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

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.