{ "model": { "rank": 5971, "code": "thing-q18657", "model_id": "vr.tr.dissociative-identity-disorder", "name": "dissociative identity disorder", "purpose": "Enable an AI agent to organize evidence about suspected or diagnosed dissociative identity disorder, track its functional consequences, and support appropriate human-led assessment and care.", "family": "Thing Registry", "category": "Cross-cutting context", "status": "research-draft", "kind": "thing", "plane": "XCT", "domain": "XCT.STA", "industry": "", "version": "", "url": "/models/thing/q18657/", "tier": 2, "score": 63, "payload": { "layer": "wikidata", "aliases": [], "aliasCount": 0, "merged": 0, "knownIn": 63, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": null, "source": { "dataset": "wikidata", "item": "Q18657", "url": "https://www.wikidata.org/wiki/Q18657", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-07T10:23:51Z", "providers": [ "Codex", "Grok" ], "missingProviders": [], "pass": 2, "cost": { "grok": { "usd": 0.0041412, "turns": 1, "seconds": 54.3, "error": null }, "codex": { "seconds": 104.7, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.3\n--------\nworkdir: R:\\02_PROJECTS\\02_Meta_Models_Platforms\\Ver.cy\\current\\thing-registry-backlog\nmodel: gpt-6-astra\nprovider: openai\napproval: never\nsandbox: read-only\nreasoning effort: none\nreasoning summaries: none\nsession id: 01a07b63-b4c9-7e63-a4f2-89293d05e2c9\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: dissociative identity disorder\nRegistry id: vr.tr.dissociative-identity-disorder\nPlane / domain: XCT / XCT.STA\nRegistry definition: (none recorded)\nN" } } }, "metaModel": { "id": "THING-Q18657", "registryId": "vr.tr.dissociative-identity-disorder", "name": "dissociative identity disorder", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q18657/", "model": { "registry_id": "vr.tr.dissociative-identity-disorder", "name": "dissociative identity disorder", "purpose": "Enable an AI agent to organize evidence about suspected or diagnosed dissociative identity disorder, track its functional consequences, and support appropriate human-led assessment and care.", "definition": "Dissociative identity disorder is a psychiatric diagnosis in which a person experiences two or more distinct personality states or an experience of possession, together with recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events, that are not better explained by cultural or religious practice, substance use, or another medical condition.", "scope_statement": "This model owns the representation of dissociative identity disorder for vr.tr.dissociative-identity-disorder within XCT / XCT.STA: identity and agency discontinuities, memory access, diagnostic uncertainty, functional state, and condition-specific support boundaries within one person's care.", "in_scope": [ "Reported and observed discontinuities in identity, agency, and control of behavior", "Memory gaps, retained awareness, and access to information across reported identity states", "Diagnostic formulation, evidence provenance, competing explanations, and classification version", "Distress, everyday impairment, episode course, and immediate support needs", "Person-approved communication, care continuity, and response to clinician-directed treatment" ], "out_of_scope": [ "The person's complete biography, identity, or legal personhood", "Independent models of PTSD, psychotic disorders, personality disorders, and other dissociative disorders", "Neurological disease, sleep disorders, and substance effects beyond their differential-assessment links", "Determination of whether an alleged traumatic event occurred or who was responsible", "Psychotherapy protocols, medication prescribing, and autonomous clinical diagnosis", "Legal capacity, criminal responsibility, or safeguarding determinations" ], "distinguishing_features": [ "Assess discontinuity in self and agency involving multiple identity states; ordinary role changes or mood shifts alone do not establish DID. [MSD Manual](https://www.msdmanuals.com/professional/psychiatric-disorders/dissociative-disorders/dissociative-identity-disorder)", "Under DSM-5-TR, establish recurrent recall gaps beyond ordinary forgetting; depersonalization alone is insufficient. [MSD Manual](https://www.msdmanuals.com/professional/psychiatric-disorders/dissociative-disorders/dissociative-identity-disorder)", "Establish clinically significant distress or impairment and assess whether experiences belong to accepted cultural practices or childhood imaginative play. [MSD Manual](https://www.msdmanuals.com/professional/psychiatric-disorders/dissociative-disorders/dissociative-identity-disorder)", "Do not classify from voice-hearing alone; evaluate the broader presentation and competing psychiatric, neurological, and substance-related explanations. [MSD Manual](https://www.msdmanuals.com/professional/psychiatric-disorders/dissociative-disorders/dissociative-identity-disorder)", "Record whether alternate states recurrently assume executive control when distinguishing ICD-11 DID from partial DID. [ICD-11 classification changes](https://pmc.ncbi.nlm.nih.gov/articles/PMC6313247/)" ], "characteristics": [ { "name": "Diagnostic formulation status", "kind": "state", "unit_or_values": "Not assessed; under assessment; provisional; clinician-confirmed; historical; revised; disputed, with assessor and date", "why_it_matters": "Separates an experience report from a clinical conclusion and preserves later revisions." }, { "name": "Diagnostic framework", "kind": "category", "unit_or_values": "Named classification, edition or release, code, and assessment jurisdiction", "why_it_matters": "Makes the criteria behind a diagnostic assertion explicit." }, { "name": "Identity and agency discontinuity", "kind": "category", "unit_or_values": "Narrative