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Dissociative Identity Disorder

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The DSM-5 is the most current diagnostic manual with a publication date of May 27, 2013. A DSMPublished by the American Psychiatric Association as the standard classification of mental disorders used by US mental health professionals. It consists of diagnostic classification, the diagnostic criteria sets, and descriptive text. The DSM-II listed multiple personality disorder as a symptom of hysterical neurosis, dissociative type. The DSM-III (1980) moved Multiple Personality Disorder from a symptom to its own disorder. The DSM-IV changed the name to dissociative identity disorder (1994) and the DSM-5 (May 2013) updated the listing to current standards. {{Rp|384}}-5 diagnosis of dissociative identity disorderPrior to the DSM-IV, dissociative identity disorder was known as multiple personality disorder, which was from 1980-1994. The International Classification of Diseases,(ICD) still uses this label, even though the ICD-11 is expected to change it. The term is misleading. No one can have more than one personality, nor is the disorder a personality disorder. {{See also| Multiple Personality Disorder}}Dissociative identity disorder is a disorder of mental states, where a individual switches from one distinct state to another distinct state, which distinguished it from OSDD/DDNOS, BPD and PTSD. {{Rp|557-570,487-494,471-486}} {{See also| Dissociative Identity Disorder}} (DIDDissociative identity disorder is a disorder of mental states, where a individual switches from one distinct state to another distinct state, which distinguished it from OSDD/DDNOS, BPD and PTSD. {{Rp|557-570,487-494,471-486}} {{See also| Dissociative Identity Disorder}}) is met when an individual has two or more "distinct states" that experience amnesia. [2] [3] Understanding the difference between a distinct state and a "less than distinct state" is essential for accurate diagnosis. [4] [5] A good rule of thumb is that a distinct state does not usually act child-like or react to unprocessed trauma memories, but instead attend to daily life activities. [6] [7] An fMRIA type of neuroimaging. Neuroimaging is an approach that allows researchers to view areas of the brain that become active during behavioral events such as emotion, perception and cognition. It is part of the science of in psychophysiology. scan is an accurate way to tell a distinct state from a less than distinct state. [5]

Distinct dissociated personality statesThe highly dissociated and compartmentalized personality states found in dissociative identity disorder occur in various mental disorders. Other terms meaning the same thing include: dissociated part, dissociated part of self and disaggregate self-state, but often the same terms used for non-dissociated state are used for dissociated states. {{See also| Alters}} {{See also| Personality}}

"Distinct dissociated personality states" are highly phobic of any state they do not connect with in an "acceptable" and self acknowledged pattern of reliability. [5] Phobic inhibitions prevent distinct states from knowing, in any self acceptable manner that other states of any magnitude exist within their realm. [5] Animistic primal fear directs the innate behavior of the distinct states since these parts are cutoff from the part of the personality that correlates and helps to control fear. [4] Where this control center is located once distinct states are separated from less than distinct states is yet unknown, but researchers believe the answers lie in the less than distinct part(s) that are observing in nature. [3]

Less than distinct states: dissociated observing and experiencing dissociated statesThe highly dissociated and compartmentalized personality states found in dissociative identity disorder occur in various mental disorders. Other terms meaning the same thing include: dissociated part, dissociated part of self and disaggregate self-state, but often the same terms used for non-dissociated state are used for dissociated states. {{See also| Alters}} {{See also| Personality}}

"Less than distinct states" are either observing in nature or are the experiencing part(s) of the personalityEvery individual has a personality that is composed of many diverse, fragmentary and generally illusory images of [[Personality|self]]. (see multiples) The DSM-IV uses the term identity in its definition of dissociation. (see identity) {{Rp|127}}. [3] It's thought that when a "less than distinct state" is created (a process of traumaThe most fundamental effect of trauma is dissociation, so we define trauma as the event(s) that cause dissociation. {{Rp|75}} The original trauma in those with dissociative identity disorder was failure of secure attachment with a primary attachment figure in early childhood. {{Rp|83}}) two things can occur. An experiencing state can be "born alongside" a dissociated observing state. [4] This is common in posttraumatic stress disorder which involves the dissociative symptoms of depersonalization and derealizationDepersonalization disorder includes derealization, since the two often co-occur. . The resulting state could be described as basic, not-elaborated, immature or even unyielding. A dissociated observing state in a complex dissociative disorder could be described as embellished, extravagant, complex, curious, learning and limitless. These states are living and growing things that will change and evolve.

Understanding DSM-5 criteria

The DSM is a tool used only for diagnosis. It is not to be used in an attempt to understand any mental disorderThe DSM-5 psychiatric manual defines this as "a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expected or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above."{{Rp|20}}. This tool gives the minimum criteria that a given work-group deemed sufficient to diagnosis a mental disorder. An individual must understand the terms used in the manual. The DSM is not a laymans tool. A trained diagnostician will understand the crucial differences between a distinct state and a less than distinct state. [8]:383-402

  • The main DSM-5 criteria for dissociative identity disorder is a disruption of identity characterized by two or more distinct states. [2] [3] [9] [10] [11]
  • The next criteria states there is amnesia between distinct states. [2] What type of amnesiaMemory loss. {{See also| amnesia}} is not mentioned since it's irrelevant.

