A quick summary of D.I.D and O.S.D.D

Dissociative Identity Disorder Dissociative Identity Disorder (DID) is a disorder that was previously recognized as Multiple Personality Disorder. It's characterized by the presence of two or more dissociated self states, known as alters, that have the ability to take executive control and are associated with some degree or inter-identity amnesia. DID is caused by chronic childhood trauma and is associated with posttraumatic stress disorder. Dissociative identity disorder (DID) is best known for alters, dissociated parts of the personality that the individual with DID experiences as separate from themself. Yet, before diagnosis, many individuals with DID are aware of the effects of having alters but not of their actual alters. Individuals with DID have dissociative amnesia for both their traumatic past and for many of their alters' activities (inter-identity amnesia), and they often experience other memory problems as well (Dell, 2006)1. They might find evidence of amnesia such as possessions that they do not remember obtaining, art or writing that they do not recognize having done, being called an unknown name by strangers who act in a familiar manner towards them, or being confronted about their supposed actions that they cannot remember. Sometimes, they might experience dissociative fugue and find themself in a different location with no explanation of how they got there. There might be periods of their life that they can’t recall. They might experience flashbacks of traumatic events and then find themself unable to recall what they remembered (American Psychiatric Association (APA), 2013)2. Individuals with DID might experience more direct evidence of their alters as well. They might hear "voices" that they do not at first understand are originating from their alters. They might experience intruding emotions, sensations, thoughts, and urges that make no sense to them and do not feel like their own. They often find themselves doing or saying things that they didn't plan to do or say, and they might sometimes feel like they're watching their body do things that they can neither predict nor control. Their skills and abilities might fluctuate, as might their knowledge. Their preferences, perceptions, and memories shift between sets (Dell, 2006)1. DID includes a range of other dissociative symptoms as well. Identity alteration accounts for the existence of alters, but DID also involves high levels of identity confusion (being unsure who one is), depersonalization (feeling disconnected from aspects of oneself, including one's emotions, thoughts, memories, physical sensations, body or parts of one's body, or identity), and derealization (feeling disconnected from one's environment or feeling like nothing is real). This can manifest as the individual: feeling like their body is foreign and not theirs; feeling like they've morphed to a different age, gender, or build; not recognizing themself in a mirror; feeling like an imposter who's taken over someone else's life; or feeling like everything that's happened to them is a script for a movie. Individuals with DID can also experience: trance states, in which they show minimal awareness of or ability to respond to their surroundings; perceptual disturbances, such as feeling as if sounds are coming from far away; and somatic symptoms, such as stomachaches, headaches, or joint pain in response to emotional stress (Dell, 2006)1. DID is so strongly associated with dissociative symptoms that a diagnosis of DID renders any other dissociative disorder diagnoses unnecessary. Because DID is the result of trauma, it's comorbid with posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (C-PTSD), and flashbacks, emotional numbing, nightmares, emotional dysregulation, and pessimism about the future are common. Individuals with DID often have other comorbid disorders as well, including mood disorders (such as major depressive disorder), anxiety disorders (such as social anxiety disorder), personality disorders (such as borderline personality disorder (BPD)), eating disorders (such as anorexia nervosa), or conversion disorder (APA, 2013)2. Occasionally, individuals with DID might experience dissociative psychosis, a type of reactive psychosis triggered by extreme stress and associated with dissociative symptoms (Dell, 2006)1. Other Specified Dissociative Disorder The DSM-5 gives the following criteria for a diagnosis of other specified dissociative disorder:

This category applies to presentations in which symptoms characteristic of a dissociative disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the dissociative disorders diagnostic class. The other specified dissociative disorder category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific dissociative disorder. This is done by recording “other specified dissociative disorder” followed by the specific reason (e.g., “dissociative trance”).

Examples of presentations that can be specified using the “other specified” designation include the following:

1. Chronic and recurrent syndromes of mixed dissociative symptoms: This category includes identity disturbance associated with less-than-marked discontinuities in sense of self and agency, or alterations of identity or episodes of possession in an individual who reports no dissociative amnesia.

2. Identity disturbance due to prolonged and intense coercive persuasion: Individuals who have been subjected to intense coercive persuasion (e.g., brainwashing, thought reform, indoctrination while captive, torture, long-term political imprisonment, recruitment by sects/cults or by terror organizations) may present with prolonged changes in, or conscious questioning of, their identity.

3. Acute dissociative reactions to stressful events: This category is for acute, transient conditions that last less than 1 month, and sometimes only a few hours or days. These conditions are characterized by constriction of consciousness; depersonalization; derealization; perceptual disturbances (e.g., time slowing, macropsia); micro-amnesias; transient stupor; and/or alterations in sensory-motor functioning (e.g., analgesia, paralysis).

4. Dissociative trance: This condition is characterized by an acute narrowing or complete loss of awareness of immediate surroundings that manifests as profound unresponsiveness or insensitivity to environmental stimuli. The unresponsiveness may be accompanied by minor stereotyped behaviors (e.g., finger movements) of which the individual is unaware and/or that he or she cannot control, as well as transient paralysis or loss of consciousness. The dissociative trance is not a normal part of a broadly accepted collective cultural or religious practice (American Psychiatric Association, 2013)1.

Other specified dissociative disorder is a category used for symptom clusters that are clearly dissociative in nature but that don't meet the criteria for another dissociative disorder. This category is used when it is known that another dissociative disorder is not present and what the symptoms are.

Examples of other specified dissociative disorder include presentations similar to DID with either no fully differentiated alters or with no amnesia between alters; dissociative symptoms such as identity confusion or assuming a new identity due to brainwashing, torture, political imprisonment, etc; dissociative symptoms that occur in reaction to trauma but do not last longer than a month; dissociative trance in which an individual loses awareness of their surroundings and so becomes under-responsive.

Before the DSM-5 was released, OSDD was known as dissociative disorder not otherwise specified (DDNOS). In addition to the above, it contained derealization unaccompanied by depersonalization in adults (which is now covered by depersonalization/derealization disorder) and ganser syndrome, a condition in which approximate answers are given to questions (which is not covered by the DSM-5 and may in fact be a factitious disorder)(4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000)2.