diagnosis

when getting a diagnosis from a psychiatrist, what do they do exactly to determine you have DID?

I did tests, a lot of tests. Which are then used to come up with a diagnostic score that is set against standardized criteria to determine what the subject may be experiencing. In a generalized summary

Familyof3 wrote:when getting a diagnosis from a psychiatrist, what do they do exactly to determine you have DID?

First of all, for diagnosis I would consult a clinical psychologist, not a psychiatrist. Although there are notable exceptions, many psychiatrists do little or no formal diagnostic work and will instead rely on "clinical impression" which generally means they wing it.

There are a variety of diagnostic tools available. All of them are just paperwork that you are given to read and fill out, or that another person fills out while talking with you. Some tools ask about your history; I recommend avoiding these as they tend to be retraumatizing. Also, you have the right to refuse to answer any questions that explore trauma. Other tools just ask about your current signs and symptoms. Then someone reads over the paperwork and scores it, and writes an assessment report. Often the scoring is complicated and the report takes hours to write.

The two best tools for diagnosing DID are the SCID-D-R by Marlene Steinberg and the MID by Paul Dell. Note this is SCID-D-R, not SCID or SCID-I or SCID-II.

There are many other tools, screening tools, that often are used first. They are fast and easy to use and to score. These include the DES, SDQ-20, and others.

What Una said! :p (I SAID mine was general) *giggle*

We’re not diagnosed yet, but I feel that we’re incredibly close. Yes, avoid psychiatrists unless you want medicine. We were referred to one, who then referred us to a psychologist. It took three sessions for the psychiatrist to actually say she didn’t believe in DID (to an alter, no less), and all we got from visiting her was a Dx of Brief Reactive Psychosis (we didn’t discuss it, I found this later on a report) and a prescription to Abilify (admittedly, this has helped us tremendously) for PTSD symptoms.

As for the psychologist, I had a prognosis of DID after the first visit. So definitely be careful in who you see. It makes all the difference in the world.

-Jeff

Una+ and others, I believe the MID is more properly characterized as a screener (like the DES and the SDQ), and not considered diagnostic. This can be seen in a recent article analyzing those three instruments against a SCID-D result, where it was shown: 1) even low scores on these screeners need to be followed up with a SCID-D, as many in the study with low scores on screeners were shown to register a dissociative disorder when studied in more detail via a SCID-D., 2) if you set the cutoff on screeners low in order to capture a high percentage of those with a dissociative disorder, you admit a have a high false positive rate, as the screeners will flag up to 40% false positives, 3) The MID was only as effective as the SDQ, and in fact the somatic subscale of the MID was better than the overall MID in terms of efficiency in identifying those likely to have a dissociative disorder. The paper I am referring to can be seen at the following link: http://ge.tt/9idxM4s/v/0?c

Thank you everyone for your replies