Validity and reliability of the Structured Clinical Interview for Depersonalization–Derealization Spectrum (SCI-DER)

Abstract

This study evaluates the validity and reliability of a new instrument developed to assess symptoms of depersonalization: the Structured Clinical Interview for the DepersonalizationDerealization Spectrum (SCI-DER). The instrument is based on a spectrum model that emphasizes soft-signs, sub-threshold syndromes as well as clinical and subsyndromal manifestations. Items of the interview include, in addition to DSM-IV criteria for depersonalization, a number of features derived from clinical experience and from a review of phenomenological descriptions. Study participants included 258 consecutive patients with mood and anxiety disorders, 16.7% bipolar I disorder, 18.6% bipolar II disorder, 32.9% major depression, 22.1% panic disorder, 4.7% obsessive compulsive disorder, and 1.5% generalized anxiety disorder; 2.7% patients were also diagnosed with depersonalization disorder. A comparison group of 42 unselected controls was enrolled at the same site. The SCI-DER showed excellent reliability and good concurrent validity with the Dissociative Experiences Scale. It signifi cantly discriminated subjects with any diagnosis of mood and anxiety disorders from controls and subjects with depersonalization disorder from controls. The hypothesized structure of the instrument was confi rmed empirically.

Rethinking Dissociation in an Age of Virtual Worlds

“…The Structured Clinical Interview for Depersonalization -Derealization Spectrum (SCI-DER) (Mula et al, 2008) was chosen as a model for a new survey. Questions were selected on the basis of how well they applied to the experience of using Second Life.…”

“…Items in this domain focus on derealization or "referring to an altered experience of the external world (Mula et al, 2008)." Question 2 is another example of this domain.…”

“…Question 12 references the Somatopsychic depersonalization domain which "describes a variety of changes in body experience such as lack of body ownership feelings, feelings of disembodiment, which can range from a nonspecific feeling of not being in the body to out-ofbody experiences and autoscopic hallucinations (Mula et al, 2008). "…”

“…The method of investigation was the development of a survey instrument based on the Structured Clinical Interview for Depersonalization -Derealization Spectrum (Mula et al, 2008). The new survey was in turn administered to a population of users of the virtual world Second Life.…”

Dissociable brain correlates for depression, anxiety, dissociation, and somatization in depersonalization-derealization disorder

“…9 However, both disorders are not entirely congruent, although studies typically report significant association between dissociative experience and DPRD self-report. 10 Neuroimaging studies on trait dissociation are still very scarce, and functional magnetic resonance imaging (fMRI) results on negative emotional memory have indicated heightened hippocampal and posterior parietal activity 11 in a nonclinical dissociators group. These findings have been corroborated by detection of underlying white matter abnormalities in the temporal lobes in patients with dissociation.…”