This R01 protocol is being submitted in conjunction with a Research Scientist Award, during support from which the applicant will serve as principal investigator on a series of projects designed to advance knowledge on diagnosis and treatment of the dissociative disorders. During the past ten years there has been a dramatic increase in attention to the five dissociative disorders. Recent research indicates the high prevalence of dissociative symptoms accompanying a broad range of psychiatric disorders. Statistics on the prevalence of dissociative disorders vary widely. Given the growing identification of dissociative symptoms and syndromes as post-traumatic and the high incidence of abuse in the psychiatric population, screening for dissociative symptoms is essential. Diagnosis is hampered without adequate screening, but comprehensive diagnostic testing is time-consuming. Brief screening methods are needed to assist in both clinical diagnosis and epidemiological research. The Mini-SCID-D Screening Inventory has been developed as an efficient, rapidly administered diagnostic tool to screen patients for dissociative disorders according to DSM-IV criteria. In contrast to other screening instruments, the Mini-SCID-D is designed to aid in screening for the five dissociative disorders, and dissociative symptoms associated with other psychiatric disorders. If indicated, the full Structured Clinical Interview for DSM-III R Dissociative Disorders(SCID-D) can then be administered. We propose to assess the reliability, sensitivity, specificity, and other psychometric properties of the Mini-SCID-D by administering the Mini-SCID-D to a sample of 300 out-patients diagnosed with dissociative disorders, anxiety disorders including post-traumatic stress disorder, and the personality disorders including borderline personality, as well as to 200 in-patients with a variety of psychiatric disorders. The Mini-SCID-D and several other psychiatric tests will be administered by experienced clinicians trained for this purpose, using materials from the pilot phase of this project. The Mini-SCID-D will be administered twice, once upon entrance in the study, and by a second examiner within one week for inter- rater reliability assessments. The full SCID-D interview will be administered by a separate interviewer following the second Mini-SCID-D interview. Reliability assessments will be made between raters, both for individual items and overall diagnosis. In addition to evaluating the inter-rater and temporal reliability of the Mini-SCID-D, we will also assess sensitivity, specificity, and psychometric properties (e.g., factor structure) of SCID-D items. Data from other screening interviews and diagnostic tests also will be compared with the Mini-SCID-D evaluation. It is expected that the Mini-SCID-D will allow for rapid and efficient screening for the dissociative disorders, which will promote further epidemiological and clinical research on these disorders.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH043352-06
Application #
2245721
Study Section
Psychopathology and Clinical Biology Research Review Committee (PCB)
Project Start
1992-05-15
Project End
1996-04-30
Budget Start
1994-05-01
Budget End
1995-04-30
Support Year
6
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Yale University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Steinberg, M; Bancroft, J; Buchanan, J (1993) Multiple personality disorder in criminal law. Bull Am Acad Psychiatry Law 21:345-56