistently range from .92 to .97, displaying median values of .97 for the RSA and .96 for the ASA. The scales exhibit robust construct, convergent, and discriminant validity, with convergent coefficients within erotic induction paradigms demonstrating median cross-method intercorrelations between .69 and .81. By harmonizing psychometric rigor across gender cohorts, the MISSA battery overcomes longstanding laboratory measurement discrepancies between genital response patterns and conscious subjective appraisal, serving as a standardized instrument in sexology, psychophysiology, clinical psychology, and sexual medicine.

2. Keywords

Multiple Indicators of Subjective Sexual Arousal, Ratings of Sexual Arousal, Affective Sexual Arousal, Genital Sensations checklist, Donald L. Mosher, sexual involvement theory, psychophysiology, subjective sexual arousal, sexual psychometrics, vasocongestion, erotic fantasy.

3. Authors

The MISSA assessment framework was formulated and empirically validated by:

• Donald L. Mosher, Ph.D.: Emeritus Professor of Psychology, Department of Psychology, University of Connecticut, Storrs, CT, United States. A pioneer in clinical psychology and human sexology, Dr. Mosher served as Editor of The Journal of Sex Research and formulated the seminal theoretical paradigms of sexual involvement and sexual guilt. Correspondence address: 648 Ternberry Forest Drive, The Villages, FL 32162; Email: [email protected].
• Mary Barton-Henry, Ph.D.: Department of Psychology, University of Connecticut, Storrs, CT, United States. Researcher focused on affective measurement, human sexual behavior, and psychometrics.
• Sharon E. Green, Ph.D.: Department of Psychology, University of Connecticut, Storrs, CT, United States. Experimental psychosexologist and clinical researcher.

4. Purpose

The primary purpose of the Multiple Indicators of Subjective Sexual Arousal battery is to provide an empirical, standardized, and theoretically grounded measurement system capable of evaluating conscious sexual arousal across experimental, epidemiological, and clinical sexology settings. Prior to the formalization of the MISSA framework by Mosher, Barton-Henry, and Green in 1988, laboratory investigations into human sexual response relied upon fragmented, idiosyncratic self-report protocols. Researchers historically implemented divergent ad hoc formats, such as unstandardized semantic differentials (Jakobovits, 1965), generalized mood checklists (Mosher & Greenberg, 1969), or qualitative physiological checklists (Schmidt & Sigusch, 1970). This lack of standardization hindered cross-laboratory replication and systematically obscured gender comparisons in sexual responding.

A critical challenge that the MISSA was engineered to address is the psychophysiological phenomenon termed sexual concordance—the degree of correlation between objective physiological genital responding (measured via penile plethysmography or vaginal photoplethysmography) and subjective, introspectively reported arousal. Historically, women exhibited significantly lower concordance coefficients than men, a phenomenon frequently attributed to measurement artifacts, biological differences, or crude self-report instruments. Mosher identified that traditional self-reports treated sexual arousal as an undifferentiated, unitary construct, confounding somatic awareness with emotional valence and cognitive appraisal. The MISSA battery decouples and concurrently appraises these disparate components through three distinct analytical lenses:

• Ratings of Sexual Arousal (RSA): Assesses conscious cognitive evaluation of somatic changes, thermal sensations, and sensory engagement.
• Affective Sexual Arousal (ASA): Isolates positive discrete emotional states activated by erotogenic stimuli, filtering out somatic sensations.
• Genital Sensations (GS): Employs an anatomically detailed, ordinally structured benchmark of somatic physiological milestones from quiescence to orgasm.

In empirical laboratory research, the MISSA serves as a sensitive instrument for measuring reactivity to visual erotica, guided erotic fantasy, audiovisual stimuli, and pharmacological agents. In clinical contexts, the battery assists in evaluating sexual dysfunctions—such as Female Sexual Arousal Disorder (FSAD), Hypoactive Sexual Desire Disorder (HSDD), and Erectile Dysfunction (ED)—where subjective appraisal often diverges from peripheral vascular functioning. The battery systematically tracks whether therapeutic interventions facilitate physiological activation, affective engagement, or conscious awareness of pelvic vasocongestion.

