Assessing therapeutic change in patients with severe dissociative disorders: the progress in treatment questionnaire, therapist and patient measures

Abstract

Background: Treatment research for dissociative identity disorder (DID) and closely related severe dissociative disorders (DD) is rare, and has been made more difficult by the lack of a reliable, valid measure for assessing treatment progress in these populations. Objective: This paper presents psychometric data for therapist and patient report measures developed to evaluate therapeutic progress and outcomes for individuals with DID and other DD: the Progress in Treatment Questionnaire – Therapist (PITQ-t; a therapist report measure) and the Progress in Treatment Questionnaire – Patient (PITQ-p; a patient self-report measure). Method: We examined the data of 177 patient–therapist pairs (total N = 354) participating in the TOP DD Network Study, an online psychoeducation programme aimed at helping patients with DD establish safety, regulate emotions, and manage dissociative and posttraumatic symptoms. Results: The PITQ-t and PITQ-p demonstrated good internal consistency and evidence of moderate convergent validity in relation to established measures of emotional dysregulation, dissociation, posttraumatic stress disorder, and psychological quality of life, which are characteristic difficulties for DD patients. The measures also demonstrated significant relationships in the hypothesized directions with positive emotions, social relations, and self-harm and dangerous behaviours. The patient-completed PITQ-p, which may be used as an ongoing assessment measure to guide treatment planning, demonstrated evidence of stronger relationships with established symptom measures than the PITQ-t. Conclusions: The PITQ-t and PITQ-p merit use, additional research, and refinement in relation to the assessment of therapeutic progress with patients with DD.

An Online Educational Program for Individuals With Dissociative Disorders and Their Clinicians: 1‐Year and 2‐Year Follow‐Up

“…The Progress in Treatment Questionnaire, patient version (PITQ‐p; Schielke, Brand, & Marsic, ) is a self‐report measure that assesses ability to manage emotions, symptoms, relationships, safety, and well‐being over the prior 7 days. The PITQ‐p consists of 32 expert‐identified items, 6 of which (items 27–32) are only completed by patients who report experiencing dissociative self‐states (DSS).…”

“…The Progress in Treatment Questionnaire, therapist version (PITQ‐t; Schielke et al., ) is a therapist‐completed measure of dissociative patients’ ability to manage emotions, symptoms, relationships, safety, and well‐being over the prior 6 months. The 29‐item instrument assesses the percentage of time patients have demonstrated expert‐identified adaptive behaviors and includes 6 items (items 24–29) that the therapist completes only for their patients with DSS.…”

“…Responses are rated on an 11‐point Likert scale with options ranging from 0% ( never ) to 100% ( always ), with higher average scores indicative of better adaptive functioning; possible scores range from 0 to 100. The PITQ‐t has demonstrated good internal consistency (Cronbach's α = .91) and adequate convergent validity with measures of emotion‐related functioning (DERS; r = −.35), PTSD (PCL‐C; r = −.41), and dissociation (DES; r = −.29), as well as correlations in expected directions with NSSI ( r = −.37) and psychological ( r = .45) and social ( r = .22) quality of life (Schielke et al., ). In the current sample, Cronbach's alpha values ranged from .92 to .95 for patients with DSS and from .89 to .94 for patients without DSS.…”

Schema therapy for Dissociative Identity Disorder (DID): rationale and study protocol

“…Progress in Treatment Questionnaire (PITQ). Finally, progress in treatment is determined using the Progress in Treatment Questionnaire, consisting of a part to be completed by the therapist (PITQ-t) and a part to be completed by the patient (PITQ-p) (Schielke, Brand, & Marsic, 2017). This questionnaire was specifically developed for treatment research in dissociative disorders and assesses (therapist ratings of) the patients' ability to safely and effectively manage their emotions, symptoms, and relationships.…”

Dissociative Identity Disorder

“…The sample may overlap with an article that shares authors and reports similar sampling methods (Jacobson et al, 2015). b Schielke et al (2017) reported that their study was part of the TOP DD study (Brand et al, 2009) but did not explicitly state that the sample overlaps with that study. c Studies were part of the TOP DD study (Brand et al, 2009) and only provided an estimated percentage of patients with DID.…”