title: Awareness of identity alteration and diagnostic preference between borderline personality disorder and dissociative disorders.
abstract: OBJECTIVE
  This study inquires into identity alteration among college students and its relationship to borderline personality disorder (BPD) and/or dissociative disorders (DDs).
  
  
  METHODS
  Steinberg Identity Alteration Questionnaire (SIAQ), Childhood Trauma Questionnaire (CTQ), and self-report screening tool of the BPD section of the Structured Clinical Interview for DSM-IV (SCID-BPD) were administered to 1301 college students. Participants who fit the diagnostic criteria of BPD (n = 80) according to the clinician-administered SCID-BPD and 111 non-BPD controls were evaluated using the Structured Clinical Interview for DSM-IV DDs (SCID-D) by two psychiatrists blind to the group membership and scale scores.
  
  
  RESULTS
  Test-retest evaluations and internal consistency analyses suggested that SIAQ was a reliable instrument. Of the participants, 11.3% reported a SIAQ score 25 or above alongside some impairment. SIAQ scores differentiated participants who fit the diagnostic criteria for a DD from those who did not. While self-report identity alteration was correlated with all childhood trauma types, clinician-assessed identity alteration was correlated with childhood sexual abuse only. Those who fit criteria for both disorders had the highest identity alteration scores in self-report and clinician-assessment. Although both syndromes had significant effect on self-report identity alteration total scores, in contrast to DD, BPD did not have an effect on the clinician-administered evaluation.
  
  
  CONCLUSIONS
  An impression of personality disorder rather than a DD may seem more likely when identity alteration remains subtle in clinical assessment, notwithstanding its presence in self-report. Lack of recognition of identity alteration may lead to overdiagnosis of BPD among individuals who have a DD.
authors.affiliation: a Department of Psychiatry , Koc University School of Medicine (KUSOM) , Istanbul , Turkey.
authors.forename: Vedat
authors.initials: V
authors.lastname: Sar
authors.affiliation: b Department of Psychiatry , Kocaeli University School of Medicine , Kocaeli , Turkey.
authors.forename: Firdevs
authors.initials: F
authors.lastname: Alioğlu
authors.affiliation: c Independent Researcher , İzmir , Turkey.
authors.forename: Gamze
authors.initials: G
authors.lastname: Akyuz
authors.affiliation: d Koc University School of Medicine (KUSOM) , Istanbul , Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Tayakısı
authors.affiliation: d Koc University School of Medicine (KUSOM) , Istanbul , Turkey.
authors.forename: Ezgi F
authors.initials: EF
authors.lastname: Öğülmüş
authors.affiliation: d Koc University School of Medicine (KUSOM) , Istanbul , Turkey.
authors.forename: Doğuş
authors.initials: D
authors.lastname: Sönmez
mesh_terms: D000293:Adolescent; D000328:Adult; D001364:Awareness; D001883:Borderline Personality Disorder / Q000175:diagnosis*; D004213:Dissociative Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D013334:Students / Q000523:psychology*; D014421:Turkey
keywords: Borderline personality disorder; dissociation; identity alteration; reliability; self-report