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Differential diagnosis

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Re: Differential diagnosis

Postby under ice » Sun Jul 24, 2011 6:44 am

How does one count the points for the Dissociative Disorders Interview Schedule?
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Re: Differential diagnosis

Postby brandic » Sun Jul 24, 2011 8:14 am

If you go to this website and take the test...

http://www.rossinst.com/sample_forms.html

after you take it it explains how to score it.

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Caroline
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Brandic (me), Asher, RAGE, Samantha, young violent part, young me (scared part), protector (semi-mute), "the part who feels no pain"

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http://nothinginmynoggin.wordpress.com/
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Re: Differential diagnosis

Postby under ice » Sun Jul 24, 2011 11:43 am

I have a couple of questions regarding the test. When a person with DID hears voices or conversation inside, is it something that you actually hear with your ears, like an auditory hallucination as if there were actual people speaking to you or with each other in the same space? Or is it 'mental' conversation? Can you actually tell this inner conversation from actual physical people talking?

Moreover I didn't understand this:
130. Is the problem with different identities or personalities due to substance abuse (e.g. alcohol blackouts) or a general medical condition?

Yes=1 No=2 Unsure=3 [ ]

Dissociative Identity Disorder

This is scored by DSM-IV rules. The subject must be positive for questions 127-130 to receive a diagnosis of DID.


Is it saying that you have to answer 'yes' to question 130 in order to receive a diagnosis of DID?
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Re: Differential diagnosis

Postby ZeldaZonk » Sun Jul 24, 2011 12:07 pm

under ice wrote:Is it saying that you have to answer 'yes' to question 130 in order to receive a diagnosis of DID?


This confused me too. Surely the answer to Q.130 would have to be 'no'...
Maybe a 'no' on this question constitutes a 'positive' answer? Am I clutching at straws?
Anyway, common sense says it would have to be a 'no'.

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Re: Differential diagnosis

Postby Una+ » Sun Jul 24, 2011 12:51 pm

under ice wrote:Moreover I didn't understand this:
130. Is the problem with different identities or personalities due to substance abuse (e.g. alcohol blackouts) or a general medical condition?

Yes=1 No=2 Unsure=3 [ ]

Dissociative Identity Disorder

This is scored by DSM-IV rules. The subject must be positive for questions 127-130 to receive a diagnosis of DID.


Is it saying that you have to answer 'yes' to question 130 in order to receive a diagnosis of DID?

That is what it says but that is the opposite of what DSM-IV says. #130 is missing the word not.
Dx DID older woman married w kids. 0 Una, host + 3, 1, 5. 1 animal. 2 older man. 3 teen girl. 4 girl behind amnesia wall. 5 girl in love. Our thread.
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Re: Differential diagnosis

Postby yakusoku » Mon Jul 25, 2011 2:06 am

This was enlightening, so I'll share my results.

Somatic complaints - YES. 17 definite yes, not including the unsure (which were mostly me thinking there are other causes, but I rarely go to the doctor unless something is pretty horrific).

Substance abuse - NO.

Psychiatric history - NO prior diagnoses that I know of, because the only other time I've been in therapy was as a very young child and I barely remember it.

Major Depressive Episode - YES to all of those questions, LOL.

Schneiderian First Rank Symptoms - 5 YES and 3 Unsure, because I know those things are internal, even if they don't feel like me.

Sleepwalking - NO, Trances - YES, Childhood Companions - UNSURE

Childhood Abuse - YES

Supernatural Experiences - 3 YES

Borderline Personality Disorder - 5 YES

Dissociative Amnesia - MAYBE? I wasn't sure I could call myself impaired...

Dissociative Fugue - NO

Depersonalization - YES

DID - YES

DDNOS - NO...well, I don't think so, at least. :roll:


Yet, part of me thinks I'm still making this all up, LOL!!!
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Re: Differential diagnosis

Postby Una+ » Mon Jul 25, 2011 3:00 am

yakusoku wrote:Schneiderian First Rank Symptoms - 5 YES and 3 Unsure, because I know those things are internal, even if they don't feel like me.

