Construct Validity of Three Measures of Depersonalization in Trauma-Exposed College 
Students 
 
by 
 
Christy Aleene Talbert 
 
 
 
 
A thesis submitted to the Graduate Faculty of 
Auburn University 
in partial fulfillment of the 
requirements for the Degree of 
Master of Science 
 
Auburn, Alabama 
December 13, 2010 
 
 
 
 
Keywords: depersonalization, dissociation, construct validity, self report 
 
 
Copyright 2010 by Christy Aleene Talbert 
 
 
Approved by 
 
Frank Weathers, Chair, Professor of Psychology 
 Adrian Thomas, Associate Professor of Psychology 
Richard Mattson, Assistant Professor of Psychology
 
 
 
 
Abstract 
 
 Depersonalization is a type of dissociation characterized by feelings of unreality and 
detachment from one?s sense of self. Despite a history rich in clinical description, 
depersonalization has proven difficult to define and thus measure. Not surprisingly, available 
measures of depersonalization have limited psychometric support. The present study examined 
the construct validity of three self-report measures of depersonalization using a sample of 
trauma-exposed college students. Depersonalization measures included the Dissociative 
Experiences Scale (DES; Bernstein & Putnam, 1986), the Cambridge Depersonalization Scale 
(CDS; Sierra & Berrios, 2000), and the Multiscale Dissociation Inventory (MDI; Briere, 2002). 
These three measures were compared with respect to their pattern of correlations with a range of 
theoretically relevant self-report measures of psychopathology. Using Westen and Rosenthal?s 
(2003) procedure for evaluating a pattern of convergent-discriminant relationships, all three 
measures demonstrated good construct validity. The CDS and MDI demonstrated the best 
convergent, discriminant, and content validity, and the results strongly supported the use of the 
CDS and MDI for the assessment of depersonalization in this population. Implications for further 
understanding and refining the construct of depersonalization are discussed. 
 
  
 
 
 
 
 
 
ii 
 
 
 
 
 
Table of Contents 
 
 
Abstract ......................................................................................................................................... ii 
List of Tables ............................................................................................................................... iv  
Introduction   ................................................................................................................................. 1 
Method ........................................................................................................................................ 19 
 Participants ...................................................................................................................... 19 
 Measures ......................................................................................................................... 20 
 Procedure ........................................................................................................................ 24 
 Data Analysis .................................................................................................................. 25 
Results   ....................................................................................................................................... 27 
 Descriptive Statistics and Internal Consistency  ............................................................. 27 
 Correlation Analyses  ...................................................................................................... 27 
 Effect Size Indices r
alerting-CV  
and r
contrast-CV
 ..................................................................... 29 
Discussion   ................................................................................................................................. 31 
References   ................................................................................................................................. 35 
Appendix    .................................................................................................................................. 43 
 
 
 
 
 
 
 
 
 
 iii
 iv
 
 
List of Tables 
 
 
Table 1: Descriptive Statistics for Dissociative Experiences Scale, Cambridge  
     Depersonalization Scale, Multiscale Dissociation Inventory, Personality Assessment  
     Inventory, and Posttraumatic Stress Disorder Checklist  ....................................................... 43 
 
Table 2: Predicted and Observed Correlations between Depersonalization Measures and     
     Criterion Measures, Raw ?s, and Integer Values of Raw ?s .................................................. 44 
 
Table 3: Effect Size Statistics r
alerting-CV  
and r
contrast-CV 
 for Depersonalization Measures ........... 45 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Introduction 
Depersonalization is a psychological experience characterized by a sense of detachment 
from one?s self and environment that often leads to significant distress and impairment 
(Guralnik, Schmeidler, & Simeon, 2000). Descriptions of depersonalization have remained fairly 
stable since they first emerged more than one hundred years ago (Sierra & Berrios, 2001). 
Clinical observations have linked a number of cognitive, affective, and perceptual experiences 
with depersonalization, including emotional numbing, impaired concentration, perceptions of the 
external environment as two-dimensional, and an inability to recognize one?s own voice or 
reflected image (Hunter, Phillips, Chalder, Sierra, & David, 2003). Other common symptoms 
include altered perceptions of the physical self (e.g., feeling as if a part of one?s body has 
changed size), loss of sense of agency (e.g., not feeling in charge of one?s thoughts or actions), 
altered perceptions of autobiographical memories (e.g., feeling distant from or not a part of a 
retrieved memory), and heightened self-awareness (Sierra & Berrios, 2001). Importantly, while 
experiencing depersonalization, individuals remain aware of the subjective nature of these 
symptoms, and therefore are not considered delusional (Hunter et al, 2003). In fact, the lack of 
delusion combined with a heightened self-awareness often exacerbates distress in individuals 
experiencing depersonalization because they fear they are losing control or going crazy.  
 Although once considered a rare phenomenon, depersonalization is in fact commonly 
found in a variety of clinical and non-clinical settings (Simeon, 2004). In a recent review, 
Hunter, Sierra, and David (2004) found transient depersonalization symptoms frequently 
reported in student and non-clinical populations, with lifetime prevalence rates ranging from 26-
1 
 