What's important is that two or more distinct states exist and that will only be the case in dissociative identity disorder. [3] [9] [10] [11] To help identify these states a clinician can observe amnesia between them which is shown in examples on this page. There is amnesia between states in other disorders, but it's amnesia between two or more distinct states that defines dissociative identity disorder. If switches are observed only from a less than distinct state to a distinct state or from a distinct state to a less than distinct state then the diagnosis would be other specified dissociative disorder or possibly other disorders that a good diagnostician would have already ruled out. The ISSTD and other organizations do offer training for mental health professionals.

Vignette: switchingFull dissociation is when an alter switches with the alter currently in executive control, resulting in amnesia for that alter. (see executive control) {{Rp|4-6}} In full dissociation, there is complete amnesia between dissociated states, which is a {{Rp|228}} criteria for a diagnosis of dissociative identity disorder in the DSM-5. {{See also| Dissociation}} between distinct and less than distinct states

For brevity sake, the term ANPA distinct state who performs the job of daily activities and does not hold trauma memories. Dissociative identity disorder is the only mental disorder where an individual can have two or more ANP. {{See also| structural dissociation}} will be used to indicate a distinct state and the term EPAn state that holds trauma memory. A term used in structural dissociation. {{Rp|38-39}} is used to determine a less than distinct state. Annabelle, a 25 year old mother gets in her car and drives to her appointment with a psychologistPsychologists usually have an advanced degree, most commonly in clinical psychology, and often has extensive training in research. Psychologists use psychotherapy (often referred to as "talk therapy" or just "therapy") to treat mental disorders. Some psychologists specialize in psychological testing and evaluation. named Dr. Getsitright. She (ANP-1) knocks on his office door and when it opens she becomes disoriented, but quickly pulls herself together in an almost seamless manner. ANP-2 walks into the office and introduces herself, and Dr. Getsitright does the same. She looks around the office and there are many things but one wall draws her attention. She sees a variety of books, journals, and some dusty nick-knacks and small antique toys. Dr. Getsitright invites her to have a seat, but in that moment her eyes are drawn to bottom of the bookcase where sits a "happy meal" bag that is folded shut. That causes her to switch to EP-1. Instead of sitting down she kneels down on the floor and inhales, but the distinct odor she expects is not present and she looses interest. She gets up and sees Dr. Getsitright watching her and she is startled. This causes her to switch with ANP-3, and she tries to make sense of where she is. This is a new place to her, but she ignores that. No other disorder will have a part that does this. ANP-3 is unable to acknowledge to herself that she does not know what is going on and she does her best to fit into the situation. Dr. Getsitright is astute and he knows exactly what has been going on, but he wants to see if he can get this distinct state to switch directly to another distinct state again. He addresses Annabelle by saying, are you ready to go to the movies? Have you decided what we are going to go and watch? ANP-3 looks at Dr. Getsitright and replies. I would love to go and see a movie, but you pick. I would really like you to choose. Dr. Getsitright has all the information he needs to diagnosis Annabelle with dissociative identity disorder. [12] [13] [9] [4]

Notice that distinct states can fail to share memory"Memory is not a static thing, but an active set of processes." {{Rp|51}} "Our earliest experiences shape not only what we remember, but also how we remember and how we shape the narrative of our lives. Memory can be seen as the way the mind encodes elements of experience into various forms of representation. As a child develops, the mind begins to create a sense of continuity across time, linking past experiences with present perceptions and anticipations of the future." {{Rp|11}} with both distinct states and less than distinct states, but only the distinct states with disregard the fact that they often have no idea how they get from one place to another or where they might show up at any given moment. This is not purposeful disregard, but is a function of amnesia and dissociation. It is due to the chemical, neurological and physical makeup of the distinct states. [12] [9]

Symptoms

The main symptom of dissociative identity disorder is dissociation which reduces distress and acts as a coping mechanism. [8]:447-469 It would be rare that anyone with dissociative identity disorder complained that anything was wrong with them. They are masters of personal neglect. Their minds are tormented and yet they function at a higher level than most in many ways, however they are moving through life in ignorance of who they are. Many probably die never even knowing they have a mental disease, and others choose not to go through the pain to fix what is wrong, and yet others will work hard for years to bring all the parts of the personality together to a point where they all share memory, including all traumatic memory. When this is done then the symptoms of dissociationDissociation is a compartmentalization of experience, where elements of a trauma are not integrated into a unified sense of the self. {{Rp|4-810, 127}}The lay persons idea of [[dissociation]], that which exists in the normal mind, is not what is referred to in this document. {{Rp|233-234}} will abate and so will the "amnesia."

