Motedayen et al.

, Cogent Psychology (2019), 6: 1585505

https://doi.org/10.1080/23311908.2019.1585505

Sex Knowledge and Attitude Test for Adolescents

(SKAT-A)

Fullard, Lief, & Scheier (2005)©

HEALTH PSYCHOLOGY | RESEARCH ARTICLE

Psychometric validation of the Sexual

Knowledge and Attitudes Test –Adolescents
(SKAT-A) in an Iranian sample
Mahsa Motedayen, Seyed Mohammad Kalantarkousheh, Lawrence M. Scheier and Martin
Komarc

Cogent Psychology (2019), 6: 1585505

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HEALTH PSYCHOLOGY | RESEARCH ARTICLE

Psychometric validation of the Sexual Knowledge
and Attitudes Test –Adolescents (SKAT-A) in an
Iranian sample
Received: 14 August 2018 Mahsa Motedayen1, Seyed Mohammad Kalantarkousheh2, Lawrence M. Scheier3* and
Accepted: 07 February 2019 Martin Komarc4
First Published: 22 February 2019
Abstract: A rise in sexually transmitted diseases and liberalization of sexual
*Corresponding author: Lawrence M.
Scheier, LARS Research Institute, attitudes has encouraged several Islamic countries to actively pursue sexual edu-
Visiting Scholar, UNC Greensboro,
Department of Public Health cation programs. Support for this effort requires psychometrically sound instru-
Education, Senior Research Scientist, ments that can be used to assess sexual attitudes and obtain a richer
Prevention Strategies, LLC,
Scottsdale, AZ, USA understanding of the relations between attitudes and behavior. To address this
E-mail: scheier@larsri.org
knowledge gap, we translated the Sexual Knowledge and Attitudes Test—
Reviewing editor: Adolescents (SKAT-A) from English to Farsi. We then examined the instrument’s
Lucia Monacis, Universita degli Studi
di Foggia, Italy factorial structure and criterion validity using exploratory structural equation mod-
Additional information is available at
eling (ESEM) with a sample of adolescent and young adult Iranians. A six-factor
the end of the article model fit well including constructs assessing premarital sexuality, masturbation,
homosexuality, pornography, abortion, and sexual coercion. All scales had adequate

ABOUT THE AUTHORS PUBLIC INTEREST STATEMENT

Mahsa Motedayen has a Master’s Degree in Sexual activity prior to marriage is traditionally
Family Counseling. She provides clinical treat- taboo in most Muslim countries, which hold dear
ment and conducts research on sexual problems the Quran’s teachings as an integral part of daily
and personal issues with adolescents and adult life. Recently, Iran expanded their public health
populations. initiatives to incorporate sexual education tar-
Seyed Mohammad Kalantarkousheh is an geting youth as part of an effort to address the
Assistant Professor of Counseling, Faculty of rising rates of STDs, HIV transmission and preg-
Psychology and Educational Studies, Allameh nancy prior to marriage. An important part of
Tabataba’i University. His private practice and these efforts involves assessing sexual attitudes
research examine the integration of Family and their relations to behavior. However, to date,
Counseling and Existential Thought based on no valid instrument has been created to monitor
Postmodern Epistemology. sexual attitudes suitable Iran’s Muslim culture.
Lawrence M. Scheier has a Ph.D. in Educational We translated the Sexual Knowledge and
Lawrence M. Scheier Psychology and Technology (1988) from the Attitudes Test-Adolescents from English to Farsi
University of Southern California. His current work and tested its factorial structure in a sample of
entails developing eHealth behavioral interven- youth and youth adults. We also tested subgroup
tions targeting youth and young adults, psycho- differences in factor structure based on gender,
metrics, and statistical modeling of longitudinal age, and religious beliefs. Overall, the obtained
data. He is President of LARS Research Institute factor structure replicated the US data with slight
and Senior Research Scientist at Prevention differences in factor composition. Attitudes were
Strategies. moderately related to behavior showing promise
Martin Komarc has a Ph.D. (2017) in Physical for educational courses reinforcing conservative
Education and Sport from Charles University in abstinence-based values.
Prague, Czech Republic. His research at the
Institute of Biophysics and Informatics 1st
Faculty of Medicine, Charles University in Prague
involves latent variable modeling and computer
adaptive testing in the fields of education, psy-
chology, and medicine.

© 2019 The Author(s). This open access article is distributed under a Creative Commons
Attribution (CC-BY) 4.0 license.

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internal consistencies ranging from .66 to .85. There was sufficient evidence sup-
porting several different forms of measurement equivalence based on gender, age
and religious participation. Associations between sexual attitudes and markers of
sexual activity were moderate and in the expected directions. Total replication of
the U.S. factor structure was not obtained, however, there is evidence that core
constructs in the instrument assessing sexual attitudes are suitable for use in a
wide range of cultures, even those predicated on a strong religious beliefs system.

Subjects: Health Psychology; Psychological Methods & Statistics; Development Studies;

Health & Development;

Keywords: sexual attitudes; sexual behavior; factorial validity; ESEM; cultural beliefs; Iran

1. Introduction
The Islamic Republic of Iran holds very dear the Quran’s religious teachings regarding the role of
family and sexuality. In this regard, research examining sexual attitudes and behavior has to
address the cultural sensitivities perpetuated by the Shi’a Islam clerics and the strict rules against
premarital sex (Tabatabaie, 2015). Indeed, the Islamic religion strictly forbids premarital sexual
relations and sexual intercourse without a valid marriage (Doi, 1984/1404). Individuals who
engage in sexual behaviors before marriage face the specter of familial and social stigma.
Recently, several Muslim countries, including Iran, have become more open to addressing sexual
education as part of a public health initiative (Faghihi, Shokouhi Yekta, & Parand, 2008). This has
brought into sharper focus the role of sexual attitudes, values, and behavior particularly in youthful
populations (Tabatabaie, 2015; Yazdi, Aschbacher, Arvantaj et al., 2006). The emphasis on learning
more about sexual attitudes is fortuitous as Muslim-oriented cultures like Iran are also experien-
cing increasing rates of unwanted teen pregnancy and sexually transmitted diseases, the latter
including human immunodeficiency virus/acquired immunodeficiency disease syndrome (HIV/
AIDS: Mohammad et al., 2007). Greater awareness of the pivotal role of sexual attitudes in sexual
activity is required in order to develop effective public health policies targeting transmission of
these diseases.

