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What I'm reading...

Meta-Analysis

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  • Mychailyszyn 2020, Differentiating Dissociative from Non-Dissociative Disorders: A Meta-Analysis of the Structured Clinical Interview for DSM Dissociative Disorders (SCID-D) [1]
"Findings suggest that the SCID-D interviews show good validity identifying and differentiating those with DDs as compared to those without DDs. The SCID-D interviews
are valid instruments for diagnosing and differentiating DD from other psychiatric disorders and feigned presentations of DD. Clinicians, researchers, and forensic experts can use the SCID-D interviews with confidence to make differential diagnoses of DDs. Future research using the SCID-D interviews is discussed."
  • Lyssenko 2007, Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies Using the Dissociative Experiences ScaleCite error: The <ref> tag has too many names (see the help page).
    • The largest mean dissociation scores were found in dissociative disorders (mean scores >35), followed by posttraumatic stress disorder, borderline personality disorder, and conversion disorder (mean scores >25). Somatic symptom disorder, substance-related and addictive disorders, feeding and eating disorders, schizophrenia, anxiety disorder, OCD, and most affective disorders also showed mean dissociation scores >15. Bipolar disorders yielded the lowest dissociation scores (mean score, 14.8). Conclusions: The findings underline the importance of careful psychopathological assessment of dissociative symptoms in the entire range of mental disorders.

Systematic reviews

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  • Dohary 2014, Dissociative Identity Disorder: An Empirical Overview[2] Full

Reviews (non-systematic)

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  • Loewenstein 2018, Dissociation Debates: Everything you know is wrong[3] - SCM and memory vs trauma evidence
  • Sar 2017, Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective[4] - cross-cultural, prevalence, causes, developmental trauma
  • Frankel 2006, The Forensic Evaluation of Dissociation and Persons Diagnosed With Dissociative Identity Disorder: Searching for Convergence[5] - Full - increase in interest, legal, brain scans
  • Spiegel2013a, Dissociative Disorders in DSM-5[6] - Full
  • Kihlstrom 2005, Dissociative Disorders [7] Full - history, old cases, causes
  • Foote 2008, Dissociative identity disorder and schizophrenia: Differential diagnosis and theoretical issues[8] - differences from schizophrenia and psychosis
  • Birnbaum 1996, Visual Function in Multiple Personality Disorder[9] - physiological differences between alters

Chapters

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  • Loewenstein 2017[10] The Dissociative Disorders. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry, 10th ed.
  • Hucker2016[11] - Legal - abstract only - validity, reliability of diagnosis confirmed
  • Kihlstrom Ch 10 Comprehensive Handbook of Psychopathology [12] - history, increased research, cases were described in print by 1944
  • van der Hart and Dohary 2010? History of the Concept of Dissociation[13] p3-26

Tiertary

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Primary

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Dissociative disorders, including dissociative identity disorder (formerly multiple personality disorder), were once thought to be exotic and rare disorders,
if indeed they existed at all (1) . Several epidemiological studies over the past 15 years have shown that dissociative disorders may have been previously underdiagnosed and that with proper screening and diagnostic instrumentation, a much higher prevalence is encountered.

