Archives of Sexual Behavior, Vol. 33, No. 1, February 2004, pp. 19–30 ( C  2004) The Psychological and Interpersonal Relationship Scales: Assessing Psychological and Relationship Outcomes Associated With Erectile Dysfunction and Its Treatment Ralph W. Swindle, Ph.D., 1,2,4 Ann E. Cameron, Ph.D., 1 Daniel C. Lockhart, Ph.D., 1 and Raymond C. Rosen, Ph.D. 3 Received December 5, 2002; revision received July 7, 2003; accepted August 28, 2003 Erectile dysfunction (ED) is associated with complex psychological and interpersonal issues. A new measure of treatment outcome, the Psychological and Interpersonal Relationship Scales (PAIRS), was developed to evaluate the broader psychological and interpersonal outcomes associated with erectile dysfunction and its treatment. Initial items were generated based on literature review, focus groups and market research, interviews with patients and partners, and consultation with expert clinicians. Domains of Sexual Self-Confidence, Spontaneity, and Time Concerns were identified and subsequently confirmed by factor analysis. A series of validation studies was performed with four separate samples, including assessment of internal consistency and test-retest reliability, convergent and discriminant validity, and treatment responsiveness. Samples for these studies included men recruited from clinical trials for ED in several countries ( N = 413) and a community sample ( N = 801). Findings from these studies indicate that PAIRS demonstrates adequate psychometric properties and appears well suited for use in further clinical studies of treatments for ED. It provides a broader assessment of treatment outcome than current measures of erectile function. KEY WORDS: erectile dysfunction; psychosocial assessment; self-esteem; sexual confidence; treatment outcome. INTRODUCTION Erectile dysfunction (ED), defined as the persistent inability to achieve or maintain an erection sufficient enough for satisfactory sexual performance, is a highly prevalent disorder in men (NIH Consensus Development Panel on Impotence, 1993) and can have negative effects on mood state, interpersonal relationships, and quality of life (Araujo, Durante, Feldman, Goldstein, & McKinlay, 1998; Feldman, Goldstein, Hatzichristou, Krane, & 1 Outcomes Research, Eli Lilly and Company, Indianapolis, Indiana. 2 Department of Psychology, Indiana University, Bloomington, Indiana. 3 Department of Psychiatry and Center for Sexual and Marital Health, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Piscataway, New Jersey. 4 To whom correspondence should be addressed at Eli Lilly and Com- pany, Lilly Corporate Center, DC 4025, Indianapolis, Indiana 46285; e-mail: swindle@lilly.com. McKinley, 1994; Laumann, Paik, & Rosen, 1999). The population-based Massachusetts Male Aging Study found that 52% of men aged 40–70 experienced at least some degree of self-reported ED, and it is estimated that ED will affect 322 million men worldwide by the year 2025 (Feldman et al., 1994; McKinley, 2000). ED is strongly related to both physical and psycho- logical risk factors. Among the major predictors of ED observed in the Massachusetts Male Aging Study were diabetes mellitus, depression, heart disease, hypertension, and decreased high density lipoprotein (HDL) levels (Feldman et al., 1994). Recent studies have shown a strong association between ED and benign prostatic hypertrophy (BPH), another common disorder in older men (Brookes, Donovan, Peters, Abrams, & Neal, 2002). Medications for diabetes, hypertension, and cardiovascular disease are also risk factors. The psychological correlates of erectile dys- function include anxiety, depression, and anger (Araujo 19 0004-0002/04/0200-0019/0 C  2004 Plenum Publishing Corporation