description with reported, observed, clinically interpreted, or uncertain evidence status", "why_it_matters": "Records the relevant experience without inferring it from names, appearance, or conversational style." }, { "name": "Executive-control pattern", "kind": "category", "unit_or_values": "Intrusion without reported takeover; reported takeover; observed behavioral transition; unclear, with context", "why_it_matters": "Supports assessment of how discontinuities affect action and the differential formulation." }, { "name": "Recall-gap burden", "kind": "measurement", "unit_or_values": "Reported episodes per stated observation period and estimated minutes or hours unaccounted for; unknown permitted", "why_it_matters": "Makes changes in lost time reviewable without treating unobserved periods as symptom-free." }, { "name": "Awareness and information access", "kind": "relation", "unit_or_values": "Person-described access to particular events or information across reported states; shared, partial, unavailable, or unknown", "why_it_matters": "Helps identify continuity needs without assuming a fixed set of identities." }, { "name": "Functional interference", "kind": "measurement", "unit_or_values": "Domain-specific narrative or named scale with version, score, date, and reporting source", "why_it_matters": "Connects assessment to missed obligations, self-care difficulties, and the person's priorities." }, { "name": "Current safety assessment", "kind": "state", "unit_or_values": "Not assessed; no immediate concern identified; concern requiring review; urgent concern, with evidence and timestamp", "why_it_matters": "Bases escalation on current circumstances rather than the diagnosis alone." }, { "name": "Support-plan accessibility", "kind": "state", "unit_or_values": "Accessible; partly accessible; inaccessible; untested, for a specified plan and context", "why_it_matters": "Shows whether the person can retrieve essential support when recall or orientation is disrupted." } ], "affordances": [ "Prepare a consented assessment summary that separates reported experiences, observations, and clinician conclusions.", "Track episodes, memory gaps, and functional effects using neutral prompts without eliciting identity changes.", "Flag unresolved differential questions and gaps in evidence for qualified clinical review.", "Offer person-approved reminders, orientation cues, and access to an existing support plan.", "Route current safety concerns through an established escalation pathway using the minimum necessary information.", "Compare person-defined outcomes over time and prepare questions for treatment review." ] }, "sources": [ { "id": "apa-dsm5tr-did", "title": "What Are Dissociative Disorders?", "url": "https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders", "what_it_supports": "APA patient-facing summary of DSM-5-TR DID diagnostic features, possession vs non-possession form, and differential considerations.", "url_status": "live" }, { "id": "who-icd11-6b64", "title": "ICD-11 for Mortality and Morbidity Statistics: 6B64 Dissociative identity disorder", "url": "https://icd.who.int/browse/2025-01/mms/en#334423054", "what_it_supports": "WHO ICD-11 definition, essential features, and the two-or-more distinct personality states criterion with amnesia.", "url_status": "live" }, { "id": "who-icd11-6b65", "title": "ICD-11 for Mortality and Morbidity Statistics: 6B65 Partial dissociative identity disorder", "url": "https://icd.who.int/browse/2025-01/mms/en#1626683677", "what_it_supports": "WHO ICD-11 distinction of partial DID, in which a non-dominant personality state does not recurrently take executive control.", "url_status": "live" }, { "id": "wikidata-q18655", "title": "dissociative identity disorder (Q18655)", "url": "https://www.wikidata.org/wiki/Q18655", "what_it_supports": "Wikidata item, aliases (including multiple personality disorder), and crosswalks to ICD-9, ICD-10, ICD-11, MeSH, DSM-5, and SNOMED CT.", "url_status": "live" } ], "structure": { "bundles": [ { "id": "identity-and-agency-discontinuity", "name": "Identity and agency discontinuity", "description": "Represent experiences of altered selfhood and control without imposing an identity inventory.", "rationale": "Recognition requires evidence about discontinuity, while respectful interaction requires preserving the person's own language.", "layers": [ { "id": "experience-and-language", "name": "Experience and language", "description": "Capture how the person describes changes in self-experience.", "findings": [ { "id": "self-and-agency-account", "name": "Self and agency account", "description": "Record concrete examples separately from diagnostic interpretations or inferred identity labels.", "questions": [ { "text": "What changes in ownership of thoughts, actions, or bodily experience does the person describe?", "kind": "definition", "id": "self-and-agency-account-q01" }, { "text": "Which terms does the person prefer, and which labels originated with an interviewer or other source?", "kind": "provenance", "id": "self-and-agency-account-q02" } ] } ] }, { "id": "control-and-transitions", "name": "Control and transitions", "description": "Describe reported intrusions and transitions in behavioral control.", "findings": [ { "id": "transition-evidence", "name": "Transition evidence", "description": "Keep subjective takeover experiences, externally observed changes, and clinical interpretation distinguishable.", "questions": [ { "text": "What was reported or observed before, during, and after a possible transition, and by whom?", "kind": "provenance", "id": "transition-evidence-q01" }, { "text": "Does the account concern altered feelings, an intrusive impulse, or a change in executive control?", "kind": "boundary", "id": "transition-evidence-q02" }, { "text": "Over what