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Dissociative Experiences Scale

The Dissociative Experiences Scale (DES) is a 28-item self-report questionnaire developed to quantify the frequency of dissociative symptoms, such as disruptions in consciousness, memory, identity, and perception of the environment, in both normal and clinical populations.^[1] Introduced by Eve M. Bernstein and Frank W. Putnam in 1986, the scale is often described as assessing three main types of dissociative experiences: dissociative amnesia, absorption and imaginative involvement, and depersonalization and derealization.^[2] Each item presents a statement about a potential dissociative experience, and respondents indicate the percentage of time (from 0% to 100%) they encounter it in daily life by marking a point on a 100-mm line; the total DES score is the mean of these 28 values, yielding a range of 0 to 100, with higher scores reflecting greater dissociative tendencies.^[1] A revised version, the DES-II, was published in 1993 by Eve B. Carlson and Frank W. Putnam to improve ease of scoring while preserving the original content and properties; it is the most widely used form.^[2] The DES is employed in clinical practice to screen for dissociative and trauma-related disorders such as posttraumatic stress disorder (PTSD) and dissociative identity disorder, and in research investigating associations with childhood trauma and psychopathology.^[3]^[4]

Development and History

Original Development

The Dissociative Experiences Scale (DES) was developed in 1986 by Eve M. Bernstein and Frank W. Putnam, researchers at the National Institute of Mental Health (NIMH) in Bethesda, Maryland.^[1] Their work addressed a need for a standardized instrument to quantify dissociation, a phenomenon involving disruptions in the integration of consciousness, memory, identity, or perception of the environment, which occurs on a continuum from everyday experiences to severe psychopathology.^[1] The primary purpose of the DES was to provide a reliable self-report measure of dissociative experiences applicable to both non-clinical populations—such as individuals prone to absorption in tasks or imaginative involvement—and clinical groups, particularly those with trauma-related disorders like multiple personality disorder (now known as dissociative identity disorder).^[1] Items for the scale were generated through a multifaceted process drawing on clinical observations, patient interviews, existing memory loss inventories, and consultations with experts in dissociation, resulting in 28 items.^[1] These were refined following pilot testing with normal and schizophrenic subjects to ensure clarity, relevance, and discriminatory power.^[1] The initial publication of the DES appeared in the Journal of Nervous and Mental Disease (volume 174, pages 727–735), where the scale's foundational structure—a 28-item questionnaire using visual analog lines for responses—was detailed alongside preliminary evidence of its utility.^[1] Early validation efforts involved administering the scale to eight distinct groups totaling 182 participants, including normal adults (n=34), college students (n=31), and patients with conditions such as multiple personality disorder (n=20), demonstrating its potential to differentiate levels of dissociation across these cohorts.^[1] This development laid the groundwork for the DES as a brief, non-pathologizing tool suitable for screening in both research and clinical settings.^[1]

Revisions and Updates

In 1993, Eve Bernstein Carlson and Frank W. Putnam revised the original Dissociative Experiences Scale (DES), resulting in the Dissociative Experiences Scale-II (DES-II), which was published in the journal Dissociation.^[5] The primary modification involved changing the response format from a continuous visual analogue scale, where respondents marked a point along a 100 mm line to indicate frequency (0-100%), to a discrete 11-point Likert-type scale with options at 0, 10, 20, ..., up to 100 percent.^[6] This alteration aimed to reduce respondent burden by simplifying the marking process and to minimize scoring subjectivity, as the original method required measuring line positions, which could introduce measurement error and complicate administration in clinical settings.^[5] Building on this revision, Waller, Putnam, and Carlson introduced the DES-Taxon (DES-T) in 1996 as a specialized subset of eight items from the DES-II, designed to distinguish pathological dissociation—conceptualized as a discrete "taxon" indicative of dissociative disorders—from normative dissociative experiences through taxometric analysis.^[7] The DES-T focuses on severe symptoms such as identity alteration and amnesia, enhancing the instrument's ability to identify high-risk individuals for dissociative pathology in research and clinical contexts.^[8] Subsequent minor updates have included translations of the DES-II into more than 20 languages, facilitating cross-cultural research and assessment while maintaining psychometric integrity through validation studies in diverse populations.^[9] Adaptations for specific groups, such as the Adolescent Dissociative Experiences Scale (A-DES) developed in 1997, extend the tool's applicability to youth aged 11-17 by adjusting items for developmental relevance without altering the core structure. These revisions collectively improve usability, precision, and clinical utility while addressing early limitations in the baseline instrument.

