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 1,117 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors describe the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D), which investigates five groups of dissociative symptoms (amnesia, depersonalization, derealization, identity confusion, and identity alteration) and systematically rates both the severity of individual symptoms and the evaluation of overall diagnosis of dissociative disorder. Preliminary findings from a study of 48 subjects with and without psychiatric diagnoses indicate good to excellent reliability and discriminant validity for the SCID-D as a diagnostic instrument for the five dissociative disorders and as a tool for the evaluation of dissociative symptoms encountered within nondissociative syndromes.
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PMID:The Structured Clinical Interview for DSM-III-R Dissociative Disorders: preliminary report on a new diagnostic instrument. 240 15

Prior research on the MMPI has cautioned against misdiagnosing schizophrenia in patients with dissociative identity disorder. The present study examined the full spectrum of the dissociative experience in relation to MMPI-2 profiles. Ninety-eight women in treatment for trauma-related disorders completed the Dissociative Experiences Scale and the MMPI-2 in routine inpatient diagnostic evaluations. Consistent with prior research, severe dissociation was associated with high elevations on MMPI-2 scales typically associated with psychotic symptoms. Contrary to hypotheses, the ostensibly most benign form of dissociation, absorption and imaginative involvement, was somewhat more strongly related to MMPI-2 scores than the more pathognomonic forms of dissociation, depersonalization and amnesia. Although it should not be misdiagnosed, severe impairment on the MMPI in conjunction with dissociation should be taken seriously as suggesting vulnerability to psychotic experience. The dissociative retreat from the stressors of outer reality opens the door to the inner world of traumatic images and affects, along with compromised reality testing and disorganized thinking.
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PMID:Dissociation and vulnerability to psychotic experience. The Dissociative Experiences Scale and the MMPI-2. 756 6

The test-retest reliability of the Dissociative Experiences Scale (DES; Bernstein EM, Putnam FW [1986] Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease 174:727-735) in a clinical sample was found to be .93 for the total DES score and .95, .89, and .82 for the three subscale scores of amnesia, depersonalization-derealization, and absorption (dissociative identity disorder [DID], DSM-IV), respectively. Test-retest reliabilities within diagnostic groups of multiple personality disorder, dissociative disorder not otherwise specified, and a general other category of psychiatric diagnoses were obtained for total and subscale scores on the DES. These ranged from .78 to .96. Tests of mean scores across the two test sessions showed the total and subscale scores to be temporally stable. The DES was also found to be highly internally consistent: Cronbach's alphas of .96 and .97 were observed for the total DES scores taken at times 1 and 2, respectively. Construct validity of the DES was demonstrated by differentiation among the subscale scores in a repeated-measures analysis of variance (F[2,154] = 32.03, p < or = .001). Normality and general distribution issues were also addressed and provided a rationale for using the DES with parametric statistics. Reasons why the DES (as it was originally designed) is not appropriate as a dependent measure in outcome research are discussed, along with needed future research. Implications of the findings for the clinical usefulness of the DES as a diagnostic instrument are noted.
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PMID:Psychometric properties of the Dissociative Experiences Scale. 771 11

The stress associated with experiencing or witnessing physical trauma can cause abrupt and marked alterations in mental state, including anxiety and transient dissociative symptoms. Intense manifestations of this pattern of response to trauma are described in a new diagnostic category proposed for DSM-IV: acute stress disorder. Severe dissociative symptoms may predict subsequent posttraumatic stress disorder. Persons who experience a series of traumatic events may be especially vulnerable to a variety of dissociative states, including amnesia, fugue, depersonalization, and multiple personality disorder. Treatment for these symptoms emphasizes strengthening supportive interpersonal relationships and developing insight that reduces psychological pain by integrating the trauma into a meaningful, less self-blaming perspective.
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PMID:Trauma and dissociation. 850 55

This study compared the frequency and types of dissociative experiences reported by detoxified alcoholics and drug abusers, and examined the relationship between dissociation and recent and lifetime use of alcohol, cannabis, cocaine, and heroin. One hundred thirty-eight self-referred male veterans detoxified from alcohol (N=62) and drugs (N=76) on inpatient units at a Veterans Affairs hospital completed questionnaires including the Dissociative Experiences Scale. Three types of dissociative experiences were examined: amnesia, depersonalization/derealization, and absorption. Ninety-one of the patients were also given the Addiction Severity Index interview to determine their histories of recent (past 30 days) and lifetime drug and alcohol use. High levels of dissociation were found in both groups, with alcoholics reporting higher levels of all three types of dissociative experiences than drug addicts. Chronicity (lifetime years) of both alcohol and cocaine use was significantly correlated with dissociation scores. The amnestic effect of chronic cocaine use persisted even after controlling for the effects of chronic alcohol use. In contrast, no dissociative effects of recent (past month) use of alcohol or drugs were found. These findings suggest that dissociation may be a chronic residual effect of long-term substance abuse, including both alcohol and cocaine. Implications are discussed for the treatment of chronic substance abusers.
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PMID:Levels of dissociation in detoxified substance abusers and their relationship to chronicity of alcohol and drug use. 860 31

