Dissociative Identity Disorder Diagnoses and Treatment
Dissociative Identity Disorder- Diagnoses and Treatment
It is very important to diagnose a case of dissociative identity disorder; if it is not diagnosed, it may lead to death. However, therapists have had many problems in diagnosing this type of disorder. This is due to two major factors. The first is that DID is seen as a very unusual disorder, and most cases of DID are mistaken for Schizophrenia. The second factor is that there is a lack of guidelines for the diagnosis of DID. Hence, even when DID is diagnosed it usually takes multiple weeks-or even months to recognize.
There are three categories of special techniques that are used to diagnose DID. The first category is screenings tools that are used to identify patients at risk for any dissociative disorder, not exclusively DID. The second category is structured interviews, and the third category is informal interviews.
There are three screenings tools that are used to identify patients at risk for a dissociative disorder. The first tool is the Dissociative Experiences Scale (DES). The DES is a twenty-eight question self-report that rates a patient’s dissociative symptoms and experiences. The patient indicates his/her agreement with a question by circling a percentage from 0% to 100%. The sum of the twenty-eight scores is taken and averaged to determine whether or not the patient suffers from a dissociative disorder. The DES is reported to have 80% sensitivity, and DID patients usually score above forty points. The two other screenings tools are the Dissociative Questionnaire and the Questionnaire of Experiences of Dissociation, and are both very similar to the DES.
There are four types of structured interviews that can be used to diagnose DID. The first interview is the Dissociative Disorder Interview Schedule (DDIS). This interview is very time consuming (it can take anywhere from forty-five minutes to three hours) and is used more in research settings than clinical. There are one-hundred thirty-one items in the interview, most which ask about childhood sexual abuse. The DDIS serves to diagnose dissociative disorders, somatization disorders, major depression, and borderline personality disorder. It is reported to have high sensitivity and a specificity for diagnosing DID. The second interview is the Structured Clinical Interview for DSM-IV Dissociative Disorders Revised (SCID-D-R). This interview is also very time consuming and is used more in research settings than clinical. In addition, it requires special training. The interview is highly sensitive to...