Exactly. This is why these are symptoms of DID, not of schizophrenia. Schizophrenia involves the same symptoms plus the delusion that the symptoms originate in the environment.
Dx DID older woman married w kids. 0 Una, host + 3, 1, 5. 1 animal. 2 older man. 3 teen girl. 4 girl behind amnesia wall. 5 girl in love. Our thread.
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Re: Differential diagnosis

Postby Una+ » Thu Aug 11, 2011 7:34 pm

A new research article about schizophrenia reviews how the (apparent) psychotic signs and symptoms used in DSM-V and ICD-10 to diagnose schizophrenia are not core features of schizophrenia.

A Disappearing Heritage: The Clinical Core of Schizophrenia by J. Parnas, Schizophr Bull. 2011 Jul 19

This article traces the fundamental descriptive features of schizophrenia described in the European continental literature form Kraepelin and Bleuler, culminating with the creation of the International Classification of Diseases (ICD)-8 (1974). There was a consensus among the researchers that the specificity and typicality of schizophrenia was anchored to its "fundamental" clinical core (with trait status) and not to positive psychotic features, which were considered as "state", "accessory" phenomena. The clinical core of schizophrenia was, in a diluted form, constitutive of the spectrum conditions ("schizoidia" and "latent schizophrenia"). The fundamental features are manifest across all domains of consciousness: subjective experience, expression, cognition, affectivity, behavior, and willing. Yet, the specificity of the core was only graspable at a more comprehensive Gestalt-level, variously designated (eg, discordance, autism, "Spaltung"), and not on the level of single features. In other words, the phenomenological specificity was seen as being expressive of a fundamental structural or formal change of the patient's mentality (consciousness, subjectivity). This overall change transpires through the single symptoms and signs, lending them a characteristic phenomenological pattern. This concept of schizophrenia bears little resemblance to the current operational definitions. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and ICD-10 seem to diagnose a subset of patients with chronic paranoid-hallucinatory variant of schizophrenia.

The article is free online via PubMed: link
Dx DID older woman married w kids. 0 Una, host + 3, 1, 5. 1 animal. 2 older man. 3 teen girl. 4 girl behind amnesia wall. 5 girl in love. Our thread.
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Re: Differential diagnosis

Postby Una+ » Thu Aug 25, 2011 3:20 pm

The Multidimensional Inventory of Dissociation (MID) is a very detailed diagnostic inventory developed by Paul F. Dell. Scoring the results requires an Excel spreadsheet. A therapist can get the spreadsheet from Dr. Dell by e-mail, or ISSTD member therapists can download it from the ISSTD website members-only area.

MID results for me were consistent with my understanding of my situation: diagnosis DDNOS or DID, plus PTSD; significant somatization and Schneiderian first rank symptoms, no character disorder.

I scored very low on "made feelings", so low that my T and I checked for data entry errors and we concluded that I had systematically scored myself in an unusual way on all questions concerning mood. I understood mood as referring to emotional climate whereas it was meant to refer to emotional weather. My T says my climate is stable from session to session but my weather is often extreme with rapid changes. Weeping one minute, laughing and cheerful the next. This is true. She say she sees this consistently in her DID clients and the variable affect is easy to mistake for bipolar disorder but it is totally different. The difference is that with DID the affect varies in accord with the varied thoughts and attitudes of the alters; the affect is consistent and what actually varies is the source identity that is producing the affect.

PDF Download: Multidimensional Inventory of Dissociation
Dx DID older woman married w kids. 0 Una, host + 3, 1, 5. 1 animal. 2 older man. 3 teen girl. 4 girl behind amnesia wall. 5 girl in love. Our thread.
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Re: Differential diagnosis

Postby Una+ » Mon May 29, 2017 4:43 pm

Dx DID older woman married w kids. 0 Una, host + 3, 1, 5. 1 animal. 2 older man. 3 teen girl. 4 girl behind amnesia wall. 5 girl in love. Our thread.
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