What is the significance of A-DES Scoring in clinical assessment?

The Dissociative Experiences Scale (DES) is a screening tool used in clinical assessment to measure dissociative experiences. The DES is a 28-item, self-administered questionnaire to assess dissociative experiences on a scale of experience to scale how frequently dissociative experiences occur.

The DES score is the average of all the questions, so the minimum score is 0, and the maximum score is 100. Scores of 30 or more indicate high levels of dissociation, and scores under 30 indicate low levels. The DES can be used to identify specific mental health conditions, and a very high number of people who score above 30 have been shown to have Posttraumatic Stress Disorder (PTSD).

However, very high scores do not necessarily mean a more severe dissociative disorder is present, as the scale measures both normal and pathological dissociation. Successful treatment of a dissociative disorder should reduce the DES score compared to the initial score. The Adolescent Dissociative Experiences Scale-II (A-DES) is a version of the DES designed for adolescents.

Printable A-DES Scoring

Download this A-DES Scoring used to identify specific mental health conditions, and a very high number of people who score above 30 have been shown to have Posttraumatic Stress Disorder (PTSD).

How do dissociative disorders manifest, and what are the associated symptoms?

Dissociative disorders are mental health conditions that involve experiencing a loss of connection with reality, memory, identity, emotion, perception, behavior, and sense of self. Dissociative symptoms can potentially disrupt every area of mental functioning.

Symptoms of dissociative disorders include feeling disconnected from yourself and the world around you, forgetting about specific periods, events, and personal information, feeling uncertain about who you are, having multiple distinct identities, sudden and unexpected shifts in mood, and problems with handling intense emotions.

Dissociative disorders typically develop after short-term or long-term trauma and stressful situations can worsen symptoms of mental disease and cause issues with daily functioning. The three types of dissociative disorders are dissociative identity disorder, dissociative amnesia, panic disorder, and depersonalization/derealization disorder. Treatment for dissociative disorders often involves psychotherapy and medication.

If you are concerned that you or a loved one may have a dissociative disorder, it is important to seek professional help.

A DES Scoring example (sample)

Unlock valuable insights into adolescent dissociative experiences by downloading this free A-DES Scoring Chart example. Whether you're a mental health professional, researcher, or simply interested in understanding dissociation in adolescents, this resource provides a clear and user-friendly guide to interpreting A-DES scores.

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A DES Scoring example (sample)

How does the dissociative experiences scale (DES) contribute to clinical assessments?

The Dissociative Experiences Scale (DES) is a widely used screening tool in clinical assessments for measuring dissociative experiences. It contributes to clinical assessments that measure dissociation in several ways:

  • Quick screening method: The DES is a simple, quick questionnaire that helps identify individuals experiencing dissociative symptoms that may require further assessment.
  • Indicating the presence of dissociative disorders: While the DES is not a diagnostic tool, high scores on the DES (30 or more) suggest that a person may have a dissociative disorder. However, low scores do not necessarily rule out dissociative disorders, as the scale measures both normal and pathological dissociation.
  • Identifying associated mental health conditions: The DES can help identify specific mental health conditions, such as Posttraumatic Stress Disorder (PTSD), dissociative disorders, borderline personality disorder, and a history of abuse.
  • Monitoring progress: The DES can be used to track progress over time, allowing clinicians to assess the effectiveness of treatment and make necessary adjustments.
  • Providing a starting point for discussion: The DES can serve as a starting point for discussing an individual's experiences and help them articulate how their life is affected by dissociation.

How are dissociative experiences assessed in adolescents, and what are the implications?

The assessment of dissociative experiences in adolescents involves utilizing a structured clinical interview and various tools tailored to the specific context of nervous and mental diseases, including posttraumatic stress disorder (PTSD) and psychological defense mechanisms.

One prominent instrument for this purpose is the Dissociative Experiences Scale (DES), endorsed by the American Psychiatric Association and acknowledged for its psychometric properties by international society, the International Society for the Study of Trauma and Dissociation.