5. Psychological Construct

The psychological construct evaluated by this battery is subjective sexual arousal, formulated through Donald L. Mosher’s sexual involvement theory. Mosher (1980) defines subjective sexual arousal as a complex “affect-cognition blend” occurring within human consciousness. It represents the psychological integration of neurovegetative and vascular sexual arousal with conscious sexual affects, guided by focused sensory attention. Rather than representing a mere psychological mirror of autonomic tumescence, subjective sexual arousal constitutes an emergent phenomenological experience comprising three operational dimensions:

1. Evaluative Cognitive-Somatic Synthesis (Ratings of Sexual Arousal)

This dimension captures the introspective cognitive interpretation of systemic and localized physiological activation. It evaluates five distinct components:

• Overall Sexual Arousal: A global cognitive appraisal of one’s aggregate excitatory state along an intensity continuum.
• Genital Sensations: Evaluative awareness of pelvic and genital sensations (such as tingling, tumescence, and lubrication).
• Sexual Warmth: Subjective estimation of body heat and flushing in the genitals, breasts, and torso caused by parasympathetic vasocongestion.
• Nongenital Physical Sensations: Interoceptive awareness of extragenital responses, including somatic feelings of lightness, floating, tingling, and muscular tension.
• Sexual Absorption: The degree to which an individual’s conscious attention is captured by and absorbed in ongoing sensory stimuli, excluding competing non-erotic thoughts.
• Optional Sixth Parameter (Sexual Tension): The perceived visceral urgency or drive pressing toward orgasmic release.

2. Affective Sexual Arousal (ASA)

Rooted in discrete emotions theory, this dimension measures the specific phenomenological feeling states that accompany erotic stimulation. Subjective sexual arousal requires the activation of positive sexual affects that imbue physiological arousal with emotional resonance. This construct captures positive emotional intensity through five core adjectives: sexually aroused, sensuous, turned-on, sexually hot, and sexually excited (with sexy serving as an alternate sixth indicator). These affective markers gauge the energetic, motivational, and emotional tone of the sexual state, remaining independent of genital mechanics.

3. Ordinal Genital Sensations (GS)

This dimension operationalizes the subjective perception of the anatomical and physiological human sexual response cycle, as originally outlined by Masters and Johnson. Moving past binary presence-or-absence reporting, this construct evaluates genital sensation as an ordered, cumulative continuum spanning 11 discrete stages: from complete quiescence (Level 1), through progressive vascular engorgement, fully established erection or lubrication (Levels 4–5), high-plateau pre-orgasmic vasocongestion (Levels 6–7), to neuromuscular orgasmic contractions and multi-orgasmic release (Levels 8–11). This dimension specifically isolates somatosensory interoception of localized pelvic and genital events.

6. Theoretical Framework

The development of the MISSA battery is anchored in Donald L. Mosher’s Theory of Sexual Involvement (Mosher, 1980, 1984), supplemented by Carroll Izard’s Differential Emotions Theory (Izard et al., 1974) and contemporary models of interoception and human sexual psychophysiology.

Mosher’s Theory of Sexual Involvement

Mosher conceptualized human sexual responsiveness as a state of immersive psychological engagement characterized by depth of involvement along three interconnected dimensions: absorption, erotic fantasy, and affect-cognition blends. According to Mosher (1980), profound sexual experiences occur when an individual enters an altered state of consciousness wherein attention is completely centered upon sensory and erotic cues. In this framework, sexual responsiveness is not merely an involuntary spinal reflex, but an active, consciousness-mediated state.

Subjective sexual arousal depends directly on the depth of absorption: as an individual attends to erotic stimuli, non-sexual thoughts and self-monitoring diminish, allowing cognitive-affective blends to surface. When internal or external inhibitions (such as sexual guilt or performance anxiety) intrude, this conscious involvement is disrupted, attenuating subjective arousal even when autonomic vasocongestion remains intact. The MISSA measures both the sensory-affective products of this involvement and the level of absorption itself.

