Category:Dissociative Identity Disorder

Description of Dissociative identity disorder

Dissociative identity disorder or DID (formerly called Multiple Personality Disorder or MPD) is defined in the DSM-IV-TR as the presence of two or more personality states or distinct identities that repeatedly take control of one’s behavior. The patient has an inability to recall personal information. The extent of this lack of recall is too great to be explained by normal forgetfulness. The disorder cannot be due to the direct physical effects of a general medical condition or substance.

DID entails a failure to integrate certain aspects of memory, consciousness and identity. Patients experience frequent gaps in their memory for their personal history, past and present. Patients with DID report having severe physical and sexual abuse, especially during childhood. The reports of patients with DID are often validated by objective evidence.

Physical evidence may include variations in physiological functions in different identity states, including differences in vision, levels of pain tolerance, symptoms of asthma, the response of blood glucose to insulin and sensitivity to allergens. Other physical findings may include scars from physical abuse or self-inflicted injuries, headaches or migraines, asthma and irritable bowel syndrome.

DID is found in a variety of cultures around the world. It is diagnosed three to nine times more often in adult females than males. Females average 15 or more identities, males eight identities. The sharp rise in the reported cases of DID in the U.S. may be due the greater awareness of DID’s diagnosis, which has caused an increased identification of those that were previously undiagnosed.

The average time period from DID’s first presentation of symptoms to its diagnosis is six to seven years. DID may become less manifest as patients reach past their late 40’s, but it can reemerge during stress, trauma or substance abuse. It is suggested in several studies that DID is more likely to occur with first-degree biological relatives of people that already have DID, than in the regular population.

Causes of Dissociative Identity Disorder

The causes of dissociative identity disorder are theoretically linked with the interaction of overwhelming stress, traumatic antecedents, Childhood trauma, adult trauma, and dissociation (PDF). insufficient childhood nurturing, and an innate ability to dissociate memories or experiences from consciousness. Prolonged child abuse is frequently a factor, with a very high percentage of patients reporting documented abuse (Current Issues in Dissociative Identity Disorder (PDF). Bridging Eastern and Western Psychiatry 1 (1): 71–87) often confirmed by objective evidence (DSM). The Diagnostic and Statistical Manual of Mental Disorders states that patients with DID often report having a history of severe physical and sexual abuse. The reports of patients suffering from DID are "often confirmed by objective evidence," and the DSM notes that the abusers in those situations may be inclined to "deny or distort” these acts.

Research has consistently shown that DID is characterized by reports of extensive childhood trauma, usually child abuse. "The clinical phenomenology of multiple personality disorder: review of 100 recent cases". "Abuse histories in 102 cases of multiple personality disorder".Multiple personality disorder in The Netherlands: a clinical investigation of 71 patients. Dissociation is recognized as a symptomatic presentation in response to psychological trauma, extreme emotional stress, and in association with emotional dysregulation and borderline personality disorder. "Rethinking the comparison of Borderline Personality Disorder and multiple personality disorder". Psychiatr Clin North Am 17 (4): 743–71. PMID 7877901. A study of 12 murderers established the connection between early severe abuse and DID (Objective documentation of child abuse and dissociation in 12 murderers with dissociative identity disorder. Am J Psychiatry, 154(12):1703-10).

Bibliography

Baer, Richard A. (2007). Switching Time: A Doctor's Harrowing Story of Treating a Woman with 17 Personalities. [New York]: Crown. ISBN 0307382664.
Braun, B.G. (1989). Dissociation: Vol. 2, No. 2, p. 066-069: Iatrophilia and Iatrophobia in the diagnosis and treatment of MPD (PDF).
Brown, D; Frischholz E, Scheflin A. (1999). "Iatrogenic dissociative identity disorder - an evaluation of the scientific evidence". The Journal of Psychiatry and Law XXVII No. 3-4 (Fall-Winter 1999): 549–637.
Gleaves, D. (July 1996). The sociocognitive model of dissociative identity disorder: a reexamination of the evidence. Psychological Bulletin 120 (1): 42–59. DOI:10.1037/0033-2909.120.1.42. PMID 8711016. "Most recent research on the dissociative disorders does not support (and in fact disconfirms) the sociocognitive model, and many inferences drawn from previous research appear unwarranted. No reason exists to doubt the connection between DID and childhood trauma. Treatment recommendations that follow from the sociocognitive model may be harmful because they involve ignoring the posttraumatic symptomatology of persons with DID."
Goettmann, B. A.; Greaves, B. G., Coons M. P. (1994).Multiple personality and dissociation, 1791-1992: a complete bibliography. Lutherville, MD: The Sidran Press, 85. ISBN 0-9629164-5-5.
Kluft, R.P. (1989). Iatrogenic creation of new alter personalities (PDF). Dissociation 2 (2): 83–91.
Putnam, Frank W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: The Guilford Press, 351. ISBN 0-89862-177-1.
Underwood, Anne. Identity Crisis - What is it like to live with 17 alternate selves? A survivor of multiple personality disorder discusses the disease and the painful integration process that made her whole. Newsweek, October 22, 2007.

Webpages

Pages in category "Dissociative Identity Disorder"

The following 42 pages are in this category, out of 42 total.