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.
| Steinberg, M; Bancroft, J; Buchanan, J (1993) Multiple personality disorder in criminal law. Bull Am Acad Psychiatry Law 21:345-56 |
