Diagnosis of dissociative identity disorder in children

The purpose of this study was to determine if clinicians considered Dissociative Identity Disorder (DID) as a diagnosis when presented, via case vignettes, with symptoms consistent with those described in the DSM-IV. The study sought to determine if sex, ethnicity, or type of symptom description (i.e., Acting Out vs. Internalized) was a variable in the diagnosis of DID. It was hypothesized that the diagnosis of DID would be made more frequently in female subject vignettes than in male subject vignettes and more frequently in Caucasian vignettes than in African-American vignettes. It was also hypothesized that female children would be diagnosed more often with internalized disorders than the male subject vignettes and that males would be diagnosed with an acting out disorder at a significantly higher rate. Lastly, it was hypothesized that Caucasian subject vignettes would receive fewer acting out diagnoses than those vignettes characterizing African-American children. This resulted in a 2 x 2 x 2 matrix to test these variables.;A total of 500 packets were sent out to licensed psychologists who are members of the California Psychological Association. Each packet contained an introduction letter, a demographic questionnaire, one of the eight case vignettes which were assigned to each name on the mailing list, and a list of common childhood disorders. One hundred and thirty-seven completed surveys were completed and returned.;The results indicated that with the confidence interval calculated for the percentage of missed diagnosis the true population rate of diagnosis of DID is between 64.8% and 79.8%. The results found no significant difference in the rate of DID diagnosis for female vs. male subject vignettes; no significant difference in the rate of DID diagnosis for Caucasian and African-American subject vignettes; no significant effect of the gender of the vignette on the type of diagnosis; and no significant effect of the gender of the vignette on the type of diagnosis. However, supplementary analyses did find that DID diagnoses were given significantly more frequently for vignettes that described a child with Acting Out behavior than a child demonstrating Internalized symptomatology.;Although the hypotheses were not supported, this study showed findings consistent with previous research. It has shed light on the effect of gender, ethnicity and the type of symptomatology (internalized vs. Acting Out) which impact the diagnosis of DID.