observation period were these events recorded, and what intervals remain unknown?", "kind": "measurement", "id": "transition-evidence-q03" } ] } ] } ] }, { "id": "memory-and-continuity", "name": "Memory and continuity", "description": "Represent recall gaps and practical access to information across time and reported states.", "rationale": "An agent needs to distinguish missing information from established events and help maintain everyday continuity.", "layers": [ { "id": "recall-gaps", "name": "Recall gaps", "description": "Describe unremembered intervals without filling them with inferred events.", "findings": [ { "id": "unaccounted-intervals", "name": "Unaccounted intervals", "description": "Record the bounds, discovery, and uncertainty of each reported gap.", "questions": [ { "text": "Which everyday or autobiographical events cannot be recalled, and how precisely can the interval be bounded?", "kind": "measurement", "id": "unaccounted-intervals-q01" }, { "text": "What independently recorded information, if any, establishes what occurred during that interval?", "kind": "provenance", "id": "unaccounted-intervals-q02" } ] } ] }, { "id": "information-access", "name": "Information access", "description": "Capture practical continuity needs without assuming all reported states have equal recall.", "findings": [ { "id": "essential-information-continuity", "name": "Essential information continuity", "description": "Identify which reminders and records the person wants available during disrupted recall.", "questions": [ { "text": "Which appointments, recent decisions, or support instructions become difficult to retrieve, and in what circumstances?", "kind": "measurement", "id": "essential-information-continuity-q01" }, { "text": "What person-approved record could preserve continuity without revealing unwanted sensitive material?", "kind": "action", "id": "essential-information-continuity-q02" } ] } ] } ] }, { "id": "diagnostic-boundaries-and-evidence", "name": "Diagnostic boundaries and evidence", "description": "Maintain the clinical formulation, competing explanations, and limits of available evidence.", "rationale": "The model must support review without turning a symptom narrative or screening result into a diagnosis.", "layers": [ { "id": "criteria-and-assessment", "name": "Criteria and assessment", "description": "Associate conclusions with a named diagnostic framework and accountable assessment.", "findings": [ { "id": "criterion-level-formulation", "name": "Criterion-level formulation", "description": "Record each criterion as supported, unsupported, unresolved, or not assessed, with its evidential basis.", "questions": [ { "text": "Which classification and version did the assessor use, and which requirements remain unresolved?", "kind": "definition", "id": "criterion-level-formulation-q01" }, { "text": "Who made the formulation, using which interviews, records, or instruments?", "kind": "provenance", "id": "criterion-level-formulation-q02" }, { "text": "Was a questionnaire used for screening, symptom monitoring, or diagnostic assessment?", "kind": "boundary", "id": "criterion-level-formulation-q03" } ] } ] }, { "id": "alternative-explanations", "name": "Alternative explanations", "description": "Track differential questions and contextual interpretation without presuming exclusion.", "findings": [ { "id": "differential-review", "name": "Differential review", "description": "Maintain evidence for competing or coexisting explanations rather than requiring a single explanation for every symptom.", "questions": [ { "text": "What evidence distinguishes this presentation from partial DID, other dissociative disorders, PTSD, or psychotic symptoms?", "kind": "boundary", "id": "differential-review-q01" }, { "text": "Which neurological, sleep-related, medication, or substance explanations require assessment?", "kind": "action", "id": "differential-review-q02" } ] }, { "id": "cultural-and-developmental-context", "name": "Cultural and developmental context", "description": "Record the context needed to interpret identity-related experiences without pathologizing unfamiliar language or practices.", "questions": [ { "text": "How does the person understand the experience within their cultural, spiritual, and developmental context?", "kind": "definition", "id": "cultural-and-developmental-context-q01" }, { "text": "What evidence distinguishes unwanted impairment from accepted practice, voluntary enactment, or developmentally expected play?", "kind": "boundary", "id": "cultural-and-developmental-context-q02" } ] } ] } ] }, { "id": "course-and-functional-impact", "name": "Course and functional impact", "description": "Connect discontinuities and recall difficulties to changes in everyday functioning.", "rationale": "State judgments need time-bounded consequences and personal baselines rather than a count of named identities.", "layers": [ { "id": "temporal-pattern", "name": "Temporal pattern", "description": "Separate symptom history, recognition history, and current observations.", "findings": [ { "id": "onset-and-context", "name": "Onset and context", "description": "Record when experiences were first noticed and which circumstances accompany changes without asserting causation.", "questions": [ { "text": "When were experiences first remembered, documented, and clinically recognized, and where do those dates differ?", "kind": "provenance", "id": "onset-and-context-q01" }, { "text": "Which contexts precede worsening or improvement, and how consistent is that association?", "kind": "measurement", "id": "onset-and-context-q02" } ] } ] }, { "id": "everyday-consequences", "name": "Everyday consequences", "description": "Assess the person's distress and the activities affected by discontinuity.", "findings": [ { "id": "functional-burden-and-priorities", "name": "Functional