Dissociative Experiences Scale

1. Abstract

The Dissociative Experiences Scale (DES), along with its widely adopted revised version, the DES-II, is the preeminent self-report instrument designed to quantify the frequency and severity of dissociative experiences across clinical and non-clinical populations. Dissociation denotes a disruption in the typically integrated functions of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior. Developed initially by Eve M. Bernstein and Frank W. Putnam in 1986, and streamlined into an 11-point percentage-response metric by Eve B. Carlson and Putnam in 1993, the DES consists of 28 self-report items. Each item represents a phenomenological manifestation of dissociation, requiring respondents to report the percentage of time (ranging from 0% to 100% in 10% increments) that they experience specific occurrences when not under the acute influence of alcohol, illicit substances, or prescribed medications.

Extensive psychometric investigations have established that the DES captures both non-pathological (normative) and pathological dissociation. The instrument demonstrates high internal consistency, with Cronbach’s alpha coefficients consistently reported between .93 and .96 across adolescent, adult, general community, and psychiatric cohorts. Test-retest reliability across intervals spanning several weeks to several months ranges between .78 and .96. Structural analyses consistently yield three robust primary factors: Absorption and Imaginative Involvement, Amnestic Dissociation (Dissociative Amnesia), and Depersonalization/Derealization. In addition, an empirically derived subset of eight items—the DES-Taxon (DES-T)—operates as a validated taxometric screening tool capable of differentiating pseudonormative dissociative absorption from pathological dissociative pathology, including Dissociative Identity Disorder (DID), Other Specified Dissociative Disorder (OSDD), and the dissociative subtype of Post-Traumatic Stress Disorder (PTSD). The DES remains an essential psychometric benchmark in trauma studies, cognitive neuropsychiatry, and diagnostic psychological evaluation.

2. Keywords

Dissociative Experiences Scale, DES, DES-II, dissociation, depersonalization, derealization, dissociative amnesia, absorption, trauma, post-traumatic stress disorder, psychometrics, taxometrics

3. Authors

The primary developers of the Dissociative Experiences Scale and its standard revision are:

• Eve M. Bernstein (Carlson), Ph.D.: Senior Research Psychologist and former Director of the Trauma and Dissociation Research Program at the National Center for PTSD, VA Palo Alto Health Care System, and Clinical Professor (Affiliated) of Psychiatry and Behavioral Sciences, Stanford University School of Medicine.
• Frank W. Putnam, M.D.: Professor Emeritus of Pediatrics and Child and Adolescent Psychiatry at Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine; Clinical Professor of Psychiatry at the University of North Carolina at Chapel Hill School of Medicine. A foundational researcher in the longitudinal assessment of developmental trauma, child abuse, and dissociative psychopathology.

Historical Context Note: Early exploratory investigations into dissociative questionnaires in the late 1970s included parallel laboratory work by Kenneth S. Bowers and Ernest R. Coons. However, the standard, globally validated, 28-item standardized psychometric instrument cited throughout international clinical literature was created and empirically validated by Bernstein and Putnam (1986), followed by the DES-II format refinement authored by Carlson and Putnam (1993).

4. Purpose

The primary purpose of the Dissociative Experiences Scale (DES/DES-II) is to provide clinicians, clinical researchers, and experimental cognitive psychologists with a standardized, objective, and quantitative metric for evaluating the frequency of dissociative phenomena. Dissociation is historically characterized by pervasive clinical heterogeneity, presenting along a broad spectrum from everyday occurrences of absorption or daydreams to severe, debilitating disruptions in autonoetic consciousness, episodic memory, and coherent self-identity. Prior to the formal operationalization of the DES in 1986, the empirical study of dissociative syndromes was impeded by the lack of psychometrically validated, standardized instruments. As a result, diagnostic evaluations relied almost exclusively on unstandardized unstructured clinical interviews, leaving the field susceptible to underdiagnosis, diagnostic ambiguity, and theoretical fragmentation.

