Interpreting the Dissociative Experiences Scale (DES)
The Dissociative Experiences Scale (DES) is a reliable and valid 28-item self-report questionnaire designed to measure the frequency of dissociative experiences, with higher scores indicating greater levels of dissociation that may warrant clinical attention.
Overview of the DES
The DES was developed to measure dissociation, which is defined as a lack of normal integration of thoughts, feelings, and experiences into consciousness and memory 1. The standard version (DES-II) consists of 28 items where respondents indicate on a 100-mm line (or 0-100% scale) how frequently they experience each dissociative symptom.
Key Features of the Scale
- Format: 28-item self-report questionnaire
- Scoring: Each item is scored from 0-100%, with the final DES score being the mean of all item scores
- Administration time: Approximately 10 minutes
- Primary domains measured: Amnesia, depersonalization/derealization, and absorption
Scoring and Interpretation
Calculating the Score
- Add up the percentage scores for all 28 items
- Divide by 28 to get the mean score (0-100)
Interpreting Score Ranges
- 0-10: Normal range of dissociative experiences
- 10-20: Mild levels of dissociation
- 20-30: Moderate levels of dissociation that may warrant clinical attention
- >30: High levels of dissociation often associated with dissociative disorders, PTSD, or other trauma-related conditions
- >40: Very high levels typically seen in individuals with dissociative identity disorder
Clinical Applications
Screening Tool
The DES serves primarily as a screening tool, not a diagnostic instrument 2. High scores indicate the need for further clinical assessment, particularly for:
- Dissociative disorders
- Post-traumatic stress disorder
- History of trauma
- Other conditions with dissociative features
Important Considerations
Item-level analysis: Recent research suggests examining individual item responses rather than relying solely on the mean score 2. Items with particularly high scores may indicate specific areas of concern.
Cultural differences: Response patterns may vary across cultures 2. Be aware that cultural factors might influence how dissociative experiences are reported and interpreted.
Psychometric strengths: The DES has demonstrated good test-retest reliability, internal consistency, and construct validity across multiple studies 1, 3.
Potential limitations: In non-clinical populations, scores may show floor effects and skewness 4. Alternative versions like the DES-C (comparative format) may be more appropriate for non-clinical research.
Advanced Interpretation
Taxometric Analysis
Some researchers have developed a subset of 8 items from the DES (known as the DES-T) to specifically identify pathological dissociation. This can help differentiate between normal dissociative experiences (like absorption) and pathological dissociation.
Predictive Factors
Research has identified several factors that predict DES scores, including 5:
- Phobic anxiety
- Anger-hostility
- Somatization
- Absorption tendencies
Recent Refinements
Item response theory analysis suggests that the DES-II is particularly suitable for measuring stronger dissociative traits, with all items showing high discriminative power 2. Some studies have suggested removing 3 items that show misfit, resulting in a 25-item version with improved psychometric properties 3.
Common Pitfalls to Avoid
Treating the DES as diagnostic: The scale is a screening tool, not a diagnostic instrument. High scores require follow-up clinical assessment.
Ignoring context: Dissociative experiences can occur in normal individuals, especially under stress, fatigue, or during activities like meditation.
Overlooking comorbidities: High dissociation scores may be associated with various conditions including PTSD, borderline personality disorder, and psychotic disorders.
Relying solely on total score: Examine patterns of responses across different types of dissociative experiences (amnesia, depersonalization/derealization, absorption).
Cultural insensitivity: Cultural factors may influence the expression and reporting of dissociative experiences.
The DES remains one of the most widely used and validated measures of dissociative experiences, providing valuable information for both clinical assessment and research purposes when properly interpreted.