74%. Hunter and colleagues (2004) also found that current clinically significant 
depersonalization symptoms was reported in 1-2% of participants randomly selected from 
community surveys, which is comparable to the prevalence of obsessive compulsive disorder, 
and that the prevalence of current clinically significant depersonalization symptoms in 
psychiatric inpatients ranged from 42- 91%. Further, depersonalization is commonly seen in a 
variety of psychological conditions, including panic attacks (Hunter et al., 2003; Cox & 
Swinson, 2002), borderline personality disorder (Zanarini, Ruser, Frankenburg, & Hennen, 2000; 
Simeon, Gross, Guralnik, Stein, Schmeidler, & Hollander, 1997), and acute reactions to 
traumatic stress (Simeon, Guralnik, Schmeidler, Sirof, & Knutelska, 2001; Harvey & Bryant, 
1998; Bremner, Steinberg, Southwick, Johnson, & Charney, 1993). Finally, although 
depersonalization is often studied as a feature of other forms of psychopathology, 
depersonalization disorder is recognized as one of the five dissociative disorders in DSM-IV-TR, 
and is defined as a ?persistent or recurrent feeling of being detached from one?s mental processes 
or body that is accompanied by intact reality testing? (APA, 2000, p. 519).  
Researchers have proposed a number of theories of depersonalization. One of the first 
theories grew out of Pierre Janet?s theory of dissociation in the latter part of the 19
th
 century (see 
van der Hart & Friedman, 1989, and van der Kolk & van der Hart, 1989, for a full discussion). 
Janet?s model of the mind distinguishes among levels of consciousness. Some psychological 
activity exists at a subconscious level that is outside one?s control and isolated from conscious 
awareness. The origin of subconscious activity is attributed to a narrowing of one?s field of 
consciousness, or a decrease in the number of psychological phenomenon that can be integrated 
into conscious awareness at one time. Janet referred to the means by which this reduction of 
consciousness occurred as dissociation.   
 2
According to Janet, dissociation occurs when factors such as physical illness, exhaustion, 
and intense emotions associated with traumatic experiences disrupt the mind?s ability to integrate 
psychological processes, leaving certain processes split off and isolated from conscious 
awareness. The isolated or dissociated processes range in complexity from a single thought or 
image and the feelings associated with it to an entire personality, as in the case of dissociative 
identity disorder (DID). Janet considered dissociation a coping strategy that functions to mitigate 
aversive emotional reactions to stressful life events. However, he also noted that dissociation 
may outlive its initial utility and become maladaptive. In that case, the individual is chronically 
unable to integrate different aspects of their experience and becomes emotionally constricted. 
With respect to depersonalization specifically, Sierra and Berrios (1997) described 
Janet?s theory as an important shift from earlier models that described depersonalization as a 
sensory deficit to a model of depersonalization as an active process. According to Sierra and 
Berrios, Janet believed that the disintegration that occurs in depersonalization is between two 
types of experiences: primary and secondary. Primary experiences include all actions elicited by 
external stimuli, such as a reflexive motor response or a triggered memory, while secondary 
experiences refer to the ?background echo? or internal representations of primary experiences. 
When the two types, primary and secondary, are disconnected, an individual experiences their 
perceptions, motor activity, emotions, and self as incomplete. Lost is the sense of a continuous 
self that occurs when primary and secondary experiences are integrated.     
 Since Janet?s theory of depersonalization several other theories have been proposed. For 
example, Mayer-Gross (1935) and Roth (1959) described depersonalization as a pre-formed 
functional response in the brain shaped by evolution. From this perspective, depersonalization is 
seen as an adaptive mechanism involving increased arousal with dissociated emotion, serving to 
 3
increase one?s chances of survival in life-threatening situations. Hunter et al. (2003) offered a 
cognitive-behavioral conceptualization of the onset of depersonalization and its development into 
a chronic disorder. According to the cognitive-behavioral model, depersonalization disorder 
results from the misinterpretation of transient depersonalization symptoms as an indication of 
permanent brain damage or severe mental illness, which in turn leads to increased anxiety and 
consequently increased depersonalization symptoms. Cognitive and behavioral attempts to avoid 
further depersonalization paradoxically increase symptom monitoring and prevent 
disconfirmation of misinterpretations. Expanding on Mayer-Gross?s conceptualization, Sierra 
and Berrios (1998) developed a neurobiological model of depersonalization. According to their 
model, depersonalization is a hard-wired biological response involving simultaneous emotional 
inhibition and vigilant alertness. Depersonalization evolved to help individuals cope with life-
threatening situations in which an individual has no control over their surroundings and the 
source of danger is unknown. The restriction of nonfunctional emotional responses (e.g., fight or 
flight) and the increase of vigilant attention allow individuals to scan the environment for 
important information. When experienced in a non-threatening situation, such a pattern of 
response engenders a disturbing experience combining an enhanced sensory clarity with a 
sudden lack of emotional feeling. 
Recent studies have provided empirical support for the neurobiological model. For 
example, Sierra et al. (2002) found a reduction in autonomic response to aversive stimuli in 
individuals with depersonalization disorder, but not in individuals with anxiety disorders or 
healthy controls. However, like the anxiety disorder group, the depersonalization disorder group 
had heightened anxiety ratings and quicker responses to neutral stimuli relative to controls. This 
pattern of findings is consistent with the reduced emotional response and increased vigilance 
 4
postulated by the neurobiological model. In addition, Phillips et al. (2001) found reduced neural 
activation in regions associated with the perception of negative emotion in individuals with 
depersonalization disorder, as predicted by the emotional inhibition component of the 
neurobiological model. 
Dissociation and depersonalization are now well-established psychological constructs, 
with increasingly well-articulated theoretical models and extensive empirical literatures. 
Nonetheless, the transition from clinical description to operational definition and scientific 
investigation has proven difficult and generated much debate. After more than a century of 
research, there is still no commonly accepted definition of dissociation (Dell, 2006). Currently, 
various definitions include (a) behaviors and perceptions that occur outside of consciousness, (b) 
the presence of two or more mental processes that are disintegrated or not associated, and (c) the 
co-occurrence of distinct mental systems normally integrated in conscious awareness, memory, 
or identity (Carde?a, 2004). DSM-IV-TR defines dissociation as a ?disruption in the usually 
integrated functions of consciousness, memory, identity, or perception? (APA, 2000, p. 519). 
Researchers have argued over the difference between dissociation and repression (Spiegel & 
Carde?a, 1991) and between ?dissociative? as a descriptive label referring to an interruption in 
conscious awareness and ?dissociation? as a process or defensive mechanism (Kihlstrom, 2005). 
The term dissociation has been used to refer to a wide variety of phenomena and processes 
including identity confusion, multiple identities, divided attention, absorption, trance, reduced 
awareness, flashbacks, and depersonalization (Brown, 2006; Holmes et al., 2005). 
 Most recent efforts at integrating disparate definitions of dissociation agree that it is not a 
unitary phenomenon. As Holmes et al. (2005) point out, a number of researchers have converged 
on a similar two-part categorization of dissociation, which the authors label ?detachment? and 
 5
?compartmentalization.? Detachment is defined as ?an altered state of consciousness 
characterized by a sense of separation from the self (as in depersonalization) or the world (as in 
derealization)? and defined compartmentalization as ?an inability to deliberately control actions 
or cognitive processes that would normally be amenable to such control? (p. 18). Holmes et al. 
note that although detachment and compartmentalization are distinct, they may co-occur. For 
example, individuals with posttraumatic stress disorder (PTSD) may experience both 
depersonalization (e.g., detachment) and amnesia (e.g., compartmentalization) following 
exposure to a traumatic event. According to Holmes et al., the detachment / 
compartmentalization classification has received considerable empirical support, with studies 
demonstrating the existence of detachment in isolation of compartmentalization, the consistent 
division of depersonalization and amnesia in factor analytic studies of the DES, and the existence 
of a distinct neurophysiological profile of detachment in experimental studies.  
 Growing consensus that dissociation is a multifaceted construct has led to increased 
studies of specific types of dissociation, including the study of depersonalization. Increased 
interest in depersonalization has led to some clarification concerning its etiology, course, and 
comorbidity with other conditions. However, it has also highlighted the numerous challenges 
involved in establishing an operational definition suitable for scientific study.  Like dissociation, 
depersonalization is a subjective experience with no characteristic behavioral manifestations 
(Levy & Wachtel, 1978; Radovic & Radovic, 2002). As such, the major basis for its diagnosis is 
the subjective, self-report of the individual experiencing it (Radovic & Radovic, 2002). Another 
difficulty in defining depersonalization is the ambiguous language used to describe it, such as 
?feelings of unreality? and ?as if.? Radovic and Radovic (2002) review some of the semantic 
difficulties that have developed from using such language. First, the term ?unreal? has various 
 6
meanings and may refer to non-existence, made up, or not normal. For example, an imaginary 
friend might be described as ?unreal,? meaning it does not exist or is made up. The experience of 
one?s body or self might also be described as ?unreal,? meaning changed in some way from what 
is normally experienced. The meaning of the term ?unreal? varies by context. Second, the use of 
the phrase ?as if? may also have various meanings. The use of ?as if? to describe 
depersonalization is often suggested as evidence of lack of delusion (e.g., it feels as if one is a 
robot, implying that one does not in fact believe oneself to be a robot). While this may be true, 