Structure and Administration

Questionnaire Items and Format

The Dissociative Experiences Scale (DES) is a 28-item self-report questionnaire designed to measure the frequency of dissociative experiences in daily life. It assesses a broad range of dissociative phenomena, including both normative and pathological forms, without requiring clinical training for administration. The items are organized around three primary domains: absorption and imaginative involvement, which captures intense focus leading to a loss of awareness of surroundings (e.g., becoming completely absorbed in a book or daydream); depersonalization and derealization, involving feelings of detachment from one's body or the unreality of the external world (e.g., observing oneself from outside); and amnesia, reflecting unexplained gaps in memory for everyday events (e.g., discovering possessions one does not recall acquiring).^[10] These domains emerged from factor analytic studies of the scale's structure, providing a comprehensive evaluation of dissociation as a continuum rather than isolated symptoms.^[2] Each item consists of a first-person statement describing a common dissociative experience, with respondents indicating the percentage of time it occurs in their life. For example, one item states: "Some people have the experience of driving or riding in a car or bus or subway and suddenly realizing that they don't remember what has happened during all or part of the trip," rated from 0% (never) to 100% (always) in 10% increments by circling the appropriate value.^[11] The response options are presented visually as a line or scale divided into segments, ensuring ease of use for self-administration. Instructions emphasize reporting experiences only when not under the influence of alcohol or drugs, and respondents are encouraged to consider their typical state over time rather than recent episodes. This format, refined in the DES-II version, uses discrete percentage points instead of a continuous line to improve accessibility and reduce respondent burden.^[12] Administration of the DES typically takes 10 to 15 minutes and is suitable for adults aged 18 and older, with no specialized training required for the administrator.^[2] It can be completed individually or in group settings, such as clinics or research studies, and is intended for anonymous use to promote honest responses. The questionnaire is freely available for clinical and research purposes, provided permission is obtained from the authors or their representatives, reflecting its development as an accessible screening tool.^[12]

Scoring Procedures

The Dissociative Experiences Scale (DES) yields a total score calculated as the average of responses to all 28 items, each rated on a scale from 0 to 100, resulting in a possible range of 0 to 100; higher scores reflect greater overall dissociative tendencies.^[5] Subscale scores are derived similarly by averaging responses within each domain: the Absorption/Imaginative Involvement subscale (12 items), the Depersonalization/Derealization subscale (8 items), and the Amnesia subscale (8 items).^[5] In the revised DES-II, respondents indicate the frequency of each experience by circling the percentage (0 to 100 in 10% increments) that best matches how often they have it; the item score is the selected percentage, used directly in computing overall and subscale averages.^[5] The DES-Taxon, a subset measure for identifying pathological dissociation, is scored by summing responses to 8 specific items and dividing by 8 to obtain an average (range 0-100); scores of 20 to 25 or higher indicate likely membership in a dissociative taxon requiring further evaluation.^[7] General interpretation guidelines classify total DES scores below 10 as within normal limits, 10 to 30 as indicative of mild dissociative experiences, and above 30 as clinically significant, though these thresholds support screening rather than diagnosis.^[5]

