Department of Psychological Sciences, Kent State University, Kent, OH, USA.
Int J Geriatr Psychiatry. 2019 Dec;34(12):1747-1757. doi: 10.1002/gps.5208. Epub 2019 Sep 11.
Sexual disinhibition in dementia is correlated with multiple negative care recipient and caregiver outcomes but remains largely overlooked in the literature. Its prevalence is not well understood, with studies reporting between 1.8% and 25% presence of sexual disinhibition in dementia samples. One reason for the variability in the reported presence of sexual disinhibition may be lack of standardized methods for assessment. Several widely used measures for neuropsychiatric symptoms do not include items to assess sexual disinhibition. When measures do include sexual disinhibition, it is not addressed in a consistent manner. Inconsistency in how questions about sexual disinhibition are phrased is problematic, given that recent work shows it can differentially influence endorsement. Working toward a gold standard of sexual disinhibition measurement in dementia is needed. To this end, a systematic review of the literature to identify potentially appropriate instruments for measurement of sexual disinhibition in this population was conducted through the Web of Science and PubMed databases between January 2019 and February 2019. An overview of the 20 measures identified in this search is provided. Each measure is evaluated for appropriateness of use in dementia samples through broad examination of psychometric properties, structure, and format and the extent to which measure content overlaps with current conceptualizations of sexual disinhibition in dementia. Five common content domains were identified: hypersexuality, lewd/aberrant sexual behavior, inappropriate sexual advances, inappropriate sexual comments, and socially disruptive sexual behavior. No single measure addressed all content domains. Directions for future research are identified and discussed.
痴呆患者的性行为抑制障碍与多种负面的患者和照护者结局相关，但在文献中仍未得到充分关注。其患病率尚未得到很好的理解，研究报告痴呆患者样本中性行为抑制障碍的发生率在 1.8%至 25%之间。报道的性行为抑制障碍发生率存在差异的原因之一可能是评估方法缺乏标准化。几种广泛使用的神经精神症状评估量表不包括评估性行为抑制障碍的项目。当评估量表包含性行为抑制障碍时，其评估方式也不一致。关于性行为抑制障碍的问题的措辞不一致是有问题的，因为最近的研究表明，它会对赞同程度产生不同的影响。需要在痴呆患者中制定性行为抑制障碍测量的金标准。为此，通过 Web of Science 和 PubMed 数据库，在 2019 年 1 月至 2 月期间进行了一项系统的文献综述，以确定该人群中测量性行为抑制障碍的潜在合适工具。本文提供了对这一搜索中确定的 20 种测量工具的概述。通过广泛检查心理测量特性、结构和格式，以及测量内容与痴呆患者性行为抑制障碍当前概念的重叠程度，评估每种测量工具在痴呆患者样本中的使用适宜性。确定并讨论了未来研究的方向。