The straight forward symptoms include amnesia, voices, conversion"The development of symbolic physical symptoms and distortions involving the voluntary muscles or special sense organs; not under voluntary control and not explained by any physical disorder." Sadock (2008). Functional Neurological Symptom Disorder is the new name for Conversion Disorder in the DSM-5 manual, and is part of the Somatic Symptom and Other Related Disorders category. Somatization Disorder was removed during the changes, but is represented in this category. {{Rp|11}}Conversion symptoms are most common in conversion disorder, but also seen in a variety of mental disorders." {{Rp|23}}"Conversion disorders" is the ICD-10 category includes somatoform dissociation within dissociative disorders of movement and sensation. {{Rp|9}}{{See also| Somatoform Disorders}}, self alteration, derealization, depersonalization, flashbacks, trances, identity confusionDefined as "a feeling of uncertainty, puzzlement, or conflict about one's own identity. "{{Rp|13}}. The structured clinical interview for the dissociative disorders and other diagnostic tools assess identity confusion. {{See also| Identity confusion}} {{See also| Diagnosis}}, awareness of other states (by the less than distinct states or after a good deal of therapy and/or self work), and the Schneiderian first-rank symptoms that include voices arguingTwo or more voices conversing, they may be arguing. Common in both schizophrenia and dissociative identity disorder. This is a type of auditory hallucination. {{Rp|45}} In dissociative identity disorder the voices belong to alter identities and this may extend to alters who are contending for physical control, for example involving the person feeling a force or an "other" that ties to control or change the person's actions, or feeling or hearing an angry other that tries to control the person.{{Rp|230}}, voices commentingRefers to voices commenting (in the form of a running commentary) on the person's behavior or thoughts. Common in both schizophrenia and dissociative identity disorder. This is a type of auditory hallucination. {{Rp|45}}{{Rp|230}}, thought withdrawalThe person believes thoughts have been taken away from his/her mind. This is a symptom of schizophrenia,{{Rp|45}} but either thought withdrawal and thought insertion are also very common in people with Dissociative Identity Disorder. {{Rp|527}}, thought insertionThe person believes that thoughts that are not his/her own thoughts have been inserted into his/her mind. {{Rp|45}}This is a symptom of schizophrenia, but either thought withdrawal and thought insertion are also very common in people with Dissociative Identity Disorder. {{Rp|527}}, made impulsesThese impulses for action are imposed on the person and do not feel like they belong to the person, who feels like the impulses are "coming from somewhere else or someone else". In dissociative disorders this can some other part is trying to overrule the host/apparently normal part of the personality. A Schnieder first-rank symptom often present in schizophrenia but common in DID.{{Rp|231}}In schizophrenia or psychosis the impulses may be given a delusional explanation, for example naming a person or object who the impulses appear the be coming from., made feelings'Made' or intrusive feelings and emotions are unexpected surges of feeling-pain, hurt, anger, fear, shame, and so on. Often these surges of feeling are inexplicable and frankly puzzling". A Schnieder first-rank symptom often present in schizophrenia. These tend to be partially dissociated intrusions from another self-state, fairly common in "PTSD, borderline personality disorder, bipolar disorder, panic disorder and ADHD."{{Rp|231}} and made actions. There are also non-psychoticA person experiencing psychosis, or a characteristic of psychosis. {{Rp|24}} auditory hallucinationsThe DSM-IV-TR psychiatric manual defined hallucinations as a "sensory perception that has the compelling sense of reality of a true perception but that occurs without external stimulation of the relevant sensory organ. Auditory hallucinations are common both in schizophrenia and dissociative identity disorder. {{Rp|525}}Hallucinations can be auditory (voices, noises or other sounds), voices commenting on the person's behavior or thoughts, voices conversing, somatic or tactile (peculiar physical sensations), olfactory (unusual smells), visual (shapes or people that are not present). {{Rp|45}}Visual hallucinations are the most common type of hallucination and are often in geometric forms and figures {{Rp|127}} Illusions are similar to visual hallucinations but are based on real images or sensations. and visual hallucinations. [8]:228-234

Epidemiology

Dissociative identity disorderPrior to the DSM-IV, dissociative identity disorder was known as multiple personality disorder, which was from 1980-1994. The International Classification of Diseases,(ICD) still uses this label, even though the ICD-11 is expected to change it. The term is misleading. No one can have more than one personality, nor is the disorder a personality disorder. {{See also| Multiple Personality Disorder}}Dissociative identity disorder is a disorder of mental states, where a individual switches from one distinct state to another distinct state, which distinguished it from OSDD/DDNOS, BPD and PTSD. {{Rp|557-570,487-494,471-486}} {{See also| Dissociative Identity Disorder}} is not rare; it is thought to occur in 1% to 3% of the world's general population. [14]