burden and priorities", "description": "Record concrete consequences and desired improvements in the person's terms.", "questions": [ { "text": "Which missed tasks, relationship difficulties, or self-care disruptions are associated with reported episodes?", "kind": "measurement", "id": "functional-burden-and-priorities-q01" }, { "text": "Which change would most improve the person's daily life, and what observation would demonstrate it?", "kind": "action", "id": "functional-burden-and-priorities-q02" } ] } ] } ] }, { "id": "safety-and-agent-interaction", "name": "Safety and agent interaction", "description": "Specify how an agent should respond when recall, orientation, or continuity of a conversation becomes uncertain.", "rationale": "The agent needs explicit boundaries for immediate support, sensitive disclosure, and potentially suggestive interaction.", "layers": [ { "id": "immediate-support", "name": "Immediate support", "description": "Connect current evidence to an existing safety and support pathway.", "findings": [ { "id": "current-safety-and-plan-access", "name": "Current safety and plan access", "description": "Assess immediate circumstances without assigning risk from the diagnostic label or a reported identity state.", "questions": [ { "text": "Is there current evidence of self-harm intent, unsafe lost-time activity, disorientation, or inability to meet essential needs?", "kind": "measurement", "id": "current-safety-and-plan-access-q01" }, { "text": "Which agreed support contact or urgent-care pathway applies, and can the person access it now?", "kind": "action", "id": "current-safety-and-plan-access-q02" } ] } ] }, { "id": "consent-and-neutral-language", "name": "Consent and neutral language", "description": "Preserve person-level permissions while respecting preferred ways of describing experience.", "findings": [ { "id": "disclosure-and-interaction-boundaries", "name": "Disclosure and interaction boundaries", "description": "Define permissions for sensitive records and prohibit agent-led attempts to evoke identities or reconstruct missing memories.", "questions": [ { "text": "What may the agent retain or disclose, and what clarification is needed if the person no longer recalls an earlier permission?", "kind": "action", "id": "disclosure-and-interaction-boundaries-q01" }, { "text": "How will the agent acknowledge distress without asserting that an unverified identity, event, or explanation is established?", "kind": "boundary", "id": "disclosure-and-interaction-boundaries-q02" }, { "text": "Which requests require referral to a clinician rather than prompting a switch or attempting memory recovery?", "kind": "action", "id": "disclosure-and-interaction-boundaries-q03" } ] } ] } ] }, { "id": "care-coordination-and-outcomes", "name": "Care coordination and outcomes", "description": "Represent the person's agreed care goals, support arrangements, and changes during treatment.", "rationale": "The model must distinguish helpful support from clinical intervention and make improvement reviewable without prescribing one identity outcome.", "layers": [ { "id": "agreed-care", "name": "Agreed care", "description": "Link condition-related needs to accountable providers and a person-approved plan.", "findings": [ { "id": "goals-and-responsibilities", "name": "Goals and responsibilities", "description": "Record chosen goals for daily functioning, continuity, and identity-related distress together with who directs care.", "questions": [ { "text": "What goals has the person agreed with their clinician, including any goals concerning cooperation or integration?", "kind": "action", "id": "goals-and-responsibilities-q01" }, { "text": "Which support tasks may the agent perform, and which decisions belong to the treating clinician?", "kind": "boundary", "id": "goals-and-responsibilities-q02" } ] } ] }, { "id": "response-and-review", "name": "Response and review", "description": "Track benefits, burdens, and reasons to revisit the plan.", "findings": [ { "id": "meaningful-change", "name": "Meaningful change", "description": "Compare functional outcomes and reported continuity against an explicit baseline without equating fewer identity labels with recovery.", "questions": [ { "text": "What changed in recall gaps, distress, daily functioning, or support dependence over the review interval?", "kind": "measurement", "id": "meaningful-change-q01" }, { "text": "Which new difficulties or unmet goals warrant clinician review, and what evidence should accompany it?", "kind": "action", "id": "meaningful-change-q02" } ] } ] } ] }, { "id": "evidence-and-external-alignment", "name": "Evidence and external alignment", "description": "What the world already says about this thing, gathered so the model can be checked against it.", "rationale": "A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.", "layers": [ { "id": "reported-evidence", "name": "Reported evidence", "description": "Findings from the breadth pass, kept separate from the structural claims.", "findings": [ { "id": "evidence-kinds", "name": "Kinds and varieties", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "DSM-5-TR dissociative identity disorder (possession-form and non-possession-form presentations)", "ICD-11 dissociative identity disorder", "ICD-11 partial dissociative identity disorder", "Specified/other dissociative disorders used when identity disruption is present but full DID criteria are not met" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of dissociative identity disorder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-identifiers", "name": "Identifiers and schemes", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "scheme": "Wikidata", "value_or_pattern": "Q18655", "note": "Item for dissociative identity disorder; also English alias