#osdd 2

Basics (& common misconceptions)

OSDD-1, OSDD-2, OSDD-3, and OSDD-4 are examples of OSDD given in the DSM. They are not the only types of OSDD.

Other Specified Dissociative Disorder, AKA OSDD, is any dissociative disorder that is not better explained by DID, DPDR, or Dissociative Amnesia, and the clinician chooses to specify why criteria are not met. OSDD is not limited to the 4 given examples. Unspecified Dissociative Disorder, AKA UDD or USDD, is any dissociative disorder that is not better explained by DID, DPDR, or Dissociative Amnesia, and the clinician does not specify why criteria are not met. So, no, DID and OSDD are not the same. We'll get further into that later, though.

Bit of a long quote from the DSM-5, but it's a very important one (defines other specified and unspecified disorders):

"DSM-5 provides two diagnostic options for presentations that do not meet the diagnostic criteria for any of the specific DSM-5 disorders: other specified disorder and unspecified disorder. The other specified category is provided to allow the clinician to communicate the specific reason that the presentation does not meet the criteria for any specific category within a diagnostic class. This is done by recording the name of the category, followed by the specific reason. For example, with an individual with persistent hallucinations occurring in the absence of any other psychotic symptoms (a presentation that does not meet criteria for any of the specific disorders in the chapter “Schizophrenia Spectrum and Other Psychotic Disorders”), the clinician would record “other specified schizophrenia spectrum and other psychotic disorder, with persistent auditory hallucinations.” If the clinician chooses not to specify the reason that the criteria are not met for a specific disorder, then “unspecified schizophrenia spectrum and other psychotic disorder” would be diagnosed. Note that the differentiation between other specified and unspecified disorders is based on the clinician’s choice to indicate or not the reasons why the presentation does not meet full criteria, providing maximum flexibility for diagnosis. When the clinician determines that there is enough available clinical information to specify the nature of the presentation, the “other specified” diagnosis can be given. In those cases where the clinician is not able to further specify the clinical presentation (e.g., in emergency room settings), the “unspecified” diagnosis can be given. This is entirely a matter of clinical judgment."

4 examples of OSDD

"Chronic and recurrent syndromes of mixed dissociative symptoms: This category includes identity disturbance associated with less-than-marked discontinuities in sense of self and agency, or alterations of identity or episodes of possession in an individual who reports no dissociative amnesia." — Referred to as OSDD-1 in community terms. Amnesia with less-than-marked discontinuities in sense of self and agency is called OSDD-1a in community terms. Alterations of identity or episodes of possession in an individual who reports no dissociative amnesia is called OSDD-1b in community terms. (Talk more on 1a & 1b later)

"Identity disturbance due to prolonged and intense coercive persuasion: Individuals who have been subjected to intense coercive persuasion (e.g., brainwashing, thought reform, indoctrination while captive, torture, long-term political imprisonment, recruitment by sects/cults or by terror organizations) may present with prolonged changes in, or conscious questioning of, their identity." — Referred to as OSDD-2 in community terms.

"Acute dissociative reactions to stressful events: This category is for acute, transient conditions that typically last less than 1 month, and sometimes only a few hours or days. These conditions are characterized by constriction of consciousness; depersonalization; derealization; perceptual disturbances (e.g., time slowing, macropsia); microamnesias; transient stupor; and/or alterations in sensory-motor functioning (e.g., analgesia, paralysis)." — Referred to as OSDD-3 in community terms.

"Dissociative trance: This condition is characterized by an acute narrowing or complete loss of awareness of immediate surroundings that manifests as profound unresponsiveness or insensitivity to environmental stimuli. The unresponsiveness may be accompanied by minor stereotyped behaviors (e.g., finger movements) of which the individual is unaware and/or that he or she cannot control, as well as transient paralysis or loss of consciousness. The dissociative trance is not a normal part of a broadly accepted collective cultural or religious practice." — Referred to as OSDD-4 in community terms. Important to note that dissociative trances can also occur in CDDs.

Bonus addition, OSDD-4 is classified as Trance Disorder in the ICD. You can read about Trance Disorder here. Possession Trance Disorder (another ICD exclusive) is also similar and can be read about here.

OSDD-1, OSDD-2, etc are not diagnostic terms. If you have "OSDD-3", your diagnosis will read something like "Other Specified Dissociative Disorder with acute dissociative reactions to stressful events". It will not say OSDD-3.

Still, I'm not against the usage of 1-4 (& 1a/1b) as community terms. It's much easier and gets the same point across.

OSDD-1 / OSDD systems

First, CDD stands for Complex Dissociative Disorder. It is not a specific diagnosis, it's a term that refers to dissociative disorders that cause alters. CDDs are DID, P-DID (ICD), OSDD-1, and sometimes UDD/USDD. Those with CDDs are referred to as systems. CDDs require trauma and dissociation at a young age in order to form.

Criterion A of DID: "Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual." (Simplified: Presence of marked discontinuities in sense of self and agency, AKA alters.)

Criterion B of DID: "Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting." (Simplified: Presence of recurring amnesia.)

OSDD-1 is when all criteria are met for DID, minus either criterion A or criterion B.

The terms OSDD-1a and OSDD-1b are inspired by the DSM 4, where DDNOS-1a and DDNOS-1b were possible diagnoses. DDNOS-1a also referred to less-than-marked alters with amnesia and DDNOS-1b referred to marked alters without amnesia. OSDD-1 is more of a spectrum though, so it's possible to not cleanly fit into "1a" or "1b". Also, some people seem to think that those with OSDD-1a have no alters at all. This isn't true. If there is no presence of alters, it is Dissociative Amnesia, not OSDD-1.

OSDD-2 is a not a CDD, as the identity disturbance in it is not alters. OSDD-2 isn't limited to childhood trauma and may be formed as an adult, thus it's not possible for OSDD-2 to be a CDD.