After assessing the global rating scale, you should determine if patient interviewees with a PTSD diagnosis also qualify for the dissociative subtype.

Research has suggested that even though dissociative symptoms such as flashbacks and psychogenic amnesia are included as part of the core PTSD diagnosis, a subgroup of PTSD patients exhibit additional symptoms of dissociation. The DSM-5 therefore now includes a dissociative subtype of PTSD as a diagnostic specifier. Recognition of this subtype has the potential to improve the assessment and treatment outcome of PTSD. The CAPS-5 assesses the two dissociative symptoms included in this subtype: depersonalization and derealization.

Although the symptoms associated with the dissociative subtype are similar to the flashbacks in symptom B3, they differ in terms of the content of the dissociation. Specifically, if the person dissociates back to the traumatic event, that is coded as a flashback and not as a separate dissociative experience. In contrast, if the person experiences something about himself (depersonalization) or the world (derealization) as unreal, and the content does not match that of the trauma, we code these as separate dissociative symptoms. They will then qualify as symptoms of the PTSD dissociative subtype if they are tied to the trauma temporally (i.e., they started or got worse after the traumatic event). Select each symptom below to learn more then Next to continue.