Etiology

There are three model's accepted by the ISSTD to explain the etiologyThe study of the cause of a disorder or disease. In the case of dissociative identity disorder, early and severe childhood trauma, especially abuse is considered to be the cause. {{See also| Etiology}} of dissociative identity disorder, but the only one of these that agrees with solid fMRI scans is the "Theory of Structural DissociationStructural dissociation (SD) is one of the three accepted etiological ideas for the etiology of dissociative identity disorder. {{Rp|158-165}} It also explains other specified dissociative disorder, dissociative forms of borderline personality disorder, and dissociative posttraumatic stress disorder {{See also| Structural dissociation}}Structural dissociation of the personality is a theory that describes the effect of trauma on the personality. It applies to PTSD, complex PTSD, other specified dissociative disorder and dissociative identity disorder. of the PersonalityEvery individual has a personality that is composed of many diverse, fragmentary and generally illusory images of [[Personality|self]]. (see multiples) The DSM-IV uses the term identity in its definition of dissociation. (see identity) {{Rp|127}}." Understanding at least the basics of Structural Dissociation is essential to knowing what is and what is not dissociative identity disorder. [15] As already has been explain at the top of this page, someone with dissociative identity disorder has two or more "distinct states". In Structural Dissociation these states are called "apparently normal parts" (ANP) which are the states that attend to daily life. Individuals with dissociative identity disorder also have two or more "less than distinct states", which in Structural Dissociation are called "emotional parts" (EP) which are the states "disturbed" by unprocessed trauma memory. [4] [16] [5]

Age, trauma and attachmentThe communication of emotion between an infant and their primary caregiver(s) is essential to shaping the developing mind. "Emotion serves as a central organizing process within the brain. In this way, an individual's abilities to organize emotions - a product in part, of early attachment relationships directly shapes the ability of the mind to integrate experience and to adapt to future stressors." {{Rp|9}} Interruption in the attachment pattern of young children with their caretaker(s) has been shown to be a primary precursor to Dissociative Disorder pathology. (see etiology) {{Rp|85}} {{Rp|97}} disorder

A combinations of things need to come about to cause dissociative identity disorder which include age, disorganized attachment with caregivers and an inability to process accumulated and overwhelming trauma. Any human who has been neglected or abused in early infancy has the potential to have dissociative identity disorder. It's not genetic. This is an environmental disorder. [17] [4] Age is a critical factor in the development of dissociative identity disorder. [12] [17] [18] In fact, Onno van der Hart and Ellert Nijenhuis have reported infant age correlates with affected strata, which lays the groundwork for dissociative identity disorder. [4] [19] What direction abuse"interactions in which one person behaves in a violent, demeaning or invasive manner towards another person (e.g. child or partner)" and/or neglect take in the first years life determines which mental disorder, if any, a child will get. [17] [4]

"The age of the individual at the time of early and chronic trauma is a critical component due to the developmental processes that, under other circumstances, would normally occur at that time. [20] In addition, the age at the beginning and the ending of the trauma is significant as it encompasses the sequence of developmental stages and should influence which developmental tasks are most disrupted. [18] It appears as if vulnerability to dissociation increases if the trauma occurs at earlier developmental stages." [21] In addition to age, neglect is also thought to play an important part in causation of dissociative identity disorder. [22] Finally and ultimately it is the child's inability to develop a unified sense of selfNormal sense of self is experienced as alterations in consciousness, but the sense of self remains stable and consistent. In individuals with a Dissociative disorder the sense of self alternates and is inconsistent across time and experience. {{Rp|160}} There is no unified sense of self. due to Structural Dissociation, which results in two or more distinct states which then are able to create more states, both distinct states and less than distinct states.

There are three etiological models accepted by the International Society for the Study of Trauma and Dissociation (ISSTD), [14]:133 an international organization which defines the top experts in the field of trauma and dissociation, and all three ideas report that dissociative identity disorder is the result of early childhood trauma. [8]:585-598Psychological trauma and dissociation are entwined closely since with trauma dissociation would not exist and without dissociation trauma would not be a problem. [23] When early trauma is chronic and severe it changes basic ways that the brainThe brain is a approximately a 1300-gram organ containing 100-billion neurons. It is the control center of the central nervous system. The mind and brain are not the same thing. (see mind) The mind emerges out of interactions between the brain and relationships during the earliest years of childhood. Different child-parent attachment relationships form differing physiological responses, patterns for interpersonal relationship and how an individual views the world. {{Rp|9}} (see attachment) operates by removing important aspects of thought and feeling and replaces them with what is considered to be dissociative aspects. [17]