the strange and unfamiliar quality of depersonalization makes it difficult to accurately describe 
within the limits of language, and thus contribute to an individual using ?as if? as a way of 
expressing doubt over the adequacy of a proposed explanation.         
 Use of the term ?derealization? has also hindered development of a clear operational 
definition of depersonalization. This term, which originated in the early 20
th
 century after the 
term depersonalization had already been established (Sierra & Berros, 2001), is defined in DSM-
IV-TR as ?an alteration in the perception or experience of the external world so that it seems 
strange or unreal? (APA, 2000, p. 822). Although DSM-IV-TR distinguishes between 
derealization and depersonalization, defined as an ?alternation in the perception or experience of 
the self so that one feels detached from, and as if one is an outside observer of, one?s mental 
processes or body (e.g., feeling like one is in a dream)? (APA, 2000, p. 822), there is no 
conclusive support that the two phenomena are independent (Sierra & Berrios, 2001). Currently, 
most investigators consider derealization and depersonalization to be different perspectives on 
the same phenomenon and do not differentiate them (Sierra, Baker, Medford, & David, 2005). 
Dugas, who coined the term depersonalization in the late 1800?s, recognized the essential 
equivalence of these two terms: ?[in depersonalization] the individual feels a stranger amongst 
 7
things, or if one prefers, things appear strange to him? (translated by Sierra & Berrios, 1996). In 
other words, either the environment feels strange to the person, or the person feels strange in the 
environment. Consistent with this approach, unless otherwise specified, in the present study 
depersonalization is considered to encompass experiences both of unreality of the self 
(?depersonalization?) and of the environment (?derealization?).   
Difficulties defining depersonalization have contributed to difficulties developing 
instruments to accurately measure it. Although several measures have been developed, they vary 
in content, primarily as a result of each measure using different definitions of depersonalization, 
and in comprehensiveness of the symptoms represented. Further, some of the measures have 
received relatively limited psychometric support.  
The most widely used measure of depersonalization is the Dissociative Experiences Scale 
(DES; Bernstein & Putnam, 1986), a 28-item self-report measure of the frequency of dissociative 
experiences. In the original DES, participants rate how often they experience each symptom by 
marking the percentage on a 100-mm line with anchors at 0% and 100%. In the revised version 
(DES ? II), participants rate the percentage of the time they experience each symptom on an 11-
point Likert-scale ranging from 0% to 100% in increments of ten. The revised DES (used in the 
current study) was designed to ease scoring and is considered comparable to the original version 
(Carlson & Putnam, 1993). A total dissociation score is calculated by averaging responses to all 
28 items. Several studies have examined the factor structure of the DES and found support for its 
division into three subscales (Stockdale, Gridley, Balogh, & Holtgraves, 2002; Carlson et al., 
1991; Schwartz & Frischholz, 1991). Subscale scores are calculated by averaging the responses 
to the items corresponding to three factors: amnesia (e.g., ?Some people find that they have no 
memory for some important events in their lives (for example, a wedding or graduation?), 
 8
absorption (e.g., ?Some people sometimes find that they become so involved in a fantasy or 
daydream that it feels as though it were really happening to them?), and depersonalization (e.g., 
?Some people sometimes have the experience of feeling that their body does not belong to 
them?).  
During development of the DES, items were generated based on discussions with clinical 
experts and interviews with individuals meeting criteria for a dissociative disorder (Bernstein & 
Putnam, 1986). The authors included items related to disturbances in identity, memory, and 
awareness, feelings of depersonalization, and absorption. Subjects included 31 college students, 
34 healthy adults, 14 individuals with alcoholism, 24 individuals with PTSD, 20 individuals with 
schizophrenia, and 20 individuals with dissociative identity disorder.  
Bernstein and Putnam (1986) found the DES to have good split-half reliability (ranging 
from .71 to .96) and good test-retest reliability (.84). Item-total correlations ranged from .50 to 
.79 with a median of .64. The DES demonstrated good criterion-related validity in that item 
scores were able to distinguish subjects with and without a dissociative disorder diagnosis. In a 
review of the DES since its introduction, Carlson and Putnam (1993) extended the reliability and 
validity evidence found in their initial study. Many factor analytic studies of the DES have 
supported the division of the DES into three subscales. However, results have not been 
consistent, particularly in non-clinical samples (Stockdale, Gridley, Balogh, & Holtgraves, 
2002). In an attempt to clarify the factor structure of the DES in non-clinical samples, Stockdale, 
Gridley, Balogh, and Holtgraves (2002) conducted confirmatory factor analyses on one-, two-, 
three-, and four-factor models of DES scores for two samples of university students, and found 
support for the three-factor structure. However, Stockdale et al. caution that the three factors 
accounted for only 45.8% of the variance, leaving a significant percentage unexplained. 
 9
There are several limitations in using the DES to measure depersonalization. First, the 
DES was not intended to be used in non-clinical populations, although it often is (Carlson & 
Putnam, 1993). Second, the DES tends to measure the number of dissociative experiences rather 
than the severity of symptoms, which may not be equivalent (Holmes et al., 2005). Third, the 
depersonalization subscale is comprised of only six items, including one item describing auditory 
hallucinations, which seems to lack face validity (Sierra & Berrios, 2000). Waller, Putnam, and 
Carlson (1996) note that the DES depersonalization items represent more extreme forms of 
depersonalization such as out-of-body experiences and sensory disturbances. However, other 
symptoms, such as emotional numbing, heightened self-observation, and alterations in the 
experience of autobiographical memory, lack representation. Based on an examination of item 
content, the DES appears to under-represent a number of symptoms theoretically and empirically 
associated with depersonalization.    
The Cambridge Depersonalization Scale (CDS; Sierra & Berrios, 2000) is a more recent 
self-report instrument assessing depersonalization specifically. It contains 29 items measuring 
depersonalization symptoms, each rated on two separate scales for frequency (0 = never to 4 = 
all the time) and duration (1 = few seconds to 6 = more than a week). A total depersonalization 
score is calculated by summing all item scores. Participants report only those symptoms 
occurring within the past six months. 
The item pool for the CDS developed from a comprehensive literature review of the 
descriptive psychopathology of depersonalization and included a statistical analysis of 200 
published cases. Based on the neurobiological model of depersonalization, symptoms associated 
with inhibited emotional processing (e.g., loss of affection for others) and heightened arousal 
(e.g., alterations in the perception of objects or body parts) were included in the item pool. After 
 10
an initial version of the scale was piloted in a sample of 40 healthy adults and 10 patients with 
anxiety disorders, revisions were made after consulting with experts in scale construction. The 
final version of the CDS was standardized using 35 individuals with depersonalization disorder, 
22 individuals with either panic disorder or generalized anxiety disorder, and 20 individuals with 
temporal lobe epilepsy.  
Initial reliability and validity evidence for the CDS supports its psychometric merit. 
Sierra and Berrios (2000) found the internal consistency and split-half reliability of the CDS to 
be .89 and .92, respectively. The CDS demonstrated good criterion-related validity in that CDS 
scores were able to differentiate individuals with depersonalization disorder from individuals 
with anxiety and temporal lobe epilepsy. Sierra et al. (2005) conducted an exploratory factor 
analysis of the CDS that derived four factors: anomalous body experience, emotional numbing, 
anomalous subjective recall, and alienation from surroundings. The four-factor model accounted 
for 73.3 % of the variance and had relatively low correlations between factors, ranging from .23 
to .34 (Sierra et al., 2005). Simeon et al. (2008) conducted a confirmatory factor analysis of the 
CDS and failed to replicate the factor structure found by Sierra et al. (2005). Simeon et al. then 
conducted an exploratory factor analysis which extracted five factors accounting for 55.8% of 
the variance. The five-factor model was similar to the four-factor model, with the exception that 
?anomalous body experience? separated into two factors, ?unreality of self? and ?perceptual 
alterations.?  
One limitation of the CDS is the relatively small number of psychometric studies 
examining its reliability and validity. Another limitation is the utility of the CDS in non-clinical 
populations (Sierra & Berrios, 2000). Because the CDS has only been tested with clinical 
 11
samples, further research is needed to examine whether the CDS is a useful measure of 
depersonalization in community and student samples.  
The Multiscale Dissociation Inventory (MDI; Briere, 2002) is another recently developed 
self-report instrument measuring dissociation. The MDI consists of 30 items divided into six 
scales measuring different types of dissociative experiences. Participants rate the frequency of 
each item on a 5-point scale ranging from 1 (never) to 5 (very often) and report only symptoms 
occurring in the past month.   
The six MDI scales include disengagement, depersonalization, derealization, emotional 
constriction, memory disturbance, and identity dissociation (Briere, 2002). Disengagement refers 
to affective and/or cognitive separation from one?s present surroundings and is similar in item 
content to the DES absorption scale. Emotional Constriction refers to reduced emotional 
responsiveness. Memory Disturbance refers to the inability to remember personal events and is 
similar to the DES amnesia scale. Identity Dissociation refers to the experience of more than one 
personality within oneself. The Depersonalization and Derealization scales are similar to DSM-
IV-TR definition of an alteration in one?s perception of the self (depersonalization) or 
environment (derealization). Given the lack of support for this distinction (as previously 
discussed), the MDI Depersonalization and Derealization items were combined into one scale in 
