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Dissociative Identity Disorder (cont.)

How is dissociative identity disorder diagnosed?

There is no specific definitive test, like a blood test, that can accurately assess that a person has dissociative identity disorder. Therefore, practitioners conduct a mental-health interview that looks for the presence of the signs and symptoms previously described. They usually ask questions to explore whether the symptoms that the client is suffering from are not better accounted for by another mental disorder, dissociative or otherwise. Other dissociative disorders include depersonalization disorder (feeling detached from themselves or surroundings), dissociative amnesia (memory problems associated with a traumatic experience), dissociative fugue (abandonment of familiar surroundings and memory lapse for the past), and dissociative disorder, not otherwise specified (episodes of dissociation that do not qualify for one of the specific dissociative disorders just described). As part of the assessment, mental-health professionals also usually ask about other mental conditions and ensure that the client has recently received a comprehensive physical examination so that any physical conditions that may mimic symptoms of DID are identified and addressed.

Dissociation, a major symptom of DID, is known to occur in a number of other mental illnesses. For example, an individual with this disorder may seek to relieve overwhelming memories of trauma by engaging in the self-mutilation that tends to be found in those with borderline personality disorder. Also, feelings and behaviors that may appear to be caused by dissociation, but are not, make it all the more difficult to distinguish DID from other conditions. Somatization disorder, psychogenic amnesia, psychogenic fugue, conversion disorder, and schizophrenia are just a few such disorders. Rape and other adult trauma victims have been found to be quite vulnerable to developing dissociative symptoms. The controversy about whether DID exists, as well as the overlap of symptoms it has with a number of other conditions, sometimes results in misdiagnosis.

DID often co-occurs with other emotional conditions, including posttraumatic stress disorder (PTSD), borderline personality disorder (BPD), and a number of other personality disorders, as well as conversion disorder. This diagnosis is sometimes feigned by individuals who may be seeking attention, as in Munchausen's syndrome. It has also been appropriately diagnosed as well as feigned in individuals involved in the criminal justice and civil or family court systems (for example, forensic cases). Adding to the diagnostic difficulty is that people like pedophiles and other sex offenders, who may legally stand to gain from having DID, genuinely suffer from significant dissociative symptoms, as well as full-blown DID. In cases where there may be an ulterior motive for being diagnosed with DID, studies show that using a structured interview tool may be the best way to determine if the person truly suffers from this condition.



Next: What are the treatments for dissociative identity disorder? »

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