Assessing dissociation: A systematic review and evaluation of existing measures

Sorawit Wainipitapong; L. S.Merritt Millman; Xi Huang; Lillian Wieder; Devin B. Terhune; Susannah Pick

doi:10.1016/j.jpsychires.2024.11.040

Assessing dissociation: A systematic review and evaluation of existing measures

Sorawit Wainipitapong, L. S.Merritt Millman, Xi Huang, Lillian Wieder, Devin B. Terhune, Susannah Pick^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

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Abstract

Objective: This review aimed to assess the psychometric properties and methodological quality of existing dissociation measures. Methods: MEDLINE, Embase, and PsycINFO were searched in May 2023 using comprehensive search terms for ‘dissociation’ combined with terms for ‘measurement’ and ‘psychometric properties’. The review was registered with PROSPERO (CRD42023423485) and followed PRISMA and COSMIN guidelines. We assessed content validity, structural validity, cross-cultural validity, and different indices of reliability comprising 1) reliability (test-retest, inter-rater, intra-rater), 2) internal consistency, and 3) measurement error. Results: Of 7570 studies, 170 were eligible, revealing 44 measures of dissociation (86% trait dissociation, 14% state dissociation) and their 14 adapted versions. None of the measures met all COSMIN criteria for good psychometric properties and high methodological quality. Overall, methodological quality was rated as follows: ‘doubtful’ for content validity, ‘adequate’ for measurement error and cross-cultural validity, and ‘very good’ for structural validity and internal consistency. Most included studies did not assess the reliability of investigated measures. Conclusion: The Dissociative Experiences Scale (DES), adolescent DES, Peritraumatic Dissociative Experiences Questionnaire, Somatoform Dissociation Questionnaire-20, and Cambridge Depersonalisation Scale demonstrated strong evidence for measuring general, child/adolescent, trauma-related (state) or somatoform dissociation, and depersonalisation, respectively. Future research should refine or develop dissociation measures following COSMIN guidelines to ensure robust methodology and psychometric properties.

Original language	English
Pages (from-to)	91-98
Number of pages	8
Journal	Journal of psychiatric research
Volume	181
DOIs	https://doi.org/10.1016/j.jpsychires.2024.11.040
Publication status	Published - Jan 2025

Keywords

COSMIN
Dissociation
Measure
Psychometric properties
Questionnaire
Tool

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10.1016/j.jpsychires.2024.11.040

Accepted manuscriptAccepted author manuscript, 4.28 MBLicence: CC BY

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@article{e34f62cc88ee4900948c894dffd488c8,

title = "Assessing dissociation: A systematic review and evaluation of existing measures",

abstract = "Objective: This review aimed to assess the psychometric properties and methodological quality of existing dissociation measures. Methods: MEDLINE, Embase, and PsycINFO were searched in May 2023 using comprehensive search terms for {\textquoteleft}dissociation{\textquoteright} combined with terms for {\textquoteleft}measurement{\textquoteright} and {\textquoteleft}psychometric properties{\textquoteright}. The review was registered with PROSPERO (CRD42023423485) and followed PRISMA and COSMIN guidelines. We assessed content validity, structural validity, cross-cultural validity, and different indices of reliability comprising 1) reliability (test-retest, inter-rater, intra-rater), 2) internal consistency, and 3) measurement error. Results: Of 7570 studies, 170 were eligible, revealing 44 measures of dissociation (86% trait dissociation, 14% state dissociation) and their 14 adapted versions. None of the measures met all COSMIN criteria for good psychometric properties and high methodological quality. Overall, methodological quality was rated as follows: {\textquoteleft}doubtful{\textquoteright} for content validity, {\textquoteleft}adequate{\textquoteright} for measurement error and cross-cultural validity, and {\textquoteleft}very good{\textquoteright} for structural validity and internal consistency. Most included studies did not assess the reliability of investigated measures. Conclusion: The Dissociative Experiences Scale (DES), adolescent DES, Peritraumatic Dissociative Experiences Questionnaire, Somatoform Dissociation Questionnaire-20, and Cambridge Depersonalisation Scale demonstrated strong evidence for measuring general, child/adolescent, trauma-related (state) or somatoform dissociation, and depersonalisation, respectively. Future research should refine or develop dissociation measures following COSMIN guidelines to ensure robust methodology and psychometric properties.",

keywords = "COSMIN, Dissociation, Measure, Psychometric properties, Questionnaire, Tool",

author = "Sorawit Wainipitapong and Millman, {L. S.Merritt} and Xi Huang and Lillian Wieder and Terhune, {Devin B.} and Susannah Pick",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2025",

month = jan,

doi = "10.1016/j.jpsychires.2024.11.040",

language = "English",

volume = "181",

pages = "91--98",

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T2 - A systematic review and evaluation of existing measures