the present study. In addition to the theoretical rationale for combining the scales, empirical 
evidence also supports this choice.  Briere, Weathers, and Runtz (2005) conducted a factor 
analysis of the MDI using a combined sample of 1,326 general population, university, and 
clinical participants. The analysis yielded five factors accounting for 68% of the variance. The 
factors matched onto the scales of the MDI, with the exception that the depersonalization and 
derealization items combined into one factor.   
 12
The initial item pool for the MDI contained 90 statements assessing each of the six types 
of dissociation listed above. Thirty items were removed after consultation with experts in 
assessment and with experts in the treatment of dissociation. An item analysis was conducted 
after an initial administration in a general population sample, resulting in the removal of 30 more 
items. The final version of the MDI was standardized using a university sample (573 students 
from a mid-sized Canadian university), a clinical sample (93 clients from the caseload of 12 
clinicians across the United States), and a community sample (70 trauma-exposed community 
residents). 
Briere (2002) found good reliability and validity evidence for the MDI. Internal 
consistency coefficients ranged from .77 to .92 across the three samples. The MDI demonstrated 
good criterion-related validity, in that MDI scores predicted PTSD diagnosis. The MDI 
correlated strongly with other measures of dissociation, including the DES, and less strongly 
with measures of non-dissociative constructs, including anxiety and anger; however, the MDI did 
correlate strongly with measures of depression, with correlations ranging from .60 to .66.  
One limitation of the MDI is the small number of studies examining its psychometric 
properties. Although initial findings are encouraging, further evidence is needed to demonstrate 
the reliability and validity of the MDI scales. Another limitation of the MDI as a measure of 
depersonalization is the separation of emotional constriction items from depersonalization and 
derealization items. Experiences of emotional numbing, such as loss of affection for others and 
reduced fear in life-threatening situations, have been associated with depersonalization (Sierra & 
Berrios, 2000); thus, the assessment of depersonalization without items representing emotional 
constriction may not adequately capture the full construct.       
 13
 Despite the limitations of available self-report measures, in an effort to establish the 
convergent and discriminant validity of depersonalization, recent studies have found a number of 
preferential associations with constructs that have historically been associated with 
depersonalization. For example, several investigators have found a significant correlation 
between depersonalization and anxiety (Hunter et al., 2003; Noyes & Kletti, 1977; Roth, 1959). 
The historical link between depersonalization and anxiety is reflected in Roth?s (1959) 
description of the ?phobic anxiety ? depersonalization syndrome.? According to Roth, 
depersonalization and anxiety were so closely associated that they constituted a single neurotic 
illness. More recent research has highlighted the role of depersonalization in anxiety-related 
disorders. Cox and Swinson (2002) found that 71% of their sample of patients with panic 
disorder experienced episodes of depersonalization. Two-thirds of the depersonalization-positive 
group reported depersonalization both as a part of and separate from panic attacks. 
Depersonalization has been found to significantly correlate with social anxiety, even after 
controlling for global severity of distress (Michal et al., 2005). Depersonalization has also been 
related to obsessive ? compulsive symptomatology, based on similarities in phenomenology, 
neurochemistry, and response to treatment (Simeon, Stein, & Hollander, 1995). However, not all 
studies have found evidence for a significant association between depersonalization and 
obsessive ? compulsive symptoms (see Sierra & Berrios, 2000). 
 As previously mentioned, depersonalization is frequently associated with trauma 
exposure (Spiegel & Carde?a, 1991). Depersonalization has been found in combat veterans with 
PTSD (Bremner, Steinberg, Southwick, Johnson, & Charney; 1993) as well as in individuals 
with acute stress disorder (ASD; Harvey & Bryant, 1998). One recent study on the relationship 
between trauma and depersonalization found childhood interpersonal trauma highly predictive of 
 14
depersonalization scores in individuals with depersonalization disorder (Simeon, Guralnik, 
Schmeidler, Sirof, & Knutelska, 2001). The authors found that among the various types of 
trauma examined, emotional abuse was the strongest predictor of depersonalization disorder 
diagnosis and depersonalization severity.  
 Despite the high comorbidity between depersonalization and depression, research 
examining this relationship is scarce. In their review of the literature on depersonalization and 
mood disorder, Mula, Pini, and Cassano (2007) conclude that depersonalization is associated 
with increased severity of depression and poorer response to treatment. They suggest that severe 
alterations in mood may sufficiently upset the stability of the self to precipitate experiences of 
depersonalization. A number of self-report studies have found significant correlations between 
measures of depersonalization and depression. For example, Lambert, Senior, Fewtrell, Phillips, 
and David (2001) found the DES depersonalization scale to correlate 0.58 (p < .01) with the 
Beck Depression Inventory. Similarly, Briere, Weathers, and Runtz (2005) found the MDI 
Depersonalization and Derealization items to correlate 0.52 (p < .01) with the PAI Depression 
scale.   
 Depersonalization has been identified as one of three areas of cognitive disturbance 
associated with borderline personality disorder (BPD; Gunderson & Singer, 1975). Zanarini, 
Ruser, Frankenburg, and Hennen (2000) examined dissociative experiences in a sample of 290 
inpatients with BPD and 90 inpatient controls with an Axis II diagnosis other than BPD. The 
patients with BPD reported significantly higher scores than controls on self-report items 
measuring depersonalization. Similarly, Korzekwa, Dell, Links, Thabane, and Fougene (2009) 
found that most of their sample of outpatients with BPD endorsed some degree of 
depersonalization. The authors note, however, that dissociation in BPD is frequently related to 
 15
trauma exposure, which makes the specificity of the link between depersonalization and BPD 
less clear. 
 A number of other psychological constructs have also been associated with 
depersonalization. For example, depersonalization has been associated with somatization and 
conversion (Spitzer, Spelsberg, Grabe, Mundt, and Freyberger, 1999). Indeed, the link between 
conversion and dissociation dates back to late 19
th
 century psychodynamic conceptualizations of 
hysteria (Kihlstrom, 1994). Depersonalization has also been associated with schizotypy. Watson 
(2001) found depersonalization and schizotypy to be almost indistinguishable in a factor analytic 
study using a college student sample. In contrast, Simeon, Guralnik, Knutelska, and Nelson 
(2004), using the same measures as Watson (2001), found only perceptual distortions to be 
elevated in individuals with depersonalization disorder, compared to healthy controls, after 
controlling for Axis II comorbidity. Simeon et al. (2004) suggest that a more restricted range of 
psychopathology in Watson?s student sample, compared to their clinical sample, might have 
prevented a clear-cut distinction between dissociation and schizotypy.    
Initial studies examining the convergent and discriminant validity of depersonalization 
measures have provided encouraging results. However, these studies have examined a limited 
number of constructs believed to be associated with depersonalization, with a limited number of 
measures of depersonalization. In addition, most of the empirical support for the assessment of 
depersonalization comes from data collected in clinical samples, limiting the generalizability of 
the findings. The current study adds to the existing literature by comparing three measures of 
depersonalization (DES, CDS, and MDI) with instruments measuring a variety of theoretically 
relevant correlates in a trauma-exposed college student sample. In the context of current theory 
 16
and empirical literature, the following hypotheses were posited regarding the DES, CDS, and 
MDI, and their association with specific correlates: 
 Hypothesis 1: Internal consistency. All three depersonalization measures were predicted 
to demonstrate high internal consistency. Based on previous reliability analyses, it was 
hypothesized that alphas range between .85 and .95 (e.g., Briere, 2002; Sierra & Berrios, 2000; 
and Bernstein & Putnam, 1986).  
Hypothesis 2: Convergent validity. Given the DES depersonalization scale, CDS, and 
MDI depersonalization scale all claim to measure the same underlying construct, it was expected 
that the three measures demonstrate good convergent validity. Based on previous psychometric 
studies as well as theoretical considerations, it was expected that the DES depersonalization 
scale, CDS, and MDI depersonalization scale show strong, positive associations with one another 
(e.g., r ? .80).  
Hypothesis 3: Discriminant validity. The shared method variance of the measures of self-
reported psychopathology used in this study was considered in predicting the discriminant 
pattern of correlations. Specifically, all measures were expected to show a minimum small 
positive correlation. Examination of the intercorrelations among the PAI scales gave further 
support for this decision (see Morey, 1991, 2007). The depersonalization measures were 
predicted to correlate most highly (r = .60) with the other dissociation scales in the ?detachment? 
category (e.g., emotional constriction) described previously by Holmes et al. (2005). The 
depersonalization measures were predicted to correlate almost as highly (r = .50) with the 
dissociation scales in the ?compartmentalization? category (e.g., amnesia). Correlations with 
depression, borderline personality disorder, and facets of schizophrenia, constructs theoretically 
and empirically linked with depersonalization, were also predicted to be .50. The 
 17
depersonalization measures were expected to correlate moderately (r = .40) with constructs 
within but not central to its nomological network, such as anxiety, conversion, and traumatic 
stress. The depersonalization measures were predicted to correlate weakly (r = .20) with 
obsessive-compulsive and paranoia symptoms, constructs less related to depersonalization, but 
potentially associated through their correlation with anxiety (Morey, 1991, 2007). Lastly, the 
smallest correlations (r = .10) were predicted between the depersonalization measures with 
mania and antisocial personality features, constructs least theoretically related to 
depersonalization.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 18
 