Etiological vignette

Let's take a look at Annabelle and see how the stratum for dissociative identity disorder was put in motion in the first weeks of her life. Anabelle is a few days old and she has already been suffocated, starved and has not felt the love and comfort of any caretaker. She is vulnerable to all sorts of mental disorders because of this neglect. [17] [18] Now a little more than six-weeks later, Annabelle lies in her crib and is alone with her thoughts. She is rarely, to never comforted, held, or played with. She is hungry, her diaper is never changed, and she is in pain. There is no one to respond to her basic needs, so what does that do to her mind? According to most experts, it causes what is known as disorganized attachment. [17] [18] That's the first criteria met. In addition, she can't form an attachment to a caregiver because her cries are met with anger. She learns not to respond to the pain of hunger, or other basic needs. [17] She is learning a basic animal response. [17] [18] [8]:93-106 An infant in this situation becomes lethargic and fails to thrive and dies, or learns to ignore the pain through dissociation. [19] [8]:185-196 There is more going on in this infant's head than her learned ability to dissociate. She is also learning to comfort and sooth herself, [8]:495-510 since she only has herself to turn to. [8]:93-106 She listens inside for anything - anything at all. What she finds is subjective, but it also follows strict patterns developed through time as humans have evolved. [8]:329-372

Annabelle is now one year old and she never cries. She displays the behavior observed in a child with disorganized attachment. She is confused, and desperately needs a caregiver, but hers, in her experience, is not safe. This is evident in her behavior when she interacts with the adults in her life. [17] The brain needs nourishment and stimulation and she has not got enough of either. [17]) The mind is different as it can create its own stimuli, which it does in Annabelle's case. Her mind is actively stimulating her brain, and in fact, it's doing it in excess to make up for the lack of external stimulation. [5] [8]:93-106 She is creating the base that is needed for her to have a complex dissociative disorder. [12] [17] [18] [8]:93-106 There are only two complex dissociative disorders and just one requires that Annabelle's first year of life involved unprocessed trauma. [24]

IntegrationIntegration (state of unification) occurs in the minds of all individuals and is a process rather than an end product. "If integration is impaired, the result is chaos, rigidity, or both. Chaos and rigidity can then be seen as the red flags of blocked integration and impaired development of the mind." {{Rp|9}} The natural process of the mind is to link differential parts (distinct modes of information processing) into a functional and unified self. No child has unified personality when born, in fact, they need years of sufficient nurturing for the parts of their personality to integrate. {{Rp|394}} "Integration is more like making a fruit salad than like making a smoothie: It requires that elements retain their individual uniqueness while simultaneously linking to other components of the system. The key is balance of differentiation and linkage." {{Rp|199}} Integration is the normal process that occurs in early childhood, but if interrupted by trauma, the child may not be able to integrate. {{Rp|143}}

See also: Treatment
See also: Integration

Therapy is the primary treatment method and there are no medications to cure or manage dissociative identity disorder; the best results are obtained when trauma memories are "processed" (reassociated), allowing dissociative boundaries to abate and a unified sense of self to thrive, thereby reducing dissociative symptoms. [8]:599-652 [25] [26] Without the ability and education needed for astute observation the clinician can arrive at an incorrect diagnosis. [8]:637-652 Therefore only those trained to diagnose complex dissociative disorders should do so. [27]

Prognosis

See also category: Healing

When untreated, there is chronic and recurrent symptoms varying overtime including long-lasting effects such as suicidal tendencies, anxiety, and dissociative symptoms. [27] [8]:637-652 Some individuals feel that they function well at different times in their life, but they are actually in a stage of denialPsychology - Defense mechanism in which the existence of unpleasant realities is disavowed; refers to keeping out of conscious awareness any aspects of external reality that, if acknowledged, would produce anxiety {{Rp|24}}Crime - "various processes by which individual actors, social groups or states either 'block, shut out, repress or cover up certain forms of disturbing information [about wrong doing] or else evade, avoid or neutralize' its consequences. (Cohen (1995){{Rp|19}}) Refers to the denial of a perpetrator of a crime, for example denying the crime or the impact of the crime, denying the victim, counter-attacks and appealing to "higher loyalties".{{Rp|125}} due to ANP phobiaPhobia of dissociated states is evident in all dissociative disorders, but in dissociative identity disorder it is highly evident.. [5] [28] At least four-years of psychotherapy are usually needed (for adults) to allow time for trauma memory processing, elimination of dissociative boundaries and for them to obtain a unified sense of self. [1] [8]:637-652 Estimates of patients that do obtain full integration range from 16.7% to 33%. [29] [30]

Disorders that inadequately trained individuals confuse with dissociative identity disorder

  • PTSD would be eliminated for the same reason as other specified dissociative disorder is, but the states seen in PTSD are far less unsophisticated than seen in other specified dissociative disorder. The EP can take over in PTSD, at least in a way that results in a re-experiencing of a trauma, but they cannot take over enough to act on their own. [8]:447-470Schizophrenia has been confused with both other specified dissociative disorder and dissociative identity disorder, but the DSM-5 criteria have been carefully written to discourage this. For example, the criteria state that for an individual to be diagnosed with dissociative identity disorder there must be distinct states with their own way of being. In schizophrenia there are no states. This is not a disorder that fits within structural dissociation. What is seen in schizophrenia is a delusionalA delusion is a "false belief, based on incorrect inference about external reality, that is firmly held despite objective and obvious contradictory proof or evidence and despite the fact that other members of the culture do not share the belief." {{Rp|24}}Delusional perception is a "perception that has a unique and idiosyncratic meaning for a person, which leads to an immediate delusional interpretation". A Schniederian first-rank symptom often associated with schizophrenia {{Rp|1434}} but not associated with dissociative identity disorder. {{Rp|391}} pattern of "state shifting." [8]:557-570

