Criteria Checklist Handout Criteria Checklist
AP Psychology / Unit 8: Clinical Psychology
Clinical Student
Case Date
300.14: Dissociative Identity Disorder
Characterized by the presence of two or more distinct personality states or an experience of possession.
Disruption of Identity: Discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning.
Amnestic Gaps: Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.
Significant Distress: Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Rule-Outs: The disturbance is not a normal part of a broadly accepted cultural or religious practice. Symptoms are not attributable to the physiological effects of a substance or another medical condition.
Related Disorders
Dissociative Amnesia
Inability to recall important autobiographical information, usually of a traumatic or stressful nature. Often involves Dissociative Fugue .
Depersonalization / Derealization
Persistent experiences of feeling detached from one's body (depersonalization) or surroundings (derealization).
The "Invisible" Condition
"DID is rarely as obvious as portrayed in films. It is often a 'hidden' disorder where switches are subtle or internalized."
Avg. 12+ years in system before diagnosis
Up to 4 misdiagnoses initially
Clinical Analysis Prep
1. Identify three symptoms listed above that are highly "subjective" (rely solely on patient report). Why does this make diagnosis difficult?
2. Differential Diagnosis: How would a clinician distinguish DID from Bipolar Disorder (rapid mood shifts vs. personality shifts)?
3. Vocabulary Check: Define 'Iatrogenic' (Look this up if needed). How does it relate to the DID validity debate?
Clinical Case Files Worksheet Confidential Clinical File #822-19
Clinical Case Files
DIFFERENTIAL ANALYSIS
Investigating Student
Review Date
Subject Background
Patient: "Alex", Age 29.History: Alex has sought treatment for nearly a decade, receiving previous diagnoses of Schizoaffective Disorder , Bipolar II , and Borderline Personality Disorder . Alex reports significant childhood trauma between ages 4 and 10, though memories of this period are fragmented and "hazy."
Clinical Observations
Alex reports hearing "voices" that argue with each other. Unlike typical Schizophrenia auditory hallucinations, Alex insists these voices are internal and have distinct names and personalities.
Friends report Alex occasionally adopts a different manner of speaking, becoming assertive and aggressive, later claiming no memory of the conversations.
Alex frequently finds items in the apartment (e.g., clothes, grocery receipts) they do not recall purchasing.
Diagnostic Challenges
High comorbidity with depression and anxiety
High levels of medical skepticism
Overlapping symptoms with Bipolar (affective shifts)
Overlapping symptoms with Schizophrenia (auditory input)
Archive 8-A: DID
Differential Diagnosis Analysis
A. Schizophrenia vs. Alex's Case
What specific evidence in the case suggests Alex is not suffering from Schizophrenia? Focus on the nature of the "voices."
B. Bipolar Disorder vs. Alex's Case
How does Alex's "loss of time" and amnesia distinguish this from the "episodes" found in Bipolar Disorder?
C. Final Evaluation: Validity Debate
Some psychologists argue DID is socially constructed (the result of therapist suggestion). Based on Alex's 10-year history of multiple misdiagnoses and childhood trauma, does this support the Posttraumatic Model or the Sociocognitive Model? Explain.
Diagnostic Dilemma Slides The Identity Lab
Unmasking Dissociative Identity Disorder
AP Psychology / Unit 8: Clinical Psychology
Diagnostic Warm-up
"A student presents with sudden gaps in memory and claims their friend saw them acting like a 'different person' in the cafeteria."
Quick Check:
• Is this enough for a DID diagnosis?
• What other DSM-5 criteria are missing?
• What "rule-outs" must a clinician check?
5 Minutes
Diagnosis Reality
Embedded media
Watch focusing on (0:50-1:14): Why is DID considered the most challenging dissociative disorder to identify?
12+ Years
Average time to reach a correct diagnosis.
4 Correct?
Average number of initial misdiagnoses.
Socratic Seminar
The 12-Year Gap
Is the delay due to clinician skepticism or the complexity of symptoms? Or both?
Comorbidity
Alex was diagnosed with Bipolar and Schizoaffective. Is DID actually a "hidden" layer beneath these?
Media Stigma
How do movies like 'Split' or 'Psycho' make clinical diagnosis even harder for real patients?
"How does a clinician determine if a 'voice' is an alternate personality or a hallucination?"
Extension: Clinical Case Files
Open your Clinical Case Files Worksheet . We will analyze the profile of "Alex" to practice differential diagnosis.
Identify "Internal" vs "External" voices.
Analyze amnestic gaps vs mood shifts.
Debate: Social vs Trauma model.
Identity Lab Facilitator Guide Identity Lab Facilitator Guide
Teacher-Facing
Lesson Purpose
This lesson tackles one of the most controversial and difficult-to-diagnose disorders in the DSM-5. Students move beyond "Hollywood" tropes to analyze the genuine clinical struggle of differential diagnosis and the systemic barriers that lead to a 12-year diagnostic delay.
Pacing & Flow
0-5: DSM-5 Criteria Review (Handout) Individual/Pairs5-10: Video Viewing (Diagnosis Reality) Whole Class10-25: Socratic Seminar (Controversy) Discussion25-40: Clinical Case Analysis (Alex) Collaboration
AP Exam Connections
• Distinguish between dissociative disorders.
• Evaluate validity of psychiatric diagnoses.
• Understand differential diagnosis (DID vs Schizophrenia).
Key Vocabulary
- Iatrogenic
- Differential Diagnosis
- Comorbidity
- Amnestic Gaps
- Posttraumatic Model
Discussion Anchors & Keys
The "12 Years" Statistic
Why is it so long? Encourage students to consider:
Clinician Skepticism: Many clinicians refuse to diagnose DID, leading patients to seek help from multiple doctors.Comorbidity masking: Symptoms often present as severe depression, self-harm, or anxiety first.The "Hidden" Nature: Patients are often unaware of their own alternate states, making reporting impossible.
Case Analysis Key (Alex)
Voices: Internal (Alex) vs. External (Schiz). Alex hears "people in a room," Schizophrenics hear "someone behind them."
Amnesia: "Loss of time" is the hallmark of DID. Bipolar episodes (Manic/Depressive) usually retain memory of the events.
Validity: Alex's 10-year struggle before a DID diagnosis argues against therapist suggestion (Sociocognitive), as they were treated for other things for a decade without "developing" DID.
Controversy Note: The Iatrogenic Debate
Remind students of the "Hillside Strangler" case or the "Sybill" controversy. Is DID a real neurobiological response to trauma (Posttraumatic Model) or is it "created" in vulnerable patients by clinicians using hypnosis or leading questions (Sociocognitive Model)? This is the core AP question. Use the Alex case to debate if 10 years of misdiagnosis makes the "created" theory less likely.
