Discriminating among diagnostic categories using the Dissociative Disorders Interview Schedule.

The Dissociative Disorders Interview Schedule was administered to 1,308 subjects in eight diagnostic categories, including 296 with dissociative identity disorder. The study tested three hypotheses: (1) the Mahalanobis distance between dissociative identity disorder and each of seven other diagnostic categories would be large, (2) the closest diagnostic category to dissociative identity disorder would be dissociative disorder not otherwise specified, and (3) nondissociative diagnostic categories would be closer to each other than any one to dissociative identity disorder. All three hypotheses were confirmed by these data.

Comment on the effectiveness of treatment for dissociative identity disorder.

Methodological criticisms of a recent study on treatment outcome of dissociative identity disorder are accurate: however, the outcome study is more methodologically sound than any previous work and therefore advances the field. The design of other studies and the conclusions to be drawn from the study under discussion are reviewed.

Two-year follow-up of inpatients with dissociative identity disorder.

Objective: A group of 135 inpatients with dissociative identity disorder was followed for 2 years to monitor treatment outcome.

Method: Fifty-four of the patients were located and reassessed after a 2-year period through the use of the same self-report measures and structured clinical interviews that had been initially administered.

Results: The patients showed marked improvement on Schneiderian first-rank symptoms, mood and anxiety disorders, dissociative symptoms, and somatization, with a significant decrease in the number of psychiatric medications prescribed.

Childhood trauma and psychiatric symptoms.

144 psychiatric inpatients who reported childhood physical or sexual trauma were administered the Symptom Check List-90-Revised, the Dissociative Experiences Scale, and the Dissociative Disorders Interview Schedule. There was a significant association of reported childhood abuse with psychotic and other symptoms. The findings support the hypothesis that experience of trauma may precede psychiatric symptoms, perhaps including positive symptoms of schizophrenia.

Millon Clinical Multiaxial Inventory--II. Follow-up of patients with dissociative identity disorder.

This study is part of a two-year follow-up assessment of 35 out of 96 patients clinically diagnosed with Dissociative Identity Disorder, who were administered the Millon Clinical Multiaxial Inventory-II. Eight subjects achieved integration during the two-year follow-up period. Significant improvement was evident for raw scores on the Self-defeating, Borderline, Paranoid, Anxiety, Somatoform, Dysthymia, Alcohol Dependence, and Drug Dependent scales among both the integrated and nonintegrated patients, with clinically meaningful Base Rate reductions occurring on Self-defeating, Borderline, Avoidant, Passive-Aggressive, Anxiety, Dysthymia, and Major Depression scales following integration.

Lifetime axis I and II comorbidity and childhood trauma history in dissociative identity disorder.

According to DSM-IV, dissociative identity disorder is characterized by the existence within the person of two or more distinctly different identities or personality states that from time to time take executive control of the person's body and behavior, with accompanying amnesia (American Psychiatric Association, 1994). By retrospective patient report, dissociative identity disorder usually occurs in conjunction with severe childhood trauma (Kluft 1985; Putnam et al. 1986; Ross 1989; Ross et al.

Axis I and II comorbidity and childhood trauma history in chemical dependency.

The authors replicated and extended two former studies on Axis I and II comorbidity and childhood trauma histories in 106 patients admitted to a chemical dependency treatment unit. Sixty-nine subjects reported a history of physical and/or sexual abuse during childhood and 26.4% met criteria for posttraumaic stress disorder.

Assessment of dissociative identity disorder with the Million Clinical Multiaxial Inventory-II.

96 patients with a clinical diagnosis of Dissociative Identity Disorder were administered the Million Clinical Multiaxial Inventory-II. The most elevated personality disorder scales were Avoidant, Self-defeating, Borderline, and Passive-Aggressive personality disorders. Elevated Axis I scales included Dysthymia, Major Depression, Thought Disorder, and Anxiety Disorder.

Positive and negative symptoms in dissociative identity disorder and schizophrenia: a comparative analysis.

A substantial number of patients with dissociative identity disorder have had previous diagnoses of schizophrenia, due to the presence of positive symptoms of schizophrenia. The authors investigated the pattern of positive and negative symptoms in patients with dissociative identity disorder, and compared it with norms in schizophrenia. A total of 108 patients with a clinical diagnosis of dissociative identity disorder were administered the Positive and Negative Syndrome Scale.