In clinical practice, the DES operates primarily as a broad-spectrum screening instrument rather than an isolated diagnostic apparatus. A high score on the DES indicates marked vulnerability to dissociative disruption and warrants comprehensive diagnostic assessment using semi-structured clinical interviews, such as the Structured Clinical Interview for DSM Dissociative Disorders (SCID-D-R) or the Dissociative Disorders Interview Schedule (DDIS). Clinical cohorts routinely evaluated with the scale include individuals presenting with severe childhood abuse, combat-related trauma, complex post-traumatic stress disorder (C-PTSD), borderline personality disorder, conversion (functional neurological symptom) disorders, and somatic symptom disorders.

From a theoretical and research standpoint, the DES was formulated to clarify the fundamental architecture of human consciousness under acute stress, psychological trauma, and chronic developmental adversity. Researchers use the DES to explore cognitive correlates of dissociation, such as source monitoring errors, deficits in cognitive inhibition, working memory fragmentation, and elevated susceptibility to false memory formation or fantasy proneness. Additionally, the DES allows clinicians to monitor longitudinal treatment trajectories. By measuring symptomatic changes across psychotherapeutic and psychiatric interventions—such as trauma-informed phase-oriented psychotherapy, Dialectical Behavior Therapy (DBT), and Eye Movement Desensitization and Reprocessing (EMDR)—the scale serves as a reliable index of symptom resolution or destabilization over time.

5. Psychological Construct

The psychological construct assessed by the DES is dissociation, defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) by the American Psychiatric Association as a disruption or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior. Rather than operating as a unidimensional, monolithic process, dissociation spans multiple operationalized subconstructs captured by distinct subscales of the DES:

Absorption and Imaginative Involvement

Absorption reflects a state of sustained, highly focused attentional engagement in which an individual’s perceptual resources become entirely directed toward an internal fantasy, narrative, or isolated external stimulus. While often observed as a non-pathological cognitive trait in healthy individuals, extreme absorption causes a complete lack of awareness of surrounding contextual cues and real-time environmental events. In the DES, this construct is represented by items assessing episodes such as becoming so immersed in a television show, book, or daydream that external reality becomes temporarily imperceptible (e.g., Items 17 and 18), or engaging in automatic highway driving behaviors without conscious awareness of the route traversed (Item 1).

Depersonalization and Derealization

Depersonalization involves persistent or recurrent feelings of detachment from one’s own mental processes, physical body, or sense of self. The individual feels like an outside observer of their personal existence, perceiving their voice as foreign, experiencing somatic alienation, or feeling as if their body parts do not belong to them (e.g., Items 7, 11, and 13). Conversely, derealization denotes a subjective sense of estrangement, unreality, or dreamlike disconnection from the external physical environment (e.g., Items 12, 16, and 28). The external world appears unfamiliar, mechanical, two-dimensional, or muffled through an intangible fog. Both phenomena involve intact reality testing, distinguishing them from primary psychotic delusions.

Amnestic Dissociation (Dissociative Amnesia)

Amnestic dissociation represents an inability to retrieve significant autobiographical information that exceeds ordinary forgetfulness. Unlike organic or neurodegenerative amnesias, dissociative amnesia is typically driven by acute psychological conflict, extreme environmental stress, or structural splits in personality organization. In the DES, this dimension is characterized by gaps in remote or immediate episodic recall. Behaviors include discovering newly acquired items in one’s possession with no conscious memory of having purchased them (Item 5), realizing that clothes have been put on without remembering dressing (Item 4), finding tangible evidence of completed actions that lack conscious awareness (Item 25), or encountering unremembered written documents produced in one’s own handwriting (Item 26).

Dissociative Identity Alteration and Intrusive Phenomena

Although overlapping with amnesia and depersonalization, identity alteration represents an interruption in a unified sense of agency and self-continuity. Affected individuals perceive internal fragmentation, manifesting as distinct voice intrusions that comment upon their actions (Item 27) or dramatic fluctuations in affect, demeanor, and behavioral repertoires where they feel like two entirely distinct individuals (Item 22). These phenomena are central to the construct of complex dissociative disorders.

