Editing Dissociative identity disorder (section)

===General===
The fifth, revised edition of the [[American Psychiatric Association]]'s [[Diagnostic and Statistical Manual of Mental Disorders]] (DSM-5-TR) diagnoses DID according to the diagnostic criteria found under [[DSM-5 codes#Dissociative disorders|code 300.14 (dissociative disorders)]]. DID is often initially misdiagnosed because clinicians receive little training about [[dissociative disorders]] or DID, and often use standard diagnostic interviews that do not include questions about trauma, dissociation, or post-traumatic symptoms.<ref name=Guidelines2011 />{{rp|style=ama|p= 118}} This contributes to difficulties diagnosing the disorder, and to clinician bias.<ref name=Guidelines2011 />

DID is rarely diagnosed in children.<ref name="pmid15560314"/> The criteria require that an individual be recurrently controlled by two or more discrete [[identity (social science)|identities]] or [[Personality psychology|personality]] states, accompanied by [[amnesia|memory lapses]] for important information that is not caused by alcohol, drugs or medications and other medical conditions such as [[complex partial seizure]]s.<ref name="DSM5" /> In children, the symptoms must not be better explained by "imaginary playmates or other fantasy play".<ref name="DSM5" /> Diagnosis is normally performed by a clinically trained mental health professional such as a [[psychiatrist]] or [[psychologist]] through clinical evaluation, interviews with family and friends, and consideration of other ancillary material. Specially designed interviews (such as the [[SCID-D]]) and personality assessment tools may be used in the evaluation as well.<ref name="webmd"/> Since most of the symptoms depend on self-report and are not concrete and observable, there is a degree of subjectivity in making the diagnosis.<ref name = Kihlstrom/> People are often disinclined to seek treatment, especially since their symptoms may not be taken seriously; thus dissociative disorders have been referred to as "diseases of hiddenness".<ref name="MacDonald"/><ref name="Recognizing Traumatic Dissociation">{{cite journal |author=Spiegel D |title=Recognizing Traumatic Dissociation |journal=American Journal of Psychiatry |volume=163 |issue=4 |pages=566–568 |year=2006 |pmid=16585425 |doi=10.1176/appi.ajp.163.4.566}}</ref>

The diagnosis has been criticized by supporters of ''therapy as a cause'' or the sociocognitive hypothesis as they believe it is a [[culture-bound syndrome|culture-bound]] and often health care induced condition.<ref name = Hersen2012/><ref name="pmid15560314">{{cite journal |vauthors=Piper A, Merskey H |year=2004 |title=The persistence of folly: Critical examination of dissociative identity disorder. Part II. The defence and decline of multiple personality or dissociative identity disorder |url=https://journals.sagepub.com/doi/epdf/10.1177/070674370404901005 |journal=Canadian Journal of Psychiatry |volume=49 |issue=10 |pages=678–683 |doi=10.1177/070674370404901005 |pmid=15560314 |s2cid=8304723 |doi-access=free}}</ref><ref name="pmid15503730" /> The social cues involved in diagnosis may be instrumental in shaping patient behavior or attribution, such that symptoms within one context may be linked to DID, while in another time or place the diagnosis could have been something other than DID.<ref name = Paris2012/> Other researchers disagree and argue that the existence of the condition and its inclusion in the DSM is supported by multiple lines of reliable evidence, with diagnostic criteria allowing it to be clearly discriminated from conditions it is often mistaken for (schizophrenia, borderline personality disorder, and seizure disorder).<ref name = Cardena/> That a large proportion of cases are diagnosed by specific health care providers, and that symptoms have been created in nonclinical research subjects given appropriate cueing has been suggested as evidence that a small number of clinicians who specialize in DID are responsible for the creation of alters through therapy.<ref name = Hersen2012/>