The Diagnostic Interview for Sexual Dysfunctions in Women for DSM‐5 and ICD‐11: Development and initial validation using a vignette‐based approach

基于情景描述的女性性功能障碍诊断访谈(DSM-5 和 ICD-11):开发和初步验证

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Abstract

OBJECTIVES: The aim of this study was to evaluate the psychometric properties of the newly developed Diagnostic Interview for Sexual Dysfunctions in Women (DISEX‐F), which covers diagnostic criteria of DSM‐5 and ICD‐11. METHODS: Thirty‐two actresses portrayed 32 cases of female sexual dysfunctions (= standardized patients). To calculate inter‐rater reliability, each standardized patient was interviewed independently by two trained diagnosticians using the DISEX‐F. Interviews were videotaped, and each videotape was evaluated by two other independent diagnosticians. Sensitivity and specificity were calculated by comparing the assigned diagnoses to the target diagnoses pre‐determined in the case vignettes. As a side criterion, the acceptance of the DISEX‐F among diagnosticians was assessed. RESULTS: Specificity was found to be generally clinically satisfying (DSM‐5: 0.90–0.99; ICD‐11: 0.95–0.99), while sensitivity (DSM‐5: 0.40–0.92; ICD‐11: 0.71–0.96) and inter‐rater reliability (DSM‐5: Cohen's kappa = 0.44–1; ICD‐11: Cohen's kappa = 0.75–0.94) greatly varied between classification systems and disorders. Imprecise acting and false differential diagnostic decisions were identified as major sources of mismatch. The acceptance of the DISEX‐F was high. CONCLUSION: Results encourage usage of the DISEX‐F for ICD‐11 diagnoses. Mixed results were found for DSM‐5 diagnoses, which can partly be explained by shortcomings in DSM‐5 criteria.

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