 
Method 
 
Participants 
 Participants were recruited by an announcement through the SONA extra credit system 
for students of any age in eligible undergraduate psychology courses. They self-identified as 
eligible by reading the announcement and affirming they had ?directly experienced a very 
stressful event (for example, a natural disaster, motor vehicle accident, or physical or sexual 
assault) and continue to be affected by it.? Questionnaire sessions were conducted several times 
a week, with a maximum of 20 participants per session. Participants were compensated with 
documentation of their participation that could be used as extra credit in many undergraduate 
psychology courses. The Auburn University Institutional Review Board approved the study. 
 Participants were 277 undergraduate students who completed the questionnaire session. 
Of those, 77 were excluded based on the following criteria: participant?s index event did not 
meet criterion A1 for a traumatic event based on the Life Events Checklist (n = 28); participant?s 
PAI profiles were presumed to be invalid due to random responding, carelessness, reading 
difficulty, confusion, or neglecting to follow instructions, measured by Infrequency scale scores 
? 75 T or Inconsistency scale scores ? 73 T (n = 38; Morey, 2003); participant left more than 
10% of a measure blank (n = 11). The final sample consisted of 200 participants. For cases in 
which less than 10% of a measure was left blank, the lowest value of the measure was substituted 
for the missing response, following the guidelines outlined in the PAI and MDI manuals (Morey, 
1991, 2007; Briere, 2002). No guidelines for handling missing responses were available for the 
 19
other measures used in the study; therefore, the same guidelines suggested for the PAI and MDI 
were applied to the CDS, DES, and PCL.     
 Participants were predominantly female (n = 120; 61%) and Caucasian (n = 162; 82%) or 
African American (n = 24; 12%). Participants? ages ranged from 18 to 26 years (M = 19.8; SD = 
2.1). All participants endorsed at least one event that met the definition of a trauma in Criterion 
A1 of DSM-IV-TR.  
Measures 
 Participants first completed a demographics form, followed by a measure of trauma 
exposure and a measure of PTSD symptoms. The other measures were counterbalanced such that 
the longest measure (Personality Assessment Inventory; Morey, 1991, 2007) was always 
presented last, depersonalization measures (three) were randomized within a block, and health 
measures (three, not relevant to this study) were randomized within a block. The presentation of 
the two blocks was also randomized. A description of the three measures used to assess 
depersonalization (DES, CDS, and MDI) was discussed in the previous section. A description of 
the measures assessing trauma exposure, other psychopathology, and personality traits is 
discussed below. 
 Life Events Checklist (LEC; Blake et al., 1995). Trauma exposure was assessed using the 
LEC. The LEC is the self-report trauma assessment portion of the Clinician-Administered PTSD 
Scale (Blake et al., 1990), the most widely used structured interview for PTSD. The LEC 
consists of 17 items, including 16 items that assess exposure to specific categories of traumatic 
events (natural disaster, sexual assault, etc.) and one item, labeled ?other,? that assesses exposure 
to events that do not fit into one of the specific categories. Respondents indicated their lifetime 
exposure to each of the categories of events by checking one or more of the following options: 
 20
happened to me, witnessed it, learned about it, not sure, and does not apply. Next, they identified 
the worst event (the one that has caused the most problems), and reported whether that event 
meets DSM-IV-TR Criterion A1 (actual or threatened death or serious injury, or a threat to the 
physical integrity of self or others) and Criterion A2 (intense fear, helplessness, or horror). 
Finally, participants provided a brief narrative of their worst event. 
 Posttraumatic Stress Disorder Checklist (PCL; Weathers, Litz, Herman, Huska, & 
Keane, 1993). The PCL is a self-report measure used to assess each of the 17 DSM-IV-TR 
symptoms of PTSD. There are three versions of the PCL. The civilian and military versions 
(PCL-C and PCL-M) are used when a specific traumatic event has not been identified. On the 
specific version (PCL-S) used in the present study, respondents first identify an index event and 
then refer to this event as they complete the 17 items. Participants indicate how much they were 
bothered by each PTSD symptom in the past month, using a five-point scale (1 = not at all to 5 = 
extremely). The PCL can be used to measure PTSD as a continuous measure of symptom 
severity (total scores between 17 and 85), or to ascribe PTSD diagnosis by treating any item 
rated as a 3 (moderately) or higher as an endorsed symptom. The PCL was used as a continuous 
measure in the present study. 
Personality Assessment Inventory (PAI; Morey, 1991, 2007). The PAI is a 344-item self-
report  measure used to assess symptoms of a broad range of psychopathology and personality 
traits. The PAI includes four validity scales to assess particular patterns of responding, such as 
the tendency to present oneself in an overly positive or negative way; 11 clinical scales; 2 
interpersonal scales, and 5 treatment scales. The PAI was standardized using community and 
clinical samples. The test-retest reliability of PAI subscales was greater than .8, and median 
 21
internal consistency rates are reported to range between .81 and .86. Community norms will be 
used in the scoring of the current study. 
The following PAI scales will be used in the current study: 
Inconsistency (ICN). The ICN scale is a validity scale consisting of 10 pairs of items with 
similar content. Five of the pairs should be answered in an opposite manner and five of the pairs 
should be answered similarly. Elevations on this scale reflect careless responding or confusion 
and should be considered invalid (Morey, 2003). 
 Infrequency (INF). The INF scale is a validity scale useful in detecting random 
responding. Individuals who complete the PAI in an idiosyncratic way due to carelessness, 
reading difficulties, or confusion will likely receive elevated scores on the INF scale. High scores 
on the INF scale suggest that the respondent did not properly attend to item content and 
interpretation of test results should be considered invalid (Morey, 2003). 
 Negative Impression Management (NIM). The NIM scale is a 9-item validity scale that 
measures negative distortion in self-presentation. To address concerns that response bias could 
confound the findings by elevating scores on all measures, the NIM scale will be used to control 
for response bias effects. It includes items reflecting an exaggerated or distorted impression of 
the self and current circumstances and items that are unlikely and bizarre (Morey, 2003, pp. 49).   
 Conversion (SOM ? C). The SOM-C scale is an 8-item clinical scale measuring sensory 
and motor symptoms prevalent in conversion disorders. Elevations may reflect impairments in 
perception (e.g., vision problems, hearing problems, or numbness) or motor problems (e.g., 
paralysis) (Morey, 2003).  
 22
 Anxiety (ANX). The ANX scale is a 24-item clinical scale measuring cognitive, affective, 
and physiological anxiety. Elevations on this scale may indicate an individual who is often tense, 
worrying, and may be nervous, timid, or dependent (Morey, 2003). 
 Obsessive-Compulsive (ARD ? O). The ARD ? O scale is an 8-item clinical scale 
measuring both the symptomatic features of the Axis I disorder and the personality features of 
the Axis II disorder. Elevations on this scale may indicate the presence of intrusive thoughts or 
behaviors, rigidity, indecision, perfectionism, and affective constriction (Morey, 2003). 
 Traumatic Stress (ARD ? T). The ARD ? T scale is an 8-item clinical scale assessing the 
experience of traumatic events that cause lasting distress. Elevations on this scale may indicate 
symptoms related to responses to traumatic stressors, such as nightmares and sudden anxiety 
reactions (Morey, 2003).   
 Depression (DEP). The DEP scale is a 24-item clinical scale measuring cognitive, 
affective, and physiological symptoms of depression. Elevations on this scale may indicate 
unhappiness, pessimism, self-doubt, dysphoria, hopelessness, and social withdrawal (Morey, 
2003). 
 Mania (MAN). The MAN scale is a 24-item clinical scale measuring symptoms of a 
manic episode, including increased activity level, irritability, and grandiosity. Elevations on this 
scale may reflect a variety of behaviors from being active and self-confident to impulsivity, 
hostility, restlessness, high energy levels, and poor judgment (Morey, 2003). 
 Paranoia (PAR). The PAR scale is a 24-item clinical scale assessing symptoms of 
hypervigilance, persecution, and resentment. Elevations on this scale may indicate interpersonal 
mistrust and hostility (Morey, 2003). 
 23
 Schizophrenia (SCZ). The SCZ scale is a 24-item clinical scale measuring unusual 
perceptions, social isolation, awkwardness in social interactions, and disorders of thought. 
Elevations may reflect unusual beliefs and perceptions, poor social competence, and difficulties 
with concentration and attention (Morey, 2003). 
 Identity Problems (BOR - I). The BOR ? I scale is a 6-item clinical scale measuring 
difficulties in identity development, one feature associated with borderline personality disorder. 
Elevations may reflect feelings of emptiness, lack of fulfillment, an absence of purpose, and 
anxiety surrounding identity issues (Morey, 2003). 
Antisocial features (ANT). The ANT scale is a 24-item clinical scale measuring features 
of psychopathy, such as a history of antisocial acts and involvement in illegal activities, 
egocentricity, and stimulus-seeking (Morey, 2003).  
Procedure 
 Questionnaire sessions were conducted in a computer lab so that participants could 
complete the questionnaires online, under the supervision of a graduate student. When 
participants arrived at the designated computer lab, computers were logged on and the 
information letter appeared on the computer screen. A graduate assistant read the entire 
information letter aloud while participants were encouraged to follow along. Participants 
indicated their consent to continue with the study by electronically checking a box indicating 
they had read and understood the information letter and wished to continue. Participants were 
reminded that they could elect to discontinue the study at any point without risk of retribution or 
loss of extra credit. 
 Next, they completed the questionnaires, whose order was randomized by Qualtrics, an 
online survey software. Participants completed questionnaires assessing trauma-exposure, 
 24
depersonalization, and general psychopathology. Participants also completed several measures 
on health behaviors which were not included in the current study. Participants were provided 
with a paper copy of the consent form, as well as a debriefing form and referral list, when they 
left the study. Participants were granted 2.5 hours of extra credit via the Sona Systems website. 
Data Analyses 
 To analyze the data, descriptive statistics and internal consistency (alpha) coefficients for 
all measures were examined. Next, zero-order correlations were calculated to evaluate the 
convergent and discriminant validity among the DES, CDS, MDI, and PAI. Finally, statistics 
developed by Westen and Rosenthal (2003; r
alerting-CV 
and r
contrast-CV
) were used to investigate the 
extent to which the observed pattern of correlations matched the pattern of correlations predicted 
by theory. Westen and Rosenthal?s (2003) procedure is summarized below. 
  As noted by Cronbach and Meehl (1955), one indication of a measure?s construct 
validity is the congruence between its observed pattern of correlations with measures of related 
constructs and the pattern predicted by theory. Westen and Rosenthal?s (2003) procedure allows 
investigators to quantify the congruence between a set of observed and expected correlations. 
The procedure is derived from contrast analysis and allows the investigator to test particular 
hypotheses specified in advance. The predicted correlations are converted to lambdas (?s) by 
subtracting the mean predicted correlation from each individual predicted correlation, resulting 
in a set of contrast weights summing to zero. The obtained correlations are converted to Z scores 
using the Fisher Zr transformation. The first statistic, r
alerting-CV
, is the simple correlation between 
the ? and Zr values. The magnitude of r
alerting-CV 
reflects the degree to which the ordering of 
predicted versus obtained correlations is consistent.  
 25
 The second statistic, r
contrast-CV
, is a more stringent test of the fit between predicted and 
obtained correlations. The r
contrast-CV
 index takes into account sample size, the median 
intercorrelations among the criterion variables, and the magnitudes of the correlations between 
the target measure (e.g., measure of depersonalization) and criterion measures (e.g., measures of 
other forms of psychopathology). It involves a series of complex computations, described in 
detail by Westen and Rosenthal (2003, pp. 617-618). Part of the procedure for calculating r
contrast-
CV
 involves calculating exact p values for Z scores, and then calculating t scores for the exact p 
values. In the present study, the Z scores fell out of the range necessary to calculate exact p 
values using a variety of statistical software programs and online statistical calculators. 
Therefore, a computational adaptation, taken from Poythress et al. (2009), was used to convert Z 
scores into t values. The adapted formula allows the user to solve for t and then calculate r
contrast-
CV
. The adapted formula has been shown to yield the same results as the original computations 
(Poythress et al., 2009).  
 