The DES is a valuable clinical tool in clinical populations, particularly adolescents. Its multidimensional inventory covers dissociative tendencies, identity alteration, and perceptual alterations, making it applicable to various diagnostic groups, including those with panic disorder or a history of childhood trauma and physical abuse.

The DES, whether in clinical interviews or self-report measures, aids in measuring dissociation in non-clinical samples, providing insight into events happening in an individual's psyche. The assessment of adolescent dissociative experiences is crucial in psychiatric care, offering a nuanced understanding of pathological dissociation and its implications for adolescents.

Using the DES as a screening instrument, clinicians can gain access to an adolescent's dissociative experiences. The instrument, particularly its Des II version available in the public domain, offers total score scores and percentile ranks, enabling family members and clinicians to gauge the severity of dissociation.

As an essential component in future research, the DES facilitates discussions about past events and adolescent identity alterations. Its broad applicability extends beyond the general population to specific age groups, such as those watching television or exhibiting high scores on the scale.

What role does the dissociative disorders interview schedule play as a diagnostic tool across age groups?

The Dissociative Disorders Interview Schedule (DDIS) is a highly structured interview used as a diagnostic tool for assessing dissociative disorders across age groups. The DDIS is designed to make DSM-5 diagnoses of somatic symptom disorder, borderline personality disorder, major depressive disorder, and all dissociative disorders.

It inquires about positive symptoms of schizophrenia, secondary features of dissociative identity disorder (DID), extrasensory experiences, substance abuse, and other items relevant to dissociative disorders. The DDIS is a comprehensive tool that allows clinicians to gather detailed information about the individual's symptoms, dissociative experiences, scale others, and history.

It is precious in differentiating between normal and pathological dissociation, as well as in identifying specific dissociative disorders such as DID, dissociative amnesia, and depersonalization/derealization disorder.

The DDIS can usually be administered in 30-45 minutes and is a valuable tool in ensuring that individuals with dissociative disorders receive appropriate care and support.

How is dissociative identity disorder clinically examined, and what associations exist with personality disorders?

Dissociative identity disorder (DID) is a rare disorder associated with severe behavioral health symptoms. DID is diagnosed through a clinical interview, such as the Dissociative Disorders Interview Schedule (DDIS) or the Structured Clinical Interview for Dissociative Disorders (SCID-D), which allows clinicians to gather detailed information about the individual's symptoms, experiences, and history.

The DDIS and SCID-D are particularly valuable in differentiating between normal and pathological dissociation, as well as in identifying specific dissociative disorders such as DID, dissociative amnesia, and depersonalization/derealization disorder.

DID is associated with overwhelming experiences, traumatic events, and abuse that occurred in childhood. DID is often misdiagnosed with other diagnoses, such as borderline personality disorder, and there is a high comorbidity between DID and other personality disorders.

Treatment for DID typically involves psychotherapy, and the goal of therapy is to help integrate the different elements of identity. Safety planning with DID patients is lifelong, and the prognosis without treatment and correct diagnosis is poor.

In what ways are A-DES scores clinically useful as a screening and diagnostic tool?

The A-DES (Adolescent Dissociative Experiences Scale) scores serve as a clinically valuable tool in screening and diagnosing adolescent dissociative experiences, especially within the context of nervous and mental diseases. As a self-report measure measuring dissociation, the A-DES assesses psychological defense mechanisms and offers insights into various diagnostic groups.