6. Theoretical Framework

The theoretical framework of the Dissociative Experiences Scale is grounded in classical neurosis models, psychodynamic trauma formulations, cognitive information processing, and structural neurobiology. Systematic theoretical inquiry into dissociation originated in the late 19th century with French psychiatrist and philosopher Pierre Janet. In his seminal work on psychological automatisms, Janet conceptualized dissociation (désagrégation) as a fundamental structural breakdown in the synthesizing capacity of the mind. Under the impact of overwhelming psychological shock (véhémence émotionnelle), the ego loses its ability to integrate newly acquired perceptual, sensory, and affective elements into a single coherent stream of consciousness. Janet posited that these unintegrated cognitive fragments split from the main conscious awareness, organizing into autonomous, subconscious psychological subsystems that operate outside the control of the primary executive self.

In the late 20th century, trauma researchers—including Frank Putnam, Eve Carlson, Bessel van der Kolk, and Judith Herman—revisited Janet’s framework, contrasting it with traditional Freudian repression. Whereas repression assumes an intact psychic apparatus that actively banishes objectionable drives into a dynamic unconscious, dissociation involves a horizontal failure of perceptual and structural integration at the moment of trauma. When individuals face intolerable threat or inescapable terror—such as chronic, developmental sexual or physical abuse—dissociative detachment serves as an adaptive neurobiological defense. By uncoupling emotional awareness, physical pain sensations (analgesia), and sensory processing from autobiographical memory encoding, the individual survives overwhelming trauma through psychological escape when physical flight or fight is impossible.

Contrasting theoretical paradigms have shaped discussions regarding the nature of the dissociative construct measured by the DES:

• The Dimensional/Continuum Model: Supported by researchers such as Colin Ross and early scale formulations, this perspective views dissociation as a single continuous spectrum ranging from normative manifestations (e.g., daydreaming, absorption, transit hypnosis) to severe pathological dissociation (DID). Under this model, pathological symptoms differ from normative behaviors primarily in frequency and degree.
• The Typological / Taxometric Model: Advanced by Niels Waller, Frank Putnam, and Eve Carlson (1996), this structural model contends that dissociation is not purely dimensional. Instead, it posits that dissociation contains a distinct qualitative typological category: the pathological dissociative taxon. In this formulation, absorption and normative imaginative engagement represent continuous, benign cognitive traits shared across the general population, whereas severe amnesia, depersonalization, and identity confusion constitute a discrete latent taxonic class rooted in severe developmental trauma and neurobiological disruption.
• The Theory of Structural Dissociation of the Personality: Developed by Onno van der Hart, Ellert Nijenhuis, and Kathy Steele, this model posits that trauma leads to structural fragmentation between an Apparently Normal Part of the Personality (ANP), dedicated to navigating daily survival, and one or more Emotional Parts of the Personality (EP), which remain anchored in unprocessed traumatic memory systems. The items of the DES accurately track the cognitive, perceptual, and amnestic friction generated by intrusions and switches between these personality subsystems.

7. Validity

The Dissociative Experiences Scale possesses extensive empirical support confirming its construct, convergent, discriminant, criterion, and cross-cultural validity across clinical and non-clinical samples globally.