AU - Wainipitapong, Sorawit

AU - Millman, L. S.Merritt

AU - Huang, Xi

AU - Wieder, Lillian

AU - Terhune, Devin B.

AU - Pick, Susannah

PY - 2025/1

Y1 - 2025/1

N2 - Objective: This review aimed to assess the psychometric properties and methodological quality of existing dissociation measures. Methods: MEDLINE, Embase, and PsycINFO were searched in May 2023 using comprehensive search terms for ‘dissociation’ combined with terms for ‘measurement’ and ‘psychometric properties’. The review was registered with PROSPERO (CRD42023423485) and followed PRISMA and COSMIN guidelines. We assessed content validity, structural validity, cross-cultural validity, and different indices of reliability comprising 1) reliability (test-retest, inter-rater, intra-rater), 2) internal consistency, and 3) measurement error. Results: Of 7570 studies, 170 were eligible, revealing 44 measures of dissociation (86% trait dissociation, 14% state dissociation) and their 14 adapted versions. None of the measures met all COSMIN criteria for good psychometric properties and high methodological quality. Overall, methodological quality was rated as follows: ‘doubtful’ for content validity, ‘adequate’ for measurement error and cross-cultural validity, and ‘very good’ for structural validity and internal consistency. Most included studies did not assess the reliability of investigated measures. Conclusion: The Dissociative Experiences Scale (DES), adolescent DES, Peritraumatic Dissociative Experiences Questionnaire, Somatoform Dissociation Questionnaire-20, and Cambridge Depersonalisation Scale demonstrated strong evidence for measuring general, child/adolescent, trauma-related (state) or somatoform dissociation, and depersonalisation, respectively. Future research should refine or develop dissociation measures following COSMIN guidelines to ensure robust methodology and psychometric properties.

AB - Objective: This review aimed to assess the psychometric properties and methodological quality of existing dissociation measures. Methods: MEDLINE, Embase, and PsycINFO were searched in May 2023 using comprehensive search terms for ‘dissociation’ combined with terms for ‘measurement’ and ‘psychometric properties’. The review was registered with PROSPERO (CRD42023423485) and followed PRISMA and COSMIN guidelines. We assessed content validity, structural validity, cross-cultural validity, and different indices of reliability comprising 1) reliability (test-retest, inter-rater, intra-rater), 2) internal consistency, and 3) measurement error. Results: Of 7570 studies, 170 were eligible, revealing 44 measures of dissociation (86% trait dissociation, 14% state dissociation) and their 14 adapted versions. None of the measures met all COSMIN criteria for good psychometric properties and high methodological quality. Overall, methodological quality was rated as follows: ‘doubtful’ for content validity, ‘adequate’ for measurement error and cross-cultural validity, and ‘very good’ for structural validity and internal consistency. Most included studies did not assess the reliability of investigated measures. Conclusion: The Dissociative Experiences Scale (DES), adolescent DES, Peritraumatic Dissociative Experiences Questionnaire, Somatoform Dissociation Questionnaire-20, and Cambridge Depersonalisation Scale demonstrated strong evidence for measuring general, child/adolescent, trauma-related (state) or somatoform dissociation, and depersonalisation, respectively. Future research should refine or develop dissociation measures following COSMIN guidelines to ensure robust methodology and psychometric properties.

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KW - Dissociation

KW - Measure

KW - Psychometric properties

KW - Questionnaire

KW - Tool

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DO - 10.1016/j.jpsychires.2024.11.040

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VL - 181

SP - 91

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JO - Journal of psychiatric research

JF - Journal of psychiatric research

ER -

Assessing dissociation: A systematic review and evaluation of existing measures

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Keywords

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