BIOL 1010 Lecture Notes - Comorbidity, Amobarbital, Posttraumatic Stress Disorder

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30 Jan 2013
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According to Liotti, a related possibility is that individuals suffering from DID have a disorganized attachment style because
they were exposed as young children to the frightening and chaotic behaviour of their caregiver.
Controversies in the diagnosis of DID:
Compared with the American sample, the Canadian respondents were significantly more susceptible about the scientific
validity and diagnostic legitimacy of DID. There were no significant differences between the views of English-speaking and
French-speaking respondents.
psychoanalytically oriented psychiatrists were significantly more accepting of the validity of DID than were biologically
oriented psychiatrists.
re-emergence of the DID diagnosis in the past thirty years can be linked to:
In DSM-III, the diagnostic criteria for DID were spelled out clearly for the first time.
Could be that clinicians has always seen a similar number of cases but chose to report them only when interest in DID
grew.
Cases of DID may have mistakenly been diagnosed as cases of schizophrenia. However the symptoms of the two
disorders are actually not very similar.
ETIOLOGY OF DISSOCIATIVE DISORDERS:
There are two major theories of DID.
One assumes that DID begins in childhood as a result of severe physical or sexual abuse. The abuses causes dissociation and
the formation of alters as a way of escaping the trauma.
It is further proposed that a diathesis present among those who do develop DID. One idea is that eing high in hypnotisability
facilitates the development of alters through self-hypnosis. Another proposed diathesis is that people who develop DID are very
prone to engage in fantasy.
The other DID theory considers the disorder to be an enactment of learned social roles. The alters appear in adulthood,
typically due to suggestions by a therapist.
A critical piece of evidence regarding the two theories is whether or not DID actually develops in childhood as a result of
abuse.
One study however has come close to providing clearer data regarding both childhood onset and abuse in cases of DID.
Concluded that there really isn’t any proof for the claim that DID is caused by childhood trauma and that DID cases in children
are rarely reported.
THERAPIES FOR DISSOCIAIVE DISORDERS:
psychoanalytic treatment is perhaps more widespread as a choice of treatment for dissociative disorders than for any other
psychological problems. (The goal f lifting repression).
PTSD is the most commonly diagnosed co-morbid disorder with DID.
Treatment of DID:
hypnosis is used commonly in the treatment of DID. The general idea is that the recovery of repressed painful memories will
be facilitated by recreating the state entered into during the original abuse, a hypothesis consistent with classic research on
state-dependent learning.
The person is hypnotised with the help of drugs such as sodium amytal and encouraged to go back in his or her mind to
events in childhood a technique called age regression. The hope is that accessing these traumatic memories will allow the
adult to realise that the ganders from childhood are not now present and his or her current life need not be governed by these
ghosts from the past.
Improvement in a DID patient’s anxiety and depression is sometimes effected through psychoactive drugs such as
tranquilizers and antidepressants, though without effect on the DID itself.
Series of agreed upon treatment guidelines focuses on: (1) safety, stabilization and symptom reduction; (2) working directly
and in depth with traumatic memories; and (3) identity integration and rehabilitation.
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