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Dissociative identity disorder (DID), previously known as multiple personality disorder, is one of multiple dissociative disorders in the DSM-5, DSM-5-TR, ICD-10, ICD-11, and Merck Manual. It has a history of extreme controversy.
Depersonalization is a dissociative phenomenon characterized by a subjective feeling of detachment from oneself, manifesting as a sense of disconnection from one's thoughts, emotions, sensations, or actions, and often accompanied by a feeling of observing oneself from an external perspective. Subjects perceive that the world has become vague, dreamlike, surreal, or strange, leading to a diminished sense of individuality or identity. Sufferers often feel as though they are observing the world from a distance, as if separated by a barrier "behind glass". They maintain insight into the subjective nature of their experience, recognizing that it pertains to their own perception rather than altering objective reality. This distinction between subjective experience and objective reality distinguishes depersonalization from delusions, where individuals firmly believe in false perceptions as genuine truths. Depersonalization is also distinct from derealization, which involves a sense of detachment from the external world rather than from oneself.
Dissociation is a concept that has been developed over time and which concerns a wide array of experiences, ranging from a mild emotional detachment from the immediate surroundings, to a more severe disconnection from physical and emotional experiences. The major characteristic of all dissociative phenomena involves a detachment from reality, rather than a false perception of reality as in psychosis.
Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences. It must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se. Examples include violence, rape, or a terrorist attack.
Depersonalization-derealization disorder is a mental disorder in which the person has persistent or recurrent feelings of depersonalization and/or derealization. Depersonalization is described as feeling disconnected or detached from one's self. Individuals may report feeling as if they are an outside observer of their own thoughts or body, and often report feeling a loss of control over their thoughts or actions. Derealization is described as detachment from one's surroundings. Individuals experiencing derealization may report perceiving the world around them as foggy, dreamlike, surreal, and/or visually distorted.
Personality Assessment Inventory (PAI), developed by Leslie Morey, is a self-report 344-item personality test that assesses a respondent's personality and psychopathology. Each item is a statement about the respondent that the respondent rates with a 4-point scale. It is used in various contexts, including psychotherapy, crisis/evaluation, forensic, personnel selection, pain/medical, and child custody assessment. The test construction strategy for the PAI was primarily deductive and rational. It shows good convergent validity with other personality tests, such as the Minnesota Multiphasic Personality Inventory and the Revised NEO Personality Inventory.
Dissociative disorders (DDs) are a range of conditions characterized by significant disruptions or fragmentation "in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior." Dissociative disorders involve involuntary dissociation as an unconscious defense mechanism, wherein the individual with a dissociative disorder experiences separation in these areas as a means to protect against traumatic stress. Some dissociative disorders are caused by major psychological trauma, though the onset of depersonalization-derealization disorder may be preceded by less severe stress, by the influence of psychoactive substances, or occur without any discernible trigger.
In psychology, emotional detachment, also known as emotional blunting, is a condition or state in which a person lacks emotional connectivity to others, whether due to an unwanted circumstance or as a positive means to cope with anxiety. Such a coping strategy, also known as emotion-focused coping, is used when avoiding certain situations that might trigger anxiety. It refers to the evasion of emotional connections. Emotional detachment may be a temporary reaction to a stressful situation, or a chronic condition such as depersonalization-derealization disorder. It may also be caused by certain antidepressants. Emotional blunting, also known as reduced affect display, is one of the negative symptoms of schizophrenia.
Complex post-traumatic stress disorder is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.
The Major Depression Inventory (MDI) is a self-report mood questionnaire developed by the World Health Organization. The instrument was constructed by a team led by Professor Per Bech, a psychiatrist based at Frederiksborg General Hospital in Denmark. The MDI differs from many other self-report inventories, such as the Beck Depression Inventory (BDI), because it is able to generate an ICD-10 or DSM-IV diagnosis of clinical depression in addition to an estimate of symptom severity.
The Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) is a test to rate the severity of obsessive–compulsive disorder (OCD) symptoms.
The Beck Anxiety Inventory (BAI) is a formative assessment and rating scale of anxiety. This self-report inventory, or 21-item questionnaire uses a scale ; the BAI is an ordinal scale; more specifically, a Likert scale that measures the scale quality of magnitude of anxiety.
The Dissociative Experiences Scale (DES) is a psychological self-assessment questionnaire that measures dissociative symptoms.
The Trauma Symptom Inventory (TSI) is a psychological evaluation/assessment instrument that taps symptoms of Posttraumatic stress disorder and other posttraumatic emotional problems. It was originally published in 1995 by its developer, John Briere. It is one of the most widely used measures of posttraumatic symptomatology.