Psychometric Properties

Reliability Measures

The Dissociative Experiences Scale (DES) exhibits high internal consistency, with Cronbach's alpha values typically ranging from 0.93 to 0.96 across multiple studies, reflecting strong interrelatedness among its 28 items.^[2] This level of consistency has been consistently reported in both non-clinical and clinical populations, underscoring the scale's ability to measure dissociation as a cohesive construct.^[13] In the original validation, item-to-scale score correlations ranged from 0.50 to 0.79 (median 0.64, all p < 0.0001), further supporting the items' homogeneity.^[1] Test-retest reliability for the DES is robust, particularly in non-clinical samples, with correlation coefficients ranging from 0.78 to 0.93 across studies and 0.84 over 4- to 8-week intervals in the original validation.^[1]^[14] In clinical groups, such as those with posttraumatic stress disorder (PTSD) or dissociative identity disorder (DID), scores demonstrate notable stability over time, indicating the scale's capacity to capture enduring dissociative tendencies.^[15] As a self-report instrument, inter-rater reliability is not applicable, but split-half reliability remains high at approximately 0.90 (Spearman-Brown corrected), with coefficients ranging from 0.83 to 0.93 across diverse samples.^[1]^[16] The DES also shows consistent performance across demographic variables in general populations, with no significant differences by sex (Mann-Whitney U-test, p > 0.05) and only weak correlations with age (r = -0.19, p < 0.01) or socioeconomic status (r = 0.15, p < 0.08).^[1] In clinical contexts, reliability remains elevated; for instance, split-half coefficients were 0.74 in PTSD patients (p = 0.01, n = 10) and 0.92 in DID patients (p < 0.0001, n = 20), affirming the scale's robustness in these groups.^[1]

Validity and Factor Structure

The Dissociative Experiences Scale (DES) demonstrates strong construct validity through its correlations with other established measures of dissociation and its ability to differentiate clinical from non-clinical populations. For instance, meta-analytic evidence indicates a large effect size (d = 1.82) for associations between DES scores and other dissociation questionnaires or interview schedules, reflecting robust convergence with related constructs. ^[14] In clinical samples, DES scores among individuals with dissociative identity disorder (DID) average 48.7 (95% CI: 46.4–50.9), substantially higher than non-clinical population means of approximately 8–11. ^[17] Similarly, multicenter studies report mean DES scores of 42.8 (SD = 19.2) in multiple personality disorder (now DID) patients, enabling effective discrimination from normal controls and other psychiatric groups with sensitivity and specificity around 76–80% at a cutoff of 30. ^[18] Convergent validity is evident in DES's moderate to large associations with trauma history (d = 0.52) and posttraumatic stress disorder (PTSD) symptoms (d = 0.75), underscoring its alignment with trauma-related dissociative phenomena. ^[14] Discriminant validity is supported by weaker correlations with measures of anxiety and depression (typically r < 0.50), indicating that DES primarily captures dissociation rather than overlapping emotional distress. ^[14] The factor structure of the DES is consistently described as comprising three primary dimensions: absorption and imaginative involvement, depersonalization/derealization, and amnesia, as confirmed by exploratory and confirmatory factor analyses across diverse samples. ^[19] These factors account for the scale's multidimensional nature, with absorption reflecting focused attention lapses, depersonalization involving detachment from self or surroundings, and amnesia capturing memory gaps. ^[20] Additionally, the DES-Taxon subscale, derived from eight items targeting severe experiences, serves as a distinct indicator of pathological dissociation, enhancing the scale's utility in identifying extreme pathology beyond normative variation. ^[8] Some studies have questioned the DES's unidimensionality, favoring the three-factor model over a single overarching construct, while empirical evaluations highlight concerns with item wording and the response format, which may contribute to lower dependability in certain contexts. ^[21] Recent item response theory analyses affirm the scale's overall validity and unidimensionality (with the first factor explaining 43% of variance), but recommend minor refinements, such as item-specific cutoffs, to improve precision in measuring strong dissociative traits. ^[15]

