Intended or Unintended Consequences? The Likely Implications of Raising the Bar for Sexual Dysfunction Diagnosis in the Proposed DSM-V Revisions: 2. For Women with Loss of Subjective Sexual Arousal
Intended or Unintended Consequences? The Likely Implications of Raising the Bar for Sexual Dysfunction Diagnosis in the Proposed DSM-V Revisions: 2. For Women with Loss of Subjective Sexual Arousal
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DOI：
10.1111/j.1743-6109.2012.02859.x
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发表时间：
2012-08-01
影响因子：
3.5
通讯作者：
Pyke, Robert
中科院分区：
文献类型：
--
作者：
Clayton, Anita H.;DeRogatis, Leonard R.;Pyke, Robert
介绍。布罗托建议在《精神疾病诊断和统计手册》第五版中将女性性欲和性唤起障碍结合起来。目的。我们提供的证据表明，所提出的标准可能会将大量患有性唤起功能障碍的女性排除在诊断或治疗之外。方法。将来自北美和欧洲近 500 名女性（其中 49 名仅被诊断患有性唤起障碍的女性）的患者报告结果测量的非治疗验证研究的评级量表数据与提议的标准进行了比较。主要成果措施。主要测量指标是早期版本的电子日记（关于性活动的电子日记）和四项先前验证的女性性功能障碍（FSD）测量指标、临床医生评定的女性性兴趣和欲望量表以及自评的女性性功能指数、性功能问卷变化和女性性困扰量表。结果。患有女性性唤起障碍（FSAD）的女性得分为明显性功能障碍和明显的性困扰。与没有 FSD 的女性相比，她们的满意性事件 (SSE) 较少，SSE 比例较低，性高潮也明显较少。结论。尽管有证据表明患有 FSAD 的女性在临床上存在性功能障碍，但我们的数据还表明，大多数患有 FSAD 的女性都不符合拟议的性兴趣/性唤起障碍的六项 A 标准，这引发了对拟议诊断分类的有效性和实用性的新担忧。建议修改拟议的新标准，以将这些陷入困境的妇女纳入其中。 Clayton AH、DeRogatis LR、Rosen RC 和 Pyke R。有意或无意的后果？在拟议的 DSM-V 修订中提高性功能障碍诊断标准的可能影响： 2. 对于主观性唤起丧失的女性。 《性医学杂志》2012 年；9：20402046。
Introduction. Brotto proposes to combine female sexual desire and arousal disorders in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Aim. We provide evidence that the proposed criteria could potentially exclude from diagnosis or treatment a large number of women with distressing dysfunction in sexual arousal. Methods. Rating scale data from nontreatment validation studies of patient-reported outcome measures including almost 500 women in North America and Europe, including 49 women diagnosed with arousal disorder only, were compared with the proposed criteria. Main Outcome Measures. The main measures were an early version of the eDiary (an electronic diary on sexual activity) and four previously validated measures of female sexual dysfunction (FSD), the clinician-rated Sexual Interest and Desire InventoryFemale and the self-rated Female Sexual Function Index, Changes in Sexual Functioning Questionnaire, and Female Sexual Distress Scale. Results. The women with female sexual arousal disorder (FSAD) scored as manifestly sexually dysfunctional and significantly sexually distressed. They had fewer satisfying sexual events (SSEs) vs. women with no FSD, with a lower proportion of SSEs, and significantly fewer orgasms. Conclusion. Despite evidence presented that women with FSAD have clinically disordered sexual function, our data also suggest that the majority of these women with FSAD would meet none of the six proposed A criteria for Sexual Interest/Arousal Disorder, raising new validity and utility concerns for the proposed diagnostic classification. Suggestions are made to modify the proposed new criteria so as to include such distressed women. Clayton AH, DeRogatis LR, Rosen RC, and Pyke R. Intended or unintended consequences? The likely implications of raising the bar for sexual dysfunction diagnosis in the proposed DSM-V revisions: 2. for women with loss of subjective sexual arousal. J Sex Med 2012;9:20402046.