Rosh Psychiatry Board Practice Exam

Dissociative Identity Disorder is characterized by the presence of two or more distinct personality states or an experience of possession, along with recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting. The disorder typically develops as a coping mechanism in response to severe trauma during early childhood, often associated with extreme stress or abuse.

Each personality state can have its own name, age, history, and characteristics, which can create a notable fragmentation of identity. This condition also significantly impacts the patient's functioning in social, occupational, and other areas, as there may be discontinuity in a person's sense of self, leading to noticeable changes in behavior and perception.

In contrast, the other disorders listed do not have this unique feature of multiple distinct personality states. Schizophrenia primarily involves symptoms like hallucinations and delusions rather than a clear change into different identities. Borderline Personality Disorder features instability in mood, behavior, self-image, and functioning but does not involve the presence of multiple distinct personality states. Generalized Anxiety Disorder focuses on excessive, uncontrollable worry about various aspects of life, not involving a distinct fragmentation of identity or personalities. Thus, Dissociative Identity Disorder is the correct choice due to