Diagnostic validity

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Mychailyszyn states - "Findings suggest that the SCID-D interviews show good validity identifying and differentiating those with DDs as compared to those without DDs. The SCID-D interviews are valid instruments
for diagnosing and differentiating DD from other psychiatric disorders and feigned presentations of DD. Clinicians, researchers, and forensic experts can use the SCID-D interviews with confidence to make differential diagnoses of DDs. Future research using the SCID-D interviews is discussed.". In full text she states that the SCID-D is better at discriminating the 2 DID factors (amnesia and identity alteration) than for the other dissociative disorders, but it's a good clinical diagnostic interview for all dissociative disorders.
  • Dorahy 2014, Systematic review - well-cited by others - linked to on the page earlier - Dissociative identity disorder: An empirical overview], a trauma specialist who often publishes on DID
states "DID was found to be a complex yet valid disorder across a range of markers.
It can be accurately discriminated from other disorders, especially when structured diagnostic interviews assess identity alterations and amnesia. DID is aetiologically associated with a complex combination of developmental and cultural factors, including severe childhood relational trauma. The prevalence of DID appears highest in emergency psychiatric settings and affects approximately 1% of the general population. Psychobiological studies are beginning to identify clear correlates of DID associated with diverse brain areas and cognitive functions. They are also providing an understanding of the potential metacognitive origins of amnesia. Phase-oriented empirically-guided treatments are emerging for DID."
states "Diagnostic Interviews
The Structured Clinical Interview for the DSM-IV Dissociative Disorders (SCID-D) is a semistructured, clinician-administered
instrument following the general SCID framework (First, Spitzer, Gibbon, & Williams, 1998) that was developed to evaluate the presence and severity of the five dissociative disorders in DSM-III-R, and subsequently, DSM-IV (Steinberg, 1995). SCID-D bases its assessment on the evaluation of five dimensions of dissociation which are considered distinct but related features of dissociative pathology: depersonalization, derealization, amnesia, identity alteration, and identity confusion. In studies in the US and the Netherlands among psychiatric inpatients and outpatients, inter-rater reliability, test–retest reliability, and discriminant validity from other psychiatric disorders have been good to excellent (Boon & Draijer, 1991; Bowman & Markand, 1996; Friedl & Draijer, 2000; Steinberg, Cicchetti, Buchanan, Rakfeldt, & Rounsaville, 1994). Research in Germany (Gast, Rodewald, Nickel, & Emrich, 2001) and Turkey (Sar et al., 2003) has also shown good psychometric properties in psychiatric samples. The Dissociative Disorder Interview Schedule (DDIS) is a more structured interview also designed to diagnose DSM-based dissociative pathology (Ross et al. 1989). Unlike the semistructured SCID-D, which permits some flexibility in wording and further elucidation of items, the DDIS is administered exactly as written, in an attempt at greater standardization. This 132-item interview assesses the core symptoms of the five DSM-IV dissociative disorders as well as Borderline Personality Disorder (BPD), somatization disorder, and major depressive disorder. It also obtains descriptions of childhood sexual and physical abuse. In studies conducted in North America, the DDIS has a reliability of 0.68 and a kappa of 0.96 for clinician agreement on the diagnosis of DID, with a false positive rate of 1% in nondissociative clinical samples (Ross, 1997). The major DDIS symptom clusters (secondary features of DID, Schneiderian symptoms, BPD criteria, and extrasensory experiences) correlate well with overall DES score (Spearman correlations = 0.67–0.78), indicating good convergent validity. The DDIS has been used in several international investigations of dissociative disorders, such as in Turkey with psychiatric inpatients (Tutkun et al., 1998) and with a general population sample (Akyüz et al., 1999; Sar et al., in press) and in a psychiatric inpatient sample in Switzerland (Modestin, Ebner, Junghan, & Erni, 1996). In Turkish studies, the DDIS demonstrates high sensitivity and specificity for the dissociative disorders when compared with individuals with epilepsy, schizophrenia, and panic disorder (Sar, Yargic, & Tutkun, 1996; Yargic, Sar, Tutkun, & Alyanak, 1998)...

:Self-Report Instruments
The most widely used self-report measure of dissociation is the DES (Bernstein & Putnam, 1986), a 28-item instrument that assesses a variety of lifetime (or “trait”) dissociative experiences on scale of 0–100, anchored at both ends as “never” and “always.”"

states "The test that best distinguished the feigners from patients with DID was the Structured Clinical Interview for Dissociative Disorders-Revised

(SCID-D-R).21 The SCID-D-R is a semistructured interview that is considered the gold standard for diagnosing dissociative disorders because it has good-to-excellent reliability and good discriminant validity. A drawback of the SCID-D-R is that it can take as long as three hours to administer to highly dissociative patients and requires specialized training."

:states "Evaluate the relative efficacy of a number of psychological tests and interviews in discriminating dissociative identity disorder (DID) from feigned dissociation and
schizophrenia. Three measures of dissociation (SCID-D, DBS, SDQ-5) two personality measures (MMPI-2, Millon-III) and a brief measure of hypnotic susceptibility (Spiegel & Spiegel's Eye-Roll Sign) were assessed for their ability to differentiate these diagnostic groups. Results indicate that the SCID-D was clearly the most efficacious instrument in discriminating DID from schizophrenia and from feigned dissociation. The DES-Taxon and the SDQ-5 were adequate in screening pathological dissociation from schizophrenia but were less discriminative of feigned dissociation. The commonly used personality inventories were unable to detect feigned dissociation and the DID group tended to have higher elevations on scales measuring psychotic symptoms than did the schizophrenic group. The Eye-Roll Sign discriminated feigned dissociation from those with dissociative disorders. Structured interviews such as the SCID-D, although resource consuming, are essential in comprehensive assessment of dissociative disorders"

