Being diagnosed as having a dissociative disorder is by no means straightforward. The ISSTD Guidelines for Treating DID in Adults (2011) give four reasons for these difficulties:
- There is a lack of education amongst clinicians about dissociation, dissociative disorders and trauma.
- Most clinicians wrongly believe that dissociative identity disorder is “a rare disorder, with a florid, dramatic presentation” (p.117).
- The standard diagnostic tools and mental status examinations that most clinicians have been taught to use during professional training do not include questions about dissociation, post-
traumatic symptoms or a history of trauma.
- Having received little or no training in dissociative disorders, many clinicians have difficulty recognising the signs and symptoms.
DIAGNOSIS VS. MISDIAGNOSIS
The ISSTD assert that assessment for dissociation should be part of every diagnostic interview, given that dissociative disorders are “at least as common, if not more common, than many other psychiatric disorders that are routinely considered in psychiatric evaluations” (p.124). A number of diagnostic tools have become available in recent years to assist with screening and diagnosis of dissociative disorders, and a summary of the most well-
Diagnosis of dissociative identity disorder is generally dependent on the criteria in the DSM-
Both view manuals view dissociative disorders somewhat differently. The DSM understands dissociative disorders as being chronic, long-
Prior to the updated DSM-
WHY IS A CORRECT DIAGNOSIS DIFFICULT TO ACHIEVE?
Dissociative identity disorder is often misdiagnosed and research suggests that people with DID usually spend between 5 and 12 years in the mental health system before receiving a correct diagnosis (ISSTD, 2011). Part of the reason for this is that people with DID often present to mental health professionals with a range of symptoms, with the specifically dissociative and post-
In the UK, getting a diagnosis for dissociative identity disorder can be extremely difficult. Many psychiatric teams do not accept the existence of the diagnosis, having been taught that it is controversial and not supported by research. Although this is patently not true, it can often be difficult to shift this mindset, and a diagnosis of borderline personality disorder or complex post traumatic stress disorder may often be the outcome in these circumstances. There are a number of individuals and organisations who provide private services and diagnostic testing for dissociative disorders—if this is a route you would like to consider, please contact PODS who can put you in touch with the relevant people.
DIAGNOSIS OF DISSOCIATIVE IDENTITY DISORDER – ADVANTAGES AND DISADVANTAGES
There are both advantages and disadvantages to receiving a diagnosis of dissociative identity disorder. The greatest benefit is receiving appropriate, publicly-
DIAGNOSIS OF DISSOCIATIVE IDENTITY DISORDER – RISK FACTORS
The risks associated with diagnosis include difficulty in obtaining life or travel insurance, and discrimination in the workplace (illegal though that may be). A correct diagnosis is rarely a guarantee of appropriate treatment, and in some cases it can mean no treatment at all as the patient is seen as ‘too complex’.
Suzette Boon helpfully comments:
…diagnosis is important, because it provides a map for you and your therapist to follow so that you get proper help…But it is probably more helpful for you to focus on what will aid you in resolving the dissociation that hampers your life, rather than to worry too much about your diagnosis.
(Boon et al, 2011, p.11)