Date of Award
2025
Degree Type
Dissertation
Degree Name
Doctor of Nursing (ND)
Department
Nursing
Abstract
Introduction/Background: Dissociative disorders are often unrecognized in outpatient mental health settings, resulting in inaccurate diagnoses, ineffective treatment, and prolonged patient distress. There is variability with the current assessment method of clinical interviewing in symptom presentation that can be mistaken for other psychiatric disorders. Clinicians usually use subjective assessment questions, increasing the risk of missing dissociative symptoms. Implementing a standardized screening tool, such as the Dissociative Experiences Scale-II (DES-II), may improve diagnostic accuracy.
Problem: Dissociative disorders are frequently unrecognized in outpatient mental health settings, leading to misdiagnosis and ineffective treatment plans (Steardo et al., 2021). The absence of standardized screening contributes to delays in diagnosis, lingering symptoms, and delays in appropriate treatment.
Method/Interventions The project follows the Plan-Do-Study-Act (PDSA) cycle and utilizes the FADE QI model. The intervention includes administering the DES-II during initial psychiatric evaluations and follow-up appointments to adults 18 years or older. Plan: Conducted a pre-implementation assessment to determine the current number of dissociative disorders before implementation (Timeframe 6 weeks) using standard clinical interviews. Integrate the DES-II into the initial psychiatric evaluation and follow-up appointment processes for adults. Do: Implemented the DES-II screening tools for all adult patients (ages 18–100) undergoing initial psychiatric assessments and follow-up appointments, and documented the number of identified dissociative disorders before and after implementation. Study: Analyzed data collected over six weeks to compare the identified dissociative disorders before and after DES-II implementation.
Act: Based on positive findings, the implementation process was established.
Results: Implementing the Dissociative Experiences Scale-II (DES-II) in an outpatient mental health clinic increased the identification of dissociative disorders. The screening process revealed seven cases of misdiagnosis, where patients previously diagnosed with other psychiatric conditions were identified as having unspecified dissociative disorder.
Conclusion: By implementing the DES-II into routine assessments, this project aims to improve diagnostic accuracy, enhance patient outcomes, and provide a model for implementation as a standardized screening tool in outpatient mental health settings.
Recommended Citation
Medina, Jocelyn, "Screening Beyond the Surface: Enhancing Dissociative Disorders Diagnosis with DES-II" (2025). Cohort XIII. 10.
https://scholarworks.utep.edu/cohort_13/10