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PTSD: National Center for PTSD

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Dissociative Symptoms Scale (DSS) and Brief Dissociative Symptoms Scale (DSS-B)


Dissociative Symptoms Scale (DSS) and Brief Dissociative Symptoms Scale (DSS-B)


The DSS is a 20-item self-report instrument that assesses past-week symptoms of dissociation that are clinically relevant and moderately severe (i.e., not types of dissociation common only among either non-clinical populations or those with dissociative disorders). It was designed to be used for clinical and research assessment. In addition to total scores, subscale scores reflect subdomains of gaps in awareness or memory, distortions in perceptions of self and one's surroundings, sensory misperceptions and cognitive-behavioral reexperiencing. Scores on the DSS and its subscales demonstrated reliability and validity in multiple clinical and non-clinical samples.

The DSS-B is an 8-item version of the DSS that includes the items that most precisely measure the 4 domains of dissociation. Scores on the DSS-B have demonstrated reliability and validity in several diverse clinical and non-clinical samples and high levels of measurement invariance across ethnoracial groups in the U.S. Because of its strong psychometric properties and brevity, the DSS-B can be useful for quickly assessing dissociation in research and clinical contexts, including assessing dissociation for the dissociative subtype of PTSD.

Administration and Scoring

For the DSS and the DSS-B, respondents are asked to indicate the frequency of each experience in the past week on a scale ranging from 0="Not at all" to 4="More than once a day". The total score for the DSS is the sum of the 20 item scores. Subscale scores are the mean of the subscale items as follows:

  • Depersonalization / Derealization: 1, 2, 5, 8, 13, 16
  • Gaps in Awareness and Memory: 11, 12, 15, 18, 19
  • Sensory Misperceptions: 6, 7, 9, 14, 20
  • Cognitive-behavioral Reexperiencing: 3, 4, 10, 17

The DSS-B is comprised of DSS items 2, 4, 6, 8, 14, 15, 17, 18 and a total score is the sum of the item scores.

Interpretation of scores can be guided by score means and standard deviations in the samples studied in the publications below. Further research on larger, epidemiologically representative samples is needed to provide more information about cut point scores. For information on research to establish cut point scores in process, contact Dr. Eve Carlson.

Sample Item

  • Instructions: For each statement below, indicate how much each thing has happened to you IN THE PAST WEEK.
  • Item: Things around me seemed strange or unreal.
  • Response: Five response options ranging from "Not at all" to "More than once a day"


Carlson, E. B., Waelde, L. C., Palmieri, P. A., Macia, K. S., Smith, S. R., & McDade-Montez, E. (2018). Development and validation of the Dissociative Symptoms Scale. Assessment, 25(1), 84-98.

Macia, K. S., Carlson, E. B. Palmieri, P. A., Smith, S. R., Anglin, D. M., Ippen, C. G., Liberman, A. F., Wong, E. C., Schell, T. L., & Waelde, L. C. (2022). Development of a brief version of the Dissociative Symptoms Scale (DSS-B) and the reliability and validity of DSS-B scores in diverse clinical and community samples. Assessment, Open Access.

To Obtain Scale

This measure was created by staff at VA's National Center for PTSD.

Download the Dissociative Symptoms Scale full (DSS) or brief (DSS-B) versions:

Are you using this measure with U.S. Veterans or Service members?

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Our PTSD Consultation Program can answer administration or scoring questions: or 866-948-7880.

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Measure availability: We provide information on a variety of measures assessing trauma and PTSD. These measures are intended for use by qualified mental health professionals and researchers. Measures authored by National Center staff are available as direct downloads or by request. Measures developed outside of the National Center can be requested via contact information available on the information page for the specific measure.

PTSD Information Voice Mail: (802) 296-6300
Also see: VA Mental Health