1.1. Studies of sexuality in the Islamic Republic of Iran

Iranian studies of sexual attitudes and behavior have examined high-risk samples (Mohammad et
al., 2007), young adults (Honarvar et al., 2016), college youth (Khalaj, Farahani, Cleland, & Mehryar,
2011; Simbar, Tehrani, & Hasehmi, 2005), and adolescents (Malek, Shokoohi, Faghihi, Bina, &
Shafiee-Kandjani, 2010; Mohammadi et al., 2006; Tehrani & Malek-Afzali, 2008). Mohammadi et
al. (2006) reported that male adolescents held relatively liberal sexual attitudes with almost one-
fifth of their sample rating themselves as unreligious. Relative to other published studies, the
sample reported higher rates of sexual activity; however, many youth possessed serious miscon-
ceptions about sexuality including sexually transmitted infections, AIDS, condom use and repro-
ductive physiology (i.e., menstrual cycle). As expected, religiosity was protective and associated
with less permissive sexual attitudes. Access to the Internet or satellite television, use of cigar-
ettes, alcohol, or drugs were all associated with more permissive sexual attitudes. Slightly more
than a quarter of the sample had experienced sexual “contact” and among these individuals,
those reporting lower religiosity were more likely to report having sexual experiences in the
absence of marriage.

Honarvar et al. (2016) conducted a population-based study with single young adults from Shiraz,
a provincial city located in southern Iran. The authors reported that a little over a third of the
sample found premarital sex acceptable and slightly under 50% had experienced premarital sex
(42% of these experiences were heterosexual). Levels of knowledge regarding HIV/AIDs symptoms,
methods of viral transmission (vaginal vs. anal sex), and prevention methods (i.e., condoms) were
relatively low. A multivariate analysis showed that alcohol and (lack of) religious beliefs were both

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significantly related to favoring premarital sex. Khalaj et al. (2011) examined premarital hetero-
sexual relations in a representative sample of single women attending university in Tehran. The
authors suggest that various changes in the context of family and liberalizing of sexual relations in
Iran are fomenting a cultural shift toward permissiveness and sexual exploration. About half of the
sample reported they had a boyfriend, but only 10% of the women acknowledge having inter-
course, with 23% admitting “some sexual contact.” More liberal family values was associated with
greater likelihood of having a boyfriend or engaging in premarital sex.

Simbar et al. (2005) assessed knowledge, attitudes, and behavior among medical, science, and
engineering students attending an Iranian university. The authors reported that, excluding medical
students (who were not cleared to answer questions about sexual activity), a small percent (8%)
acknowledged having intercourse before marriage with a huge discrepancy in the number of males
(16%) versus females (0.6%) reporting intercourse. Consistent with other Iranian studies, knowl-
edge of reproductive sexuality was apparently absent with 75% of the sample believing that HIV
prevention methods should include applying moral principles, <50% using condoms and 17%
stating that abstinence is a viable prevention method. The sample moderately endorsed that
contraceptives should be made available to youth, a need for sexual education, and disagreement
with withholding information from youth as a form of prevention, that sex education stimulates
high-risk behavior, and the sample was relatively split evenly regarding the importance of contra-
ceptives and its availability to youth.

1.2. Outstanding issues and concerns

The work that has been done so far provides a basic understanding of sexual attitudes and
sexuality in Iran. Notwithstanding, there remain several concerns that need to be addressed.
First, many of the scales used to assess sexual attitudes were not validated prior to their use
with Muslim samples. In some cases, qualitative pilot work with focus groups or expert review was
conducted to establish the item’s face validity, however, rigorous psychometric testing was absent.
Second, many of the scales used contained very limited content assessing sexual attitudes (e.g.,
Mohammad et al., 2007) or behavior, given deference for the conservative, if not secular, nature of
the samples. Third, the nature of sampling varied considerably between studies, with some studies
examining sexual attitudes and behavior in females only (Khalaj et al., 2011; Mosavi, Babazadeh,
Najmabadi, & Shariati, 2014), males only (Mohammad et al., 2007; Mohammadi et al., 2006), high-
risk samples (Tehrani & Malek-Afzali, 2008), or Muslim youth residing in westernized European
countries, which may not be representative of the larger Muslim population (Smerecnik, Schaalma,
Gergo, Meijer, & Poelman, 2010). In some cases, very young participants (<20 years of age) were
not allowed to answer questions about sexual activity (Tehrani & Malek-Afzali, 2008). Moreover, in
some cases, participants had very limited sexual experiences with only a handful reporting sexual
intercourse or physical contact that extends beyond what is frequently termed touching, fondling
or “petting.” The low base rates of sexual behavior can restrict variances and bias estimates of
factor loadings and correlations (Kline, 1994). Taken together, the tremendous heterogeneity in
sampling strategies, the inconclusive nature of questionnaire procedures, and the very limited
range of sexual behaviors assessed may leave us with an incomplete understanding regarding
both the structure of sexual attitudes and also their relations to behavior.

2. Focus of the present study

The present study addresses these and other gaps in the literature by developing and testing a
psychometrically refined measure of sexual attitudes and behavior for use with Iranian samples.
We first translated the English version of the SKAT-A to Farsi using standard translation procedures
(Harkness, Van De Vijver, & Mohler, 2003). This process involves several concerted steps, which we
outline below. We then assessed the factorial validity of the newly translated instrument using
exploratory structural equation modeling (ESEM) techniques. Recent work has eteablished the
methodological advantages to using ESEM compared to exploratory (EFA) or confirmatory (CFA)
factor analysis (Asparouhov & Muthén, 2009; Marsh et al., 2009). In the case of CFA, the heavy
restriction imposed through simple structure (items can only load on one factor >0) spuriously

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inflates correlations between factors (Marsh, Liem, Martin, Morin, & Nagengast, 2011). The over-
estimation of zero-order relations leads to greater Type I errors (rejecting the null that a factor-to-
factor correlation is not different from zero). In contrast, ESEM does not require simple structure
(allowing loadings >0 on nontarget factors) resulting in a more veridical interpretation of factor
correlations and factor loadings. There is now a growing body of literature that demonstrates the
power and flexibility of ESEM compared to CFA including studies of physical self-concept in youth
(Morin & Maïano, 2011), self-concept in children (Morin, Ahrens, & Marsh, 2016), and personality in
German secondary school students (Marsh et al., 2010). In all cases ESEM outperformed the CFA
producing better fit and clearer substantive interpretations for multidimensional constructs.

In addition, when compared to EFA, ESEM provides a statistical means to test model invariance
using multiple group comparisons with appropriate parameter constraints.1 Following accepted
conventions for testing measurement invariance (e.g., Dimitrov, 2010), we examined model
equivalence across demographic subgroups of gender, age and also religious commitment levels
(i.e., attending religious functions). All three of these sample characteristics have been tied to
observed subgroup differences in sexual attitudes. We then validated the newly constructed
instrument using several common behavioral markers of sexual activity. Collectively, these differ-
ent strategies should yield preliminary information on the suitability of the SKAT-A for the Iranian
culture.

