Cross-cultural study of conviction subtype Taijin Kyofu

Proposal and reliability of Nagoya-Osaka diagnostic criteria for social anxiety disorder

Yoshihiro Kinoshita*, Junwen Chen, Ronald M. Rapee, Susan Bögels, Franklin R. Schneier, Yujuan Choy, Jung Hye Kwon, Xinghua Liu, Elisabeth Schramm, Denise A. Chavira, Yumi Nakano, Norio Watanabe, Tetsuji Ietzugu, Sei Ogawa, Paul Emmelkamp, Jianxue Zhang, David Kingdon, Toshihiko Nagata, Toshi A. Furukawa

*Corresponding author for this work

Research output: Contribution to journalArticle

15 Citations (Scopus)


Conviction subtype Taijin-Kyofu (c-TK) is a subgroup of mental disorder characterized by conviction and strong fear of offending others in social situations. Although the concept of c-TK overlaps with that of social anxiety disorder (SAD), patients with c-TK often may not be diagnosed as such within the current Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria. We propose the Nagoya-Osaka criteria to amend this situation. This study examined the cross-cultural interrater reliability of the proposed criteria. Eighteen case vignettes of patients with a variety of complaints focused around social anxieties were collected from 6 different countries, and diagnosed by 13 independent raters from various nationalities according to the original DSM-IV and the expanded criteria. The average agreement ratio for the most frequent diagnostic category in each case was 61.5% with DSM-IV and 87.6% with the modified DSM-IV with Nagoya-Osaka criteria (p < 0.001). These findings indicate that the Nagoya-Osaka criteria for SAD can improve interrater reliability of SAD.

Original languageEnglish
Pages (from-to)307-313
Number of pages7
JournalJournal of Nervous and Mental Disease
Issue number4
Publication statusPublished - Apr 2008

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