what is DDNOS?

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disorders in which the predominant feature is a dissociative symptom (i.e., a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment) that does not meet the criteria for any specific Dissociative Disorder. Examples include

1. Clinical presentations similar to Dissociative Identity Disorder that fail to meet full criteria for this disorder. Examples include presentations in which a) there are not two or more distinct personality states, or b) amnesia for important personal information does not occur.

2. Derealization unaccompanied by depersonalization in adults.

3. States of dissociation that occur in individuals who have been subjected to periods of prolonged and intense coercive persuasion (e.g., brainwashing, thought reform, or indoctrination while captive).

4. Dissociative trance disorder: single or episodic disturbances in the state of consciousness, identity, or memory that are indigenous to particular locations and cultures. Dissociative trance involves narrowing of awareness of immediate surroundings or stereotyped behaviors or movements that are experienced as being beyond one’s control. Possession trance involves replacement of the customary sense of personal identity by a new identity, attributed to the influence of a spirit, power, deity, or other person, and associated with stereotyped “involuntary” movements or amnesia and is perhaps the most common Dissociative Disorder in Asia. Examples include amok (Indonesia), bebainan (Indonesia), latah (Malaysia), pibloktoq (Arctic), ataque de nervios (Latin America), and possession (India). The dissociative or trance disorder is not a normal part of a broadly accepted collective cultural or religious practice. (See Appendix B in DSM-IV-TR for suggested research criteria.)

5. Loss of consciousness, stupor, or coma not attributable to a general medical condition.

6. Ganser syndrome: the giving of approximate answers to questions(e.g., “2 plus 2 equals 5”) when not associated with Dissociative Amnesia or Dissociative Fugue

From the DSM-IV

Dissociative Disorder Not Otherwise Specified (DDNOS) is an inclusive category for classifying dissociative syndromes that do not meet the full criteria of any of the other dissociative disorders. A person diagnosed with Dissociative Disorder Not Otherwise Specified (DDNOS) typically displays characteristics very similar to some of the other discussed dissociative disorders, but not severe enough to receive their diagnoses. DDNOS includes variants of Dissociative Identity Disorder in which personality “states” may take over consciousness and behavior but are not sufficiently distinct, varients where alters are present but either do not take over consciousness or only ever do so in a co-consiouss mannor with the host, or variants of Dissociative identity disorder in which there is no amnesia for personal information. Other forms of DDNOS include possession and trance states, Ganser’s syndrome, derealization unaccompanied by depersonalization, dissociated states in people who have undergone intense coercive persuasion (e.g., brainwashing, kidnapping), and loss of consciousness not attributed to a medical condition.

DDNOS occurs primarily in men (80%) and is currently regarded as a dissociative means of withdrawal from a traumatic or stressful circumstance. It is characterized by absurd or approximate responses to interview dialogue, a dazed or clouded level of consciousness, somatic conversion symptoms (eg, pseudoparalysis), hallucinations, and, frequently, anterograde amnesia regarding the episode.