3. Method

3.1. Development of the SKAT-A

The Sexual Knowledge and Attitudes Test—Adolescents (SKAT-A) is a self-report instrument
developed to assess sexual knowledge, attitudes, and behaviors. The SKAT was first developed
using samples of graduate, medical, and nursing students (e.g., Miller & Lief, 1976, 1979). Initial
factor analysis using principal components analysis with varimax rotation produced a four-factor
model including heterosexual relations, sexual myths (masturbation, pornography, and homosexu-
ality), autoeroticism, and abortion. The instrument was then extensively refined (Fullard, Johnston,
& Lief, 1998), and further validated with US adolescents as the SKAT-A (Fullard & Scheier, 2010;
Lief, Fullard, & Devlin, 1990). Fullard et al. (1998) reported adequate internal consistency estimates
for five subscales including masturbation (α = .87), homosexuality (α = .83), pornography (α = .73),
premarital sex (α = .77), and abortion (α = .73) obtained with a sample of college undergraduates.
Lief et al. (1990) showed the revised version had temporal stability over a three-week period and
internal consistency also with a sample of college undergraduates. They also demonstrated
concurrent validity using two other popular sexual attitudes scales. Subsequent confirmatory
factor analyses with simple structure using a sample of 516 urban high school students produced
six reliable factors including Premarital Sexuality (α = .71), Rape/Coercion (α = .71), Masturbation
(α = .78), Abortion (α = .50), Homosexuality (α = .74), and Pornography (α = .54). Two-week test-
retest reliability was .88 with the high school sample. Validity coefficients ranged from a low of .18
between intercourse and pornography attitudes to a high of .42 between frequency of sexual
experiences (a composite including dating, kissing, petting, and oral sex) and premarital sexual
attitudes.

3.2. Instrument composition

The SKAT-A contains a background information section (demographics, family, and personal
characteristics), a 41-item knowledge section with True/False/Not Sure response formats (this
section is not included in this report), a behavior inventory section with 15 questions regarding
sexual activity, condom use, sources of information about sex, age of sexual debut, reasons for not
having sex, contraception use, reasons for use/nonuse, 17 additional questions assessing fre-
quency in the past year for dating, kissing, intercourse, masturbation, viewing pornography,
discussing contraception, sex with friends, family, and sexual coercion, and an additional set of
items assessing female contraceptive use, males getting females pregnant, frequency of sexual
intercourse, and STDs. A fourth section includes 40 attitudinal items using a 5-point Likert response

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format (“fully disagree” to “fully agree”). The instrument has been administered to thousands of
youth in the US and abroad and currently has been translated into Spanish (Peruvian and Mexican),
Indian (Kannada), and Malaysian languages.

3.2.1. Translation
We followed standard procedures in the cultural translation of the SKAT-A (Venuti, 1998). A
bilingual individual translated from English to Farsi.2 A second independent bilingual translator
then back translated the SKAT-A from Farsi to English without the help of the original version. This
English version was then reviewed by one of the authors (LMS) who provided comments on the
adequacy of the back translation process. In particular, we took note of lexical differences for
words and/or idiomatic expressions between the two cultures. A discussion ensued between the
first and second authors regarding the adequacy of certain terms (i.e., face validity), their inter-
pretive meaning in the Farsi language; common vernacular for sexual mores in the Iranian culture,
and their comparable use in the English language.

This procedure resulted in some minor item wording differences between the English and Farsi
versions of the questionnaire, which were then reconciled. These changes included addition of
place of residence and marital status, the latter item used because the Iranian sample included
older young adults who may be married. Educational grade delineations were made to comport
with Iranian schooling. Changes were also made to questions regarding race and religious/sect
background to be consistent with Iranian culture. Three questions in the Behavioral Inventory
section were worded differently (e.g., the term “sexual intercourse” was changed to “having a
relationship”).

3.3. Cognitive pretesting

The SKAT-A (Farsi) was cognitively pretested using a sample of 30 high school and university
students (21 university students and 9 high school students). The sample included 17 females and
13 males. The survey was administered to high school students at a public library and adminis-
tration was conducted by the first author and a graduate student in counseling from the same
University. The high school students ranged in age from 17 to 19 and the University students
ranged from 21 to 25 years of age. The first author instructed participants that the survey was
voluntary, required approximately 30 minutes to complete, and that survey responses were
completely anonymous (minimizing social desirability). The first author remained in the vicinity
to address any questions regarding the survey. This entailed determining whether participants had
any difficulty with the terminology used in the questionnaire (i.e., words like orgasm and STD) and
whether they required clarification of any of the items. In keeping with standard cognitive
pretesting procedures, students were encouraged to ask questions using think aloud procedures
(Forsyth, Lessler, & Hubbard, 1992). Cognitive pretesting took place primarily in the demographi-
cally diverse North and East sections of Tehran over a three-week period.

3.4. Sample recruitment

The Iranian investigative team used a messaging service that is very popular and attractive to
younger audiences to recruit participants (variety of channels Telegram). The message stated “the
link below relates to research in the area of sexuality. In order to participate in this study click on
the link, and reply to the questions.” This message ran for several days. After clicking on the URL
link the participant would see a screen that informed them there was no need to input any
personal information. Participants were further informed they could receive information about
the study if they provided an email address (without linking names to email). Such information
would include aggregate profiles only (e.g., scores for males vs. females, older vs. younger, and so
forth). At the end of this introductory paragraph was an email address to communicate with
researchers and provide suggestions. The recruitment process lasted six months (May-October,
2016) and the message links with the questionnaire was distributed to 6,637 people from 31
provinces of Iran. A total of 1106 valid questionnaires were submitted online. The University IRB
approved the research and the analyses were conducted using de-identified data by the US team.

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A Category 4 exemption under 45 CFR 46.101(b) was granted by the US IRB given the use of
anonymous data in the analyses.

3.5. Analytic strategy

We analyzed the SKAT-A (Farsi) using exploratory structural equation modeling (ESEM) techniques
with the Mplus program (Muthén & Muthén, 2008). Defaults in the ESEM procedure set for max-
imum likelihood estimation and Geomin rotation. Adequacy of model fit was based on several fit
indices including the standardized root mean square residual (SRMR: Jöreksog & Sörbom, 1989),
the root mean square error of approximation (RMSEA: Steiger & Lind, 1980), the Comparative Fit
Index (CFI: Bentler, 1990), the Tucker Lewis Index (TLI: Tucker & Lewis, 1973), the Bayes
Information Critiera (BIC: Schwarz, 1978), and the χ2/df ratio (Byrne, 2012). With the exception
of the information criterion indexes, which are intended to be sample size dependent, the remain-
ing fit indices are independent of sample size, sensitive to model parsimony, and accurately reflect
model misspecification (Bentler, 2007).