multiple personality disorder." }, { "scheme": "ICD-11 MMS", "value_or_pattern": "6B64", "note": "WHO code for dissociative identity disorder; sibling 6B65 is partial dissociative identity disorder." }, { "scheme": "ICD-10 / ICD-10-CM", "value_or_pattern": "F44.81", "note": "Dissociative identity disorder; ICD-10 parent F44 is dissociative [conversion] disorders." }, { "scheme": "ICD-9-CM", "value_or_pattern": "300.14", "note": "Historic multiple personality code listed on the Wikidata mapping." }, { "scheme": "DSM-5 / DSM-5-TR", "value_or_pattern": "300.14", "note": "APA diagnostic code aligned with ICD-9-CM numbering; DSM-5-TR also maps to ICD-10-CM F44.81." }, { "scheme": "MeSH", "value_or_pattern": "D009105", "note": "Medical Subject Headings descriptor Multiple Personality Disorder / DID." }, { "scheme": "SNOMED CT", "value_or_pattern": "31611000", "note": "SNOMED concept for multiple personality disorder / DID as mapped from Wikidata." } ], "questions": [ { "id": "evidence-identifiers-q01", "text": "Which of these identifiers and schemes hold for the sense of dissociative identity disorder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-standards-and-regulation", "name": "Standards and regulation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "American Psychiatric Association, DSM-5-TR: diagnostic criteria and associated features for dissociative identity disorder (300.14 / F44.81).", "World Health Organization, ICD-11 MMS: 6B64 Dissociative identity disorder and 6B65 Partial dissociative identity disorder, under Dissociative disorders.", "World Health Organization, ICD-10 / ICD-10-CM: F44.81 Dissociative identity disorder.", "Clinical and legal practice is otherwise governed by ordinary mental-health, capacity, and evidence law in each jurisdiction rather than a DID-specific statute; no DID-only product or device standard applies." ], "questions": [ { "id": "evidence-standards-and-regulation-q01", "text": "Which of these standards and regulation hold for the sense of dissociative identity disorder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-real-world-use", "name": "Real-world use", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Assigned in psychiatric, psychological, and trauma-service assessments when identity disruption plus amnesia meet DSM-5-TR or ICD-11 criteria.", "Used as an ICD/DSM billing and statistical code (F44.81 / 6B64 / 300.14) in health records and epidemiology.", "Encountered in trauma-focused psychotherapy, where treatment typically targets safety, stabilization, and integration of traumatic memory rather than encouraging new identities.", "Raised in forensic and civil proceedings (competence, criminal responsibility, witness reliability), where the diagnosis is contested and requires differential assessment for malingering.", "Discussed in public and clinical debate as a post-traumatic developmental condition versus a sociocognitive/iatrogenic construct." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of dissociative identity disorder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-measurements", "name": "Typical measurements", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "quantity": "Number of distinct personality states reported or observed", "typical_range": "at least 2 required for diagnosis; clinical series often report several to a dozen, with higher counts less typical", "unit": "count" }, { "quantity": "Age at first diagnosis", "typical_range": "commonly late adolescence to early adulthood in clinic samples; childhood onset of symptoms is often reported retrospectively", "unit": "years" }, { "quantity": "Dissociative symptom burden (e.g. Dissociative Experiences Scale, DES)", "typical_range": "mean DES in DID samples is typically high (often cited around 40-60) versus community means near 5-15", "unit": "DES score (0-100)" }, { "quantity": "Amnestic gaps", "typical_range": "recurrent, clinically significant; duration from minutes to days or longer, not attributable to ordinary forgetting", "unit": "time (minutes to days) and frequency" } ], "questions": [ { "id": "evidence-measurements-q01", "text": "Which of these typical measurements hold for the sense of dissociative identity disorder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-failure-modes-and-hazards", "name": "Failure modes and hazards", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Misdiagnosis as schizophrenia, bipolar disorder, borderline personality disorder, or epilepsy, delaying trauma-informed care or prompting inappropriate antipsychotic or mood-stabilizer regimens.", "Iatrogenic shaping of identities in highly suggestive interview or therapy contexts, especially where recovered-memory techniques are used.", "Factitious presentation or malingering, particularly in forensic settings, which can both false-positive the diagnosis and discredit genuine cases.", "Self-harm, suicidality, and high psychiatric comorbidity (PTSD, depression, substance use), which drive most acute medical risk rather than identity switching itself.", "Functional impairment from amnesia, time loss, and conflicting self-states (work, parenting, legal, financial).", "Stigma and sensational media portrayals that distort clinical presentation and can affect jury and clinician judgment." