A new instrument, the Clinician Administered Dissociative States Scale (CADSS), was developed to measure present-state dissociative symptoms. Initial analyses showed good interrater reliability and construct validity. CADSS scores successfully discriminated patients with dissociative disorders from patients with other psychiatric disorders and from healthy subjects.
A multidisciplinary, international group used taxonomic principles and a modified Delphi method to create a taxonomy of altered states of consciousness based on central phenomenological features. They identified eight distinct states, some with subcategories: proto and transitional, delirium, minimal to no awareness, experiential detachment, enhanced physicality, altered identity, imaginary/fantasy/visionary, and unity/mystical. The authors hope this taxonomy will foster conceptual clarity and stimulate research across specializations, helping reveal what is common and different across triggers and antecedents of altered states, and encouraging phenomenological, psychological, cultural, and neuroscientific understanding.
About 4.1% of U.S. adults meet criteria for pathological dissociation likely indicating a dissociative disorder. People with pathological dissociation have worse physical and mental health, high rates of most major psychiatric disorders, and are often hospitalized for psychiatric reasons. Over half have attempted suicide—significantly more than those with lifetime major depression. Childhood maltreatment—including physical abuse, witnessing domestic violence, physical neglect, emotional abuse, and emotional neglect—each uniquely and additively predicts the severity of pathological dissociation and its three core experiences: amnesia, depersonalization/derealization, and identity alteration. Maltreatment levels in the pathological dissociation group exceed those in major depression and match those in PTSD, underscoring the need for better diagnosis and treatment of these common and debilitating conditions.