Dissociative disorders/ DSM 5

over the past year I have been including the DSM 5 website in posts where members have had questions related to what DID is and the changes the American Psychaitric Associations was doing to dissociative disorders..

We now have our copy of the DSM 5 here at the crisis center where I work..

here is what the DSM 5 says for the diagnostic criteria of DID ......as recognized ........by the American Psychiatric Association/DSM 5....

Dissociative Identity Disorder 300.14 (F44.81)

A. Disruption of identity characterized by two or more distinct personality states which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.

B. Recurrent gaps in the recall of every day events, important personal information, and or traumatic events that are inconstant with ordinary forgetting.

C the symptoms cause clinical significant distress or impairment in social, occupational or other important areas of functioning.

D. The disturbance is not a normal part of a broadly accepted cultural or religious practice.

Note in children the symptoms are not better explained by imaginary playmates or other fantasy play.

E. The Symptoms are not attributable to the physiological effects of a substance (e.g. Blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g. complex partial seizures)

along with this diagnostic criteria are 5 pages that go into more detail in categories of diagnostic features that explains the above diagnostics in more detail, Associated features supporting diagnosis, the statistical prevalence of the disorder, the development and course of the disorder, Risk and Prognosis Factors, Culture Related Diagnostic Issues, Suicide Risks and the Functional consequences of this disorder. The DSM 5 also addresses Differential Diagnosis (other dissociative disorders that share the same symptoms) and Comorbidity (having more than one diagnosis)

The DSM 5 diagnostics for the dissociative Disorder now known as depersonalization/derealization disorder is....

Depersonalization/derealization Disorder 300.6 (F48.1)

A the presence of persistant or recurrent experiences of depersonalization, derealization or both:

1. Depersonalization: Experiences of unreality, detachment or being outside observer with respect to ones thoughts, feelings, sensations, body or actions (e.g perceptual alterations, distorted sense of time, unreal or absent self, emotional or physical numbing)

2. Derealization: experiences of unreality or detachment with respect to surroundings (e.g. individuals or objects are experienced as unreal dreamlike, foggy, lifeless or visually distorted)

B. During the depersonalization or derealization experiences, reality testing remains intact.

C. the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. the disturbance is not attributable to the physiological effects of a substance (e.g. a drug of abuse, medication) or other medical condition. (e.g. Seizures)

E. The disturbance is not better explained by another mental disorder such as schizophrenia, panic disorder, major depressive disorder, acute stress disorder, post traumatic stress disorder or other dissociative disorder.

the DSM 5 also goes through the categories of diagnostic features, associated features supporting diagnosis, prevalence, development and course, Risk and Prognosis Factors, Cultural Related Diagnostic issues, Functional consequences of depersonalization/derealization disorder, differential diagnosis, and comorbidity.

for Dissociative Amnesia the DSM 5 has these diagnostic criteria.....

Dissociative Amnesia 300.12 (F44.0)

A. An inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting.

Note: Dissociative Amnesia most often consists of localized or selective amnesia for a specific event or events or generalized amnesia for identity and life history.

B. the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The disturbance is not attributable to the physiological effects of a substance (e.g. alcohol or other drug of abuse, a medication) or a neurological or other medical condition (e.g. partial complex seizures, transient global amnesia, sequalae of a closed head injury/traumatic brain injury, or other neurological condition)

D. The disturbance is not better explained by dissociative identity disorder, posttraumatic stress disorder, acute stress disorder, somatic symptom disorder, or major or mild neurocognitive disorder.

Coding note: the code for dissociative amnesia without dissociative Fugue is 300.12 (F44.0) The code for dissociative amnesia with dissociative Fugue is 300.13 (F44.1)

Specify if:
300.13 (F44.1) with dissociative Fugue: Apparently purposeful travel or bewildered wandering that is associated with amnesia for identity or for other important autobiographical information.

The DSM covers the same categories as already stated for DID and depersonalization/derealization disorder.

as many are aware the Diagnostic label DDNOS has been eliminated from the DSM. DDNOS is now called ...

Unspecified Dissociative Disorder 300.15 (F44.9)

under this diagnostic label the DSM 5 states....

this category applies to presentations in which symptoms characteristic of dissociative disorder that cause clinically significant distress or impairment in social, occupational or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the dissociative disorders diagnostic class. the Unspecified dissociative disorder category is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific dissociative disorder, and includes presentations for which there is insignificant information to make a more specific diagnosis (e.g. in emergency room settings)

the DSM does not go into any further detail like it did with DID, depersonalization/derealization disorder and dissociative amnesia.

the last dissociative disorder listed in the DSM 5 is...

Other Specified Dissociative Disorder 300.15 (F44.89)

the DSM 5 states....