    History

See also: History of DID
1280px-Plaque Pierre Janet, 54 rue de Varenne, Paris 7.jpg

Paul F. Dell led a drive to separate the complex dissociative disorders from other disorders, and his multi-authored, 864 page book titled: Dissociation and the Dissociative Disorders: DSM-V and Beyond, was an attempt made in 2009 to bring to the forefront the main ideas of the research community. [15] [17] There was little agreement at that time and the massive text book strongly reflected that. More recently, Ellert R.S. Nijenhuis and Onno van der Hart have led the field with an unearthing of knowledge that was influenced by the French genius, Pierre Marie Félix Janet. [18] [32]

Pierre Marie Félix Janet, amid an onslaught of naysayers, determined that the minds ability to dissociate, a term he coined, was influenced by what he called "dissociative determinations," which are referred to today as subjective trauma. [32] Janet insisted that the mind is made up of a network of neurons that, when healthy, work together in harmony, but when "infected" by a trauma memory the mind has no choice but to react to and interact with stimulus. [29] [32] While the process had purpose in human evolution, it is counter-productive today in most circumstances. [17] [16]

Janet observed the human reaction to trauma and understood it, but this important knowledge was stifled by influential researchers that followed Janet. [32] There was a media circus in response to media including "Sybil," "Three Faces of Eve," and the Billy Milligan story. The symptoms and presentation were mixed portrayals of dissociative identity disorder, and other specified dissociative disorder. All this confusion created a Frankenstein effect that was more fantasy than reality. [18]

Janet's work became lost in the controversy brought forth by Freud and the later popular media flap, and there it stayed for the most part, until Ellert R. S. Nijenhuis dug into the original writings of Janet and brought them to light. [9] Nijenhuis, a brilliant psychologist and psychotherapistPyschotherapists are often called a 'therapists'. These professionals may be a psychiatrist, psychologist or other mental health professional who have specialist training in psychotherapy. They are qualified to work with patients in a clinical setting. himself, was able to make sense of what he found. [9] In fact, he did more than that. He demanded that Janet's work be heard and understood. Onno van der Hart, another brilliant psychotraumatomologist and mentor to Nijenhuis, aided in the work and together they processed the important historic information. [33] Later, Kathy Steele joined the two men and the three researching clinicians published the landmark book: The Haunted SelfThe DSM-IV uses the term identity in its definition of dissociation. (see identity) {{Rp|127}}: Structural Dissociation and the Treatment of Chronic Traumatization. [4]. There were earlier journal articles by the three authors, but it was the book that fully introduced the concept of what today is called structural dissociation of the personality. [8]:3-26 Today, scans and imaging tools have backed up the theory of structural dissociationStructural dissociation (SD) is one of the three accepted etiological ideas for the etiology of dissociative identity disorder. {{Rp|158-165}} It also explains other specified dissociative disorder, dissociative forms of borderline personality disorder, and dissociative posttraumatic stress disorder {{See also| Structural dissociation}}Structural dissociation of the personality is a theory that describes the effect of trauma on the personality. It applies to PTSD, complex PTSD, other specified dissociative disorder and dissociative identity disorder. of the personality. [12]

There was nothing about "multiple personalities" in the DSM-I, but in the DSM-II did mention the term as a symptom of neurosisNeurosis is an emotional disorder. Neurotic refers to a person displaying a symptom of emotional distress, which could range from anxiety, panic attacks depression, and lying, to promiscuity. {{Rp|97}} This historical term referred to a very large group of conditions, which were later divided between Mood Disorders, Dissociative Disorders, Anxiety Disorders, Somatization Disorder and Personality Disorder. Neurosis was removed from the DSM completely because it suggested a "cause" common to the categories under that term, and to "reduce confusion" {{Rp|272}}. The DSM-III was the first time that multiple personality disorderPrior to the DSM-IV, dissociative identity disorder was known as multiple personality disorder, which was from 1980-1994. The International Classification of Diseases,(ICD) still uses this label, even though the ICD-11 is expected to change it. The term is misleading. No one can have more than one personality, nor is the disorder a personality disorder. {{See also| Multiple Personality Disorder}} was listed in a DSM as a diagnosis of its own. The name was misleading however, since this mental disorder has never been listed as a personality disorder. At this time in history otherwise specified dissociative disorder, schizophrenia and even borderline personality disorder often were mistaken for one another. [25] Those days are long past, and today's trauma-trained researchers and clinicians have little trouble telling these disorders apart. [32]

Trauma and DissociationDissociation is a compartmentalization of experience, where elements of a trauma are not integrated into a unified sense of the self. {{Rp|4-810, 127}}The lay persons idea of [[dissociation]], that which exists in the normal mind, is not what is referred to in this document. {{Rp|233-234}} Project

For more information see our other project site on dissociative identity disorder.