We also used a Geomin rotation in the models (Epsilon = 0.01).3 This setting best mimics an
oblique rotation, and is considered the optimal rotation for ESEM with four or more factors and
when cross-loadings are expected to be small but the factor structure is unknown (Caro, Sandoval-
Hernández, & Lüdtke, 2014). To determine an appropriate factor solution, we set the factor loading
cut-off at .40 (Tabachnick & Fidell, 2007), used the traditional eigenvalue >1.0, and visually
inspected the scree test for evidence of a bend in the plot of eigenvalues against the number of
components (Cattell, 1966). We also examined the interpretability of factors, especially if an item
had a substantially large cross-loading on more than one factor. Based on Monte Carlo simulation
efforts (Muthén & Muthén, 2002) we have sufficient numbers of subjects to achieve precise
parameter estimates with adequate power >.80.4

4. Results

4.1. Sample description

The sample is 49% female and the mean age is 24 (SD = 6.26). A majority of the sample were
single (80%) with 18% reporting they were married, 2% divorced, and <1% widowed. A majority
were from Tehran (45%) with smaller amounts from Khorasan Razavi (6%), Esfehan (6%), and
Alborz (6%) and even fewer from Fars (4%), Azarbaijan Sharghi (4%), Mazandaran (3.5%), and Gilan
(3%), with the remainder <1% in over 23 small villages located on the outskirts of Tehran. The
sample contained 19% high school students, 55.5% enrolled in the University, and 25% in a
graduate program. Among the high school participants, the largest proportion was registered in
a diploma program (6%), followed in decreasing grade order by 12th grade (5%), 11th grade
(3.4%), 10th grade (2.5%), and 9th grade (2%). Among the University participants, a majority were
enrolled in a bachelor degree program (59%) followed by Master’s degree (11%), Associate degree
(6.5%), Ph.D. (4%) and the rest were enrolled in some other educational program.

When asked about their race/ethnic backgrounds, a majority reported they were Fars (63%) with
the next largest group Tork (19%), Kord (6%), LOR (4%) and Gilac (3.5%). Smaller numbers reported
they were Arab (1.4%), Mongrel (1.5%), Torkaman or Balooch (<1%). Religious affiliation was reported
as 96% Islam-Sheih, 3.4% as Islam-Sunni, and very small numbers for Jewish, Zoroastrian or Christian
faiths (<1%). Employment status was fairly evenly distributed with 32% stating they were students,
24.5% employed, 24% self-employed, 16% unemployed and 3.7% stated they were a housewife.
Participants were asked how often they attended a religious ceremony and 38% indicated “never”
while 44% said “less than once a month,” 8.4% said “once a month,” 5.7% said “several times/
month,” 2% said “one a week,” and 2.2% said “several times/week.”

4.2. Results of ESEM analyses

We began the factor analysis procedure with the full set of 40 attitudinal items. Eight of these
items assessing sexual education (e.g., “sex education should be required in the schools” and “sex

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education should be restricted to anatomy”) did not exceed the minimum threshold for a loading
(>.40). Based on a careful review of the item loadings and understanding the cultural sensitivities
inherent in the sample regarding sex education, we decided to eliminate these items and rerun the
factor analysis with the remaining 32 items.

Table 1 shows the results of the ESEM model testing sequence from a 1 to 8-factor model solution.
As expected, model fit improved with increasing extraction of factors. With the progressive addition
of factors, the CFI improves, the RMSEA and SMSR decrease below the acceptable benchmarks (<.05)
as does the BIC, with lower values indicating better fit. There is a noticeable change in fit statistics at
the 7-factor model, marked by a slowing down of the decrement in the BIC. However, upon closer
inspection of the item-to-factor loadings the 6-factor model not only favored parsimony it also made
sense from a substantive point of view. The six factors (and their average rotated factor loading)
included a 5-item factor assessing premarital sexuality (e.g., “sex relations before marriage is not
morally acceptable”: avg. λ = .636), a 5-item factor assessing masturbation (e.g., “those who have
healthy sexual activities don’t masturbate”: avg. λ = .672), a 4-item factor assessing homosexuality (e.
g., “homosexuals should be allowed to marry each other”: avg. λ = .71), a 5-item factor assessing
pornography (e.g., ‘only individuals that have perversion watch porn movies’: avg. λ = .50), a 4-item
factor assessing abortion (e.g., “abortion permit shall be issued to a pregnant female”: avg. λ = .58),
and a 6-item factor assessing sexual coercion (e.g., ‘women should obey men’s sexual requests’: avg.
λ = .46). As further indication of the rotational efficiency, the largest off-factor loading was .29 and the
average of these loadings was .06 for premarital sexuality, .08 for masturbation, .04 for homosexuality,
.08 for pornography, .05 for abortion, and .05 for sexual coercion.5

Two masturbation (“boys who have group masturbation will become homosexuals in the future,”
and “female young adults who masturbate are weird”) and one pregnancy item (“a pregnant
young adult should decide about abortion rather than their parents or boyfriend”) failed to load on
any factor. These items presented respondents with difficult grammatical constructions (contain-
ing a compound sentence structure), used unfamiliar vernacular (i.e., “weird”), or contained multi-
ple options (e.g., offering two choices with respect to abortion decisions), all of which may have
contributed to interpretational confusion.

Table 2 contains the factor intercorrelations for the 6-factor solution. The associations ranged
from a low of r = .08 between pornography and sexual coercion to a high of r = .56 between
masturbation and pornography. The average magnitude of association across the 15 correlated
pairs was r = .35. Sexual coercion had the smallest magnitude of association with the remaining
factors (avg. r = .19) while premarital sexuality had the largest magnitude of association with the
remaining factors (avg. r = .40).6

4.3. Tests of invariance

We tested measurement invariance in a progression moving from a basic configural model (the
same number of factors exists in each group), to test metric (equivalence of factor loadings), scalar
(equivalence of item intercepts), equivalence of variance/covariances (structural relations) and
factor means. Table 3 shows the results of the invariance tests for gender (540 female vs. 566
male), age (738 ≤ 25 years vs. 366 > 26), and religious commitment (418 never vs. 688 at least
once). For the most part, there was little evidence for substantive parameter differences in the
models across subgroups. Any differences were quite trivial by nature, and given it sensitivity the
large-sample chi-square test would be significant in most cases. In all cases, the configural model
fit well establishing the 6-factor model was equivalent across groups (first line). The imposition of
various model constraints did not lead to substantial degradation of model fit. The change at each
step in the model testing sequence observed in all of the inferential fit indices (e.g., CFI, the RMSEA,
and SRMR) are quite small, indicating the different model constraints are tenable.

