Multidimensional Inventory of Dissociation – 60-item version (MID-60)

Assessments

Description
The Multidimensional Inventory of Dissociation 60-item version (MID-60) is a screening tool for adults (18 years +) that assesses dissociative symptoms and experiences specific to DSM-5-TR dissociative disorders. It also captures dissociative experiences, PTSD and somatic symptoms, and phenomena closely related to dissociation such as trance and self-confusion. There is also an adolescent version for use with adolescents ages 16 to 19 years of age – the MID-60-A.

Validity and Reliability
Dissociation is an adaptive defence in response to high stress or trauma that is characterised by memory loss, depersonalisation, derealisation, identity confusion, and identity alteration. Around 10% of the population will meet criteria for a dissociative disorder during their lifetime (Kate, Hopwood, Jamieson, 2020).

Interpretation
Scores for each item range from zero (never) to 10 (always). The MID-60 mean score represents the percentage of time the person self-reports having dissociative symptoms and experiences. Hence, a person with dissociative identity disorder may have dissociative symptoms and experiences around half the time (51%) whereas for a university student this may be 13% of the time. A mean score of more than 21% indicates clinically significant symptoms. Interpretation of MID-60 mean scores is consistent with the 218-item MID. Specifically: 0–7: Does not have dissociative experiences 7–14: Has few diagnostically significant dissociative experiences 15–20: Mild dissociative symptoms and experiences. PTSD or a mild dissociative disorder (such as dissociative amnesia, depersonalisation / derealisation disorder) are possible 21–30: May have dissociative disorder and/or PTSD 31–40: May have a dissociative disorder (such as OSDD-1 or DID) and PTSD 41–64: Probably has DID or a severe dissociative disorder and PTSD 64 +: Severe dissociative and post-traumatic symptoms. High scores may also reflect neuroticism, attention seeking behaviour, exaggeration or malingering of symptoms, or psychosis Subscales The MID-60 provides information on subscales relevant to different diagnoses. This enables the clinician to form an impression about the likely diagnosis. For example, a score of 27% is clinically significant, but does not indicate the most likely diagnosis. If the subscales of PTSD and depersonalisation/derealisation are both above the clinical threshold, this can indicate the person has the dissociative subtype of PTSD, whereas if the memory-related subscales are above the clinical threshold this can indicate dissociative amnesia. Another example is a person who scores 45%, which would seem to indicate dissociative identity disorder. Yet, if the subscale score for amnesia (for recent events) is not elevated, this points towards a more severe case of other specified dissociative disorder. The subscales are: DID: Amnesia (for recent events) – items 42, 45, 48, 58. Clinical cutoff = 10 DID / OSDD-1: Subjective awareness of alter personalities and self-states – items 3, 36, 39, 49, 57. Clinical cutoff = 20 DID / OSDD-1: Angry intrusions – items 28, 33, 35, 46, 60. Clinical cutoff = 18 DID / OSDD-1: Persecutory intrusions – items 22, 37, 44, 56, 59. Clinical cutoff = 18 Derealisation/Depersonalisation – items 2, 7, 9, 13, 25, 47, 50, 53. Clinical cutoff = 20 Dissociative Amnesia: Distress about severe memory problems – items 1, 8, 20, 38, 43, 52. Clinical cutoff = 30 Dissociative Amnesia: Loss of autobiographical memory – items 16, 19, 24, 29, 34. Clinical cutoff = 34 PTSD: Flashbacks – items 4, 15, 31, 40, 54. Clinical cutoff = 16 Conversion Disorder: Body symptoms – items 5, 10, 14, 18. Clinical cutoff = 10 Conversion Disorder: Pseudo-Seizures (Psychogenic non-epileptic seizures) – item 26. Clinical cutoff = 10 General Subscales: Trance – items 21, 27, 30, 32, 41, 51. Clinical cutoff = 11.7 General Subscales: Self-confusion – items 6, 11, 12, 17, 23, 55. Clinical cutoff = 33.3 The MID-60 is for screening purposes, is not designed to be the sole determinant of a diagnosis and should always be used in conjunction with clinical expertise. Further evaluations can be conducted with the Structured Clinical Interview for DSM-5 Dissociative Disorders (SCID-D) or Dissociative Disorders Interview Schedule (DDIS).

Developer
Kate, M.-A., Jamieson, G., Dorahy, M. J., & Middleton, W. (2021). Measuring Dissociative Symptoms and Experiences in an Australian College Sample Using a Short Version of the Multidimensional Inventory of Dissociation. Journal of Trauma & Dissociation, 22(3), 265-287. https://doi.org/10.1080/15299732.2020.1792024

Number Of Questions
60

References
Dell, P. F. (2006). The Multidimensional Inventory of Dissociation (MID): A Comprehensive measure of pathological dissociation. Journal of Trauma & Dissociation, 7(2), 77-106. Dell, P. F., Coy, D. M., & Madere, J. (2017). An Interpretive Manual for the Multidimensional Inventory of Dissociation (MID). In (2nd ed.). https://www.mid-assessment.com/request-mid-analysis/ Kate, M.-A., Jamieson, G., & Middleton, W. (2021). Childhood Sexual, Emotional, and Physical Abuse as Predictors of Dissociation in Adulthood. Journal of Child Sexual Abuse, 1-24. https://doi.org/10.1080/10538712.2021.1955789 Kate, M.-A., Jamieson, G., & Middleton, W. (2022). Parent-child dynamics as predictors of dissociation in adulthood. [Manuscript submitted for publication]. Psychological Sciences, Southern Cross University. Kate, M.-A., Jamieson, G., Dorahy, M. J., & Middleton, W. (2021). Measuring Dissociative Symptoms and Experiences in an Australian College Sample Using a Short Version of the Multidimensional Inventory of Dissociation. Journal of Trauma & Dissociation, 22(3), 265-287. https://doi.org/10.1080/15299732.2020.1792024 Kate, M.-A., Hopwood, T., & Jamieson, G. (2020). The prevalence of Dissociative Disorders and dissociative experiences in college populations: a meta-analysis of 98 studies. Journal of Trauma & Dissociation, 21(1), 16-61. https://doi.org/10.1080/15299732.2019.1647915 Korzekwa, M. I., Dell, P. F., Links, P. S., Thabane, L., & Fougere, P. (2009). Dissociation in Borderline Personality Disorder: A Detailed Look. Journal of Trauma & Dissociation, 10(3), 346-367. https://doi.org/10.1080/15299730902956838 Laddis, A., & Dell, P. F. (2012). Dissociation and Psychosis in Dissociative Identity Disorder and Schizophrenia. Journal of Trauma & Dissociation, 13(4), 397-413. https://doi.org/10.1080/15299732.2012.664967

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