This category applies to presentations in which symptoms characteristic of a dissociative disorder that causes clinically significant distress or impairment in social, occupational or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the dissociative disorders diagnostic class. The Other Specified Dissociative Disorder category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific dissociative disorder. This is done by recording "Other Specified Dissociative Disorder" followed by the specific reason (e.g. "Dissociative Trance")

Examples of presentations that can be specified using the "other specified" designation include the following:

1. Chronic and recurrent syndromes of mixed dissociative symptoms: This category includes identity disturbance associated with less-than-marked discontinuities in sense of self and agency, or alterations of identity or episodes of possession in an individual who reports no dissociative amnesia.

2. Identity disturbance due to prolonged and intensive coercive persuasion: individuals who have been subjected to intensive coercive persuasion (e.g. brainwashing, thought reform, indoctrination while captive torture, long term political imprisonment, recruitment by sects/cults or by terror organizations) may present with prolonged changes in or conscious questioning of, their identity.

3. Acute Dissociative reactions to stressful events: this category is for acute transient conditions that typically last less than 1 month and sometimes only a few hours or days. These conditions are characterized by constriction of consciousness, depersonalization, derealization,perceptual disturbances (e.g. time slowing, macropsia) micro-amnesias, transient stupor; and or alterations in sensory-motor functioning (e.g. analgesia, paralysis)

4 Dissociative Trance: This condition is characterized by an acute narrowing or complete loss of awareness of immediate surroundings that manifests as profound unresponsiveness or insensitivity to environmental stimuli. the unresponsiveness may be accompanied by minor stereotyped behaviors (e.g. finger movements) of which the individual is unaware and/or that he or she can not control, as well as transient paralysis or loss of consciousness. The dissociative trance is not a normal part of a broadly accepted collective cultural or religious practice.

It is the diagnostic book that treatment providers in the USA are now using / or are in the process of switching over to using for diagnosing dissociative disorders.

other locations, treatment providers, cultures and such may go by different standards, and wording.

Wow... Thank you for this. I was very confused as to where I fit. This helps.

Dear Grand Magnate, I don't think you read my full post.

I was confused at first what you were talking about because you have no other post in this thread so I didnt understand what you felt I didnt read.. then I went back over my replies and saw in ....another thread...I had replied to you.

in that other thread you asked if what you had was DID or something else. then explained your symptoms. my reply to you was that we can not diagnose (tell you whether your problems are DID or not) that what you posted could be anything, any mental or physical health problem, then I gave you two examples of what I mean....the inner child concept and DID alters that some people call inner child. they are two different things but share the same symptoms. acting like a child, reacting like a child, ....and other things.

then I gave you the link for this thread so that you can read what America (USA) goes by for what is and isnt DID. for actual diagnosis of whether or not whats going on with you is DID or something else (your threads title question) you will need to contact your treatment providers who can do actual diagnostic evaluations to see if you fit the above diagnostic criteria for DID if you are in america.

for other countries who do not use the DSM 5 standards for what is and inst DID again you will need to contact your treatment providers who will explain to you what is and isnt DID in your location.

It happen again. The most common way to explain "it" is I lost time. I found myself sitting on a bus heading to downtown. Apparently I told numerous people on the bus I was headed to work but I just recently moved this city and I don't have a job yet. I'm just happy that I'm okay.

Bump....

thanks Alwayschanging for bumping this up when you did. and now I think with all the new people here who may need this Im bumping it up again

now that I have located this thread again I thought I would do a bit of updating. for example ...

when I first posted this thread back in 2013 the DSM 5 was just published by the American Psychiatric Association. The APA is the nationwide agency here in america where one of its jobs is to over see, and put together what mental disorders there are in america, what their diagnostics are, and much more.When I first posted this thread American treatment providers were just transferring over to using the new standards, rules, tests, diagnostics,....put int place by the APA. Treatment providers were given a two year grace period where they would not be held accountable for using outdated standards.

it is now 2018, which means that deadline has come and gone. Treatment providers in the USA must now all be using the DSM 5 and the new mental health system of tests and such. what happens if they dont well if caught they can be prosecuted on many laws depending upon the state they live in. here in my own state I know someone who was prosecuted on NY's state law of causing emotional / physical harm to a mentally challenged person because using the out dated diagnostics and procedures caused the person to be diagnosed with a mental disorder they they did not have, and treatment options caused emotional and physical damage.

Im not saying people in general cant use outdated terms and such when talking about their mental disorders, just that treatment providers are no longer allowed to use outdated diagnostics, outdated tests...

the next update I would like to do in this thread is that now 5 years later, after the new standards went into place the rest of the world is now also using the DSM 5.........Along with.......their own manuals.

as some of you know a few months back I was doing some research and part of that involved my contacting american embassy's around the world to verify what diagnostic manuals that country uses and what dissociative disorders they have in those countries.. the answers I got back was that every country around the world now uses the DSM 5 along with their own countries diagnostic manuals.