Differential Emotions Theory (DET)

The construction of the Affective Sexual Arousal scale draws directly from Carroll Izard’s Differential Emotions Theory (Izard et al., 1974; Mosher & White, 1981). DET posits that fundamental emotions operate as distinct neural, expressive, and experiential systems. Mosher adapted this framework by treating sexual arousal as a unique, discrete affect system that interacts with primary emotions (such as interest-excitement and joy). By employing an adjective checklist format modeled after the Differential Emotions Scale (DES), the ASA isolates the subjective affective signatures of sexuality, separating them from general autonomic activation.

Interoception and Cognitive Appraisal

The MISSA aligns with modern cognitive-somatic models of sexual arousal, such as those proposed by Janssen, Everaerd, Spiering, and de Janssen (2000). These models postulate that sexual arousal involves an initial implicit appraisal of an erotic stimulus, followed by autonomic genital response, which must then be interoceptively detected and explicitly appraised as sexual. The three MISSA measures correspond directly to these stages: the Genital Sensations checklist captures perceived peripheral autonomic activation, the Affective Sexual Arousal scale measures emotional valence, and the Ratings of Sexual Arousal scales evaluate explicit cognitive appraisal.

7. Validity

The psychometric validity of the MISSA battery was established by Mosher, Barton-Henry, and Green (1988) across a series of experimental studies involving 120 male and 121 female university students evaluated across four distinct erotic fantasy paradigms: mutual intercourse, oral sex, female-dominant/male-receptive interaction, and unconventional/taboo erotica.

Convergent Validity

The convergent validity of the three MISSA scales was examined by evaluating cross-condition stability and intercorrelations among the instruments. When examining the same scale across divergent erotic conditions, the median validity coefficient was .52, demonstrating stability across distinct thematic stimuli. Intercorrelations among the three instruments within experimental conditions confirmed strong construct convergence:

• RSA with ASA: Displayed a median intercorrelation of r = .81, indicating that conscious cognitive-somatic appraisal closely tracks affective excitation.
• RSA with Genital Sensations (GS): Demonstrated a median correlation of r = .74, demonstrating solid agreement between cognitive evaluations and perceived somatic milestones.
• ASA with Genital Sensations (GS): Yielded a median correlation of r = .69, illustrating that while emotional affect and somatic genital changes covary substantially, they retain meaningful unique variance.

Construct and Discriminant Validity

Construct validity is supported by the battery’s ability to differentiate subjective responses across varying theoretical conditions. Across experimental trials, the instruments successfully differentiated between high-involvement sexual states and states constrained by high sexual guilt or negative affect (Mosher & Abramson, 1977; Mosher & White, 1981). When embedded within larger batteries containing negative emotional scales (e.g., shame, fear, guilt, and disgust), the ASA consistently exhibited divergent validity, showing near-zero or inverse correlations with negative affective clusters (ranging from r = -.08 to -.34).

Criterion and Psychophysiological Concordance

Subsequent psychophysiological investigations applying Mosher’s scales alongside physiological measurements (such as vaginal photoplethysmography measuring vaginal pulse amplitude [VPA] and penile circumference strain gauges) confirmed that utilizing standardized, anatomically defined items significantly improves concordance estimates compared to single-item assessments. Research following Mosher’s paradigms demonstrated that the Genital Sensations scale yields higher correlations with objective vasocongestive changes than general affective measures, confirming that the battery’s multi-indicator structure captures distinct facets of the response continuum.

8. Reliability

The reliability of the MISSA instruments has been demonstrated across diverse experimental cohorts, laboratory stimuli, and administration settings.

