DSM-5 (American Psychiatric Association’s manual) lists symptoms of Dissociative Identity Disorder (Multiple Personality) in the wrong order

DSM-5 lists alternate personalities first and memory gaps second.

As implied by my recent post on “The Psychiatric Interview and Mental Status Examination,” chapter one of the American Psychiatric Association’s textbook of psychiatry, the first step in diagnosing multiple personality is, almost always, to elicit a history of memory gaps.

Multiple personality rarely presents with obvious alternate personalities (which usually stay inside during psychiatric interviews). You screen for multiple personality by looking for its footprints: the memory gaps that the host personality has for the periods of time that an alternate personality had come out.

So if DSM-5 had wanted to be helpful in diagnosing multiple personality, it would have listed its key symptoms (the “diagnostic criteria”) in this order: 1. memory gaps, 2. alternate personalities. For it is only after discovering memory gaps that a clinician will consider the possible presence of alternate personalities.

Indeed, you often make first contact with an alternate personality when you inquire as to what went on during a memory gap: the alternate personality who was out during that time may come out and tell you.

Then why do the DSM-5 diagnostic criteria for dissociative identity disorder make the mistake of listing alternate personalities first and memory gaps second? Its reasons, whatever they are, are rationalizations. Any clinician who expects to see alternate personalities first will almost always miss the diagnosis.