The Children's Depression Inventory is a psychological assessment that rates the severity of symptoms related to depression or dysthymic disorder in children and adolescents. The CDI is a 27-item scale that is self-rated and symptom-oriented. The assessment is now in its second edition. The 27 items on the assessment are grouped into five major factor areas. Clients rate themselves based on how they feel and think, with each statement being identified with a rating from 0 to 2. The CDI was developed by American clinical psychologist Maria Kovacs, PhD, and was published in 1979. It was developed by using the Beck Depression Inventory (BDI) of 1967 for adults as a model. The CDI is a widely used and accepted assessment for the severity of depressive symptoms in children and youth, with high reliability. It also has a well-established validity using a variety of different techniques, and good psychometric properties. The CDI is a "Level B test," which means that the test is somewhat complex to administer and score, with the administrator requiring training.
The Child Mania Rating Scales (CMRS) is a 21-item diagnostic screening measure designed to identify symptoms of mania in children and adolescents aged 9–17 using diagnostic criteria from the DSM-IV, developed by Pavuluri and colleagues. There is also a 10-item short form. The measure assesses the child's mood and behavior symptoms, asking parents or teachers to rate how often the symptoms have caused a problem for the youth in the past month. Clinical studies have found the CMRS to be reliable and valid when completed by parents in the assessment of children's bipolar symptoms. The CMRS also can differentiate cases of pediatric bipolar disorder from those with ADHD or no disorder, as well as delineating bipolar subtypes. A meta-analysis comparing the different rating scales available found that the CMRS was one of the best performing scales in terms of telling cases with bipolar disorder apart from other clinical diagnoses. The CMRS has also been found to provide a reliable and valid assessment of symptoms longitudinally over the course of treatment. The combination of showing good reliability and validity across multiple samples and clinical settings, along with being free and brief to score, make the CMRS a promising tool, especially since most other checklists available for youths do not assess manic symptoms.
The General Behavior Inventory (GBI) is a 73-question psychological self-report assessment tool designed by Richard Depue and colleagues to identify the presence and severity of manic and depressive moods in adults, as well as to assess for cyclothymia. It is one of the most widely used psychometric tests for measuring the severity of bipolar disorder and the fluctuation of symptoms over time. The GBI is intended to be administered for adult populations; however, it has been adapted into versions that allow for juvenile populations, as well as a short version that allows for it to be used as a screening test.
The Dimensional Obsessive-Compulsive Scale (DOCS) is a 20-item self-report instrument that assesses the severity of Obsessive-Compulsive Disorder (OCD) symptoms along four empirically supported theme-based dimensions: (a) contamination, (b) responsibility for harm and mistakes, (c) incompleteness/symmetry, and (d) unacceptable (taboo) thoughts. The scale was developed in 2010 by a team of experts on OCD led by Jonathan Abramowitz, PhD to improve upon existing OCD measures and advance the assessment and understanding of OCD. The DOCS contains four subscales that have been shown to have good reliability, validity, diagnostic sensitivity, and sensitivity to treatment effects in a variety of settings cross-culturally and in different languages. As such, the DOCS meets the needs of clinicians and researchers who wish to measure current OCD symptoms or assess changes in symptoms over time.
The Clinically Administered PTSD Scale (CAPS) is an in-person clinical assessment for measuring posttraumatic stress disorder (PTSD). The CAPS includes 30 items administered by a trained clinician to assess PTSD symptoms, including their frequency and severity. The CAPS distinguishes itself from other PTSD assessments in that it can also assess for current or past diagnoses of PTSD.
References
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- 1 2 Dalenberg, Constance; Naish, Brandi; Abu-Rus, Ana (7 May 2021). "Dissociation, Dissociative Disorder, and Their Treatment". Handbook of Interpersonal Violence and Abuse Across the Lifespan. pp. 1–26. doi:10.1007/978-3-319-62122-7_177-1. ISBN 978-3-319-62122-7.
- 1 2 Brand, Bethany; Loewenstein, Richard J. (October 2010). "Dissociative Disorders: An Overview of Assessment, Phenomonology and Treatment". Psychiatric Times. Archived from the original on 2024-05-07.
- ↑ Dorahy, Martin J.; Brand, Bethany L.; Şar, Vedat; Krüger, Christa; Stavropoulos, Pam; Martínez-Taboas, Alfonso; Lewis-Fernández, Roberto; Middleton, Warwick (2014). "Dissociative identity disorder: An empirical overview". Australian & New Zealand Journal of Psychiatry. 48 (5): 402–417. doi:10.1177/0004867414527523. PMID 24788904.
- 1 2 3 4 5 6 Jeffirs, Stephanie M.; Petri, Jessica M.; Camden, Abigail A.; Jackson, Brianna N.; Weathers, Frank W. (2023). "Psychometric evaluation of the multiscale dissociation inventory (MDI): A replication and extension in two trauma-exposed samples". European Journal of Trauma & Dissociation. 7 (2). doi:10.1016/j.ejtd.2023.100324.
- 1 2 3 MDI, multiscale dissociation inventory: Professional manual. Psychological Assessment Resources. 2002. OL 31598656M. Archived from the original on 2024-03-16. Retrieved 2024-03-16.
- ↑ Briere, John (2002). "MDI, Multiscale Dissociation Inventory: Professional Manual". Archived from the original on 2024-03-16. Retrieved 2024-03-16.