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of dissociative identity disorder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-regional-variation", "name": "Regional variation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "North American DSM-5-TR practice uses a single DID category with possession-form and non-possession-form specifiers in description; ICD-11 (used more widely internationally) splits DID (6B64) from partial DID (6B65).", "Possession-form presentations are more often reported in settings where spirit-possession is a culturally sanctioned idiom; DSM-5-TR requires that the disturbance not be a normal part of broadly accepted cultural or religious practice.", "The older name multiple personality disorder remains in popular and some legal language; ICD-10 still nested the concept under dissociative [conversion] disorders (F44).", "Prevalence estimates and clinical recognition vary sharply by country and service; DID is diagnosed more often in some specialist trauma clinics in North America, the Netherlands, and parts of Europe than in general psychiatric services elsewhere.", "Forensic acceptance of DID as a basis for insanity or diminished responsibility is jurisdiction-specific and often skeptical." ], "questions": [ { "id": "evidence-regional-variation-q01", "text": "Which of these regional variation hold for the sense of dissociative identity disorder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-neighbours", "name": "Neighbouring kinds and how to tell them apart", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "name": "Partial dissociative identity disorder (ICD-11 6B65)", "difference": "A non-dominant personality state intrudes on consciousness and agency but does not recurrently take full executive control of the person's functioning, so ICD-11 DID (6B64) is not met." }, { "name": "Other specified / unspecified dissociative disorder, including DSM-5-TR 'identity disturbance due to prolonged and intense coercive persuasion'", "difference": "Identity disruption or dissociative symptoms are present, but the combination of two or more distinct personality states plus recurrent amnesia required for DID is not fulfilled." }, { "name": "Post-traumatic stress disorder, including dissociative subtype", "difference": "PTSD is organized around trauma re-experiencing, avoidance, and hyperarousal; the dissociative subtype adds depersonalization/derealization without requiring distinct personality states that take control and associated identity amnesia." }, { "name": "Borderline personality disorder", "difference": "BPD identity disturbance is a persistently unstable self-image and affect, not recurrent, relatively enduring personality states with amnesia for everyday events; the two can co-occur and need independent assessment." }, { "name": "Schizophrenia and other psychotic disorders", "difference": "Auditory hallucinations and passivity phenomena in psychosis lack the structured, recurrent personality states and autobiographical amnesia of DID; insight, thought disorder, and negative symptoms help separate them, though DID patients may hear voices of other states." }, { "name": "Bipolar disorder", "difference": "Mood-episode polarity and duration (days to weeks of mania/depression) explain state changes; DID switches are typically faster, identity-organized, and accompanied by amnesia rather than a primary mood syndrome." }, { "name": "Complex partial seizures / temporal lobe epilepsy and other neurological amnestic syndromes", "difference": "Epileptic events have EEG/clinical seizure signatures, stereotyped auras, and post-ictal confusion; DID amnesia is psychologically organized and not explained by a medical condition (DSM/ICD exclusion)." }, { "name": "Malingering or factitious disorder, and culturally normative possession", "difference": "Malingering is judged by secondary-gain evidence and validity testing; religious or ceremonial possession is excluded when it is a normal, accepted practice and not distressing or impairing in the required clinical sense." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of dissociative identity disorder this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "How should DSM-5-TR and ICD-11 requirements be mapped without treating DID, partial DID, and other specified dissociative presentations as interchangeable?", "Which assessment instruments and change measures are adequately validated for the person's age, language, culture, and care setting?", "How can longitudinal recording of identity-related experiences minimize suggestion, excessive self-monitoring, and unnecessary fixation on labels?", "What evidence best distinguishes subjective memory inaccessibility, ordinary forgetting, and alternative causes when independent records are sparse?", "Which outcomes and review intervals best capture sustained benefit across different person-chosen treatment goals, given limitations in comparative treatment evidence?" ], "statistics": { "bundles": 7, "layers": 13, "findings": 21, "questions": 37 } }, "draft": { "generator": "vr.draft.v3", "status": "draft-generated", "researched": false, "archetype": "disease or condition", "method": "Written from the archetype playbook - what this kind of thing needs beyond identity and provenance - and from the structure that recurred across 6,333 models already researched by two engines. Applied to this entry by rule. No source was read for this thing and no claim here is researched. This entry carries no facets of its own, so they were inferred from its domain - a guess about a whole domain applied to one thing.", "facetsInferred": true, "nextPass": "A researcher replaces this draft with a sourced specification. Treat every sentence below as a proposal to argue with.", "purpose": "Give an agent a durable, checkable way to recognise a dissociative identity disorder, record what state it is in, and decide what may be done with it.", "whatItIs": "Enable an AI agent to organize evidence about suspected or diagnosed dissociative identity disorder, track its functional consequences, and support appropriate human-led assessment and care.", "characteristics": { "substance": "abstract", "origin": "conceptual", "agency": "inert" }, "whatYouCanDoWithIt": [ "observed and measured" ], "distinguishingFeatures": [ "Described in 63 Wikipedia languages, which