Dissociative disorder not otherwise specified is a strange-
The diagnostic criteria are given below, but on the whole DDNOS is the diagnosis of choice for partial dissociative identity disorder. The ISSTD Treatment Guidelines make a helpful distinction between two types of DDNOS: ‘not yet’ and ‘not quite’. Type 1a DDNOS is people who do in fact have dissociative identity disorder but have not yet been diagnosed. Type 1b DDNOS is people who do not quite meet the diagnostic criteria for DID — usually because they do not have amnesia between alters, or their alters/parts are not quite ‘separate’ enough to be classified as different identity states. DDNOS is actually the most common dissociative disorder and so there is some debate about whether it should be reformulated: as a ‘residual’ category it is meant to mop up a few cases that do not quite fit into other diagnostic boxes, not be a category all of its own!
Colin Ross (2007, p.142) says that: “The dividing line between dissociative identity disorder and most cases of Dissociative Disorder Not Otherwise Specified is arbitrary. Most cases of DDNOS are partial forms of DID which lack either clear switching of executive control, full amnesia barriers between identity states, or clear differentiation and structure of identity states. They are partial forms of DID with the same patterns of childhood trauma and co-
In summary, many people will be diagnosed with DDNOS because during the diagnostic process they fail to exhibit either amnesia between alters, or sufficiently elaborated alters. Many however may go on to be diagnosed with dissociative identity disorder at a later point, and many may actually have DID but there was not sufficient evidence for it during the brief diagnostic interview, based on the restrictive criteria specified by the DSM-
Diagnostic Criteria (Code 300.15) from DSM-
This category is included for disorders in which the predominant feature is a dissociative symptom (ie, a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment) that does not meet the criteria for any specific Dissociative Disorder. Examples include:
© PODS 2012
Carolyn Spring is Director of PODS and developed dissociative identity disorder (DID) as a result of organised abuse in childhood. After studying at Cambridge University, she worked for a number of years in Children's Social Care supporting at-
Carolyn is also Director of START (Survivors Trauma and Abuse Recovery Trust), the charity running PODS, which enables people to recover from childhood abuse and live healthy lives, both physically and mentally. She is also author of Recovery is my best revenge: my experience of trauma, abuse and dissociation.