The present study evaluates the relationship between abuse experiences, dissociation and eating disorders (ED) in an Italian female college sample. In particular, the study aims at comparing the dissociative effects of abuse experiences in ED and normal subjects. Dissociative experiences were assessed by Dissociation Questionnaire (DIS-Q), which appeared to be an internally consistent and valid instrument. The presence of ED in 491 female college students was assessed by a two-stage epidemiological procedure. The factor structure of the DIS-Q in our sample allowed us to identify specific features that could differentiate ED subjects from normals. Experiences of losing control appeared to characterize ED subjects and they were more serious in ED individuals who reported sexual or physical abuse. Normal subjects who reported a serious trauma had more frequently amnesia, identity alterations, derealization and depersonalization experiences when compared to nonabused subjects.
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PMID:Dissociative experiences and eating disorders in a female college sample. 918 83

The question of whether organic conditions, such as complex partial seizures, can cause dissociative symptoms is controversial. Although a diagnostic category for organic dissociation is included in the tenth edition of International Classification of Disease, it has never been identified in the Diagnostic and Statistical Manual. Its inclusion in the upcoming DSM-IV is currently under debate. This article surveys representative literature regarding the role of organic factors in the causation of dissociative symptoms and considers the differential diagnosis of organic dissociation from current and historic perspectives. Dissociative symptoms and disorders (including amnesia, fugue, depersonalization, multiple personality, automatisms, and certain furors) can be induced by a variety of medications, drugs of abuse, and medical illnesses or conditions affecting cerebral function. Organic dissociation can be distinguished from intoxication, amnestic disorder, and delirium. Psychiatric nosology and our conceptualization of altered mental states and functions would benefit from use of the concept of an organic dissociative syndrome, which has clinical, neurophysiologic, and medicolegal significance. Such a category should be included in DSM-IV.
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PMID:The concept of an organic dissociative syndrome: what is the evidence? 938 42

This article presents a qualitative analysis of the experience of parenting of mothers with dissociative disorders. This analysis was performed to complement the quantitative analysis of problems of mothers with dissociative disorders that Benjamin, Benjamin, and Rind (1996) presented previously. They found that the functioning of these mothers, as well as their subjective experience of mothering, was poorer than that of either clinical or nonclinical control mothers. Our goal was to provide a clearer, richer picture of their problems in parenting. Using the mothers' own words, we describe how the five symptom areas of dissociation (amnesia, depersonalization, derealization, identity confusion, and identity alteration) impeded their parenting efforts. We conclude with a discussion of the necessity of addressing parenting in the treatment of client-mothers with dissociative disorders.
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PMID:The parenting experiences of mothers with dissociative disorders. 967 40

Depersonalization disorder comprises one of the four major dissociative disorders and yet remains poorly studied. There are no reports describing the application of dissociation scales to this population. Our goal was to investigate the applicability of four such scales to depersonalization disorder and to establish screening criteria for the disorder. Two general dissociation scales and two depersonalization scales were administered to 50 subjects with DSM-III-R depersonalization disorder and 20 healthy control subjects. The depersonalization disorder group scored significantly higher than the normal control group in all scales and subscales. Factor analysis of the Dissociative Experiences Scale (DES) yielded three factors as proposed previously, absorption, amnesia, and depersonalization/derealization. A DES cutoff score of 12, markedly lower than those previously proposed for the screening of other dissociative disorders, is required for the sensitive detection of depersonalization disorder. Alternatively, the DES pathological dissociation taxon (DES-taxon) score recently generated in the literature appears more sensitive to the detection of depersonalization disorder and is better recommended for screening purposes. The other three scales were fairly strongly correlated to the DES, suggesting that they may measure similar but not identical concepts, and cutoff scores are proposed for these scales also. General implications for the screening and quantification of depersonalization pathology are discussed.
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PMID:The detection and measurement of depersonalization disorder. 974 59

The author provides a preliminary framework for a systematic and dynamic understanding of dissociation through a consideration of the theories of Hughlings Jackson. Jackson's ideas are briefly reviewed. He saw the proper scientific investigation of mental illness as an experimental investigation of mind. Accordingly, his argument begins with this fundamental concept. His views of the brain-mind relationship and of mind, or self, resemble modern conceptions. He viewed the self as double and focused on those disruptions of the self system which he called the "dreamy state." This state involves an "uncoupling" of normal consciousness, resulting in the loss of the most recently developed forms of memory and of the stream of consciousness. Dissociation is seen here as analogous to the dreamy state. Jacksonian theory predicts the main features of dissociation, i.e., constriction of consciousness, a particular form of amnesia, disaggregation of perceptual phenomena, depersonalization, derealization, and hallucinosis. It leads to the view that dissociation can be seen, in essence, as an uncoupling of consciousness.
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PMID:The contribution of Hughlings Jackson to an understanding of dissociation. 1113 56


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