is a measure of how widely the thing is known, not of how important it is." ], "openQuestionsForResearch": [ "Which of the bundles below does a real task actually need, and which are ceremony?", "What does this thing have that the facets do not capture at all?", "Which neighbouring kind is most often confused with a dissociative identity disorder, and on what evidence are they told apart?" ], "whatItIsMadeOf": "an abstraction with no physical instance", "physicalCharacter": [ "Does nothing on its own; everything it does, something else did to it.", "These come from the domain this entry sits in rather than from the entry itself, so treat them as a first guess about the whole domain applied to one thing." ], "whatCanBeDoneWithIt": [ "observe it, measure it, record its state" ], "howItIsRecognised": [ "Recognised by criteria applied to signs and findings, not by appearance. Two conditions can look identical and be distinguished only by test." ], "relatedModels": [], "standing": "Described in 63 Wikipedia languages, which measures how widely it is written about rather than how important or how common it is.", "structure": { "bundles": [ { "id": "identity-and-classification", "name": "Identity, naming and classification", "description": "How an agent tells one dissociative identity disorder from another, and a dissociative identity disorder from things that resemble it.", "rationale": "Recognition comes before every other claim. Without stable identity nothing else in the model can be trusted to be about the same thing twice.", "layers": [ { "id": "naming-and-identifiers", "name": "Names and identifiers", "description": "The names this thing goes by and the identifiers that survive translation and time.", "findings": [ { "id": "preferred-name-and-aliases", "name": "Preferred name, aliases and local names", "description": "Which name to use, which names mean the same thing, and which merely sound similar.", "questions": [ { "id": "preferred-name-and-aliases-q01", "text": "What identifies and describes the name of a dissociative identity disorder, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "preferred-name-and-aliases-q02", "text": "Who or what asserted this about the name of a dissociative identity disorder, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "preferred-name-and-aliases-q03", "text": "What may an agent decide or do once the name of a dissociative identity disorder is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "stable-identifiers", "name": "Stable identifiers and external keys", "description": "Identifiers that keep pointing at this kind of thing across systems and languages.", "questions": [ { "id": "stable-identifiers-q01", "text": "What identifies and describes an identifier for a dissociative identity disorder, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stable-identifiers-q02", "text": "Who or what asserted this about an identifier for a dissociative identity disorder, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stable-identifiers-q03", "text": "What may an agent decide or do once an identifier for a dissociative identity disorder is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "classification-and-granularity", "name": "Classification and granularity", "description": "Where a dissociative identity disorder sits among kinds, and how finely a task needs to cut it.", "findings": [ { "id": "kind-and-parents", "name": "Kind, parents and neighbouring kinds", "description": "The classes this thing belongs to and the ones it is next to.", "questions": [ { "id": "kind-and-parents-q01", "text": "What identifies and describes the kind of a dissociative identity disorder, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "kind-and-parents-q02", "text": "Who or what asserted this about the kind of a dissociative identity disorder, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "kind-and-parents-q03", "text": "What may an agent decide or do once the kind of a dissociative identity disorder is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "distinguishing-features", "name": "Distinguishing features", "description": "What separates a dissociative identity disorder from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a dissociative identity disorder, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "distinguishing-features-q02", "text": "Who or what asserted this about what distinguishes a dissociative identity disorder, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "distinguishing-features-q03", "text": "What may an agent decide or do once what distinguishes a dissociative identity disorder is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "state-and-lifecycle", "name": "State and lifecycle", "description": "The states a dissociative identity disorder passes through and the events that move it between them.", "rationale": "Most decisions about a thing depend on what state it is in now, which is a claim with a time on it, not a property.", "layers": [ { "id": "lifecycle-stages", "name": "Lifecycle stages", "description": "From coming into existence to ceasing to be one of these.", "findings": [ { "id": "stages-and-transitions", "name": "Stages and transitions", "description": "The stages worth naming and what moves a dissociative identity disorder between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a dissociative identity disorder, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stages-and-transitions-q02", "text": "Who or what asserted this about the lifecycle of a dissociative identity disorder, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stages-and-transitions-q03", "text": "What may an agent decide or do once the lifecycle of a dissociative identity disorder is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "observations-and-status", "name": "Observations