- and "These results support the SCID-D as being the “gold standard” in assessing dissociative dis- orders and indicate that a structured interview is essential when under- taking any comprehensive assessment of pathological dissociation"

: (typos here are mine )

Structured Interviews

Structured clinical interview for DSM-IV Dissociative disorders (SCID-D). The SCID-D was developed by Stelnberg, Rounsaville, and Cicchettl (1990) to assess the presence

and severity of amnesia, depersonallzation, dereallzadon, identity confusion, and identity alteration symptoms. General, open-ended screening questions are followed by more detailed quesdons. Diagnostic reliability was assessed for presence/absence of a dissociative disorder, type of dissociative disorder, and severity of specific dissociative symptoms. Inter-rater reliability was in the good to excellent range. Agreement (Kappa) on presence or absence of a dissociative disorder was 0.92; for the diagnosis of DID the kappa was 0.90 (Steinberg et al., 1990) . The SCID-D has been updated for the DSM-IV criteria (Steinberg, 1993), and this version is sometimes referred to as SCID-D-R. Follow-up invesdgations (see Stelnberg, 1995) have reported good to excellent inter-rater and test-retest reliability and very good discriminant validity of the SCID-D for the assessment of dissociative symptom severity and for the dissociative disorders in a variety of populations. These results have been replicated by the Dutch researchers Boon and Draijer (1991), who obtained 97.7% agreement on presence/absence of a dissociative disorder, and 100% agreement of diagnoses of DID. Other investigations (Boon &: Draijer, 1993b; Steinberg, Cicchetti, Buchanan, Rakfeldt, & Rounsaville, 1994) have reported that the SCID-D is effective in distinguishing between patients with clinically diagnosed dissociative disorders and other psychiatric disorders, as well as accurately distinguishing between patients with seizures and pseudoseizures (Bowman & Markand, 1996).
Dissociative disorder interview schedule (DDIS).
The DDIS (Ross, Norton, & Fraser, 1989, Ross, Norton, & Wozney, 1989) is a structured symptom checklist designed to identify four dissociative disorders (psychogenic amnesia, psychogenic fugue, depersonalization disorder, and DID), and three disorders with related symptomatology (borderline personality disorder [BPD], somatizadon disorder, and major depressive disorder). An update of the DDIS for the DSM-IV can be obtained through the web site for the Colin A. Ross Institute http://rossinst.com).
The DDIS appears to generate fairly reliable and valid data. The initial study (Ross et al., 1989) reported acceptable inter-rater reliability, with an overall Kappa coefficient of 0.68; for the diagnosis of DID specifically, kappa was 0.78, with sensitivity of 90% and specificity of 100%. In the only study of which we are aware that examined the concurrent validity of the DDIS and SCID-D, Ross, Duffy, and EIlason (1999) reported a kappa of .74 for diagnoses from the two instruments with masked raters.
 Overall, these data support the reliability of both instruments. The reliability data reported for the SCID-D and the DDIS compare favorably with instruments for other psychiatric diagnoses. For example, in a study of the Structured Clinical Interview for DSM-III-R (SCID), Williams et al. (1992) reported an overall weighted inter-rater agreement for 21 separate diagnoses of 0.61, with a range of 0.40 to 0.86. Thus, the reliability estimates reported by Steinberg et al. (1990) for the SCID-D were actually higher than for any mental disorder studied by Williams and colleagues Although these reliability estimates are not directly comparable (the data reported by Williams et al., 1992, were estimates of both interrater and test-retest reliability), they clearly suggest that the SCID-D can be used to reliably diagnose dissociative disorders and, specifically, DID. "