References

  1. ^ a b Bethany L. Brand (2012): What We Know and What We Need to Learn About the Treatment of Dissociative Disorders, Journal of Trauma and Dissociation, 13:4, 387-396
  2. ^ a b c American Psychiatric Association, (2013). . APA..
  3. ^ a b c d e Lanius, Ulrich (2014) (coauthors: Sandra L. Paulsen, Frank M. Corrigan). . New York:Springer Publishing Company. 10: 0826106315.
  4. ^ a b c d e f g h i Vanderhart, Onno (2006) (coauthors: Nijenhuis, Ellert; Steele, Kathy). . New York:Norton. 13: 978-0393704013.
  5. ^ a b c d e f g Dorahy, Martin; van der Hart, Onno (2014). DSM-5’s PTSD with Dissociative Symptoms: Challenges and Future Directions. Journal of Trauma and Dissociation. (doi:10.1080/152906)
  6. ^ Fisher, Sebern (2014). . Norton. 13: 978-0393707861.
  7. ^ Dalenberg, Constance; DaleGlaser,Ph.D., Omar M. Alhassoon, Ph.D. (2012). STATISTICAL SUPPORT FORSUBTYPES IN POSTTRAUMATIC STRESS DISORDER:THE HOW AND WHYOFSUBTYPE ANALYSIS. DEPRESSION AND ANXIETY, volume 29. (doi:10.1002/da.21926)
  8. ^ a b c d e f g h i j k l m n o p q r s Dell, Paul (2009) (coauthors: Barlow, MR, Beere, DB, Bianchi, I, Blizard, RA, Bluhm, RL, Braude, SE, Bremner, JD, Bromberg, PM, Brown, LS, Bryan, RA, Butler, LD, Cardena, E, Carlson, EA, Carlson, E, Dalenbert, C, Dallam, S,Dell, PF, den Boer, JA, Dorahy, MJ, Dutra, L, Evans, C, Fairbank, JA, Farrelly, S, Ford, JA, Frankel, AS, Freyd, JJ, Ginzburg, K, Gold, SN, Howell, EF, Jager-Hyman, S, Jessop, MA, Kletter, H, Kluft, RP, Koopman, C, Lanius, RA, Lawson, D, Liotti, G, Lyons-Ruth, K, Moskowitz, A, Nijenhuis, ERS, Nurcombe, B, O'Neil, JA, Ozturk, E, Pain, C, Paulson, KL, Read, J, Ross, CA, Rudegeair, T, Saltzman, K, Sar, V, Schore, AN, Scott, JG, Seibel, SL, Siegel, DJ, Silbert, JL, Silvern, L, Simeon, D, Somer, E, Sroufe, LA, Steele, K, Stern, DB, Terhune, DB, van der Hart, O, van Duijl, Marjolein, Waelde, LC, Weiner, LA, Williams, O, Yates, TM, Zanarini, MC.). . New York, NY:Routledge. 13: 978-0415957854.
  9. ^ a b c d e f Obsuth, Ingrid; Hennighausen, Laura E. Brumariu and Karlen Lyons-Ruth (2014). Disorganized Behavior in Adolescent–Parent Interaction: Relations to Attachment State of Mind, Partner Abuse, and Psychopathology. Child Development, volume 85, issue 1. (doi:10.1111/cdev.12113)
  10. ^ a b Spiegel, David. An Ingeneious Study of Intergenerational Transmission of the Effects of PTSD. The American Journal of Psychiatry, volume 171, issue 8. (doi:10.1176/appi.ajp.2014.14050611)
  11. ^ a b Frewen, Paul; Lanius, Ruth A. (2014). Trauma-Related Altered States of Consciousness: Exploring the 4-D Model. Journal of Trauma & Dissociation, volume 15, issue 4, 2014, page 436-456. (doi:10.1080/152977)
  12. ^ a b c d e Schlumpf, YR; Reinders, AATS, Nijenhuis, ERS, Luechinger, R, van Osch, MJP, et al. (2014). Dissociative Part-Dependent Resting-State Activity in Dissociative Identity Disorder: A Controlled fMRI Perfusion Study. PLoS ONE, volume 9, issue 6, 2014. (doi:10.1371/journal.pone.0098795)
  13. ^ Nijenhuis, Ellert R. S.; van der Hart, Onno (2011b). Defining Dissociation in Trauma. Trauma & Dissociation, volume 12, issue 4, page 469-473. (doi:10.1080/152999)
  14. ^ a b ISSTD. Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. Journal of Trauma & Dissociation, volume 12, issue 2, 28 February 2011, page 115–187. (doi:10.1080/152947)
  15. ^ a b Kluemper, Nicole; Dalenberg, Constance (2014). Is the Dissociative Adult Suggestible? A Test of the Trauma and Fantasy Models of Dissociation. Journal of Trauma and Dissociation, volume 15, issue 4, 2014, page 457-476. (doi:10.1080/152972)
