Child Dissociative Checklist (CDC), Version 3

The Child Dissociative Checklist (CDC), developed by Frank Putnam and colleagues, is a validated 20-item observer-report measure used to assess dissociative…

Questions: 20
Duration: 10 min
Original title: Child Dissociative Checklist (CDC), Version 3
Adaptation: Child Dissociative Checklist (CDC), Version 3
Authors: Putnam, F. W., Helmers, K. & Trickett, P. K.
Created: 1993

The Child Dissociative Checklist (CDC), developed by Frank Putnam and colleagues, is a validated 20-item observer-report measure used to assess dissociative behaviors in children between 5 and 12 years of age. Unlike adult measures that rely on subjective internal experiences, the CDC captures dissociation through observable behavioral shifts, such as trance-like states, spontaneous age regression, rapid personality changes, and inexplicable forgetting.

Because childhood dissociation can closely mimic inattention, learning difficulties, or defiant behavior, using a reliable observational tool is a vital differential step before assigning ADHD parenting strategies that rely on continuous executive function. The CDC provides a structured way for clinicians to gather data from caregivers who observe the child across different daily contexts. It serves as an essential, repeatable measure in trauma assessments, helping to differentiate trauma-related dissociation from other neurodevelopmental profiles and tracking symptom fluctuations throughout the course of treatment.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

19/ 40

The CDC is a 20-item screening tool completed by a primary adult/informant (parent, teacher, or clinician) who knows the child well. It aims to identify dissociative behaviors in children aged 5 to 12 years, based on observations of current behavior or over the past 12 months. It explores the domains of dissociative amnesia, identity confusion/alteration, depersonalization/derealization, perceptual disturbances, and mood and behavioral fluctuations, often linked to traumatic experiences. It does not provide a diagnosis but guides toward an in-depth clinical evaluation.

généralefemales · general population · 5–12 years · 1993 · Putnam et al. (1993)

040

M = 2.3 ± 2.7

cliniquefemales · pathology: sexual abuse · 5–12 years · 1993 · Putnam et al. (1993)

040

M = 6 ± 6.4

cliniquemixed · pathology: Dissociative Disorder NOS · 5–12 years · 1993 · Putnam et al. (1993)

040

M = 16.8 ± 4.7

cliniquemixed · pathology: Dissociative Identity Disorder · 5–12 years · 1993 · Putnam et al. (1993)

040

M = 24.5 ± 5.2

For information

Cut-off≥ 12clinically significant dissociation

Identifies individuals requiring further screening to determine the presence of clinically significant dissociation.

Hulette et al. (2011)View the study ↗

Scoring

Sum, total score from 0 to 40, each item is rated on a 3-point scale (from 0 to 2).

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What the test measures

The CDC measures the frequency and severity of observable dissociative behaviors, organizing a wide range of atypical childhood presentations into a unified clinical picture.

Amnesia and forgetting: Gaps in memory for known traumatic events, daily routines, or recently acquired skills.
Depersonalization and derealization: Episodes of spacing out, trance-like states, or derealization that disrupt engagement with the environment.
Identity alteration: Using different names, referring to oneself in the third person, or displaying stark, rapid shifts in personality and preferences.
Developmental regression: Sudden, temporary losses of age-appropriate skills, such as returning to baby talk or thumb-sucking.
Somatoform and perceptual disturbances: Rapidly shifting physical complaints, unexplained injuries, or hearing voices.

This measure is primarily intended for children aged 5 to 12, relying on the careful observation of parents, foster carers, or teachers.

When and why to use it

Clinicians use the CDC to screen for dissociative pathology, particularly when a child presents with a complex trauma history or a confusing array of behavioral symptoms that resist standard interventions.

Baseline assessment: To map post-traumatic reactions during the initial intake, especially for children with known or suspected abuse.
Differential support: To accurately recognize PTSD's three pillars and dissociative subtypes rather than misinterpreting spacing out as mere inattention.
Treatment monitoring: To track changes in dissociative frequency over time as the child builds internal safety and emotion regulation skills, stepping out of ineffective avoidance loops.
Complex presentations: To organize highly fragmented symptoms (such as imaginary companions taking the blame, intense unexplained tantrums, or spontaneous regressions) into a coherent formulation of complex PTSD or a dissociative disorder.

Using a validated score adds objective weight to clinical impressions, ensuring that easily misunderstood behaviors are properly framed as survival responses rather than willful disobedience.

