Background Gastrointestinal-specific anxiety (GSA) is a critical psychosomatic factor influencing symptom perception and quality of life in disorders of gut-brain interaction (DGBI). The Visceral Sensitivity Index (VSI) is a validated instrument used to assess GSA in DGBI such as irritable bowel syndrome (IBS). However, a culturally adapted and psychometrically validated Chinese version is currently unavailable. This study aimed to develop and comprehensively validate a Chinese version of the VSI (VSI-C). Methods The VSI-C was developed through dual translation, back-translation, cultural adaptation, and pilot testing. Its content validity was assessed by an expert panel. The included DGBI patients completed the VSI-C, the Hospital Anxiety and Depression Scale (HADS), and the Patient Health Questionnaire-15 (PHQ-15). Structural validity was evaluated using exploratory factor analysis (EFA), with the factor model tested by confirmatory factor analysis (CFA) and further corroborated visually via exploratory graph analysis (EGA). Convergent validity was assessed through Pearson correlations with the HADS and PHQ-15. Internal consistency and split-half reliability were evaluated using Cronbach’s α and the Spearman-Brown coefficient, respectively. Floor and ceiling effects were analyzed based on score distributions. Finally, receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal clinical cutoff score. Results A total of 102 DGBI patients were included. The scale demonstrated excellent content validity (S-CVI/Ave = 0.91). EFA identified a stable four-factor structure, which was confirmed by CFA with good model fit (χ 2 /df = 1.539, RMSEA = 0.073, CFI = 0.910) and visually corroborated by EGA. The VSI-C showed significant positive correlations with HADS-A, HADS-D, and PHQ-15 scores (all p 0.05), supporting convergent validity. It exhibited good internal consistency (Cronbach’s α = 0.861) and split-half reliability (Spearman-Brown coefficient = 0.860). No floor or ceiling effects were observed. The optimal cutoff score was 41.5, with a sensitivity of 67.3% and a specificity of 75.5%. Conclusion The VSI-C is a reliable, valid, and clinically useful tool for assessing GSA in Chinese DGBI patients. Its implementation facilitates the systematic integration of psychological assessment into clinical management, promoting personalized care within a biopsychosocial framework.
Fu et al. (Wed,) studied this question.