Table 4 shows means scores for the six attitude factor composites by age, gender, and religious
commitment level. Although there was no consistent pattern observed for these comparisons,

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 Table 1. Model fit indices for ESEM factor analysis of SKAT-A Farsi
Model χ2 (df) CFI TLI RMSEA 90%CI lower 90%CI upper SRMR AIC BIC Δ χ2 (df)
https://doi.org/10.1080/23311908.2019.1585505

Factor 1 4683.8 (464) 0.645 0.621 0.091 0.088 0.093 0.075 100319.4 100800.2
Motedayen et al., Cogent Psychology (2019), 6: 1585505

Factor 2 3382.5 (433) 0.752 0.716 0.078 0.076 0.081 0.060 99080.1 99716.2 1301.3 (31)
Factor 3 2525.7 (403) 0.822 0.781 0.069 0.066 0.072 0.048 98283.3 99069.6 856.8 (30)
Factor 4 1667.7 (374) 0.891 0.856 0.056 0.053 0.059 0.037 97483.3 98414.9 858 (29)
Factor 5 1203.3 (346) 0.928 0.897 0.047 0.044 0.050 0.030 97075.0 98146.8 464.3 (28)
Factor 6 784.9 (319) 0.961 0.939 0.036 0.033 0.040 0.022 96710.6 97917.6 418.4 (27)
Factor 7 583.7 (293) 0.976 0.959 0.030 0.026 0.033 0.018 96561.3 97898.6 201.2 (26)
Factor 8 492.2 (268) 0.981 0.965 0.028 0.024 0.031 0.016 96519.9 97982.3 91.5 (25)
CFI = Comparative Fit Index; RMSEA = Root Mean Square Error of Approximation; CI = Confidence Interval;
SRMR = Square Root Mean Residual; TLI = Tucker Lewis Index; Δ = change value.

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Table 2. Correlations from 6-factor model

1 2 3 4 5 6
1 Premarital Sexuality 0.846
2 Masturbation 0.488 0.845
3 Homosexuality 0.507 0.460 0.835
4 Pornography 0.361 0.563 0.308 0.733
5 Abortion 0.483 0.402 0.440 0.334 0.702
6 Sexual Coercion 0.167 0.132 0.249 0.080 0.331 0.660
All p’s < .05. Geomin rotation. Omega reliability estimate on the diagonal.
Calculated using parameter estimates obtained from a CFA model (McDonald, 1999).

several interesting findings should be noted. First, older participants had higher (more conserva-
tive) premarital sexual attitude, abortion, and sexual coercion scores. For gender, females reported
more conservative masturbation and pornography attitudes and less conservative (less approving)
sexual coercion scores. All six attitude factor scores differed significantly based on level of religious
commitment. In all six cases, participants who never attended religious events reported less
conservative sexual attitudes.
4.4. Sexual behavior items
There were 11 sexual behavior items in the SKAT-A that were suitable for the Iranian culture. We
contrasted responses on these items by the three demographic grouping measures (age, gender,
and religious commitment level) using proportional tests of independence (Table 5). For age (up to
25 vs. 26 and older), younger participants were more likely to report having less sexual experience
compared to friends, χ2(2) = 9.17, p < .05, to have a much earlier sexual debut, χ2(3) = 77.86,
p < .001, to be younger on their first date, χ2(3) = 101.16, p < .001, and more likely to report they
talked with friends about sex more frequently (once a day) than older participants, χ2(4) = 15.64,
p < .01. Older participants, on the other hand, were more likely to report they forced their sexual
partner to have sex, χ2(1) = 4.24, p < .05, more likely to be forced to have sex, χ2(1) = 10.84,
p < .001, and more likely to have an STD infection, χ2(1) = 31.62, p < .001, than younger
participants.

A total of six of the 11 gender comparisons were significant. Male participants were more
likely to report they had greater sexual knowledge compared to their friends, χ2(2) = 22.36,
p < .001, be younger at their sexual debut, χ2(3) = 12.06, p < .01, talk more frequently about
sex with their friends, χ2(4) = 64.01, p < .001, report having more sexual partners, χ2(2) = 28.53,
p < .001, more likely to force their partner to have sex, χ2(1) = 6.20, p < .05, and less likely to
report they were forced to have sex, χ2(1) = 6.84, p < .01 or discuss sex with their parents, χ2
(1) = 24.00, p < .001.

Level of religious commitment also significantly differed with those reporting less religious
commitment (never attending events) were more likely to report greater sexual experience
compared to their friends, χ2(2) = 14.01, p < .001, more sexual knowledge than their friends, χ2
(2) = 20.39, p < .001, and were more frequently discuss sex with their friends, χ2(4) = 11.26, p < .05.

Table 6 contains the correlations between the 11 sexual behavior items and the 6 factor
(weighted) composite scores. Interestingly, these associations were relatively small in magni-
tude. The average association across all 66 correlations was r = .086, indicating less than 1%
common variance. The largest average correlation within each attitudinal composite across the
11 sexual behaviors was for premarital sex, r = .105, and the largest correlation within the sexual
behavior items across the 6 attitudinal composites was for sexual knowledge compared to
friends, r = .18.

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 Table 3. Fit indices for measurement invariance tests
χ2 (df) CFI TLI RMSEA 90%CI 90%CI SRMR Δ χ2 (df)
https://doi.org/10.1080/23311908.2019.1585505

lower upper
Motedayen et al., Cogent Psychology (2019), 6: 1585505

Age Configural invariance 1140.1 (638) 0.958 0.935 0.038 0.034 0.041 0.026
(< 26 years, ≥ 26 years) FL invariance 1364.0 (794) 0.953 0.941 0.036 0.033 0.039 0.035 223.8 (156)
Intercepts invariance 1480.8 (820) 0.945 0.933 0.038 0.035 0.041 0.038 116.9 (26)
Factor Var/Cov invariant 1520.1 (841) 0.943 0.933 0.038 0.035 0.041 0.043 39.3 (21)
Factor means invariant 1556.1 (847) 0.941 0.931 0.039 0.036 0.042 0.044 35.9 (6)
Gender Configural invariance 1147.0 (638) 0.957 0.933 0.038 0.034 0.042 0.027
(female, male) FL invariance 1365.9 (794) 0.952 0.94 0.036 0.033 0.039 0.035 218.9 (156)
Intercepts invariance 1514.1 (820) 0.942 0.929 0.039 0.036 0.042 0.038 148.2 (26)
Factor Var/Cov invariant 1565.6 (841) 0.939 0.928 0.039 0.036 0.042 0.045 51.5 (21)
Factor means invariant 1810.4 (847) 0.919 0.905 0.045 0.042 0.048 0.057 244.8 (6)
Religious Commitment Configural invariance 1199.8 (638) 0.946 0.916 0.040 0.036 0.043 0.028
(never, at least once) FL invariance 1421.9 (794) 0.940 0.925 0.038 0.035 0.041 0.037 222.0 (156)
Intercepts invariance 1468.8 (820) 0.938 0.925 0.038 0.035 0.041 0.039 47.0 (26)
Factor Var/Cov invariant 1501.8 (841) 0.937 0.925 0.038 0.035 0.041 0.043 33.0 (21)
Factor means invariant 1753.5 (847) 0.913 0.898 0.044 0.041 0.047 0.088 251.7 (6)
CFI = Comparative Fit Index; RMSEA = Root Mean Square Error of Approximation; CI = Confidence Interval;
SRMR = Square Root Mean Residual; TLI = Tucker Lewis Index; Δ = change value; FL = Factor Loading; Var/Cov = Variance/Covariance matrix.