Clinical and Research Applications

Screening and Diagnostic Utility

The Dissociative Experiences Scale (DES) serves primarily as a screening tool for identifying potential dissociative disorders, such as dissociative identity disorder (DID), depersonalization-derealization disorder, and other specified dissociative disorder (OSDD), within clinical settings including trauma clinics, PTSD assessments, and general psychiatric evaluations. Developed to detect a broad range of dissociative symptoms, the DES helps clinicians flag individuals who may require further investigation, particularly those with histories of trauma where dissociation often co-occurs with conditions like PTSD.^[17] In practice, a total score exceeding 30 on the DES indicates elevated risk, prompting referral for more in-depth assessment.^[3] Integration of the DES into diagnostic processes involves follow-up with structured interviews, such as the Dissociative Disorders Interview Schedule (DDIS) or the Structured Clinical Interview for Dissociative Disorders (SCID-D), to confirm diagnoses when scores surpass the 30 threshold.^[3] This approach enhances differential diagnosis by distinguishing dissociative disorders from overlapping conditions like borderline personality disorder (BPD), where dissociative symptoms may appear but lack the pathological identity alterations seen in DID. Similarly, the DES aids in ruling out malingering, as high scores in suggestible individuals can mimic true pathology, necessitating corroborative clinical judgment.^[22] In therapeutic contexts, the DES informs treatment planning for trauma survivors by quantifying dissociation severity, guiding interventions like trauma-focused therapies that address dissociative barriers to processing.^[17] It is also applied in specialized clinics evaluating comorbid conditions, such as dissociation in eating disorders or substance use disorders, where elevated DES scores correlate with trauma-related symptoms and inform integrated care strategies.^[17] Despite its utility, the DES is not a standalone diagnostic instrument and must be paired with clinical interviews to avoid misdiagnosis, as it captures both normative and pathological experiences. The DES-Taxon (DES-T), an 8-item subscale focusing on severe symptoms, improves specificity for pathological dissociation over the full DES, with a cutoff of approximately 20 identifying cases more accurately and reducing false positives from suggestibility or absorption.^[23]

Normative Data and Interpretations

Normative data for the Dissociative Experiences Scale (DES) have been established through meta-analyses and large-scale studies across diverse populations, providing benchmarks for interpreting scores on a scale ranging from 0 to 100. In non-clinical samples, mean total scores typically range from 4.4 to 14.3, with community adults averaging 11.6 (SD = 10.6). Undergraduate students often score around 10.6, reflecting common experiences like absorption in everyday activities.^[5] Clinical populations exhibit markedly higher scores, indicating elevated dissociative symptoms. Individuals with posttraumatic stress disorder (PTSD) have mean scores of approximately 31 (range: 26–31.5), while those with dissociative identity disorder (DID) average 48 (range: 38.9–48.7), with fewer than 1% of DID patients scoring below 30.^[24] In eating disorders, mean scores fall between 20 and 35, highlighting a moderate elevation compared to non-clinical groups.^[17] Subscale analyses reveal distinct patterns across groups. The amnesia subscale (items assessing memory gaps) yields the highest scores in clinical populations, such as those with DID or PTSD, often exceeding 40, whereas absorption (items related to imaginative involvement) is more prominent in non-clinical samples, with means around 15–20 reflecting normative imaginative tendencies.^[24] Depersonalization/derealization subscales remain lower in general populations (means <10) but rise significantly in dissociative disorders. Interpretations of DES scores guide risk assessment, with scores of 0–9.9 indicating low risk of dissociative psychopathology, 10–29.9 suggesting moderate risk warranting further evaluation, and ≥30 signaling high risk for referral to a structured clinical interview.^[24] Cultural considerations are essential, as translations of the DES into languages like Spanish, Turkish, and Japanese maintain reliability but may yield slightly varied norms due to differences in reporting dissociative experiences influenced by cultural norms around trance or spiritual practices. Longitudinal studies demonstrate score stability in non-traumatized individuals, with test-retest correlations of 0.79–0.84 over 4–8 weeks, supporting the measure's consistency over time.^[24] In contrast, scores often elevate following trauma exposure, with increases observed in PTSD cohorts post-event, underscoring the scale's sensitivity to acute stressors.^[25]

