Discriminating among Diagnostic Categories Using the Dissociative Disorders Interview Schedule

The Dissociative Disorders Interview Schedule was administered to 1,308 subjects in eight diagnostic categories, including 296 with dissociative identity disorder. The study tested three hypotheses: (1) the Mahalanobis distance between dissociative identity disorder and each of seven other diagnostic categories would be large, (2) the closest diagnostic category to dissociative identity disorder would be dissociative disorder not otherwise specified, and (3) nondissociative diagnostic categories would be closer to each other than any one to dissociative identity disorder. All three hypotheses were confirmed by these data. The findings support the conclusion that dissociative identity disorder is a discrete category or taxon.

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"A naturalistic study of dissociative identity disorder and dissociative disorder not otherwise specified patients treated by community clinicians": Correction to Brand et al. (2009).

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/a0017060 ◽

2009 ◽

Vol 1 (3) ◽

pp. 205-205

Author(s):

Bethany Brand ◽

Catherine Classen ◽

Ruth Lanius ◽

Richard Loewenstein ◽

Scot McNary ◽

...

Keyword(s):

Dissociative Identity Disorder ◽

Dissociative Disorder ◽

Naturalistic Study ◽

Not Otherwise Specified

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Pervasive Refusal Syndrome

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000128 ◽

2011 ◽

Vol 39 (5) ◽

pp. 351-359 ◽

Cited By ~ 6

Author(s):

Thomas Jans ◽

Juliane Ball ◽

Maike Preiss ◽

Michael Haberhausen ◽

Andreas Warnke ◽

...

Keyword(s):

Food Intake ◽

Dissociative Disorders ◽

Dissociative Disorder ◽

Passive Resistance ◽

Diagnostic Categories ◽

Clinical Presentations ◽

Pervasive Refusal Syndrome ◽

Case Vignettes ◽

Life Threatening ◽

Core Features

Pervasive refusal syndrome (PRS) has been proposed as a new diagnostic entity among child and adolescent psychiatric disorders. It is characterized by a cluster of life-threatening symptoms including refusal of food intake, decreased or complete lack of mobilization, and lack of communication as well as a retreat from normal life activities. Active refusal to accept help as well as neglect of personal care have been core features of PRS in the limited number of cases reported in the last decade. There have, however, been cases with predominantly passive resistance, indicating the possibility that there may be a continuum from active refusal to passive resistance within PRS. Postulating this continuum allows for the integration of “depressive devitalization” – a refusal syndrome mainly characterized by passive resistance – into the concept of PRS. Here, three case vignettes of adolescent patients with PRS are presented. The patients’ symptomatology can be allocated on this continuum of active refusal to passive resistance supporting the usefulness of such a continuum in comparing various clinical presentations of PRS. PRS and dissociative disorders are compared in greater detail and contrasted within this discussion of differential diagnoses at the poles of such a continuum. PRS is a useful diagnosis for cases involving symptoms of predominating refusal and retreat which cannot satisfactorily be classified by existing diagnostic categories, and which can mostly clearly be separated from dissociative disorder.

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