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 Table 4. Attitude factor composites by age, gender and religious ceremony
Age Gender Religious ceremony
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Up to 25 26 and more p Female Male p Never At least once p

Motedayen et al., Cogent Psychology (2019), 6: 1585505

Premarital 15.89 (4.72) 16.85 (4.95) 0.002 16.74 (5.05) 16.35 (4.73) 0.186 14.22 (4.61) 17.94 (4.51) 0.000
Sexuality
Masturbation 21.82 (5.51) 22.01 (5.52) 0.585 22.98 (5.15) 20.97 (5.68) 0.000 19.68 (5.48) 23.33 (5.07) 0.000
Homosexuality 12.91 (3.96) 13.35 (3.99) 0.085 13.01 (3.90) 13.40 (4.07) 0.104 11.32 (3.92) 14.36 (3.58) 0.000
Pornography 13.63 (3.73) 13.56 (3.91) 0.776 14.47 (3.73) 12.76 (3.79) 0.000 12.09 (3.55) 14.51 (3.74) 0.000
Abortion 12.94 (3.93) 13.89 (4.02) 0.000 13.36 (4.00) 13.79 (4.02) 0.072 12.04 (3.79) 14.51 (3.86) 0.000
Sexual Coercion 10.81 (3.35) 11.31 (3.26) 0.017 10.36 (3.00) 11.91 (3.40) 0.000 10.28 (3.03) 11.68 (3.34) 0.000
Tabled values are means (SD). Statistical comparisons conducted using independent Student’s t-tests.
Non-parametric Mann-Whitney tests did not produce substantial test statistic or parameter estimate deviations.

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 Table 5. Sexual behavior comparisons by age, gender, and religious ceremony
Age Gender Religious Commitment
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Up to 25 26 and more p Female Male p Never At least once p

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Sexual experience compared to friends 0.010 0.053 0.001

Less experience 47.15% 37.70% 46.85% 41.34% 40.19% 46.37%
Same experience 31.30% 35.52% 32.78% 32.51% 30.38% 34.01%
More experience 21.54% 26.78% 20.37% 26.15% 29.43% 19.62%
Sexual knowledge compared to friends 0.300 0.000 0.000
Less knowledge 18.02% 19.13% 21.67% 15.19% 14.59% 20.64%
Same knowledge 42.28% 37.43% 44.44% 37.28% 36.12% 43.60%
More knowledge 39.70% 43.44% 33.89% 47.53% 49.28% 35.76%
Age of first sexual relationship 0.000 0.007 0.134
Up to 15 10.29% 6.35% 4.61% 12.01% 11.16% 6.88%
16 to 20 69.77% 44.44% 58.99% 61.13% 54.91% 64.49%
21 to 25 19.94% 30.69% 27.19% 21.55% 26.34% 22.10%
26 and more 0.00% 18.52% 9.22% 5.30% 7.59% 6.52%
Age on first date 0.000 0.214 0.679
Up to 13 6.26% 2.60% 6.00% 3.92% 4.61% 5.19%
13 to 17 52.24% 28.90% 43.65% 44.24% 41.79% 45.38%
18 to 22 39.18% 49.68% 40.88% 44.93% 45.24% 41.35%
23 and more 2.33% 18.83% 9.47% 6.91% 8.36% 8.08%
Sexual intercourse person of opposite sex 0.415 0.405 0.618
Never 19.40% 12.73% 16.00% 18.80% 17.55% 17.65%
Less than once a month 39.13% 41.82% 38.29% 41.03% 38.30% 41.18%
Once a month 21.74% 20.00% 20.00% 22.22% 19.68% 22.62%
Once a week 18.39% 24.55% 24.57% 16.67% 23.40% 17.19%
Talking with friends about sex 0.004 0.000 0.024

(Continued)

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 Table 5. (Continued)
Age Gender Religious Commitment
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Up to 25 26 and more p Female Male p Never At least once p

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Never 13.99% 17.01% 19.22% 10.64% 15.50% 14.10%

Less than once a month 24.05% 32.99% 33.58% 19.36% 22.22% 28.39%
Once a month 19.39% 14.95% 19.46% 17.45% 16.37% 19.67%
Once a week 26.53% 27.84% 19.95% 32.98% 27.78% 26.35%
Once a day 16.03% 7.22% 7.79% 19.57% 18.13% 11.50%
Number of sexual partners 0.448 0.000 0.217
1 56.09% 52.17% 71.33% 41.90% 50.70% 58.33%
2–3 39.57% 45.65% 27.27% 52.51% 46.48% 37.22%
4 and more 4.35% 2.17% 1.40% 5.59% 2.82% 4.44%
Talk with parents about sex 0.632 0.000 0.277
No 84.69% 86.08% 78.59% 90.43% 86.55% 83.86%
Yes 15.31% 13.92% 21.41% 9.57% 13.45% 16.14%
Forcing sexual partner to have sex 0.039 0.013 0.376
No 91.11% 86.08% 92.70% 87.66% 88.89% 90.72%
Yes 8.89% 13.92% 7.30% 12.34% 11.11% 9.28%
Being forced to have sex 0.001 0.009 0.699
No 90.52% 82.05% 85.68% 91.28% 89.18% 88.33%
Yes 9.48% 17.95% 14.32% 8.72% 10.82% 11.67%
Having an STD infection 0.000 0.499 0.170
No 98.83% 91.24% 97.57% 96.81% 96.20% 97.77%
Yes 1.17% 8.76% 2.43% 3.19% 3.80% 2.23%

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 Table 6. Correlations between factor composite scores and sexual behavioral items
Premarital Masturbation Homosexuality Pornography Abortion Sexual
https://doi.org/10.1080/23311908.2019.1585505

