DID, PTSD & Dissociation Terms · Diagnosis & Testing
Do I Have DID? How DID Is Diagnosed and What the Tests Can (and Can’t) Tell You
In short: Only a trained clinician can diagnose DID, usually through a careful interview, often over more than one visit. Questionnaires can show that a closer look is worth taking, but no questionnaire or online quiz can tell you that you have DID.
Why is DID hard to recognize?
Many people with DID spend years in mental health care before they are diagnosed. One early study found an average of nearly seven years. DID can look like other conditions, such as depression, bipolar disorder, PTSD, borderline personality disorder, psychotic disorders, or seizure disorders, so a clinician has to rule those out.
What the diagnosis manual says
In the United States, clinicians use the DSM-5-TR. It lists five things that must all be true for a DID diagnosis:
- Two or more distinct personality states. There are clear changes in a person’s sense of self and sense of control, along with changes in feelings, behavior, memory, perception, or thinking. Some cultures describe this as possession. Others may notice it, or the person may report it.
- Repeated memory gaps for everyday events, important personal information, or traumatic events, more than ordinary forgetting.
- Real distress or trouble in daily life, work, or relationships.
- Not part of a widely accepted cultural or religious practice. In children, it isn’t explained by imaginary friends or pretend play.
- Not caused by alcohol, drugs, or a medical condition such as seizures.
Most other countries use the World Health Organization’s ICD-11, which includes DID and a separate diagnosis called Partial DID.
Screening questionnaires (you fill these out)
- DES (Dissociative Experiences Scale). Made in 1986 by Eve Bernstein and Frank Putnam. It has 28 questions about everyday experiences, like driving somewhere and not remembering the trip. Scores run from 0 to 100. Its authors suggest that a score of 30 or more means a fuller evaluation is worth doing. The DES has been used in hundreds of studies and gives steady, consistent results.
- MID (Multidimensional Inventory of Dissociation). Made by Paul Dell in 2006. It has 218 questions, including 50 that check whether answers are consistent. Research shows it is reliable, but it is long.
Diagnostic interviews (a trained clinician asks the questions)
- SCID-D (Structured Clinical Interview for Dissociative Disorders). Made by Marlene Steinberg at Yale. It asks about five core experiences: memory gaps (amnesia), feeling unreal or outside yourself (depersonalization), the world feeling unreal (derealization), confusion about who you are, and changes in who you are. A 2021 review of 15 studies found it does a good job telling dissociative disorders apart from other conditions, and from people who are pretending.
- DDIS (Dissociative Disorders Interview Schedule). Made by Colin Ross and colleagues in 1989. In its first study, it correctly identified 90% of people already diagnosed with what was then called multiple personality disorder, and it did not wrongly identify anyone who didn’t have it.
How good are these tests?
Two words come up a lot. Reliable means a test gives about the same result each time. Valid means it really measures what it says it measures.
Questionnaires like the DES are for screening, not diagnosis. In one large study, only about 17 of every 100 people who scored 30 or higher on the DES actually had DID, while 99 of every 100 who scored under 30 did not. So a high score means “worth a closer look,” and a low score makes DID unlikely. Interviews like the SCID-D are more accurate but need a trained person to give them.
Researchers also disagree about where DID comes from. Those who hold the trauma model say research shows trauma causes dissociation. Those who hold the sociocognitive model say therapy, media, and suggestion play a bigger part than trauma. Each side has published reviews arguing its case.
About online DID quizzes
Online quizzes, including Ivory Garden’s own DID Quiz, are not diagnostic tools or a substitute for evaluation by a qualified mental health professional. They are intended simply as informal tools for curiosity and personal reflection, and should be taken with a grain of salt rather than used to diagnose yourself or anyone else.
If you think you might have DID
It can help to write down the experiences that worry you, such as lost time or memory gaps, so you can share them. Look for a clinician who has training in trauma and dissociation. Our Where to Find a Therapist page explains where to look. You can also ask whether they use a structured interview, such as the SCID-D or DDIS.
A note about theories
The therapies and theories about trauma and DID are ideas that researchers are still studying and arguing about. None of them are proven facts. What works for one person may not work for another. Please take the time to read about any therapy yourself, ask questions, and decide what feels right for you.
Sources
American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.; DSM-5-TR).
World Health Organization. International Classification of Diseases, 11th Revision (ICD-11).
Putnam, F. W., Guroff, J. J., Silberman, E. K., Barban, L., & Post, R. M. (1986). The clinical phenomenology of multiple personality disorder: Review of 100 recent cases. Journal of Clinical Psychiatry, 47(6), 285–293.
Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease, 174(12), 727–735.
Carlson, E. B., & Putnam, F. W. (1993). An update on the Dissociative Experiences Scale. Dissociation, 6(1), 16–27.
Carlson, E. B., Putnam, F. W., Ross, C. A., et al. (1993). Validity of the Dissociative Experiences Scale in screening for multiple personality disorder: A multicenter study. American Journal of Psychiatry, 150(7), 1030–1036.
van IJzendoorn, M. H., & Schuengel, C. (1996). The measurement of dissociation in normal and clinical populations: Meta-analytic validation of the Dissociative Experiences Scale (DES). Clinical Psychology Review, 16(5), 365–382.
Dell, P. F. (2006). The Multidimensional Inventory of Dissociation (MID): A comprehensive measure of pathological dissociation. Journal of Trauma & Dissociation, 7(2), 77–106.
Steinberg, M., Cicchetti, D., Buchanan, J., Hall, P., & Rounsaville, B. (1993). Clinical assessment of dissociative symptoms and disorders: The Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). Dissociation, 6(1), 3–15.
Mychailyszyn, M. P., Brand, B. L., Webermann, A. R., Şar, V., & Draijer, N. (2021). Differentiating dissociative from non-dissociative disorders: A meta-analysis of the Structured Clinical Interview for DSM Dissociative Disorders (SCID-D). Journal of Trauma & Dissociation, 22(1), 19–34.
Ross, C. A., Heber, S., Norton, G. R., Anderson, D., Anderson, G., & Barchet, P. (1989). The Dissociative Disorders Interview Schedule: A structured interview. Dissociation, 2(3), 169–189.
Dalenberg, C. J., Brand, B. L., Gleaves, D. H., et al. (2012). Evaluation of the evidence for the trauma and fantasy models of dissociation. Psychological Bulletin, 138(3), 550–588.
Lynn, S. J., Lilienfeld, S. O., Merckelbach, H., et al. (2014). The trauma model of dissociation: Inconvenient truths and stubborn fictions. Comment on Dalenberg et al. (2012). Psychological Bulletin, 140(3), 896–910.
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