书城心理学心理创伤的理论与研究
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第38章 1 分离体验量表

(Dissociative Experience Scale,简称DES)

DES是Bernstein和Putnam(Bernstein&Putnam,1986)发展的一套包括28个项目用于评估分离性症状的简要自陈式量表(Boon&Drajer,1993),该量表测试分离性体验,判定分离在精神病障碍上的影响和测定分离性障碍(Carlson&Putnam,1993;Bernstein&Putnam,1986;Coons et al。,1989;Branscomb,1991;Boon&Draijer,1993;Saxe et al。,1993)。DES评估分离的连续性,陈述范围从一般性到本质上最严重的程度,如“有些人有时候会感觉他们周围其他的人、物和世界是不真实的”。请被试在0%~100%之间选择出自己符合这种情况的百分比。这种量表容易施测,对被试没有侵入性或伤害性。

DES综合了DSM中关于分离性障碍的诊断标准和专家们的意见,所测特征是相对状态的稳定,所需要的是日常生活中分离性体验的发生频率。量表中有28个问题,每一问题的评分均从0%~100%,按10%递增,共10个评分档次供被测者选择。28个问题所得分之总和除以28便为DES得分。Cross等将这28个问题分为四类,包含三种变量因素:第一类(因素1)称为“注意—想象干扰”,由具有高度普遍性的有关体验组成,属良性体验,共12条,如“对谈话内容的遗忘”和“对疼痛的忽视”等;第二类(因素2)称“分离状态特性”,有4条,是多重人格障碍的次重要特征;第三类(因素3)称“人格解体—现实解体”,有5条;第四类有7条,不负载任何因素。因素2和3均可筛选出分离性障碍者,并可将多重人格障碍鉴别出来。

目前DES应用在以下几方面:第一,各种精神障碍疾病患者分离水平的测定,如PTSD、进食障碍、边缘型人格障碍,也可用于检测非临床人群的分离水平,如一般人群、大学生、青少年等。第二,筛选分离性症状与其他精神症状以及其他专科疾病症状之间的关系,如自杀、躯体转换、慢性骨盆疼痛、经前综合征、癫痫、攻击行为和超常体验,也用于研究理性体验与儿童性行为紊乱、物质滥用的关系。第三,分离性水平与生物学过程间的关系。已经发现进食障碍患者的DES评分与脑脊液中高香草酸含量呈明显正相关,而与茁-脑啡肽呈明显负相关;DES评分高者对痛觉的反应更迟钝。

DES在三个研究中的重测信度系数是0.79~0.94,在两个研究中的分半信度系数是0.83~0.93(Carlson&Putnam,1993)。目前该量表已经被译成法国、西班牙、意大利、北印度、柬埔寨、以色列、日本、挪威、捷克等多国文字,其信效度评分基本一致。本实验用DES测试筛选了三所学校的大学本科学生和研究生,共回收有效量表2981份。其中华师本科生有效回收量表844份,研究生387份,星海本科生有效回收量表1426份,华工本科生有效回收量表324份。

DES英文版

Dissociative Experience Scale

This questionnaire consists of twenty-eight questions about experiences that you may have in your daily life。We are interested in how often you have these experiences。It is important, however, that your answers show how often these experiences happen to you when you are not under the influence of alcohol or drugs。To answer the questions, please determine to what degree the experience described in the question applies to you circle the number to show what percentage of the time you have the experience。

1. Some people have the experience of driving a car and suddenly realizing that they don't remember what has happened during all or part of the trip。Circle a number to show what percentage of the time this happens to you。

2.Some people find that sometimes they are listening to someone talk and they suddenly realize that they did not hear part or all of what was said。Circle a number to show what percentage of the time this happens to you。

3.Some people have the experience of finding themselves in a place and having no idea how they got there。Circle a number to show what percentage of the time this happens to you。

4.Some people have the experience of finding themselves dressed in clothes that they don't remember putting on。Circle a number to show what percentage of the time this happens to you。

5.Some people have the experience of finding new things among their belonging that they do not remember buying。Circle a number to show what percentage of the time this happens to you。

6.Some people sometimes find that they are approached by people that they do not know who call them by another name or insist that they have met them before。Circle a number to show what percentage of the time this happens to you。

7.Some people sometimes have the experience of feeling as though they are standing next to themselves or watching themselves do something and they actually see themselves as if they were looking at another person。Circle a number to show what percentage of the time this happens to you。

8.Some people are told that they sometimes do not recognize friends or family members。Circle a number to show what percentage of the time this happens to you。

9.Some people find that they have no memory for some important events in their lives(for example, a wedding or graduation)。Circle a number to show what percentage of the time this happens to you。

10.Some people have the experience of being accused of lying when they do not think that they have lied。Circle a number to show what percentage of the time this happens to you。

11.Some people have the experience of looking in a mirror and not recognizing themselves。Circle a number to show what percentage of the time this happens to you。

12.Some people have the experience of feeling that other people, objects, and the world around them are not real。Circle a number to show what percentage of the time this happens to you。

13.Some people have the experience of feeling that their body does not seem to belong to them。Circle a number to show what percentage of the time this happens to you。

14.Some people have the experience of sometimes remembering a past event so vividly that they feel as if they were reliving that event。Circle a number to show what percentage of the time this happens to you。

15.Some people have the experience of not being sure whether things that they remember happening really did happen or whether they justdreamed them。Circle a number to show what percentage of the time this happens to you。

16.Some people have the experience of being in a familiar place but finding it strange and unfamiliar。Circle a number to show what percentage of the time this happens to you。

17.Some people find that when they are watching television or a movie they become so absorbed in the story that they are unaware of other events happening around them。Circle a number to show what percentage of the time this happens to you。

18.Some people find that they become so involved in a fantasy or daydream that it feels as though it were really happening to them。Circle a number to show what percentage of the time this happens to you。

19.Some people find that they are sometimes able to ignore pain。Circle a number to show what percentage of the time this happens to you。

20.Some people find that they sometimes sit staring off into space, thinking of nothing and are not aware of the passage of time。Circle a number to show what percentage of the time this happens to you。

21.Some people sometimes find that when they are alone they talk out loud to themselves。Circle a number to show what percentage of the time this happens to you。

22.Some people find that in one situation they may act so differently compared with another situation that they feel almost as if they were two different people。Circle a number to show what percentage of the time this happens to you。

23.Some people sometimes find that in certain situations they are able to do things with amazing ease and spontaneity that would usually be difficult for them(for example, sports, work, social situations, etc。)。Circle a number to show what percentage of the time this happens to you。

24.Some people sometimes find that they cannot remember whether they have done something or have just thought about doing this(for example, not knowing whether they have just mailed a letter or have just thought about mailing it)。Circle a number to show what percentage of the time this happens to you。

25.Some people find evidence that they have done things that they do not remember doing。Circle a number to show what percentage of the time this happens to you。

26.Some people sometimes find writings, drawing, or notes among their belonging that they must have done but cannot remember doing。Circle a number to show what percentage of the time this happens to you。

27.Some people sometimes find that they hear voices inside their head that tell them to do things or comment on things that they are doing。Circle a number to show what percentage of the time this happens to you。

28.Some people sometimes feel as if they are looking at the world through a fog so that people and objects appear far away or unclear。Circle a number to show what percentage of the time this happens to you。