Assessment of Dissociation, Trauma-Related Disorders, and Dissociative Disorders
Bethany L. Brand, Hugo J. Schielke, Francesca Schiavone, Ruth A. Lanius
Finding Solid Ground: Overcoming Obstacles in Trauma Treatment July 1, 2022 DOI: 10.1093/med-psych/9780190636081.003.0002 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Practical guide or manual Peer reviewed |
|---|---|
| Key points | Argues that trauma-related and dissociative disorders are frequently underdiagnosed and misdiagnosed because clinicians lack training in their assessment, leading symptoms to be mistaken for psychosis, bipolar disorder, borderline personality disorder, or malingering. Proposes that structured and self-report assessment tools, combined with clinical interviewing and attention to comorbidities and differential diagnosis, can improve recognition and treatment access. |
Abstract
The assessment of trauma-related disorders (TRD) and dissociative disorders (DD) is not widely taught. Accurate assessment of dissociative symptoms can be challenging without adequate training. Clinicians who have not been trained in assessing TRD may mistakenly attribute TRD and DD symptoms to psychosis, bipolar disorder, borderline personality disorder, or malingering. As a result, TRD and DD are frequently underdiagnosed and misdiagnosed, preventing these highly symptomatic individuals from receiving appropriate treatment. This chapter provides a practical overview of the assessment of trauma-related and dissociative symptoms, including self-report measures and structured assessment tools that can complement the clinical interview; the assessment of common comorbidities; methods of distinguishing TRD and DD from diagnoses with similar presentations; and potential alternative explanations for apparently dissociative experiences. The chapter also discusses the possible challenges and pitfalls of using “general” psychological assessment instruments that have not been validated with individuals with complex trauma histories.