and current status", "description": "What is observed about a dissociative identity disorder, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a dissociative identity disorder is recorded so that it can be superseded rather than overwritten.", "questions": [ { "id": "observation-record-q01", "text": "What identifies and describes an observation of a dissociative identity disorder, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "observation-record-q02", "text": "Who or what asserted this about an observation of a dissociative identity disorder, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "observation-record-q03", "text": "What may an agent decide or do once an observation of a dissociative identity disorder is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "diagnosis-and-criteria", "name": "Diagnosis, criteria and coding", "description": "What makes a case of dissociative identity disorder a case, and under which revision.", "rationale": "Criteria change between revisions, so a diagnosis without its coding revision cannot be compared with a later one.", "layers": [ { "id": "criteria", "name": "Diagnostic criteria", "description": "The criteria in force and who issues them.", "findings": [ { "id": "criteria-record", "name": "Criteria, issuer and revision", "description": "What must be true for a diagnosis, according to whom.", "questions": [ { "id": "criteria-record-q01", "text": "What criteria define dissociative identity disorder, issued by which body, in which revision?", "kind": "definition" }, { "id": "criteria-record-q02", "text": "What changed between revisions that would reclassify existing cases?", "kind": "boundary" } ] } ] }, { "id": "coding", "name": "Coding and terminology", "description": "The codes used to record it and their mapping.", "findings": [ { "id": "coding-record", "name": "Codes and mappings", "description": "Which classification codes apply and how they map.", "questions": [ { "id": "coding-record-q01", "text": "Which classification and terminology codes cover dissociative identity disorder, and how do they map to each other?", "kind": "definition" }, { "id": "coding-record-q02", "text": "What is lost when a case is mapped from one scheme to another?", "kind": "boundary" } ] } ] } ] }, { "id": "course-and-population", "name": "Course, population and care", "description": "How dissociative identity disorder develops, whom it affects, and what is done about it.", "rationale": "The condition, the diagnosis and the episode of care are three different things, and an agent must not merge them.", "layers": [ { "id": "course", "name": "Course and stages", "description": "Onset, progression, remission and outcome.", "findings": [ { "id": "course-record", "name": "Stages and transitions", "description": "The stages recorded and what moves a case between them.", "questions": [ { "id": "course-record-q01", "text": "What course does dissociative identity disorder typically take, and what marks each stage?", "kind": "definition" }, { "id": "course-record-q02", "text": "What separates the condition itself from an episode of care for it?", "kind": "boundary" } ] } ] }, { "id": "population", "name": "Affected populations", "description": "Who is affected, how often, and on what evidence.", "findings": [ { "id": "epidemiology", "name": "Prevalence and its basis", "description": "Rates with their population, period and source.", "questions": [ { "id": "epidemiology-q01", "text": "What prevalence or incidence is reported for dissociative identity disorder, in which population and period?", "kind": "measurement" }, { "id": "epidemiology-q02", "text": "What may an agent not conclude about an individual from a population rate?", "kind": "action" } ] } ] } ] }, { "id": "provenance-and-evidence", "name": "Provenance, evidence and time", "description": "Where every claim about a dissociative identity disorder came from and when it held.", "rationale": "A claim without a source and a time cannot be superseded, only overwritten, and an agent that overwrites loses the ability to explain itself.", "layers": [ { "id": "source-and-authority", "name": "Source and authority", "description": "Who said it, on what evidence, and how strongly.", "findings": [ { "id": "claim-provenance", "name": "Claim provenance and confidence", "description": "The authority behind each claim about a dissociative identity disorder and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a dissociative identity disorder, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "claim-provenance-q02", "text": "Who or what asserted this about a claim about a dissociative identity disorder, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "claim-provenance-q03", "text": "What may an agent decide or do once a claim about a dissociative identity disorder is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "time-and-versions", "name": "Time, versions and supersession", "description": "When a claim was true, when it was learnt, and what replaced it.", "findings": [ { "id": "validity-and-supersession", "name": "Validity period and supersession", "description": "How an old claim about a dissociative identity disorder is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a dissociative identity disorder, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "validity-and-supersession-q02", "text": "Who or what asserted this about the validity of a claim about a dissociative identity disorder, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "validity-and-supersession-q03", "text": "What may an agent decide or do once the validity of a claim about a dissociative identity disorder is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] } ] }, "statistics": { "bundles": 5, "layers": 10, "findings": 12, "questions": 32 } } } }