Construct and Known-Groups Criterion Validity

The construct validity of the DES was established by Bernstein and Putnam (1986) through known-groups validation paradigms. The scale shows marked differences across varying diagnostic cohorts, verifying that elevated scores correspond to diagnostic conditions defined by dissociative phenomena:

• Non-Clinical Adult General Population: Mean DES scores typically range from 4.0 to 8.0, with a normative median centered around 4.5.
• Somatic Symptom / Conversion Disorders: Moderately elevated mean scores between 14.0 and 20.0.
• Post-Traumatic Stress Disorder (PTSD): Highly elevated mean scores ranging from 28.0 to 35.0, reflecting trauma-induced intrusions, depersonalization, and peri-traumatic dissociation.
• Borderline Personality Disorder: Substantial elevations with mean scores between 18.0 and 28.0.
• Dissociative Identity Disorder (DID): Markedly elevated scores, with cross-validation studies consistently reporting mean scores between 45.0 and 60.0. Less than 1% of the non-clinical general population scores above a threshold of 30, whereas more than 85% of confirmed DID patients exceed this cut-off.

Convergent and Discriminant Validity

Convergent validity is supported by strong positive correlations between the DES and other psychometric instruments measuring related constructs. Significant correlations emerge between the DES and the Structured Clinical Interview for DSM Dissociative Disorders (SCID-D-R), the Multiscale Dissociation Inventory (MDI), the Peritraumatic Dissociative Experiences Questionnaire (PDEQ), and the Childhood Trauma Questionnaire (CTQ). Furthermore, DES scores correlate positively with validated measures of adult alexithymia (Toronto Alexithymia Scale; TAS-20) and trait anxiety.

Discriminant validity has been demonstrated by showing that the DES measures dissociative phenomena rather than generic psychological distress, psychotic symptoms, or neurosis. While DES scores show weak to moderate correlations with general neuroticism and somatic anxiety (r values typically ranging between .20 and .35), these correlations are markedly lower than its associations with specialized trauma and dissociative inventories (r > .70). Furthermore, taxometric analyses have demonstrated that the pathological dissociative taxon (DES-T) discriminates dissociative disorders from schizophrenia, bipolar disorder, and major depressive disorder with low false-positive rates.

8. Reliability

The reliability of the Dissociative Experiences Scale has been verified across diverse empirical studies, demonstrating high internal consistency and temporal stability.

Internal Consistency

Across validation studies spanning adult clinical populations, military veterans, university student cohorts, and cross-cultural adaptations, the DES exhibits high internal consistency. In the foundational validation by Bernstein and Putnam (1986), the scale demonstrated a split-half reliability coefficient of .93. Subsequent psychometric evaluations of the DES-II (Carlson & Putnam, 1993) reported overall internal consistency coefficients (Cronbach’s alpha) typically falling between .93 and .96. Individual subscales demonstrate strong reliability values:

• Amnestic Dissociation Subscale: Cronbach’s α typically ranges from .82 to .88.
• Depersonalization/Derealization Subscale: Cronbach’s α typically ranges from .86 to .92.
• Absorption and Imaginative Involvement Subscale: Cronbach’s α typically ranges from .83 to .89.

Test-Retest Stability

Evaluating test-retest reliability is essential for verifying that the DES captures stable trait dissociative tendencies alongside fluctuating state-dependent experiences. In the original evaluation by Bernstein and Putnam (1986), an assessment-reassessment design across an 8-week interval with a mixed psychiatric and non-clinical cohort generated a Spearman test-retest rank correlation coefficient of r = .84 (p < .001). Subsequent studies utilizing intervals ranging from 4 weeks to 6 months in stable adult samples have confirmed temporal stability, with test-retest coefficients consistently observed between .78 and .96. In therapeutic outcome studies, systematic reductions in DES scores over multi-year periods parallel clinical gains, demonstrating sensitivity to clinical recovery without compromising underlying measurement stability.

9. Factor Analysis

The structural dimensionality of the 28-item Dissociative Experiences Scale has been evaluated using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and taxometric methods.