 
 
 
 
 
 
 
 
 
 26
 
 
Results 
Descriptive Statistics and Internal Consistency 
 Possible and observed ranges, means, and standard deviations for each of the measures 
are presented in Table 1. Results of the internal consistency analysis are also presented in Table 
1. The CDS and MDI depersonalization scale exhibited high internal consistency in this sample, 
with alpha coefficients of .93 and .90, respectively. The DES depersonalization scale exhibited 
adequate internal consistency (alpha = .77). The PAI clinical scales exhibited adequate to high 
internal consistency, with alphas ranging from .66 (ARD-O and BOR-I) to .91 (ANX).   
Correlation Analyses 
 Correlations among the three depersonalization scales with the other dissociation scales 
and PAI scales are shown in the left side of Table 2. Convergent validity was assessed by 
examining the associations among the DES depersonalization scale, CDS, and MDI 
depersonalization scale. Significantly strong positive correlations among the depersonalization 
measures were observed, ranging from r = .65 (p < .01) between the DES Depersonalization 
scale and CDS, to r = .82 (p < .01) between the CDS and MDI depersonalization scale. 
 Discriminant validity was assessed by examining the association of depersonalization 
measures with measures of other constructs varying in theoretical relatedness to 
depersonalization. As stated in Hypothesis 3, the three depersonalization measures were expected 
to correlate most highly with measures of other types of dissociation, correlate moderately with 
related constructs such as trauma exposure, depression, and anxiety, and correlate least with 
unrelated constructs such as antisocial features. Significantly strong correlations were found 
 27
between the other dissociation measures and the DES Depersonalization scale (r = .44 - .54, p < 
.01); the CDS (r = .54 - .69, p <.01), and the MDI Depersonalization scale (r = .51 - .73, p < .01). 
Moderate correlations were found between BOR-I, ANX, SOM-C, and ARD-T and the DES 
depersonalization scale (r = .32 - .39, p < .01); the CDS (r = .39 - .46, p < .01); and the MDI 
depersonalization scale (r = .42 - .49, p < .01). The weakest correlations were found between 
ARD-O, MAN, and ANT and the DES Depersonalization scale (r = .17 - .25, p < .01); the CDS 
(r = .21 - .28, p < .01); and the MDI Depersonalization scale (r = .21 - .31, p < .01).  
 In general, evidence for discriminant validity was demonstrated for the DES 
depersonalization scale, CDS, and MDI depersonalization scale. However, a few of the 
associations between the depersonalization measures and other correlates were higher than 
expected. Specifically, the correlations between each of the depersonalization measures with the 
DEP and SCZ scales were as strong as the correlations between the depersonalization measures 
and other dissociation measures, ranging between r = .43 - .65 (p < .01) for DEP and r = .51 - .61 
(p < .01) for SCZ. Similarly, the observed correlations between the depersonalization measures 
and PAR were higher than expected, ranging between r = .34 - .41 (p < .01).  
 In order to examine the influence of negative response bias, partial correlations were 
computed, controlling for NIM, and reported in parentheses in Table 2. The overall pattern of the 
partial correlations was similar to the bivariate associations; however, the magnitude of the 
partial correlations, compared to the full correlations, was reduced. After controlling for NIM, 
the associations remaining significant between the depersonalization measures and PAI scales 
included: SCZ with the DES depersonalization scale (r = .24, p < .01); DEP, BOR-I, and SCZ 
with the CDS (r = .25 - .33, p < .01); and DEP, BOR-I, SCZ, ANX, ARD-T, and MAN with the 
MDI depersonalization scale (r = .18 - .34, p < .01).      
 28
Effect Size Indices r
alerting-CV 
and r
contrast-CV
 