Sexuality Coercion
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Sexual experience compared to friends (N = 1106)ƹ −.176** −.131** −.091** −.163** −.191** −.063*
Sexual knowledge compared to friends (N = 1106)ƹ −.161** −.234** −.125** −.209** −.229** −.102**
ƹ
Age of first sexual relationship (N = 500) −.055 .056 .050 .118** .031 −.085
Age on first date (N = 867)ƹ .065 .045 .087* .099** .014 .019
Sexual intercourse—person of opposite sex (N = 409)ƹ −.176** −.145** −.059 −.063 −.181** −.047
Talking with friends about sex (N = 881)ƹ −.133** −.156** −.089** −.193** −.109** .007
Number of sexual partners (N = 322)ƹ −.047 −.057 .051 −.126* −.064 .089
Talking with parents about sex (N = 881)β −.052 .016 −.056 −.009 −.025 −.111**
Forcing sexual partner to have sex (N = 881)β −.125** −.118** −.041 −.087* −.055 .058
Being forced to have sex (N = 882)β −.091** −.048 −.054 −.014 −.042 .034
Having an STD infection (N = 881)β .071* .038 .057 .026 .072* .002
ƹ
Spearman correlation coefficient; βPoint bi-serial correlation coefficient; * = p < 0.05; ** = p < 0.01

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5. Discussion
This article used ESEM to explore the psychometric properties of a Farsi translated instrument
assessing sexual attitudes and behavior (SKAT-A). The sample of predominantly Muslim Iranians
consisted of high school youth and college-age young adults that responded to a messaging
service with a hyperlink to the survey platform. The majority of the sample was from Tehran, a
major metropolis with one-fifth of the nation’s population, and was ethnically and demogra-
phically diverse. The translation procedure produced some minor changes to item wording,
necessitated by the cultural differences between westernized and the more secular Iranian
society. This is not atypical and has been observed to occur in other studies assessing sexual
behavior where cultural sensitivities matter (e.g., Mohammad et al., 2007). Outside of these few
changes in vernacular (primarily with behavioral items) the core portions of the instrument
remained intact and cognitive testing indicated the instrument has face validity.

The ESEM factor analyses produced an adequate 6-factor solution meeting the criteria of
both parsimony and a clear substantive interpretation of the factors. The benchmark for factor
loadings was somewhat strict (>.40) but produced a meaningful solution with very few sizable
cross-loadings. The lack of substantial cross-loadings suggests that the obtained factors repre-
sent distinct clusters clearly operationalized by their respective items. As expected, the ESEM
produced a better fit compared to a CFA, the latter which requires simple structure (Morin &
Maïano, 2011). Importantly, the 6-factor dimensional structure was consistent with the English
version (Fullard & Scheier, 2010), with the exception that we did not obtain a clear-cut factor
assessing sexual education. Even given that the SKAT-A was initially developed with English
speaking youth, it would appear there is a common ground with regard to assessing sexual
attitudes in both Muslim religious communities and more westernized industrial countries.

With only one exception, scale reliabilities exceeded the traditional benchmark of .70, the
exception was the 4-item scale assessing abortion. The four abortion items include providing a
permit for abortion to females, equating abortion with homicide, allowing abortion only in cases of
rape or incest, and abortion perceived as more sinful than an unwanted child. There was one
additional abortion item asking who should decide about abortion, however, this item did not load
appreciably on this or any other factor. A careful inspection of the pattern of factor inter-correla-
tions shows that we achieved good discriminant validity with the largest association only account-
ing for 32% of shared variance (pornography and masturbation). The weakest set of relations was
observed between sexual coercion and all of the remaining attitudinal factors, perhaps indicating
that being forced into sexual relations is not a large part of Iranian sexual experiences and
unrelated to their conservative attitudes.

One of the goals of this study involved empirically examining the relations between attitudes
and behavior. The focus on attitudes dovetails nicely with a reasoned action approach (Ajzen &
Fishbein, 1977), which posits attitudes as one of several precursors to behavioral action.7 Cast in
a health setting, application of a reasoned action approach would suggest that modification of
attitudes through psycho-educational interventions will produce behavior change (Ajzen,
Albarracín, & Hornik, 2007). In light of the utility of this overarching theoretical framework,
one interesting finding was that the associations between sexual attitudes and behavior were
at best modest in size. Even given the low magnitude of association, the pattern of relations did
reveal that less sexual experience and less sexual knowledge (compared to friends) is asso-
ciated with more conservative views toward sex, and likewise, later sexual debut was also
related to more conservative attitudes. This bodes well for designing theory-based psychological
interventions that utilize persuasive communication strategies to target attitudinal change.
Moreover, efforts like this remain consistent with Islamic teaching, reinforcing decency, mod-
esty and the need for abstinence until marriage. One other notable finding was the relation
between having an STD (2.3% said “yes”) and sexual attitudes, which were all positive, indicat-
ing these individuals had more conservative values. It is possible that contracting a STD caused
reactive dissonance pushing these individuals in the direction of more conservative beliefs.

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The multiple group comparisons, which adhered to conventions for testing weak, strong, and
strict invariance, indicated that the obtained 6-factor structure fit well for all three subgroup
comparisons. This suggests that the SKAT-A Farsi efficiently assesses sexual attitudes in Iranians
with no discrepancy in the meaning of the attitudinal items or the underlying dimensional
structure between subgroups.

As expected, age factored into sexual experience with older participants reporting more sexual
knowledge and experience. Care must be taken when interpreting these findings as there may also
be an age cohort effect. For instance, older participants also reported their sexual debut occurring
at an older age (>21) and also dating for the first time when they were older (>18). In conjunction
with this finding, older participants also held more conservative values toward premarital sexu-
ality, abortion, and sexual coercion. The latter finding may reflect confounding given that older
participants had more sexual experiences yielding more opportunities for sexual coercion, and not
reflect the effect of age alone.

Also consistent with other studies of Muslim cultures females reported less knowledge about sex
(compared to their friends), they were less likely to talk frequently about sex with their friends (once a
week or once a day) and they had more conservative attitudes toward sex. Females also reported
being older at their sexual debut and were more likely to have fewer sex partners compared to males.
Despite evidence showing that the primary source of information about sex is from peers among
Iranian youth (Malek et al., 2010), females in the current study were more likely to talk with their
parents about sex. This opens the door for involving parents in their child’s sexual upbringing,
particularly if they converse about sexuality in a supportive manner. This approach is consistent with
Islamic teaching reinforcing the important role parents have to shepherd their child’s growth and
guide their behavior (Faghihi et al., 2008). Considerable evidence from studies of western youth show
that parental communication is protective (e.g., Giles & Scheier, 2014). This is bolstered by a study
showing that Iranian female college students having premarital sex also reported less mother-
daughter communication on sensitive issues (Khalaj et al., 2011). A review of studies conducted in
Africa also reinforce the importance of parent-child communication in stimulating protective behaviors
(e.g., Bastien, Kajula, & Muhwezi, 2011). Likewise, interventions framed by communication theories
have successfully targeted sex-related risk taking in youth (e.g., O’Donnell, Myint-U, Duran, & Stueve,
2010) making it conceivable to adopt these approaches in Iran. Along these lines, Shirpak, Ardebili,
Shirpak et al. (2007) demonstrated significant effects on sexual knowledge and attitudes from a brief
didactic sex education course administered to married females attending urban health centers in Iran.