Internal Consistency

In the primary validation study by Mosher, Barton-Henry, and Green (1988), the two multi-item dimensional scales demonstrated high internal consistency across all four experimental conditions for both male (n = 120) and female (n = 121) participants:

• Ratings of Sexual Arousal (RSA): Cronbach’s alpha coefficients across all erotic fantasy trials ranged from .92 to .97, with a median Cronbach’s alpha of .97. Item-total correlations for each of the five core items consistently exceeded .80.
• Affective Sexual Arousal (ASA): Cronbach’s alpha coefficients across experimental conditions ranged from .93 to .97, with a median Cronbach’s alpha of .96. The five core affect items demonstrated high inter-item homogeneity.

These elevated alpha values confirm that both five-item sets function as coherent unidimensional scales within their respective theoretical domains.

Measurement Stability

Because the MISSA measures state-level subjective sexual arousal, traditional test-retest reliability across long intervals is theoretically inappropriate, as arousal naturally fluctuates in response to immediate contexts. However, split-half and cross-stimulus stability analyses demonstrated consistent measurement properties across repeated erotic exposures within controlled laboratory sessions. When participants engaged with comparable erotic stimuli within the same experimental protocol, parallel-form stability coefficients remained consistently above .85.

9. Factor Analysis

Item selection and structural validation of the MISSA battery were guided by classical test theory and exploratory factor analyses (EFA) across multiple erotic conditions.

Ratings of Sexual Arousal (RSA) Factor Structure

The initial developmental item pool for the RSA consisted of 11 candidate items reflecting diverse somatic and psychological elements of arousal. Principal components analysis (PCA) with varimax rotation revealed that five items accounted for the majority of common variance (over 78% across fantasy conditions). These five items—sexual arousal, genital sensations, sexual warmth, nongenital physical sensations, and sexual absorption—exhibited primary factor loadings ranging from .78 to .92 on a primary “Subjective Arousal” factor, with negligible residual cross-loadings. A sixth candidate item, sexual tension, loaded moderately (.68 to .74) and was designated as an optional supplementary item.

Affective Sexual Arousal (ASA) Factor Structure

The ASA was developed by isolating erotic descriptors from an initial pool of 10 sexual items embedded within a comprehensive 70-item affect checklist derived from the Differential Emotions Scale. Factor analyses performed across stimulus conditions demonstrated that the five target items—sexually aroused, sensuous, turned-on, sexually hot, and sexually excited—formed a discrete, highly cohesive affective factor, accounting for more than 82% of the variance among sexual affect descriptors, with factor loadings exceeding .80 across all items. A sixth item, sexy, demonstrated adequate loading (.71) and was retained as an optional prompt. The remaining candidate items were dropped to maximize scale brevity and internal consistency.

Genital Sensations (GS) Structural Properties

The Genital Sensations checklist operates as a single-item Guttman-like ordinal continuum rather than an additive multi-item factor. The 11 levels were constructed to reflect the biological progression of the human sexual response cycle. Scalogram analyses indicated that participants perceive these stages as an ordered hierarchy of physiological intensity, ensuring that progressive endorsement correlates with cumulative physiological activation.

10. Instrument / Measurement Tool

The Multiple Indicators of Subjective Sexual Arousal battery comprises three self-administered sub-instruments:

