Since I started writing about dissociation with a plan to explain the different forms of dissociative disorders, our way of understanding them has changed. Or at least our way of characterizing them in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5) has changed.
Previously, four main categories of dissociative disorders were identified in the DSM-IV-R: Dissociative Amnesia, Dissociative Fugue, Dissociative Identity Disorder, and Depersonalization Disorder. Those who did not meet all the criteria for one of those four could be diagnosed with Dissociative Disorder Not Otherwise Specified.
Changes regarding the diagnosing of dissociative disorders in the DSM-5 include the following:
- Derealization is included in the name and symptom structure of what previously was called depersonalization disorder and is now called depersonalization/derealization disorder.
- Dissociative fugue is now a specifier of dissociative amnesia rather than a separate diagnosis.
- The criteria for dissociative identity disorder have been changed to indicate that symptoms of disruption of identity may be reported by the client as well as observed by the clinician, and that gaps in the recall of events may occur for everyday and not just traumatic events. Also, experiences of pathological possession in some cultures are included in the description of identity disruption.
- Dissociative Disorder Not Otherwise Specified is now referred to as Other Specified Dissociative Disorder
- A diagnosis of Unspecified Dissociative Disorder has been added.
Are you familiar with these changes? Do they make sense? Further our understanding or improve treatment? Let me know what you think!