La Comunidad Nativa Nomatsiguenga de San Ramón de Pangoa

DISSOCIATIVE EXPERIENCES SCALE

DIRECTIONS: This questionnaire consists o f twenty-eight questions about experiences that you may have in your daily life. W e are interested in how often you have these experiences. To answer the questions, please determine to what degree the experience described in the question applies to you and circle a number, as shown in the exam ple below , to show what percentage o f the tim e this happens to you.

Example: 0% 10% 20% 30% 40% (509§ 60% 70% 80% 90% 100% (never)

1 Som e p eople have the experience o f driving or riding in a car or bus or train and suddenly realizing that they d on ’t remember what has happened during all or part o f the trip.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2 Som e people find that som etim es they are listening to som eone talk and they suddenly

realize that they did not hear part or all o f what was said/

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 3 Som e people have the experience o f finding them selves in a place and having no idea how

they got there.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 4 Som e people have the experience o f finding them selves dressed in clothes that they don ’t

remember putting on.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 5 Som e p eople have the experience o f finding new things am ong their belongings that they do

not remember buying.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6 Som e people som etim es find that they are approached by people who they do not know w ho

call them by another name or insist that they have m et them before.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 7 Som e p eople som etim es have the experience o f feelin g as though they are standing next to

them selves or watching them selves do som ething and they actually see them selves as it they were looking at another person.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 8 Som e p eople are told that they som etim es do not recognize friends or fam ily members.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 9 Som e p eople find that they have no mem ory for som e important event in their lives (for

exam ple, a wedding or graduation).

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 10 Som e people have the experience o f being accused o f lying when they do not think they have

lied.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 11 Som e people have the experience o f looking in a mirror and not recognizing them selves.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 12 Som e people have the experience o f feeling that other people, objects, and the world around

them are not real.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 13 Som e p eople som etim es have the experience o f feelin g that their body does not seem to

belong to them.

14 S om e p eop le have the experience o f som etim es remem bering a past event so vividly that they feel as if they were reliving that event.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

15 Som e p eop le have the experience o f not being sure whether things that they remember happening really did happen or whether they just dreamed them.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

16 Som e p eop le have the experience o f being in a familiar place but finding it strange and unfamiliar.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

17 Som e p eop le find that when they are watching television or a m ovie they b ecom e so absorbed in the story that they are unaware o f other events happening around them.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

18 Som e p eop le find that they becom e so involved in a fantasy or daydream that it feels as thought it w ere really happening to them.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 19 Som e p eop le som etim es find that they som etim es are able to ignore pain.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 20 Som e p eop le find that they som etim es sit staring o f f into space, thinking o f nothing, and are

not aware o f the passage o f time.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 21 Som e p eop le som etim es find that when they are alone they talk out loud to them selves.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 22 Som e p eop le find that in one situation they may act so differently compared with another

situation that they feel alm ost as it they were two different people.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 23 Som e p eop le som etim es find that in certain situations they are able to do things with amazing

ease and spontaneity that would usually be difficult for them (for exam ple, sports, work, social situations, etc.)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 24 Som e p eop le find evidence that they have done som ething or have just thought about doing

that thing (for exam ple, not know ing whether they have just mailed a letter or have just thought about m ailing it).

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 25 Som e p eop le find evidence that they have done things that they do not remember doing.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 26 Som e p eop le som etim es find writings, drawings, or notes among their belongings that they

must have done but cannot remember doing.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 27 Som e p eop le som etim es find that they hear v oices inside their head that tell them to do things

or com m ent on thing that they are doing.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 28 Som e p eop le som etim es feel as if they are looking at the world through a fo g so that people

and objects appear to be far away or unclear.