  16. ^ a b Steele, Kathy; van der Hart, Onno; Nijenhuis, Ellert R. S. (2001). Dependency in the Treatment of Complex Posttraumatic Stress Disorder and Dissociative Disorders. Trauma & dissociation, volume 4, issue 1, page 79-116. (doi:10.1300/J229v02n04_05)
  17. ^ a b c d e f g h i j k l m Siegel, Daniel (2012). . Guilford press. 13: 978-1462503902.
  18. ^ a b c d e f g h Chu, James A. (2011). . Hoboken, N.J.:John Wiley & Sons..
  19. ^ a b Loewenstein, R. J.; Brand, B.L., Spiegel, D. (2014). Dispelling myths about dissociative identity disorder treatment: an empirically based approach. Psychiatry, volume 77, issue 2, 2014. (doi:10.1521/psyc.2014.77.2.169)
  20. ^ NICE Clinical Guidelines, No. 26. Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care..
  21. ^ Gentile, JP; Dillon, KS; Gillig, PM (2013). Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder.. Innovations in clinical neuroscience, volume 10, issue 2, 2013 Feb, page 22-29.
  22. ^ Ross, Colin A.; Ness, Laura. Symptom Patterns in Dissociative Identity Disorder Patients and the General Population. Journal of Trauma & Dissociation, volume 11, issue 4, 7 October 2010, page 458–468. (doi:10.1080/152939)
  23. ^ Siegel, Daniel (2010). . Bantam. 10.1521/ijgp.2010.60.4.605.
  24. ^ a b Nijenhuis, Ellert; van der Hart, Onno (2011). Dissociation in Trauma: A New Definition and Comparison with Previous Formulations. Journal of Trauma & Dissociation, volume 12, issue 4, 2011. (doi:10.1080/152992)
  25. ^ a b Vermetten, Eric; Spiegel, Eric (2014). Trauma and Dissociation: Implications for Borderline Personality Disorder. Current Psychiatry Reports, volume 16, issue 2. (doi:10)
  26. ^ Solomon, Roger; Nijenhuis, Ellert R. S.; van der Hart, Onno (2010). Journal of EMDR Practice and Research, volume 4, issue 2, 2010, page 76-92. (doi:10.1891/1933-3196.4.2.76)
  27. ^ a b Brand, Bethany; Dorahy, Martin, Sar, Vedat, Krüger, Christa, Stavropoulos, Pam, Martínez-Taboas, Alfonso, Lewis-Fernández,Roberto, Middleton,Warwick (2014). Psychiatry Australian and New Zealand Journal of http://anp.sagepub.com/content/48/5/402 Dissociative identity disorder: An empirical overview. Aust N Z J Psychiatry, volume 48, issue 402, 2014. (doi:10.1177/0004867414527523)
  28. ^ Brand, B.; Loewenstein, Richard J. (2010). Dissociative disorders: An overview of assessment, phenomenology, and treatment. Psychiatric Times.
  29. ^ a b Loewenstein, R. J.; Brand, B. (2014). Does phasic trauma treatment make patients with dissociative identity disorder treatment more dissociative?. J Trauma Dissociation, volume 15, issue 1, 2014, page 52-65. (doi:10.1080/152950)
  30. ^ Brand, B.; Classen, C. C., McNary, S. W., Zaveri, P. (2009). A review of dissociative disorders treatment studies. J Nerv MentDis., volume 197, issue 9, page 646-54. (doi:10.1097/NMD.0b013e3181b3afaa)
  31. ^ Fernando, Silvia Carvalho; Beblo, Thomas, Schlosser, Nicole, Terfehr, Kirsten, Otte, Christian, Löwe, Bernd, Wolf, Oliver Tobias, Spitzer, Carsten, Driessen, Martin, Wingenfeld,Katja (2014). The Impact of Self-Reported Childhood Trauma on Emotion Regulation in Borderline Personality Disorder and Major Depression. Journal of Trauma & Dissociation, volume 15, issue 4, 2014, page 384-401. (doi:10.1080/152962)
  32. ^ a b c d e Whitfield, Charles (1995). . HCI. 10: 1558743200.
  33. ^ Lanius, Ruth A.; Eric Vermetten, Richard J. Loewenstein, Bethany Brand, Christian Schmahl, Douglas Bremner, David Spiegel (2010). Emotion Modulation in PTSD: Clinical and Neurobiological Evidence for a Dissociative Subtype. Am J Psychiatry, volume 167, issue 6, 2010. (doi:10.1176/appi.ajp.2009.09081168)
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