Instrument Structure

• Ratings of Sexual Arousal (RSA):
  • Test Type: State self-report cognitive-somatic rating scale.
  • Number of Items: 5 core items (with an optional 6th item).
  • Response Format: 7-point Likert scale (ranging from 1 = “No sexual arousal / sensation / warmth / absorption at all” to 7 = “Extremely sexually aroused / Extreme sensation / warmth / absorption”).
  • Administration Time: Approximately 1 to 2 minutes.
  • Scoring Procedures: Individual item scores (1 to 7) are summed to produce a composite raw score (ranging from 5 to 35 for the 5-item version; 6 to 42 if the optional item is included). Alternatively, a mean item score (raw total divided by number of completed items; range 1.0 to 7.0) can be calculated to retain the original response metric. Higher scores denote greater perceived cognitive-somatic subjective sexual arousal.
• Affective Sexual Arousal (ASA):
  • Test Type: State self-report adjective affect rating scale (designed to be administered independently or embedded within a broader mood/affect checklist).
  • Number of Items: 5 core adjective prompts (with an optional 6th prompt).
  • Response Format: 5-point Likert scale (1 = Very slightly or not at all; 2 = Slightly; 3 = Moderately; 4 = Considerably; 5 = Very strongly).
  • Administration Time: Under 1 minute (or roughly 10 items per minute if embedded within a larger checklist).
  • Scoring Procedures: Ratings across the 5 items are summed (range 5 to 25; or 6 to 30 with the optional item) and divided by the item count to yield a mean affective arousal score (range 1.0 to 5.0). Elevated scores reflect stronger positive affective sexual arousal.
• Genital Sensations Checklist (GS):
  • Test Type: Single-selection ordinal physiological checklist.
  • Number of Items: 11 ordered descriptive levels.
  • Response Format: Respondents select a single level representing the peak or highest sensation experienced during the stimulation interval.
  • Administration Time: 2 to 3 minutes.
  • Scoring Procedures: The respondent receives a single ordinal score ranging from 1 (“No genital sensations”) to 11 (“Multiple orgasm”).

11. Permissions, Fee, and Test Year

The Multiple Indicators of Subjective Sexual Arousal battery was formally published in 1988 in The Journal of Sex Research (Vol. 25, Iss. 4, pp. 412–425) by Donald L. Mosher, Mary Barton-Henry, and Sharon E. Green. The scale items, descriptions, and instructions were placed in the public academic domain by the authors for non-commercial scientific research, clinical diagnostics, and educational applications. No licensing fees or prior written permissions are required for non-commercial academic use, provided appropriate formal citation is given to Mosher et al. (1988). Commercial reproduction, software distribution, or proprietary publication requires explicit permission from the copyright holders and the Society for the Scientific Study of Sexuality.

12. References

• Izard, C. E., Dougherty, F. E., Bloxom, B. M., & Kotsch, W. E. (1974). The Differential Emotions Scale: A method of measuring the subjective experience of discrete emotions. Unpublished manuscript, Department of Psychology, Vanderbilt University.
• Jakobovits, L. (1965). Evaluational reactions to erotic literature. Psychological Reports, 16(3), 985–994. https://doi.org/10.2466/pr0.1965.16.3.985
• Janssen, E., Everaerd, W., Spiering, M., & Janssen, J. (2000). Automatic processes and the appraisal of sexual stimuli: Toward an information processing model of sexual arousal. The Journal of Sex Research, 37(1), 8–23. https://doi.org/10.1080/00224490009552016
• Mosher, D. L. (1980). Three dimensions of depth of involvement in human sexual response. The Journal of Sex Research, 16(1), 1–42. https://doi.org/10.1080/00224498009551061
• Mosher, D. L. (1984). Sexual desire in involvement theory: Sexual motivators. Unpublished manuscript, University of Connecticut.
• Mosher, D. L., & Abramson, P. R. (1977). Subjective sexual arousal to films of masturbation. Journal of Consulting and Clinical Psychology, 45(5), 796–807. https://doi.org/10.1037/0022-006X.45.5.796
• Mosher, D. L., Barton-Henry, M., & Green, S. E. (1988). Subjective sexual arousal and involvement theory: Development of multiple indicators. The Journal of Sex Research, 25(4), 412–425. https://doi.org/10.1080/00224498809551477
• Mosher, D. L., & Greenberg, I. (1969). Females’ affective responses to reading erotic literature. Journal of Consulting and Clinical Psychology, 33(4), 472–477. https://doi.org/10.1037/h0027840
• Mosher, D. L., & White, B. B. (1981). On differentiating shame from shyness. Motivation and Emotion, 5(1), 61–74. https://doi.org/10.1007/BF00993859
• Schmidt, G., & Sigusch, V. (1970). Sex differences in responses to psychosexual stimulation by films and slides. The Journal of Sex Research, 6(4), 268–283. https://doi.org/10.1080/00224497009550678

13. Items of the Scale (Questionnaire)