  • Screening test for dissociation: A-DES scores act as an efficient screening test, providing a quick and reliable way to identify adolescents experiencing dissociative symptoms. This is particularly relevant for general psychiatric patients who may exhibit a range of mental health challenges.
  • Diagnostic tool for multiple personality disorder and other diagnostic groups: The A-DES serves as a diagnostic tool for disorders characterized by dissociation, such as multiple personality disorder. Its utility extends to various diagnostic groups, allowing clinicians to distinguish and understand dissociative experiences across mental health conditions.
  • A self-report measure of dissociation: Adolescents can provide valuable self-report data through the A-DES, aiding clinicians in obtaining information about their dissociative experiences. This self-report measure contributes to a more comprehensive understanding of the adolescent's mental state.
  • Perceptual alteration scale: The A-DES includes a perceptual alteration scale, enabling clinicians to assess the extent to which an adolescent may be experiencing distortions in their perception. This contributes to a nuanced evaluation of dissociative symptoms.
  • Overall scores as a diagnostic indicator: The A-DES scores serve as diagnostic indicators, helping clinicians gauge the severity of dissociative experiences. High scores may prompt further investigation and consideration of dissociative disorders.
  • Average score analysis: Analyzing the average score on the A-DES provides clinicians with a summary measure, aiding in interpreting an adolescent's overall level of dissociation.
  • Identification of past events: A-DES scores contribute to the identification of dissociative experiences related to past events. This historical perspective is crucial for understanding the context of dissociation and potential triggers in adolescents.
  • Transdiagnostic indicator for other groups: Beyond specific diagnostic categories, the A-DES can be a transdiagnostic indicator, revealing commonalities in dissociative experiences across different mental health conditions.

What is the relationship between psychological defense mechanisms and pathological dissociation?

Psychological defense mechanisms and pathological dissociation are interconnected aspects of the mind's response to stress, trauma, or overwhelming experiences. While they serve distinct functions, they have a relationship, particularly in how individuals cope with and protect themselves from threatening or distressing situations.

Coping strategies

Psychological defense mechanisms are adaptive strategies the mind employs to manage anxiety and protect the individual from emotional pain. These mechanisms operate on an unconscious level, including denial, repression, and projection. On the other hand, pathological dissociation involves a more severe and maladaptive disruption in one's normal integration of consciousness, memory, identity, or perception.

Trauma response

Both psychological defense mechanisms and pathological dissociation can be responses to trauma. When faced with post-traumatic stress disorder or with overwhelming stress or threat, the mind may employ defense mechanisms to maintain a sense of equilibrium. In some cases, however, especially with severe or repeated trauma, pathological dissociation may manifest as a more extreme coping or psychological defense mechanism, leading to a significant disruption in one's sense of self or reality.

Spectrum of dissociation

Psychological defense mechanisms can be seen as part of a dissociation spectrum. Dissociation, in a general sense, involves a disconnection between different aspects of consciousness, memory, or identity. While psychological defense mechanisms or mechanisms may involve mild forms of dissociation, pathological dissociation represents a more extreme and clinically significant end of this spectrum.

Common underlying factors

Both psychological defense mechanisms and pathological dissociation may share common underlying factors, such as early life experiences, attachment patterns, and the impact of significant stressors. Individuals who experience chronic or post-traumatic stress disorder or trauma may rely on various defense mechanisms initially, but under extreme conditions, dissociation may become more pronounced and dysfunctional.

Overlap in symptoms

There can be an overlap in symptoms between certain defense mechanisms and dissociative experiences. For example, dissociation may involve a detachment from reality, which can resemble aspects of denial or repression seen in defense mechanisms.

Clinical presentation

In clinical settings, individuals with specific psychological defense mechanisms may be more prone to developing dissociative disorders. Both defense mechanisms and pathological dissociation can be addressed in therapy to promote healthier coping strategies and integration of fragmented aspects of the self.

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How high did you score on the DES assessment?
How high did you score on the DES assessment?

Commonly asked questions

How high did you score on the DES assessment?

The DES score is the average of all the questions. Therefore, the smallest score is 0, and the maximum score is 100. To figure this out for yourself, score each question by dropping the zero from the percentage of each response, for example, 30% = 3; 80% = 8, and then add these values together.

What is the DES cutoff score?

The total scores can be between 0 and 100, where scores of 30 or more indicate high levels of dissociation.

What are the results of a DES?

The A-DES is scored by summing item scores and dividing by 30 (number of items). The overall score ranges from 0 to 10. A-DES scores of 4 or greater suggest pathological levels of dissociation, and further evaluation is warranted.

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