This paper reviews clinical, phenomenological, and epidemiological data regarding diagnosis in general, and illustrates possible treatment interventions for dissociative identity disorder, with a focus on psychotherapy interventions and a review of current psychopharmacology recommendations as part of a comprehensive multidisciplinary treatment Jan 12, · M Night Shyamalan’s new movie, Split, stars James McAvoy as a character with 23 different personalities. And, like most screen portrayals of the disorder, it May 25, · Research from found little evidence to suggest that people with this disorder are more likely to engage in violent or unlawful behavior than people not living with the condition
Dissociative Identity Disorder: Overview and Current Research - Inquiries Journal
This paper entails a description of factors related to diagnosis and treatment of Dissociative Identity Disorder. Epidemiology, including risk factors and sociocultural aspects of the disorder are presented, along with recommendations for treatment. Highlights of current research focusing on neurobiological and psychobiological aspects of DID provide additional insight into providing accurate diagnosis and appropriate treatment.
Recommendations for dissociative disorder research paper research involve studies that will elaborate on research already completed, and provide a more detailed analysis of the characteristics of this unique and complex disorder.
Dissociative Identity Disorder DID is a fascinating disorder that is probably the least extensively studied and most debated psychiatric disorder in the history of diagnostic classification. There is also notable lack of a consensus among mental health professionals regarding views on diagnosis and treatment. Dissociative disorder research paper one study involving doctoral-level clinicians, nearly one-third believed that a diagnosis of Borderline Personality Disorder was more appropriate than DID.
According to the diagnostic criteria outlined in the current edition of the DSM, diagnosis of DID requires the presence of at least two personalities, with a personality being identified as a entity having a unique pattern of perception, thought, and relational style involving the both the self and the environment. Extensive and unusual loss of memory pertaining to personal information another feature of DID.
Differential diagnosis generally involves ruling out the effects of chemical substances and medical as opposed to psychological conditions.
When evaluating children, it is also important to ensure that symptoms are distinguishable from imaginary play American Psychiatric Association, In dissociative disorder research paper populations, the estimated prevalence of DID ranges from 0. Females are more likely to receive a diagnosis of DID, at a ratio of Lewis-Hall, This author also contends that the disproportionately high number of females diagnosed with DID dispels the notion that incestual abuse is largely responsible for the development of DID.
In addition, individuals diagnosed with DID commonly have a previous diagnosis of Schizophrenia. However, dissociative disorder research paper, this most likely represents dissociative disorder research paper misdiagnosis rather than comorbidity, due to the fact that both disorders involve experiencing Schneiderian symptoms ibid.
While the dissociative disorder research paper of DID are complex in themselves, the presence of multiple additional symptoms further complicates diagnosis and treatment. The course and prognosis of untreated DID is uncertain, and for individuals with comorbid disorders, prognosis is less favorable. Other factors influencing a poor prognosis include remaining in abusive situations, dissociative disorder research paper with criminal activity, substance abuse, eating disorders, or antisocial personality features.
Although DID occurs more frequently in the late adolescence or early adult age groups, the average age of diagnosis is thirty, with most diagnoses occurring years after the onset of symptoms.
However, other factors in addition to a history of abuse, such as disorganized or disoriented attachment style and a lack of social or familial support best predict that an individual will develop DID ibid. Studies on genetic factors contributing to DID present mixed findings. Another study utilizing objective ratings of dissociative behavior found that shared environmental factors had little effect in both adopted siblings and twin pairs Becker-Blease, et al, As this study did not specifically investigate pathological dissociation, more research is needed to determine if the genetic tendency to experience dissociation varies according to type of dissociation pathological or non-pathologicaland whether trauma influences the pathological development of a pre-existing tendency to dissociate.
A study conducted with inpatient, outpatient, and the general population in China found prevalence rates of 0, dissociative disorder research paper. Factors related to individualistic and collectivistic cultures may contribute to the prevalence and etiology of DID. According to Fujii et al. While most North Americans participants with DID were physically or sexually dissociative disorder research paper in childhood, Japanese participants diagnosed with DID were far less likely to have experienced physical or sexual abuse.
The North American participants in this study also had nearly three times as many alter personalities as Japanese participants. Although the ultimate goal of treatment is integrated functioning of the alter personalities ISSD,the presence of multiple comorbid disorders, experiences of trauma, and safety concerns make a comprehensive treatment plan necessary. The International Society for the Study of Dissociation ISSD published some basic guidelines to aid clinicians in treating DID, dissociative disorder research paper.
As might be expected from successful treatment, clients dissociative disorder research paper later phases of treatment reported less self-harming behavior, symptom reduction, and more positive behavior than clients in stage 1, as indicated by scores on the Dissociative Experiences Scale II, the Posttraumatic Stress Checklist-Civilian, and the Symptom ChecklistRevised Brand, et al.