As expected, religious commitment was protective, with more involvement in religious ceremonies
associated with more conservative sexual attitudes. The same was largely true of behavior, with
individuals reporting greater religious commitment also reporting less sexual experience and less
sexual knowledge compared to their friends, and they were also less likely to discuss sex with their
friends on a frequent basis. This finding is in keeping with other Iranian studies that have reported a
protective effect for religious beliefs and participation (Honarvar et al., 2016; Mohammadi et al.,
2006). Future research may want to expand on this theme and confirm what particular aspects of
religious commitment is protective, given there are differences between participation in religious
traditions and believing in the faith’s core principles. Learning more about these differences could be
useful if the nation’s religious leaders wish to incorporate sex education into their moral foundation.

5.1. Implications
The Iranian government is now more than ever aware of the need for sexual education to remediate
the rising specter of sexually transmitted disease, including HIV/AIDs, and unwanted pregnancy.
There is even a nationwide push to develop effective health promotion programs that can offset the
poor understanding of sexual reproductive health by youth (Ghorbani, Zamani-Alavijeh, Shahry, Zare,
& Marashi, 2015). Toward this goal, the Farsi version of the SKAT-A provides a psychometrically
reliable instrument that can be used to monitor the sexual attitudes and behavior of young
Iranians. Equally compelling, the instrument can gauge the success of sexual education as it takes

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hold in Iran (Tabatabaie, 2015). The observation of gender differences in sexual attitudes suggests
that programs may want to address familial socialization through gender sensitive interventions (e.g.,
Farahani, Shah, Cleland, & Mohammadi, 2012). This strategy has been successfully applied in the US
as a mother-daughter intervention to reduce substance use (Schinke, Fang, & Cole, 2009) and also
HIV risk (Di Noia, Schinke, Pena, & Schwinn, 2004). Programs of this nature can be adapted to fit
Muslim value structures and capitalize on traditional methods of delivery (i.e., reproductive health
clinics) or use computer-mediated platforms to expand their reach.

Second, the current study also provides much need information to formulate government health
policy and design programs targeting a more informed society with greater awareness of sexual
reproductive health and protections against STDs. As Halstsead (1997) pointed out two decades
ago Muslim communities such as the Iranian Republic are not against sexual education as long as
it is not in conflict with the fundamental principles inherent in Islamic teaching. This underscores
the important protective effect of religious commitment, which is consistent with Islamic teach-
ings. Finding ways to combine this knowledge with the importance of family guidance in teaching
children about human sexuality would be an important next step.

Several cautions should be noted. The cross-sectional nature of the survey prohibits making
causal assertions. Longitudinal studies are required that track the evolution of sexual attitudes and
behavior. This will enable the identification of critical age periods for intervention and finding when
attitudes are most malleable. In addition, the current psychometric work represents only the
beginning of scale construction as further refinement and validation of the SKAT-A Farsi must
ensue to rigorously test the instrument in different settings and under different administration
conditions.

Funding Notes
The authors received no direct funding for this research. 1. Technical considerations for how these parameter
constraints are handled with both unrotated and
Author details rotated solutions is explained in both Marsh et al.
Mahsa Motedayen1 (2009) and also in Asparouhov and Muthén (2009).
E-mail: mahsamtyn@gmail.com 2. The English and Farsi version of the SKAT-A may be
ORCID ID: http://orcid.org/0000-0002-0081-9214 purchased from LARS Research Institute, USA (www.
Seyed Mohammad Kalantarkousheh2 larsri.org).
E-mail: kalantar.counseling@gmail.com 3. We also compared this setting to .05, .03, .1 and .5 as
ORCID ID: http://orcid.org/0000-0002-3269-1489 a crude sensitivity analysis, suggested by one of the
Lawrence M. Scheier3 reviewers. The deviations in factor loadings were quite
E-mail: scheier@larsri.org trivial (range .01 to .04) across the four Epsilon com-
ORCID ID: http://orcid.org/0000-0003-2254-0123 parisons to .01 and averaged for all six factors.
Martin Komarc4 4. This determination was based on using 10,000 replica-
E-mail: komarc@volny.cz tions with ML estimation and using the criteria of
1
Department of Psychology and Education Science, adequate coverage (the 95% Confidence Interval
University of Tehran, Tehran, Iran. contains the parameter), low standard error bias, and
2
Department of Counseling, Faculty of Psychology and a high proportion of replications where we can reject
Education Sciences, Allameh Tabataba’i University, the null specifying the parameter is zero at the .05
Tehran, Iran. level, in essence, the power of the study to reject the
3
LARS Research Institute, Visiting Scholar, UNC null when it is false.
Greensboro, Department of Public Health Education, 5. Communalities (h2) and rotated factor pattern load-
Senior Research Scientist, Prevention Strategies, LLC, ings are available from the third author.
Scottsdale, AZ, USA. 6. At the suggestion of one reviewer, we also compared
4
Faculty of Physical Education and Sport, Department of the fit of a CFA model positing simple structure against
Kinanthropology and Humanities, Charles University in the 6-factor ESEM. Although purely descriptive, the fit
Prague, Prague, Czech Republic. of the ESEM was superior, χ2 = 784.92(319), CFI = .961,
TLI = .939, RMSEA = .036, SRMR = .022, AIC = 96,710,
Cover image BIC = 97,917 compared to the CFA, χ2 = 1705.17(449),
Source: Author. CFI = .894, TLI = .883, RMSEA = .05, SRMR = .051,
AIC = 97,370, BIC = 97,926. Clearly, the restrictions on
Citation information factor loadings in the CFA model (nontarget loadings
Cite this article as: Psychometric validation of the Sexual are constrained to be zero) leads to a poorer fit. In
Knowledge and Attitudes Test –Adolescents (SKAT-A) in addition, the average factor correlation in the CFA is
an Iranian sample, Mahsa Motedayen, Seyed Mohammad quite high (ravg. = .49), compared to the ESEM
Kalantarkousheh, Lawrence M. Scheier & Martin Komarc, (ravg. = .35) resulting in less optimal discriminant
Cogent Psychology (2019), 6: 1585505. validity in the CFA model.

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7. This is a simplification of the theory of reasoned action, Schreer, & S. L. Davis (Eds.), Handbook of sexuality-
which requires inclusion of beliefs (subjective norms and related measures (pp. 30–35). Thousand Oaks, CA:
social acceptability), and intentions, the latter posited to Sage Publications.
be more proximal instigators of behavior change. Fullard, W., & Scheier, L. M. (2010). The sexual knowledge
However, attitudes are an essential component of the and attitude test – adolescents: Psychometric prop-
theory and can be the focus of persuasive change. erties using confirmatory factor analysis methods. In
T. D. Fisher, C. M. Davis, W. L. Yarber, & S. L. Davis
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