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The questions

Below is a list of behaviors describing children. For each item that describes your child NOW or WITHIN THE PAST 12 MONTHS, circle 2 if the item is VERY TRUE of your child, 1 if it is SOMEWHAT TRUE or SOMETIMES TRUE, and 0 if the item is NOT TRUE of your child.
1. The child does not remember or denies traumatic or painful experiences that are known to have happened.
Assesses the child's inability to recall or tendency to deny known painful events.
- Not true
- Somewhat true or sometimes true
- Very true
2. The child goes into a daze or trance, or often seems “spaced-out.” Teachers may report that he or she frequently “daydreams” at school.
Probes the occurrence of staring blankly or appearing disconnected from the immediate surroundings.
- Not true
- Somewhat true or sometimes true
- Very true
3. The child shows rapid personality changes. He or she may switch from shy to outgoing, feminine to masculine, or fearful to aggressive.
Captures sudden and extreme changes in the child's demeanor, assertiveness, or gender expression.
- Not true
- Somewhat true or sometimes true
- Very true
4. The child is unusually forgetful or confused about things he or she should know, for example, forgetting the names of friends, teachers, or other important people, losing belongings, or getting lost easily.
Evaluates whether the child inexplicably loses track of familiar people, places, or possessions.
- Not true
- Somewhat true or sometimes true
- Very true
5. The child has a very poor sense of time. He or she loses track of time, may think it's morning when it's actually afternoon, gets the day of the week wrong, or is confused about an event that just happened.
Assesses profound confusion regarding the time of day, days of the week, or the sequence of recent events.
- Not true
- Somewhat true or sometimes true
- Very true
6. The child shows marked variations from one day to the next, or even from one hour to the next, in their skills, knowledge, food preferences, or physical abilities: for example, changes in handwriting, memory of previously learned information like multiplication tables, spelling, use of tools, or artistic skills.
Probes for marked, sudden variations in previously mastered abilities, knowledge, or preferences.
- Not true
- Somewhat true or sometimes true
- Very true
7. The child shows rapid regressions to a younger age level of behavior, for example, a twelve-year-old who starts baby-talking, sucking their thumb, or drawing like a four-year-old.
Captures instances where the child rapidly reverts to behaviors typical of a much younger age.
- Not true
- Somewhat true or sometimes true
- Very true
8. The child has difficulty learning from experience; for example, explanations, usual discipline, or punishments do not change their behavior.
Evaluates the child's apparent inability to learn from consequences, which may reflect a lack of continuous awareness.
- Not true
- Somewhat true or sometimes true
- Very true
9. The child continues to lie or deny misbehavior even when the evidence is obvious.
Assesses whether the child continues to deny behaviors despite clear, undeniable evidence.
- Not true
- Somewhat true or sometimes true
- Very true
10. The child talks about himself or herself in the third person (e.g., 'he' or 'she') when referring to themselves, or sometimes insists on being called by another name. He or she may also claim that things they did were done by someone else.
Probes identity confusion through the use of alternate names or distancing language when referring to oneself.
- Not true
- Somewhat true or sometimes true
- Very true
11. The child has physical complaints that change quickly, such as headaches or stomach aches. For example, he or she may complain of a headache one moment and seem to have forgotten about it the next.
Captures physical symptoms that appear suddenly and are forgotten just as quickly.
- Not true
- Somewhat true or sometimes true
- Very true
12. The child exhibits inappropriate sexual behaviors with other children or with adults.
Evaluates the presence of age-inappropriate sexualized actions directed toward others.
- Not true
- Somewhat true or sometimes true
- Very true
13. The child has unexplained injuries or may sometimes deliberately injure themselves.
Assesses the occurrence of physical harm that the child cannot explain or deliberately inflicts upon themselves.
- Not true
- Somewhat true or sometimes true
- Very true
14. The child reports hearing voices talking to them. The voices may be friendly or angry and may come from 'imaginary friends' or sound like the voices of parents, friends, or teachers.
Probes reports of hearing voices that may originate internally or be attributed to imaginary beings.
- Not true
- Somewhat true or sometimes true
- Very true
15. The child has a very vivid imaginary companion or companions. He or she may insist that this imaginary companion(s) is/are responsible for things they have done.
Captures the presence of highly autonomous imaginary friends who are often blamed for the child's actions.
- Not true
- Somewhat true or sometimes true
- Very true
16. The child has intense temper tantrums, often for no apparent reason, and may show unusual physical strength during these episodes.
Evaluates intense, seemingly unprovoked temper tantrums accompanied by surprising physical strength.
- Not true
- Somewhat true or sometimes true
- Very true
17. The child frequently sleepwalks.
Assesses the frequency of ambulation during sleep, a common dissociative crossover symptom.
- Not true
- Somewhat true or sometimes true
- Very true
18. The child has unusual nighttime experiences, for example, he or she may report seeing 'ghosts' or say that things happen at night that they cannot explain (e.g., broken toys, unexplained injuries).
Probes for unusual nocturnal experiences, such as seeing apparitions or discovering unexplained events by morning.
- Not true
- Somewhat true or sometimes true
- Very true
19. The child frequently talks to himself or herself, may use a different voice, or sometimes argues with himself or herself.
Captures instances of the child arguing with themselves or speaking in distinct, alternating voices.
- Not true
- Somewhat true or sometimes true
- Very true
20. The child has two or more distinct and separate personalities that take control of their behavior.
Assesses the explicit manifestation of separate identities that assume executive control over the child's behavior.
- Not true
- Somewhat true or sometimes true
- Very true