Dissociative Identity Disorder (cont.)

Medical Author:
Medical Editor:

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 gathers information, looking for the presence of the signs and symptoms previously described.

The diagnostic criteria for dissociative identity disorder are as follows:

  1. The presence of two or more distinct identities or personality states (each with its own relatively persistent pattern of perceiving, relating to, and thinking about him or herself and the world)
  2. At least two of the identities or personality states repeatedly take control of the person's behavior.
  3. Inability to recall important personal information that is too severe to be explained by ordinary forgetfulness
  4. The illness is not the result of the direct physiological effects of a substance (for example, blackouts or other abnormal behavior during alcohol or other drug intoxication) or a general medical condition (for example, seizures). In children, the symptoms are not caused by imaginary playmates or other fantasy play.

Professionals usually gather facts about the individual's childhood and 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 types of 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 person 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.

Symptoms of some other mental disorders may be mistaken for dissociation. The wide changes in emotions associated with bipolar disorder or experienced by individuals with narcissistic personality disorder when triggered by minor slights are two such examples. Blackouts that can be related to substance abuse or dependence are other instances of an individual being unaware of his or her surroundings that mimics dissociation.

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. DID 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, as well as people with antisocial personality disorder, may legally stand to gain from having DID. While some of those individuals may feign the diagnosis in an effort to benefit legally, others 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.


Patient Comments

Viewers share their comments

Dissociative Identity Disorder - Symptoms Question: What were the symptoms of your dissociative identity disorder?
Dissociative Identity Disorder - Causes and Risks Question: If identified, what was the cause of your dissociative identity disorder? Do any relatives have it?
Dissociative Identity Disorder - Treatment Question: Please discuss your treatment for dissociative identity disorder, including therapy or medication.

STAY INFORMED

Get the Latest health and medical information delivered direct to your inbox!