Psychological assessment - No one single set of symptom found for all individuals with DID - use a battery of tests

individually tailored 1. initial phase - build rapport - through examination of psychosocial/trauma history 2. battery of assessment - cognitive test - WAIS-III: DID patient should not show signs of illogical thinking or impaired reality; their IQ often fall under normal range - structured, objective personality test with validity scales (to assess exaggerating or minimizing symptoms) - MMPI-2: DID patients report internal conicts in answering question, due to different aspects of their personalities can feel, think, behave differently - no single diagnostic pattern, but often elevated F scale (validity scale; fake bad), consistent with trauma exposure, and Sc (Schizophrenia) scale (contain trauma-/dissociation-linked items such as difculty in attention and memory, negative self-attitude, dysphoria, unusual sensorimotor experiences; all common in DID) - many DID patients may give technically invalid proles on personality tests; the assessors should be aware of the impact of dissociation/trauma on testing - projective personality tests: to conrm diagnosis and get information about the individuals conicts rather than to diagnosis - TAT: stories told in themes of danger, trauma, refuge, dissociation - Rorschach: help individual delve into their unconscious to face the conict the dissociation has been trying to mask; provides a broad view of persons cognition and problem solving, affective style, representation of self and others, vulnerabilities - self-report measure of dissociation - DES: most used for screening rather than diagnosis - assess amnestic dissociation, depersonalization, derealization, absorption - popular due to ease of administration and scoring - high score not necessarily indicative of DID; need to be followed by further assessment - structured interview for dissociation - SCID-D-R: gold standard measure for diagnosing DID; the only one to provide exact diagnoses from DSM-IV - includes questions like: - have you ever felt as if there were large gaps in your memory? (amnesia) - have you ever felt that you were watching yourself from a point outside of your body? (depersonalization)

- have you ever felt as if familiar surroundings or people you knew seemed unfamiliar or unreal? (derealization) - have you ever felt as if there was a struggle going on inside of you? (identity confusion) - have you ever acted as if you were a completely different person? (identity alteration) - good inter-rater reliability, differentiating between factitious and malingered cases; but limited sensitivity, specicity, discriminative validity - allows the interviewer to observe physical behaviors in response to anxiety induced by the test (e.g. eye rolls) 3. Review the ndings and arrive at a diagnosis Brand, B. L., Armstrong, J. G., & Loewenstein, R. J. (2006). Psychological assessment of patients with dissociative identity disorder. Psychiatric Clinics of North America, 29, 145-168.