Exploratory and Confirmatory Factor Structures

Although early single-sample studies posited a single general factor, the prevailing consensus among psychometricians supports a correlated three-factor structural model, originally derived through principal components analysis with varimax and oblimin rotations by Carlson et al. (1993) and replicated across international adaptations:

• Factor 1: Depersonalization and Derealization (Items 7, 11, 12, 13, 27, 28). This factor captures disruptions in body ownership, feelings of unreality regarding one’s surroundings, and related perceptual distortions. Factor loadings for primary items routinely exceed .60, with Item 7 (watching oneself from the outside) and Item 13 (body feeling foreign) frequently loading above .75.
• Factor 2: Amnestic Dissociation (Dissociative Amnesia) (Items 3, 4, 5, 6, 8, 9, 10, 25, 26). This dimension accounts for memory gaps for autobiographical events and unremembered actions. Primary markers, such as finding new unremembered possessions (Item 5) or evidence of unremembered actions (Item 25), show high loadings between .65 and .80 on this factor.
• Factor 3: Absorption and Imaginative Involvement (Items 1, 2, 14, 15, 17, 18, 20, 23, 24). This factor captures sustained attentional hyperfocus, immersion in internal daydreams, and highway driving lapses. Item 17 (absorption in media) and Item 18 (immersion in daydreaming) typically demonstrate loadings above .70 on this component.

Confirmatory Factor Analysis (CFA) Model Fit

Confirmatory factor analyses testing this three-factor correlated model have reported adequate to good psychometric fit indices across clinical and community samples:

• Comparative Fit Index (CFI): Ranges from .91 to .95 across independent structural studies.
• Tucker-Lewis Index (TLI): Typically reports values between .90 and .94.
• Root Mean Square Error of Approximation (RMSEA): Ranges between .045 and .062 (90% CI [.041, .068]), indicating acceptable to close approximate fit.
• Standardized Root Mean Square Residual (SRMR): Consistently falls below the recognized .060 benchmark.

Taxometric Analyses: The DES-Taxon (DES-T)

Taxometric investigations using MAMBAC, MAXCOV, and MAXEIG procedures conducted by Waller, Putnam, and Carlson (1996) revealed that rather than exhibiting simple linear continuity across all items, a subset of 8 items reflects a latent taxonic category: the DES-T (comprising Items 3, 5, 7, 8, 12, 13, 22, and 27). Individuals belonging to the pathological dissociative taxon exhibit elevated base rates on these items, providing a psychometrically efficient screening subset that avoids the confounding effects of non-pathological absorption.

10. Instrument / Measurement Tool

• Instrument Name: Dissociative Experiences Scale (DES) / Dissociative Experiences Scale-II (DES-II)
• Authors: Eve M. Bernstein (Carlson), Ph.D., and Frank W. Putnam, M.D.
• Instrument Type: Standardized Self-Report Psychometric Questionnaire / Screening Inventory
• Administration Format: Paper-and-pencil questionnaire, clinician-administered, or computerized/digital assessment
• Item Count: 28 items
• Target Population: Adolescents and adults (typically ages 16 and older); an adapted variant, the Adolescent Dissociative Experiences Scale (A-DES), exists for youth aged 11 to 17.
• Administration Time: Approximately 10 to 15 minutes
• Response Scale (Authentic): Percentage of time experienced, anchored on an 11-point percentage continuum from 0% to 100% in 10% increments (0%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%). In the original 1986 DES, responses were recorded on 100 mm Visual Analogue Scales (VAS), which were subsequently updated in the DES-II to categorical 10% increment check-boxes to simplify administration and scoring.
• Scoring Methodology:
  • Sum the numerical percentages indicated across all 28 items (treating 0% as 0, 10% as 10, etc.) and divide the total sum by 28. This produces an overall mean DES total score ranging from 0 to 100.
  • Missing items are handled by calculating the sum of completed items divided by the number of completed items, provided that no more than 3 items are omitted.
  • Subscale scores are calculated by summing and averaging the specific item sets for Amnesia, Depersonalization/Derealization, and Absorption.
  • DES-Taxon (DES-T) Scoring: Calculates the average score across the eight taxonic items (3, 5, 7, 8, 12, 13, 22, and 27) or applies taxometric Bayesian probability formulas. An average DES-T score exceeding 20 points indicates high clinical probability of taxon membership.
• Clinical Interpretation Guidelines:
  • Score < 15: Typical non-clinical range; normative experiences of absorption and everyday distraction.
  • Score 15 – 29: Mild to moderate dissociation; common in clinical populations with anxiety disorders, affective disorders, or uncomplicated PTSD.
  • Score ≥ 30: Clinical screening cut-off point; indicates marked dissociative pathology. Scores at or above 30 warrant targeted semi-structured clinical diagnostic interviews (such as the SCID-D or DDIS) to rule in or out Dissociative Identity Disorder, OSDD, or Dissociative Subtype PTSD.
  • Score ≥ 45: Highly suggestive of severe complex dissociative conditions, specifically Dissociative Identity Disorder.

