Psychopathology: Theory and Practice

The assessment of dissociative disorders

In this presentation, Remy Aquarone, director of the Pottergate center, Norwich, UK, explains the value of the Structured Clinical Interview (SCID-D). This assessment instrument was created for the diagnosis of DSM-IV Axis 1 disorders, a list that includes Dissociative Disorders. Remy Aquarone takes us through the criteria for the assessment and diagnosis of dissociation disorders, giving detailed explanation of key symptoms. These include the five dissociative disorders outlined in DSM-IV: Dissociative amnesia, dissociative fugue, depersonalisation disorder, dissociative disorders (not otherwise specified) and dissociative identity disorders (DID). He outlines the importance of a structured assessment process for distinguishing between dissociative disorders and other possible diagnoses so that an appropriate treatment strategy can be reached. He continues to describe how symptoms of past trauma bring people into treatment, the challenges and rigors of effective psychotherapy and an effective treatment approach. The presentation stresses the importance of firm structures, boundaries and supporting the patient’s need to include a coping adult personality/part in the therapeutic alliance. The goal of therapy is discussed, including views on the importance of integration.