 
 Correlations for the DES depersonalization scale, CDS, and MDI Depersonalization scale 
with the two other DES scales (Amnesia and Absorption), four other MDI scales (Emotional 
Constriction, Disengagement, Memory Disturbance, and Identity Dissociation), and ten PAI 
scales (DEP, BOR-I, SCZ, ANX, SOM-C, ARD-T, ARD-O, PAR, MAN, and ANT) were used 
to compute two effect size indices, r
alerting-CV 
and r
contrast-CV
, to compare observed correlations 
with a theory-based set of predictions. Predicted correlations and ? values that represent the 
contrast weights are shown on the right side of Table 2.  
 The results of these analyses are shown in Table 3. Substantially large values for the first 
index, r
alerting-CV
, were found for the DES depersonalization scale, CDS, and MDI 
depersonalization scale (r
alerting-CV
 = .88, .88, and .90, respectively). Thus, the order of predicted 
and observed correlations between the depersonalization measures and criterion variables is 
highly congruent. The second index, r
constrast-CV
, was computed for each of the depersonalization 
measures, and incorporated the median intercorrelation among the criterion variables for each 
target measure (r = .37 for DES depersonalization scale; r = .35 for CDS; and r = .35 for MDI 
depersonalization scale). The coefficients for r
constrast-CV
 were .71, .79, and .83, for the DES 
depersonalization scale, CDS, and MDI depersonalization scale, respectively, with small 
corresponding p-values associated with all three values of r. Once again, the magnitude of 
r
constrast-CV
 suggests substantial correspondence between the theoretical predictions and observed 
pattern of correlations. Although statistical procedures for comparing r
constrast-CVs 
have not been 
developed, examining the 95% confidence intervals associated with each index has been 
suggested as one way to compare r
constrast-CV
 effect sizes (Bombel, Mihura, & Meyer, 2009). 
Using this method of comparison, the 95% confidence interval around the DES 
 29
depersonalization scale?s r
constrast-CV
 effect size did not overlap the MDI depersonalization scale 
confidence interval. This suggests a weaker match between predicted and observed correlations 
for the DES Depersonalization scale than the MDI Depersonalization scale. None of the other 
comparisons of r
constrast-CV
 effect size confidence intervals were non-overlapping.     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 30
 
 
Discussion 
 In this study, the construct validity of three self-report measures of depersonalization was 
examined in a trauma-exposed college student sample. Internal consistency coefficients, 
convergent and discriminant correlation coefficients, and construct validity effect size indices 
developed by Westen and Rosenthal (2003) were analyzed for the DES, CDS, and MDI. With 
respect to the first hypothesis, the DES depersonalization scale, CDS, and MDI 
depersonalization scale exhibited adequate to excellent reliability, as indicated by high alpha 
coefficients. Given the influence of the number of items in calculating alpha, it should be noted 
that the three depersonalization measures ranged in number of items from six (DES 
depersonalization scale) to 29 (CDS). With respect to the second hypothesis, the three 
depersonalization measures demonstrated good convergent validity. As predicted, the DES 
depersonalization scale, CDS, and MDI depersonalization scale were strongly correlated, 
extending existing convergent validity evidence for these measures (Sierra & Berrios, 2000; 
Briere, 2002). 
 Regarding the third hypothesis, results generally supported the discriminant validity of 
the depersonalization measures. The DES, CDS, and MDI correlated more strongly with other 
measures of dissociation than with measures of moderately related constructs, such as anxiety, 
borderline personality features, and exposure to traumatic stress; which, in turn, correlated more 
strongly with depersonalization than measures of least related constructs, such as mania and 
antisocial features. The high degree of congruence between the predicted and observed pattern of 
correlations was reflected in large effect size indices r
alerting-CV 
and r
contrast-CV
. Based on the set of 
 31
correlates chosen and predictions made in this study, the MDI depersonalization scale 
demonstrated the best match between predicted and observed correlations, followed by the CDS, 
and then the DES depersonalization scale. In reviewing the item content of the target measures, 
the CDS and MDI assess for a wider range of symptoms associated with depersonalization than 
the DES. Given the influence of construct underrepresentation on a scale?s validity (Messick, 
1995), the narrower range of the DES depersonalization scale may have impacted its subsequent 
relationship to a number of relevant constructs. All effect size indices, however, were significant, 
giving evidence to the construct validity of the DES, CDS, and MDI as measures of 
depersonalization in a non-clinical student sample.  
 Although r
alerting-CV 
and r
contrast-CV
 allow for the quantification of a pattern of convergent 
and discriminant relationships, the single number yielded by each statistic does not identify 
which correlations failed to support the predictions (Smith, 2005). Therefore, a review of 
individual correlations is necessary to identify any surprising relationships, a few of which were 
found in the current study. For example, the association between paranoia (PAI PAR) and the 
depersonalization measures ranged from .34 (DES) to .41 (MDI), which was stronger than 
expected. Likewise, both mania (PAI MAN) and antisocial features (PAI ANT) were more 
strongly associated with depersonalization than expected. However, after controlling for negative 
response bias, none of the correlations with PAI PAR, PAI MAN, or PAI ANT remained 
significant, with the exception of PAI MAN and MDI (r = .18, p < .01). As suggested by Mula, 
Pini, and Cassano (2007), extreme changes in mood may induce experiences of 
depersonalization, offering one interpretation of this finding. 
    Interpretation of the present findings is restricted by several limitations. First, the use of 
self-report measurement introduces risk of participant bias influencing the results and the 
 32
addition of error by participants who did not follow instructions. An attempt was made to 
minimize the effects of careless responding by excluding participants who exhibited response 
patterns that suggested responding without attention to item content. Partial correlations 
controlling for response bias were included in Table 2. Although controlling for negative 
response bias reduced the strength of most of the correlations, the overall rank-order pattern was 
maintained. Nevertheless, it would be desirable to investigate the convergent and discriminant 
correlations of depersonalization with relevant correlates using maximally different methods of 
measurement, such as behavioral observation, clinical interview, and physiological indicators. As 
emphasized by Campbell and Fiske (1959), a multi-trait, multi-method matrix is needed to 
separate method from trait variance. 
 Second, using Westen & Rosenthal?s (2003) procedure requires a predetermined 
selection of external correlates. Although a variety of theoretically and empirically relevant 
variables were used in the present study, the findings for the DES, CDS, and MDI might have 
differed with the selection of alternative correlates. Future research will be necessary to 
determine whether the current findings uphold when different criterion measures are included.  
 Third, it is important to note these findings were collected using a nonclinical student 
sample, and therefore these participants were likely to be relatively well-functioning compared to 
clinical samples. While the observed range of scores shown in Table 2 does not extend the full 
possible range, a significant amount of variability was found. Likewise, all participants reported 
exposure to traumatic stress, ranging from motor vehicle accidents to sexual assault. Despite the 
limitations of using a college student sample, one of the aims of the current study was to extend 
existing validity evidence for the three depersonalization measures to a non-clinical population. 
Given the reported prevalence of depersonalization in normal individuals (Mula, Pini, & 
 33
Cassano, 2007; Hunter, Sierra, & David, 2004), establishing evidence for the appropriate use of 
the DES, CDS, and MDI in assessing depersonalization outside of a clinical setting is an 
important first step in student and community research.        
     Overall, the findings of this study provide convincing support for the construct validity 
of the DES, CDS, and MDI as measures of depersonalization in a trauma-exposed college 
sample. They also suggest that depersonalization is a unique type of dissociation differentially 
related to a variety of psychopathology and personality features. In light of this finding, measures 
assessing specific types of dissociation (e.g., CDS) or multiple types of dissociation (e.g., MDI) 
may be considered more useful than single-score dissociation measures. As noted by Briere, 
Weathers, and Runtz (2005), the assessment of specific dissociative symptoms allows for more 
accurate information and specific clinical intervention. Depersonalization is a distressing 
condition associated with fears of going crazy and losing control, problems maintaining focus on 
difficult tasks, and interpersonal stress caused by an extreme sense of emotional disconnection 
(Simeon, 2004). In addition, when comorbid with other disorders, depersonalization is associated 
with greater clinical severity and poorer response to treatment (Cox & Swinson, 2002; Mula, 
Pini, & Cassano, 2007). For these reasons, the continued process of construct validation is 
warranted to further understand depersonalization in both research and practice. 
 
