Silberg J L
Sheppard Pratt Health System, Towson, Maryland, USA.
J Pers Assess. 1998 Dec;71(3):421-39. doi: 10.1207/s15327752jpa7103_10.
The purpose of this study was to investigate psychological testing features of children and adolescents with dissociative disorder diagnoses to provide diagnostic information that might facilitate early intervention. The psychological testing protocols of 30 children diagnosed with dissociative disorders 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 dissociative disorder not otherwise specified (DDNOS) diagnosis. A rater, blind to the diagnosis, scored these protocols for the presence or absence of behavioral and testing response variables hypothesized to discriminate between the dissociative patients and the mixed group of other diagnoses. Behavioral features significantly more common in the dissociative group included forgetting, staring, unusual motor behaviors, dramatic fluctuations, fearful and angry reactions to stimuli, physical complaints during testing, and expressions of internal conflict. Significant indications of dissociation in the test responses included images of multiplicity, malevolent religiosity, dissociative coping, depersonalized imagery, emotional confusion, extreme dichotomization, 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 discriminant validity of DID and DDNOS as diagnostic categories in childhood and provide clinical information that may be useful for early diagnosis of traumatized children with dissociative pathology.
本研究的目的是调查患有分离性障碍的儿童和青少年的心理测试特征，以提供可能有助于早期干预的诊断信息。将30名被诊断为分离性障碍的儿童的心理测试方案与连续30名入住谢泼德·普拉特医院且未被诊断为分离性身份障碍（DID；以前称为多重人格障碍）或未另行指定的分离性障碍（DDNOS）的患者的测试方案进行比较。一名对诊断不知情的评估者对这些方案进行评分，以确定是否存在假设可区分分离性障碍患者与其他诊断混合组的行为和测试反应变量。在分离性障碍组中明显更常见的行为特征包括遗忘、凝视、异常运动行为、剧烈波动、对刺激的恐惧和愤怒反应、测试期间的身体不适以及内心冲突的表达。测试反应中明显的分离迹象包括多重性形象、恶意宗教信仰、分离性应对、人格解体形象、情绪混乱、极端二分法、残害和折磨形象以及神奇转变。这些行为和反应变量的组合能够筛选出93%的分离性障碍样本。这些结果为DID和DDNOS作为儿童诊断类别的判别效度提供了支持，并提供了可能有助于早期诊断患有分离性病理的受创伤儿童的临床信息。
