# Questionnaires to Measure Depersonalization



## TDX

*The Cambridge Depersonalisation Scale*

The Cambridge Depersonalisation Scale is the most commonly used instrument to measure depersonalization symptoms. It comes in 2 versions:

*The trait version*: This questionnaire contains 29 items. On each item there is a question about a depersonalization symptom. The response format consists of 2 scales which measure frequency and intensity of depersonalization symptoms for the period of the last 6 months. This format is used to not only capture depersonalization disorder, but to also distinguish between other disorders where depersonalization symptoms occur less frequent (e. g. anxiety disorders, temporal lobe epilepsy). The score is obtained by adding frequency and intensity for each item. A score between 0 to 300 can be obtained.

The trait version can easily obtained on the internet:
http://www.zpid.de/pub/tests/5261_CDS-Traitversion.pdf

There are versions for various other languages like french, spanish, italian, german and japanese. In Germany there is also a version with 30 items and two short versions with 9 and 2 items.

*The state version*: The state version contains 22 items which ask for the intensity of depersonalization symptoms at the moment. Each question is answered on a bar from 0% to 100%. It is designed to detect changes of the symptom intensity which may occur in a short timeframe.

In contrast to the trait version the state version cannot be easily obtained. It is well hidden and to my knowledge it can only be found in the book "Overcoming Depersonalization and Feelings of Unreality" by David, Lawrence and Hunter. So I copied it. You can find it here:
http://docdro.id/zIAJlG7

*Strangely they ask to mark a point at a bar. This is inconvenient, so it's better to just choose a value 0%, 10%, 20%, ..., 100% for each item and then add the score of each item to obtain the overall score.*


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## ThoughtOnFire

Thanks for posting this TDX!

I have one to share as well: http://biobehavioral.site.aplus.net/viewarticle.php?id=19


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## inferentialpolice

The essential flaw with "DP-only" screeners such as Cambridge -- in addition to the basic fact that they are NOT diagnostic -- are that they misattribute certain dissociative manifestations as being DP when in fact endorsement of those questions are indicative of some different (perhaps more severe) dissociative condition. As I've mentioned in previous postings, DP is experienced within many conditions, but when it is frequent or persistent (chronic) and otherwise medically unexplained it falls within the domain of the dissociative disorders, and within that, there is a division of dissociative experiences which characterize particular dissociative diagnoses, but the Cambridge asks about those distinguishing symptoms as if they are all part of Depersonalization Disorder when in fact they are the domain of some other dissociative disorder. For example, these questions from the Cambridge:

14. It seems as if things that I have recently done had taken place a long time ago. For example anything which I have done this morning feels as if it were done weeks ago. 
16. I feel detached from memories of things that have happened to me - as if I had not been involved in them.

are asking after symptoms of dissociative amnesia for one's biographical information. Having symptoms which rise both to the levels of dissociative amnesia and DP disorder together is a form of DDNOS, now called Other Specified Dissociative Disorder under DSM-5. Treatment for DDNOS is suggested to follow the DID/DDNOS treatment guidelines published here:

https://www.isst-d.org/default.asp?contentID=49

One reason that so many on this board are refractory to "treatment" for DP may be because they in fact have a higher order dissociative condition which indicates employment of a treatment paradigm that they have not yet availed themselves.


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## TDX

> are asking after symptoms of dissociative amnesia for one's biographical information.


These items do not ask for amnesia, because amnesia means you cannot access memory, while the CDS-items mean that the memory _feels_ different although it's available.


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## TDX

I have difficulty in memory encoding, but at least I don't have alienated recall.


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## inferentialpolice

Dissociative amnesic events are not like what is commonly thought about amnesia. In particular, DA refers specifically to the disruptions in recall of biographical events. One's sense for when something happened to them is an aspect of biographical recall. The main point, however, is that the grab-bag of symptoms that many on this board attribute to DP, and similarly, the grab-bag of symptoms that those who study DP alone attribute to DP alone, are mistaken to the extent that such symptoms are indicative of dissociative conditions beyond mere DP, which these board participants and DP-scientists fail to consider. The consequence of limited one's view of symptoms as being part of a DP-only phenomenon is that treatments geared toward the greater spectrum dissociative disorders are not applied when in fact the sufferer is laboring under these greater conditions and could benefit from a more precisely targeted treatment paradigm.


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## inferentialpolice

Additional screeners and diagnostic tests for depersonalization, what follows below is quoted from http://www.dissociative-identity-disorder.net/wiki/Depersonalization_disorder

SCI-DER, Cambridge Depersonalization Scale and Steinberg Depersonalization Test

The SCI-DER, CDS and Steinberg Depersonalization Test are all questionnaires designed to assess depersonalization and derealization in order to assess symptoms, although these should not be used for a definitive diagnosis.

[Below are some links for the above mentioned screener tests, none which are NOT diagnostic:

SCI-DER: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626926/ (impresses me as a bit of a scid-d ripoff)

CDS: http://www.excellenceforchildandyouth.ca/sites/default/files/meas_attach/Cambridge_Depersonalization_Scale_(CDS).pdf

Steinberg screener for DP: http://www.strangerinthemirror.com/questionnaire.html

Here is a general dissociation screener looking for any type of dissociative symptom suggestive of a dissociative disorder: http://www.hebpsy.net/files/ruZXkl5YGeKcvt6dBZpS.pdf

that one can be taken and scored automatically if opened in Acrobat reader.