11. Permissions & Fee and Test Year

The original Dissociative Experiences Scale was developed in 1986 by Eve M. Bernstein and Frank W. Putnam, with the revised scale (DES-II) published in 1993. The developers placed the Dissociative Experiences Scale in the public domain for research, academic, and clinical use to facilitate empirical investigation into trauma and dissociative pathology without cost barriers. Consequently, the DES is considered an open-access, royalty-free psychometric instrument. Clinicians, universities, hospitals, and independent researchers are permitted to reproduce, translate, and utilize the DES and DES-II in diagnostic evaluations and empirical studies without paying licensing fees or seeking explicit written permission, provided that full academic attribution and appropriate citation are preserved. Commercial exploitation or proprietary software repackaging without modification remains subject to intellectual property laws.

12. References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425787

Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease, 174(12), 727–735. https://doi.org/10.1097/00005053-198612000-00004

Bowers, K. S., & Coons, E. R. (1979). Scale for the assessment of reported dissociative experiences. The Journal of Nervous and Mental Disease, 167(12), 888–895.

Carlson, E. B., & Putnam, F. W. (1993). An update on the Dissociative Experiences Scale. Dissociation: Progress in the Dissociative Disorders, 6(1), 16–27. https://hdl.handle.net/1794/1446

Carlson, E. B., Putnam, F. W., Ross, C. A., Torem, M., Coons, P., Dill, D. L., Loewenstein, R. J., & Braun, B. G. (1993). Validity of the Dissociative Experiences Scale in screening for multiple personality disorder: A multicenter study. The American Journal of Psychiatry, 150(7), 1030–1036. https://doi.org/10.1176/ajp.150.7.1030

Dalenberg, C. J., Brand, B. L., Gleaves, D. H., Dorahy, M. J., Loewenstein, R. J., Cardeña, E., Frewen, P. A., Carlson, E. B., & Spiegel, D. (2012). Evaluation of the evidence for the trauma and fantasy models of dissociation. Psychological Bulletin, 138(3), 550–588. https://doi.org/10.1037/a0027447

International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12(2), 115–187. https://doi.org/10.1080/15299732.2011.537247

Janet, P. (1889). L’automatisme psychologique: Essai de psychologie expérimentale sur les formes inférieures de l’activité humaine. Félix Alcan.

Putnam, F. W., Carlson, E. B., Ross, C. A., Anderson, G., Clark, P., Torem, M., Bowman, E. S., Coons, P., Chu, J. A., & Dill, D. L. (1996). Dissociative Experiences Scale: Analysis of three samples. The Journal of Nervous and Mental Disease, 184(11), 673–679. https://doi.org/10.1097/00005053-199611000-00004

van der Hart, O., Nijenhuis, E. R. S., & Steele, K. (2006). The haunted self: Structural dissociation and the treatment of chronic traumatization. W. W. Norton & Company.

Waller, N. G., Putnam, F. W., & Carlson, E. B. (1996). Types of dissociation and dissociative types: A taxometric analysis of dissociative experiences. Psychological Methods, 1(3), 300–321. https://doi.org/10.1037/1082-989X.1.3.300

13. Items of the Scale