References

[1]
Development, reliability, and validity of a dissociation scale - PubMed
The Dissociative Experiences Scale (DES) has been developed to offer a means of reliably measuring dissociation in normal and clinical populations.
[2]
Dissociative Experiences Scale – II (DES-II) - NovoPsych
The DES-II was developed by Carlson and Putnam (1993) as a revision of the original DES (Bernstein & Putnam, 1986) to measure dissociative experiences in ...
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Validity of the Dissociative Experiences Scale in screening for ...
Objective: The Dissociative Experiences Scale has proved a reliable and valid instrument to measure dissociation in many groups, but its capacity to ...
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https://doi.org/10.1037/a0027447
[5]
An Update on the Dissociative Experiences Scale - ResearchGate
Aug 9, 2025 · Reviews studies that relate to the norms, reliability, and validity of the Dissociative Experiences Scale (DES).
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Improving the psychometric properties of the dissociative ...
Jan 7, 2020 · The aim of the present study was to collect new psychometric evidence to improve the properties of the DES-II using Rasch analysis.Study Design And... · Fig. 1 · Fig. 2
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Types of dissociation and dissociative types: A taxometric analysis of ...
Carlson, E. B., & Putnam, F. W. (1993). An update on the Dissociative Experiences Scale. Dissociation: Progress in the Dissociative Disorders, 6(1), 16–27.
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Waller, N. G., Putnam, F. W., & Carlson, E. B. (1996). Types of dissociation and dissociative types: A taxometric analysis of Dissociative Experiences ...
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(PDF) On the factor structure of the Dissociative Experiences Scale ...
Sep 1, 2015 · ... Dissociative Experiences Scale-Revised; DES-II, Carlson and ... translated into more than 20 languages and it has mostly. been used ...
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[PDF] Development and Validation of the Dissociative Symptoms Scale
The Dissociative Experiences. Scale (DES; Bernstein & Putnam, 1986) includes items ranging from mild to very severe. On the severe end of the spectrum, six ...
[11]
[PDF] Dissociative Experiences Scale-II (DES-II)
Directions: This questionnaire consists of twenty-eight questions about experiences that you may have in your daily life. We are interested in how often you ...
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Dissociative Experiences Scale - II
### Summary of Dissociative Experiences Scale (DES-II)
[13]
Psychometric properties of the Dissociative Experiences Scale
The test-retest reliability of the Dissociative Experiences Scale (DES; Bernstein EM, Putnam FW [1986] Development, reliability, and validity of a dissociation ...
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(PDF) Improving the psychometric properties of the dissociative ...
This model allows the estimation of participants' level of dissociation, the degree of misfit of each item, the reliability of each item, and their measurement ...
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Meta-analytic validation of the Dissociative Experiences Scale (DES)
The Dissociative Experiences Scale (DES) has now been used in over 100 studies on dissociation. This article reports on a series of meta-analyses.Missing: undergraduates | Show results with:undergraduates
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Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies ...
Sep 26, 2017 · This meta-analysis offers a systematic and evidence-based study of the prevalence and distribution of dissociation, as assessed by the Dissociative Experiences ...Abstract · Conclusions · Discussion
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(PDF) Validity of the Dissociative Experiences Scale in screening for ...
The Dissociative Experiences Scale has proved a reliable and valid instrument to measure dissociation in many groups, but its capacity to distinguish ...
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Improving the psychometric properties of the dissociative ...
Jan 7, 2020 · The aim of the present study was to collect new psychometric evidence to improve the properties of the DES-II using Rasch analysis.Missing: generation | Show results with:generation<|control11|><|separator|>
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Factor Structure of the Dissociative Experiences Scale - ResearchGate
Aug 6, 2025 · Even though a three-factor structure (ie, absorption, amnesia, and depersonalization-derealization dimensions) has been consistently documented, ...
[20]
The Dissociative Experiences Scale: An Empirical Evaluation of ...
Sep 28, 2025 · In addition, the measure has demonstrated poorer dependability (e.g., short-term test–retest reliability) than other dissociation measures. The ...
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An item response theory analysis of the Dissociative Experiences ...
Jan 9, 2025 · We used the Japanese version of the Dissociative Experiences Scale II [19], which consists of 28 items; participants rated on an 11-point scale ...Missing: norms | Show results with:norms
[22]
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Sep 3, 2020 · Self-reported peritraumatic dissociation is typically assessed months or years after trauma exposure and may be influenced by current distress levels and other ...