Now that all the countries of the world are now on the same page. this means that if someone from another country moves to america their diagnosis wont change, they will still be able to be treated for their mental disorders. and vice versa now americans traveling to other countries or moving to other countries can now have continuity of care also.

another updating to this thread.... since the posting of this thread treatment providers have received many updates called Supplemental Updates from the APA on various mental disorders, definitions, diagnostics .... So for example the testing process that a friend you may now did a month ago or a year ago is not going to be the same tests and testing process that you may go through today, tomorrow ....These Supplemental Updates are not available to just anyone. Usually just treatment providers, but sometimes they are opened up in survey form after the changes have been in place and used for a while.

In other words people can research online and self diagnose but most likely they will not be able to do so with accuracy and treatment providers will know when someone is trying to fit their self into a mental disorder.

for example most do not know that OSDD is actually a "category" so to speak, Thats what I call it anyway. it has a complete listing of other dissociative disorder names that is not public. A person can tell their treatment provider they have OSDD and which diagnostics from the DSM 5 but they cant explain what that number means, what the actual disorder name for number 1 diagnostic is, or number 2 diagnostic is.........Unless they have gone through the diagnostic process and told the actual disorder name of their other specified dissociative disorder.

there is a reason why this was put into place.... many people were diagnosed and thrown into a melting pot diagnosis in each mental disorder called NOS, when they actually didnt have a disorder or the treatment provider could not figure out what that persons problem was, .... all kinds of reasons americans were dumped into the NOS diagnosis's.

now people are not just randomly diagnosed and shoved into a melting pot diagnosis for what ever reasons. now any time anyone sees the wording "other Specified" or its abbreviation "OS" that means the diagnosing treatment provider must tell you why you are in that category and what your actual disorder name is that is not listed in the DSM 5.

example on my files my OSDD diagnosis is wrote like this.....

diagnosis...... OSDD- Macropsia, tachypsychia, mixed 38 (my diagnosis category first, then the two actual other dissociative disorder names then severity and number from one of the testing scales)

if you read the DSM5 diagnostics for OSDD you will find some examples of disorder names but you will not find the complete listing, and what each disorder labels defining information. for that you get from your treatment providers.

my point please dont use this thread for diagnostic purposes, whats in the information is only what I quoted from the DSM 5. it does not contain any of the information that you will get from your treatment providers and from the Supplemental Updates that treatment providers receive.

like the disclaimer at the bottom of the page says, nothing on psych central is meant for diagnostic purposes. please consult own treatment providers.

I wanted to add something here.... many many not remember or if new, dont know the back story on this thread ..... I mean its was 5 years ago when this thread first was posted...

In may 2013 the APA put in place a new mental health system that included spending decades working on the then existing diagnostic manual called the DSM IV TR, going through it, revising, being in contact with treatment providers and the mentally and anyone else that dealt with the mentally ill. they did this work through mental health statistics, feedback from mental health professionals, survey reports including from those with mental illness who chose to take part in this process of creating the new diagnostic manual DSM 5 and the new mental health standards. they also notified the world on what steps they were at and how to participate in what they are doing, by way of a website named for the new diagnostic manual DSM 5. ( dsm5.org ) finally after decades of work and collaborating with professionals from around the world the DSM 5 was complete and available to treatment providers and anyone else that had the hundreds of dollars to get one.

well here on psych central shortly before the DSM 5 release and after, posts began to show up of members frustration over not being able to afford the DSM 5, scared because their treatment providers were changing their diagnosis's and not knowing how and why, scared because of all the rumors floating around the web that their mental disorder no longer existed, posts asking other members if they had a DSM5 and could they look up this or that, posts asking each other what the diagnostic criteria was for dissociative disorders now.....

thought I would be nice and use the DSM 5 at my work, spend hours typing in the main DSM 5 pages on dissociative disorders for those on the dissociative boards and the PTSD information on the PTSD board so that other members could have the information ..........for free.......... that they were looking for, rather than they having to pay hundreds of dollars to purchase their own or wait months and months possibly a year for their own treatment providers and libraries to decide to get a copy of the DSM 5.

like already stated this information is not for diagnostic purposes. No where in this thread or site am I using this info to diagnose. in fact most if not all my posts and threads include a disclaimer to contact ones own treatment providers if you feel you may have a mental disorder.

I realize that not everyone needs or wants this information.

But some do and thats what this is for.

the fact of the matter is the DSM 5 is in world wide usage now so whether its me or someone else on psych central using their access to a DSM 5 and copying the information onto the boards no matter what the mental disorder, so that others can have that information about their mental disorders, its going to happen.