]

SCID-D

This is a structured clinical interview, which is the diagnostic tool for depersonalization/derealization disorder and all dissociative disorders. It was developed by Dr Marlene Steinberg to assess all dissociative disorders.[5] Dr Steinberg is co-author of the well known book THE STRANGER IN THE MIRROR: Dissociation The Hidden Epidemic.[6]

[DDIS: Another less sensitive diagnostic interview, highly structured, is the DDIS, that can be seen here:

http://www.rossinst.com/downloads/DDIS-DSM-5.pdf

]


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## inferentialpolice

redacted, my sense is that many on this list report symptoms like this list posted just today in the forum, and if upon reflection (or inspection of people's postings) you agree that such complaints are common, you may then want to adjust your statement of "rarely (never?) see complains of actual amnesia on this forum":

"So I've posted previously about what I'm going through lately. In a nutshell, I've felt spaced out and off balance for quite some time (a little over a year now) and as of a few weeks have been having some issues with focus, disorientation, concentration and short term memory, primarily when it comes to recalling the day's events, retaining information, and knowing precisely what I said, and to who. Along with it, I've been having frequent panic attacks regarding what's happening to me, as well as flare-ups of OCD, trouble sleeping, and basically just feeling lonely, inconsolable and overly worried pretty much 24/7 over the past month. In short, it's been hell. I'm currently taking a low dose of citalopram daily, as well as a xanax morning and night for the panic, which is helping a little."


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## Amina_x

Thanks for posting! Very helpful.


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## af_1993

my biggest concern is my brain fog..poor concentration and poor memory..really kill me!


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## hennessy

ThoughtOnFire said:


> Thanks for posting this TDX!
> 
> I have one to share as well: http://biobehavioral.site.aplus.net/viewarticle.php?id=19


I got 8-9 of this(I think in this one, there are questions that an OCD sufferer might answer as yes) and I scored 150 at the Cambridge scale. I was doing good last weeks but didn't know it was that good. I feel a little detachment and sometimes I have brain fog/concentration problems but I don't have the other symptoms. Does this mean I have dp?


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## TDX

> I got 8-9 of this(I think in this one, there are questions that an OCD sufferer might answer as yes)


The test has never been validated, so we don't really know if it's a good test.



> and I scored 150 at the Cambridge scale.


If you have more than 70 points in CDS it's likely that you have Depersonalization Disorder. But even with this cut-off the misclassification rate is roughly 10%. It's not a substitue to a psychiatric diagnosis.



> That's the best test imo, concise yet comprehensive.


In my opinion it's crap. For example if you set item 14 ("I have felt that my emotions are not in my control") to "Almost all of the time" and you check all the 3 items on how it inteferes with your life the questionare says that you have "Mild Depersonalization".

There are some psychiatric disorders where patients have difficulty to control their emotions, like depression (if you're not numb), PTSD or Borderline. But inability to control emotions is not a DP-symptom. Because of this the validity seems questionable to me.

It's also unclear how Steinberg came to the ranges for classifying the severity. The questionare was never published anywhere and it was never validated.


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## TDX

> Fuck everything else.


The Fewtrell Depersonalization Scale might be useful, too. There was a study where it seemed to achieve quite good properties. Unfortunately I wasn't able to find it anywhere. It seems to have been created for nothing. There have been no uses after the study of Lambert et al.

I thought about asking the Depersonalization Research Unit for it, but as they don't answer E-Mails I suppose this wouldn't work.

I have an idea: Will you go again to the Depersonalization Research Unit? If yes: Could you ask for the Fewtrell Depersonalization Scale? It would be useful if we had another acceptable questionare.


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## TDX

There is another problem: The Steinberg Test is bugged. Item 7 is not added to the score.


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## dmgice

These kinds of tests just confirm it even more for me. I find myself sometimes getting so inside my head that I feel physically hot and my finger tips feel like they aren't on my hands. I have two broken teeth currently and I haven't gotten them treated because I can push my tongue into the sharp edge of the tooth and feel a little bit of pain. It's how I know I'm awake sometimes. But.. I'm glad that there's a forum and this will be my first reply here. I did go and talk to a therapist and I am going back today so I don't know what will happen or where to go from there but.. I'm glad I found this forum. I'll be around, reading up and yeah... those tests...

Thank you for linking to those. I am grateful for that. Thanks.


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## bojito

I'll start from the end: I think that one of the most frustrating things that I experience is that as for now I trnd to believe Im the only person on the planet which suffers from this bizzare phenonemen, which I have no idea whether it is a symptom if DP, or something else. I dont feel detached from my body (at least not as I understand detachment), nor do I see fogy clouds.I do experience brain fogs occasionally (lately less), nemory loss, a bit of cognition damage. But the main horrific sensation is that: I feel as if my head is a weird object lying on my shoulders, and I experience ppl as sort of sticks, or lumps of meat, that carry some kind of weird ball on their body, and all heads-on-bodies seem as if they could belong to grotesque charechters on southpark. This sensatuin the my head is not "connected" to my body, and the visional experience of others, are driving me insane. I dont know if it will help catagorizing my self, but since I fell so lonely with it , maybe I need to know. So if u have heard of similar phenonemens, it woyld help me a lot to hear about it.


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