Dissociative symptomatology in children and adolescents as displayed on psychological testing

The purpose of this study was to investigate psychological testing features of children and adolescents with dissociative disorder diagnoses to provid e diagnostic information that might facilitate early intervention. The psyc hological testing protocols of 30 children diagnosed with dissociative diso rders were compared with the testing protocols of 30 consecutive admissions to the Sheppard Pratt Hospital who did not receive a dissociative identity disorder (DID; formerly termed multiple personality disorder) or dissociat ive disorder not otherwise specified (DDNOS) diagnosis. A rater, blind to t he diagnosis, scored these protocols for the presence or absence of behavio ral and testing response variables hypothesized to discriminate between the dissociative patients and the mixed group of other diagnoses. Behavioral f eatures significantly more common in the dissociative group included forget ting, staring, unusual motor behaviors, dramatic fluctuations, fearful and angry reactions to stimuli, physical complaints during testing, and express ions of internal conflict. Significant indications of dissociation in the t est responses included images of multiplicity, malevolent religiosity, diss ociative coping, depersonalized imagery, emotional confusion, extreme dicho tomization, images of mutilation and torture, and magical transformation. A combination of these behavioral and response variables was able to select 93% of the dissociative sample. These results add support to the discrimina nt validity of DID and DDNOS as diagnostic categories in childhood and prov ide clinical information that may be useful for early diagnosis of traumati zed children with dissociative pathology.