Dissociative Identity Disorder (DID) in DSM-5 is distinguished from DSM-IV by which modification?

• A DID now requires a documented history of childhood trauma to be diagnosed
• B Transitions between identity states may be reported by the patient (not only observed by a clinician), and symptoms may include hearing voices as voices from within the head ✓
• C The minimum number of identity states was increased from 2 to 4
• D Amnesia criterion was removed; DID now requires only identity disruption

Explanation

DSM-5 modified the DID criteria in two important ways: (1) identity disruption may be reported by the patient themselves rather than requiring external observation, acknowledging covert presentations; (2) voices perceived as coming from distinct identities (but experienced as coming from inside the head) are recognised as possible presentations, distinguishing them from externalised auditory hallucinations in psychosis. The amnesia criterion was retained (option D is incorrect). There is no minimum number of identity states specified beyond two (option C is incorrect), and childhood trauma history — though commonly associated — is not a diagnostic criterion (option A is incorrect).

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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