“In some instances the patient will have a visual image of a contrasexual alter. For example, one female patient endorsed the presence of two male alters with the same name, one a boy of about age 10 wearing a baseball cap and the other a slightly older but still aggressive adolescent. Because a patient's use of visual images provides rich evidence for the degree of identity alteration, each of the SCID-D's follow-up sections incorporates questions about visual images to allow the patient to elaborate on this symptom.”