RESUMO
We review the empirical evidence for the validity of the Dissociative Identity Disorder (DID) diagnosis, the vast majority of which has come from research conducted within the last 10 years. After reviewing three different guidelines to establish diagnostic validity, we conclude that considerable converging evidence supports the inclusion of DID in the current Diagnostic and Statistical Manual for Mental Disorders. For instance, DID appears to meet all of the guidelines for inclusion and none of the exclusion guidelines; proposed by Blashfield et al. [Comprehensive Psychiatry 31 (1990) 15-19], and it is one of the few disorders currently supported by taxometric research. However, we also discuss possible problems with the current diagnostic criteria and offer recommendations, based on recent research, for possible revisions to these criteria.
Assuntos
Transtornos Dissociativos/classificação , Transtornos Dissociativos/diagnóstico , Determinação da Personalidade/normas , Adulto , Viés , Criança , Transtornos Dissociativos/etiologia , Humanos , Determinação da Personalidade/estatística & dados numéricos , Transtornos da Personalidade/classificação , Transtornos da Personalidade/diagnóstico , Guias de Prática Clínica como Assunto/normas , Escalas de Graduação Psiquiátrica/normas , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Reprodutibilidade dos TestesRESUMO
This study outlines the development of the Screening SIRS, an abbreviated version of the Structured Interview of Reported Symptoms (SIRS), for use as a screening measure of malingering in a correctional setting. Seventy-five inmates complaining of psychological impairment were tested for malingering. A subset of the participants was given both the original SIRS and the Screening SIRS as a separate test with the test order counterbalanced; the remainder were given the original SIRS and a derived classification was determined by extracting the Screening SIRS scale scores. Using Receiver Operating Characteristic analyses, classification based on the Screening SIRS was significantly better than chance. With a sensitivity of 87% and specificity of 73%, the Screening SIRS was highly predictive of classifications based on the original SIRS. These findings have instrumental implications in correctional settings where identification of possible malingerers through a screening procedure may facilitate optimal allocation of resources.
Assuntos
Psiquiatria Legal/métodos , Simulação de Doença/diagnóstico , Programas de Rastreamento/métodos , Prisões , Escalas de Graduação Psiquiátrica/normas , Adolescente , Adulto , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: To examine posttraumatic symptomatology among women with eating disorders. METHOD: A sample of 294 women diagnosed as having anorexia nervosa (n = 121), bulimia nervosa (n = 103), or eating disorder-not otherwise specified (n = 70) completed a version of the posttraumatic stress disorder (PTSD) Symptom Scale along with instruments measuring specific eating disorder symptomatology and comorbid psychopathology. RESULTS: Of the total sample, 154 (52%) reported current symptomatology consistent with PTSD. However, severity of PTSD symptomatology was unrelated to either type or eating disorder or severity of either anorexic or bulimic symptomatology. Severity of PTSD symptoms was significantly associated with depression, anxiety, and dissociative experiences. DISCUSSION: The findings suggest that PTSD symptomatology is common and an important clinical variable among women with eating disorders, although apparently it is not directly related to the eating disorder per se.