Cross-cultural adaptation and validation of the Cambridge Depersonalisation Scale
ABSTRACT The Cambridge Depersonalisation Scale (CDS) is a self-rating questionnaire constructed to capture the frequency and duration of depersonalization symptoms over the last six months. The instrument has proved to be valid and reliable and can be useful in both clinical and neurobiological research.
This paper presents the Spanish adaptation and validation of the CDS. The study was carried out in two stages. First, we developed the Spanish version of the CDS by means of a cross-cultural adaptation methodology. Second, the CDS was tried on a sample of 130 subjects: 77 patients meeting DSM-IV-TR criteria for schizophrenia, 35 with depression disorders and 18 with anxiety disorders. Scores were compared against clinical diagnoses (gold standard). Furthermore, all the subjects of the study were administered the following: Dissociation Experiences Scale (DES), Positive and Negative Syndrome Scale (PANSS), Beck's Depression Inventory (BDI), and the Hamilton Anxiety Rating Scale (HARS).
38 patients (29.2 %) had depersonalization symptoms. The scale showed high internal consistency (Cronbach's alpha > 0.9 and split-half reliability > 0.8) and a test-retest reliability of 0.391. Convergent validity was 0.65 (p < 0.001) and discriminant validity was 0.308 (p < 0.05). The area under the ROC curve was 0.94. A cut-off of 71 appears to be most useful (sensitivity and specificity were 76.3 % and 89.1 %, respectively).
The Spanish version of the CDS has good reliability and validity, similar to the original instrument.
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- "It captures the frequency and duration of depersonalization experiences, exists both in a state (CDS-22) and a trait (CDS-30) version, and has been translated into several other languages (e.g. Michal et al., 2004; Molina Castillo et al., 2006). 274 M. GAEBLER ET ALII  In line with patient reports, the vast majority of cases in the literature, the view of the ICD-10 as well as current recommendations for the revision of the diagnostic criteria in DSM-5 (Spiegel et al., 2011), we will not explicitly distinguish between depersonalization and derealization in this text. "
ABSTRACT: Describing, understanding, and explaining subjective experience in depression is a great challenge for psychopathology. Attempts to uncover neurobiological mechanisms of those experiences are in need of theoretical concepts that are able to bridge phenomenological descriptions and neurocognitive approaches, which allow us to measure indicators of those experiences in quantitative terms. Based on our own on going work with patients who suffer from depersonalization disorder (DPD) and describe their experience as flat and detached from self, body, and world, we introduce the idea of phenomenal depth as such a concept. Phenomenal depth is conceptualized as a dimension inherent to all experiences, describing the relatedness of one's self with one's mental processes, body, and the world. More precisely, it captures the experience of this relatedness and embeddedness of one's experiences, and it is thus a meta- or secondorder experience. The psychopathology of DPD patients can be understood very generally as an instance of reduced phenomenal depth. We will argue that similar experiences in depression can also be understood as a reduction in phenomenal depth. We relate those ideas to neurocognitive studies of perception, emotion regulation, and the idea of predictive coding. Finally, we will speculate about possible neurobiological underpinnings of the dimension of phenomenal depth.Journal of Consciousness Studies 07/2013; 20(7-8):269-291. · 0.77 Impact Factor
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- "The severity and phenomenology of depersonalization was determined by means of the Cambridge Depersonalization Scale (CDS), a 29-item self-rating scale designed to explore in detail the phenomenology of depersonalization within the last 6 months (Sierra and Berrios, 2000). The scale has been used in different cultures and consistently found to have a good psychometric profile (Michal et al., 2004; Molina Castillo et al., 2006; Sugiura et al., 2009). We used the Beck Anxiety Inventory (BAI) as a primary measure of anxiety (Beck et al., 1988) given that it is a widely validated scale, which comprehensively explores somatic and cognitive anxiety symptoms. "
ABSTRACT: A significant association between anxiety and depersonalization has been found in healthy controls and psychiatric patients irrespective of underlying conditions. Although patients with depersonalization disorder (DPD) often have a history of severe anxiety symptoms, clinical observations suggest that the relation between anxiety and depersonalization is complex and poorly understood. Using relevant rating scales, levels of anxiety and depersonalization were assessed in 291 consecutive DPD cases. 'High' and 'low' depersonalization groups, were compared according to anxiety severity. Correlation and multivariate regression analyses were also used to assessed the contribution of anxiety to the phenomenology and natural course of depersonalization. A low but significant association between depersonalization and anxiety (as measured by Beck's Anxiety Inventory) was only apparent in those patients with low intensity depersonalization, but not in those with severe depersonalization. Levels of anxiety did not seem to make specific contributions to the clinical features of depersonalization itself, although DPD patients with high anxiety seem characterised by additional non-specific perceptual symptoms. The presence of a 'statistical dissociation' between depersonalization and anxiety adds further evidence in favour of depersonalization disorder being an independent condition and suggests that its association with anxiety has been overemphasized.Psychiatry Research 03/2012; 197(1-2):123-7. DOI:10.1016/j.psychres.2011.12.017 · 2.47 Impact Factor
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ABSTRACT: Depersonalization occurs in healthy individuals and across a broad range of psychiatric patients. Data on depersonalization in persons linked to patients through genetics, environment or education are scarce. Due to their higher risk of developing psychosis, first-degree healthy relatives might show differences with the general population. This study examines depersonalization in patients with schizophrenia or schizophrenia spectrum disorders, their first-degree healthy relatives and normal controls. The Cambridge Depersonalization Scale was used to measure depersonalization in a sample of 147 clinically stable patients with schizophrenia or schizophrenia spectrum disorders, 73 first-degree relatives with no psychiatric history and 172 healthy controls. Mixed effect models were used to account for both the familial structure of the data and the effect of sociodemographic characteristics. Patients obtained higher scores than relatives and controls for frequency and duration of depersonalization experiences, number of items responded positively and total depersonalization, while first-degree relatives obtained lower scores than patients and controls for all these characteristics. First-degree relatives of patients reported fewer episodes of depersonalization, which were less intense and of shorter duration, than healthy controls. This finding might be related to a protection mechanism that keeps first-degree relatives away from near-psychotic experiences. The nature of such a mechanism remains to be discovered.Psychopathology 02/2010; 43(3):141-9. DOI:10.1159/000288635 · 2.08 Impact Factor