Assessment and Diagnosis of DID
This chapter describes basic assessment methods to identify the presence of dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS). These methods include diagnostic face-to-face interviews, screening instruments, and assessment instruments. Most patients with DID have spent years in the mental health system with incorrect primary diagnoses, such as schizophrenia, bipolar disorder, and anxiety disorders, before being correctly diagnosed. The primary reason for this is that most clinicians have not been adequately trained in graduate school or medical school to recognize dissociative disorders, if they have been trained for this at all. Frequently, the training they have received has included a bias against recognition of the existence of DID; furthermore, those who are willing to consider DID as a diagnosis have often been taught that the presentation of DID is florid, with switching that is easy to spot. To the contrary, “only 6% make their DID obvious on an ongoing basis” (Kluft, 2009, p. 600). Also, the result of poor clinical training, but much less frequent, is false-positive diagnoses. Clinicians who have not been adequately trained in differential diagnosis (including dissociative disorders) are more likely to make mistakes in either direction.