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Lecture 6

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Western University
Psychology 2310A/B
Rod Martin

Dissociative Identity Disorder: A Controversial Diagnosis DSM-IV-TR Diagnostic Criteria-used to be multiple personality disorder -Think schizophrenia is split personality… schizophrenia is psychotic disorder, DID is dissociative. 1. Two or more distinct identities or personality states Each has its own relatively enduring pattern of perceiving, relating to environment, self Alters very different from host, host is very passive, alters can be aggressive and destructive, average number of alters is 10, range from 2-100’s. 2. Recurrently take control of person’s behavior Some identities aren’t aware of other, some know others exist, critical with one another, can be in open conflict with one another. Transition often caused by stress, 3. Loss of memory for personal information Frequent gaps in memory of history, more passive identities have fewer memories, aggressive ids have more control, more memories. 4. Not due to physiological effect of a substance or general medical condition Complex partial seizures can look like this, children with imaginary friends not considered DID. Associated Features Often history of severe childhood abuse Post-traumatic symptoms Nightmares, flashbacks, heightened startled response. High rates of comorbidity – depression, anxiety, borderline personality, suicide, substance abuse, PTSD, eating disorders Often meet criteria for borderline personality disorder Self-mutilation, suicide attempts, aggression Destructive relationships Usually highly hypnotizable, dissociative tendencies Suggestible, easy to hypnotize. Course Tends to be chronic and recurrent More common in women than men (3 – 9 x) Women tend to have more identities Avg women have 15 and men have avg 8 personalities. Typically diagnosed at 29 – 35 years Average of 6-7 years between first symptom presentation and diagnosis of DID See numerous doctors before getting diagnosed, shows unreliability Common “alters” Shirley Mason, said to be diagnosed through therapy. The Host- original personality, unaware of alters The Child- memories of trauma, cuteness, anxiety, depression, hyper sexuality The Avenger- aggression directed towards others, revenge for abuse The Protector- protecting against others that will give further abuse The Trauma Repository- PTSD symptoms The Narcissist- strong energetic acting out character, nonconformist, critical The Helper- better adjusted, help with character. Video: -Tony - At least 53 different personalities - Different voices, one alter was a cousin who dies of a brain tumor - Draw out each alter in therapy and probe for information - Change can be subtle like a cough or blink - No recollection of what happens when other alters come out, alters don’t tell host what they did - Refers to himself as imposter, alters see original personality as intruding on them History of DID Extremely rare until 30 years ago Only about 200 cases before 1980 1957 – “Three Faces of Eve” based on real case 1970s – “Sybil” - book, film based on real case Drew media attention to multiple personality 1980’s – dramatic increase in cases DSM III- MPD now legit specific disorder, treat with hypnosis, uncover personalities during hypnosis. 1986- 6,000 cases only in North America Glamorous disorder that brought attention to therapists and patients. Over diagnosis? Growing clinical interest Therapy books, journal articles Conferences, professional associations 1990s – False Memory Syndrome controversy – growing concerns – lawsuits 2000s – dramatic drop-off in numbers of cases Trauma Theory of DID A “Diathesis – Stress” model Stress: Childhood - severe trauma, abuse Diathesis: High
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