 
 
 
 
 
 34
 
 
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Appendix 
 
Table 1 
Descriptive Statistics for  Dissociative Experiences Scale, Cambridge Depersonalization Scale, 
Multiscale Dissociation Inventory, Personality Assessment Inventory, and Posttraumatic Stress Disorder 
Checklist 
Measure Items Possible  
Range 
Observed  
Range 
M SD Alpha 
DES       
 
     Depersonalization/Derealization  6 0-100 7-70 13.7 7.7 .77 
     Absorption  16 0-100 9-67 26.4 12.5 .88 
     Amnesia  6 0-100 7-57 13.6 8.1 .68 
CDS 29 0-290 0-226 26.6 28.3 .93 
MDI   
     Depersonalization/Derealization 10 10-50 10-42 14.1 5.5 .90 
     Disengagement  5 44-125 44-125 74.1 18.3 .87 
     Emotional Constriction  5 46-131 46-131 59.9 18.3 .92 
     Memory Disturbance 5 45-172 45-159 67.1 22.2 .80 
     Identity Dissociation 5 47-283 47-224 54.9 21.7 .79 
PAI Validity Scale     
     NIM 9 44-144 44-92 51.1 9.9 .68 
PAI Clinical Scales     
    SOM-C 8 43-114 43-105 48.9 9.1 .78 
    ANX 24 34-103 36-96 56.1 11.8 .91 
    ARD-T 8 41-99 41-99 55.8 13.4 .89 
    ARD-O 8 25-89 30-86 51.1 11.7 .66 
     DEP 24 35-111 35-101 54.6 12.4 .90 
     MAN 24 25-103 29-86 54.3 11.4 .84 
     PAR 24 29-112 36-86 55.4 11.2 .85 
     SCZ 24 32-124 33-92 49.8 11.2 .85 
     BOR-I 6 36-89 36-86 58.1 11.3 .66 
     ANT 24 36-115 39-90 57.4 11.2 .83 
PCL 17 17-85 17-83 35.7 15.6 .94 
Note. N=200. DES=Dissociative Experiences Scale; CDS=Cambridge Depersonalization Scale; MDI=Multiscale 
Dissociation Inventory; MDI Depersonalization/Derealization=Multiscale Dissociation Inventory Depersonalization 
and Derealization Scales combined; PAI=Personality Assessment Inventory; NIM=Negative Impression 
Management; PIM=Positive Impression Management; SOM-C= Conversion; ANX=Anxiety; ARD-T=Traumatic 
Stress; ARD-O=Obsessive-Compulsive; DEP=Depression; MAN=Mania; PAR=Paranoia; SCZ=Schizophrenia; 
BOR-I=Borderline Features - Identity Problems; ANT=Antisocial Features; PCL=PTSD Checklist. T-scores derived 
from trauma-exposed adult community standardization sample reported for MDI Disengagement, Emotional 
Constriction, Memory Disturbance, and Identity Dissociation scores. T-scores derived from census-matched 
standardization sample reported for PAI Validity and Clinical Scales. Raw scores reported for DES scales, CDS, 
MDI Depersonalization/ Derealization scale, and PCL. 
 43
Table 2 
Predicted and Observed Correlations between Depersonalization Measures and Criterion Measures, 
Raw ?s, and Integer Values of Raw ?s  
 Observed Correlations  Predicted Correlations and ?s  
Criterion 
Variable 
DES-DP/DR 
r(pr) 
CDS 
r(pr) 
MDI-DP/DR 
r(pr) 
Predicted 
r 
Raw ?s Raw ?s as 
Integers 
DES-DP/DR - - - .80 .34 3 
CDS .65*(.50*) - - .80 .34 3 
MDI-DP/DR .74*(.64*) .82*(.77*) - .80 .34 3 
MDI-ECON .54*(.44*) .67*(.60*) .73*(.68*) .60 .14 1 
MDI-DENG .44*(.27*) .57*(.27*) .64*(.52*) .60 .14 1 
DES-ABS .52*(.38*) .59*(.38*) .62*(.51*) .60 .14 1 
MDI-MEMD .53*(.38*) .69*(.38*) .73*(.63*) .50 .04 0 
MDI-IDDIS .52*(.33*) .54*(.33*) .61*(.44*) .50 .04 0 
DES-AMN .50*(.37*) .56*(.37*) .51*(.38*) .50 .04 0 
PAI-DEP .43*(.14) .56*(.27*) .56*(.29*) .50 .04 0 
PAI-BOR-I .33*(.11) .46*(.25*) .46*(.25*) .50 .04 0 
PAI-SCZ .51*(.24*) .61*(.33*) .60*(.34*) .50 .04 0 
PAI-ANX .36*(.11) .39*(.09) .45*(.20*) .40 -.06 -1 
PAI-SOM-C .32*(-.02) .42*(.06) .42*(.08) .40 -.06 -1 
PAI-ARD-T .39*(.08) .43*(.09) .49*(.21*) .40 -.06 -1 
PAI-ARD-O .17*(.01) .21*(.04) .23*(.07) .20 -.26 -3 
PAI-PAR .34*(.04) .40*(.05) .41*(.09) .20 -.26 -3 
PAI-MAN .25*(.12) .28*(.13) .31*(.18*) .10 -.36 -4 
PAI-ANT .24*(.12) .21*(.06) .21*(.07) .10 -.36 -4 
Note. N=200. Partial correlations, controlling for PAI Negative Impression Management, reported in parentheses. 
DES-DP/DR = Dissociative Experiences Scale, Depersonalization/Derealization Scale; CDS = Cambridge 
Depersonalization Scale; MDI-DP/DR = Multiscale Dissociation Inventory, Depersonalization and Derealization 
Scales; MDI-ECON = MDI Emotional Constriction Scale; MDI-DENG = MDI Disengagement Scale; DES-ABS = 
DES Absorption Scale; MDI-MEMD = MDI Memory Disturbance Scale; MDI-IDDIS = MDI Identity Dissociation 
Scale; DES-AMN = DES Amnesia Scale; PAI = Personality Assessment Inventory; DEP = Depression; BOR-I = 
Borderline Features ? Identity Problems; SCZ = Schizophrenia; ANX = Anxiety; SOM-C = Conversion; ARD-T = 
Traumatic Stress; ARD-O = Obsessive-Compulsive; PAR = Paranoia; MAN = Mania; ANT = Antisocial Features.   
*p < .01. 
 
 
 
 
 
 
 
 
 
 
 44
 45
Table 3 
Effect Size Statistics r
alerting-CV  
and r
contrast-CV 
 for Depersonalization Measures 
Quantity DES-DP/DR CDS MDI-DP/DR 
r
alerting-CV  
 .88 .88 .90 
r
contrast-CV 
  .71 .79 .83 
95% CI    
     From: .63 .73 .78 
     To: .77 .84 .87 
Z
contrast
11.63 13.73 15.09 
t
contrast
 13.96 17.79 20.71 
p
contrast
<.001 <.001 <.001 
Note. DES-DP/DR = Dissociative Experiences Scale, Depersonalization/Derealization Scale; CDS = Cambridge 
Depersonalization Scale; MDI-DP/DR = Multiscale Dissociation Inventory, Depersonalization and Derealization 
Scales; CI = confidence interval.