References

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  1. ^ Mychailyszyn, Matthew P.; Brand, Bethany L.; Webermann, Aliya R.; Şar, Vedat; Draijer, Nel (2020-05-18). "Differentiating Dissociative from Non-Dissociative Disorders: A Meta-Analysis of the Structured Clinical Interview for DSM Dissociative Disorders (SCID-D)". Journal of Trauma & Dissociation. 0 (0): 1–16. doi:10.1080/15299732.2020.1760169. ISSN 1529-9732. PMID 32419662.
  2. ^ Dorahy, Martin J.; Brand, Bethany L.; Sar, Vedat; Krüger, Christa; Stavropoulos, Pam; Martínez-Taboas, Alfonso; Lewis-Fernández, Roberto; Middleton, Warwick (May 2014). "Dissociative identity disorder: An empirical overview" (PDF). The Australian and New Zealand Journal of Psychiatry. 48 (5): 402–417. doi:10.1177/0004867414527523. ISSN 1440-1614. PMID 24788904.
  3. ^ Loewenstein, Richard J (2018). "Dissociation debates: everything you know is wrong". Dialogues in Clinical Neuroscience. 20 (3): 229–242. PMC 30581293. PMID 30581293. {{cite journal}}: Check |pmc= value (help)CS1 maint: url-status (link)
  4. ^ Şar, Vedat; Dorahy, Martin J; Krüger, Christa (2017-05-02). "Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective". Psychology Research and Behavior Management. 10: 137–146. doi:10.2147/PRBM.S113743. ISSN 1179-1578. PMC 5422461. PMID 28496375. This paper examines the etiological factors of DID, setting them around the current most widely accepted primary driver of the psychopathology: developmental traumatization. Secondarily, family and sociocultural factors and further cognitive and neurobiological disturbances emerge in tandem with this primary factor.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  5. ^ Frankel, A. Steven; Dalenberg, Constance (2006-03-01). "The Forensic Evaluation of Dissociation and Persons Diagnosed with Dissociative Identity Disorder: Searching for Convergence" (PDF). Psychiatric Clinics of North America. Dissociative Disorders: An Expanding Window into the Psychobiology of the Mind. 29 (1): 169–184. doi:10.1016/j.psc.2005.10.002. ISSN 0193-953X.
  6. ^ Spiegel, David; Lewis-Fernández, Roberto; Lanius, Ruth; Vermetten, Eric; Simeon, Daphne; Friedman, Matthew (2013). "Dissociative disorders in DSM-5". Annual Review of Clinical Psychology. 9: 299–326. doi:10.1146/annurev-clinpsy-050212-185531. ISSN 1548-5951. PMID 23394228.
  7. ^ Kihlstrom, John F. (April 2005). "Dissociative Disorders". Annual Review of Clinical Psychology. 1 (1): 227–253. doi:10.1146/annurev.clinpsy.1.102803.143925. ISSN 1548-5943.
  8. ^ Foote, Brad; Park, Jane (June 2008). "Dissociative identity disorder and schizophrenia: Differential diagnosis and theoretical issues". Current Psychiatry Reports. 10 (3): 217–222. doi:10.1007/s11920-008-0036-z. ISSN 1523-3812.
  9. ^ Birnbaum, M. H.; Thomann, K. (June 1996). "Visual function in multiple personality disorder". Journal of the American Optometric Association. 67 (6): 327–334. ISSN 0003-0244. PMID 8888853.
  10. ^ Sadock, Benjamin J. (2017). "The Dissociative Disorders". In Sadock, Benjamin K.; Sadock, Virginia A; Ruiz, Pedro (eds.). Kaplan & Sadock's Comprehensive Textbook of Psychiatry (10th ed.). Wolters Kluwer/ Lippincott Williams & Wilkens. pp. 1866–1952. ISBN 978-1-4511-0047-1.
  11. ^ Hucker, S. J. (2016-01-01), Payne-James, Jason; Byard, Roger W. (eds.), "Forensic Psychiatry and Forensic Psychology: Multiple Personality Disorder", Encyclopedia of Forensic and Legal Medicine (Second Edition), Elsevier, pp. 659–661, ISBN 978-0-12-800055-7, retrieved 2020-06-10
  12. ^ Kihlstrom, John; Sutker, Patricia B. (2007-05-08). Adams, Henry E. (ed.). Comprehensive Handbook of Psychopathology. Springer Science & Business Media. ISBN 978-0-306-47377-7.
  13. ^ van der Hart, Onno; Dorahy, Martin J. (November 2010). Dell, Paul F.; O'Neill, John (eds.). Dissociation and the Dissociative Disorders: DSM-V and Beyond. Routledge. pp. 3–26. ISBN 978-1-135-90603-0.
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