While elements of each phase occur throughout treatment, these phases describe the dominant concerns of therapy during the stages of treatment.
Because of the intense feelings experienced as a result of trauma, individuals with DID may behave in ways that facilitate exploitation or are dangerous to themselves or others.
Thus, dissociative disorder research paper, a primary goal for treatment is to manage these behaviors and teach impulse control with some form of cognitive or behavioral therapy.
Even when amnesia exists between alters, therapists should hold the client responsible for behaviors of all alters. Therapists should also realize that some clients do not desire fusion or integration of their personalities. In this case, the goal of treatment would involve working towards cooperative functioning of alters. Identifying relationships between alters and communicating with alters directly are strategies useful in treating DID. Requesting that the client listen inwardly to alters may facilitate necessary discussion among alters and between the therapist and client ISSD, No randomized trials have been conducted to compare the effectiveness of various theoretical orientations or dissociative disorder research paper in treating DID.
Although research involving pharmacotherapy for DID is scarce, two studies involving diazepam and perospirone seem promising. Following unsuccessful treatment with antidepressants and tranquilizers, Okugawa, Nobuhara, Kitashiro, and Kinoshita examined the effects of treating DID with perospirone, a medication originally intended for the treatment of schizophrenia.
The clinical features of this case involve two alternate personalities, who presented as a male 23 years and a female 17 years. The client host was female and 30 years old, and had been diagnosed with DID for 13 years. During presentation of the young female personality, the client reported hearing the male alter, which was her primary symptom, along with anxiety and identity dissociation. The client experienced remission of anxiety and hallucinatory symptoms after a month of treatment with dissociative disorder research paper. Treatment was continued for 5 months, and medication was gradually reduced over a period of 9 months.
At the time of writing, the client had experienced remission of dissociative symptoms for 1 year, dissociative disorder research paper. The results of this case study seem remarkable, especially because use of medication alone was responsible for drastic and sustained improvement in functioning, and continued use of medication was not required to maintain remission of symptoms.
In this study, diazepam was used to successfully facilitate memory retrieval in an amnestic client who was unable to recall his location or identity. However, because the efficacy and safety of diazepam has not been demonstrated in the treatment of an adequate number of cases of dissociative disorders, it is difficult to generalize these findings or assess the appropriateness of this treatment.
Medication is generally applicable to secondary features and comorbid disorders, and not DID itself. Considering the complexity of DID and the lack of conclusive research on treatment methods, the best treatment approach would involve an integrative style.
The use of medication for anxiety and trauma-related symptoms and the phase approach allows for immediate treatment of distressing symptoms, flexibility, dissociative disorder research paper, and a continual evaluation of progress. Depending on which theoretical orientation is more appropriate, various psychotherapeutic modalities can be used to address specific problems as necessary.
Inflexibly using one approach may hinder successful treatment, especially because DID often involves comorbid disorders that may need to be considered separately. Because research supports the importance of social support as a preventative factor, all efforts should be made to discover sources of support for the client once stability is achieved.
Group psychotherapy is one way to achieve this goal. Advantages of group therapy include reducing isolation related to a diagnosis of DID, the opportunity to interact with both genders in heterogeneous groups, and an accepting peer group that replaces the secrecy and isolation surrounding childhood abuse.
Group therapy provides clients with the opportunity observe others and learn the purpose of alters, and hope for their own recovery as others in the group improve Buchele, There are advantages and disadvantages to every treatment method, and it is the responsibility of the therapist dissociative disorder research paper explore feasible options and empower clients in their recovery. Continued on Next Page » 1 2 Next » Cite References Print American Psychiatric Association.
Diagnostic and statistical manual of mental disorders text revision. Washington, DC: Author. Ballew, L.
Intravenous diazepam for dissociative disorder: Memory lost and found. Psychosomatics, 44, A genetic analysis of individual differences in dissociative behaviors in childhood and adolescence.
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Psychological Trauma: Theory, Research, Practice, and Policy1 2 — Bryant, R. Autobiographical memories across personalities in Dissociative Identity Disorder: A case report.
Journal of Abnormal Psychology, 4 Buchele, B. Group psychotherapy for persons with multiple personality and dissociative disorders. Bulletin of the Menninger Clinic57 3 Cormier, J. Professional skepticism of Multiple Personality Disorder.
Professional Psychology: Research and Practice 29 2 Elzinga, B. Directed forgetting between, but not within, dissociative personality states. Journal of Abnormal Psychology, 2— Fujii, Y, dissociative disorder research paper.
Dissociative disorder research paper Personality Disorder in Japan. Psychiatry and Clinical Neurosciences, dissociative disorder research paper, 52 Gleaves, D. An examination of the diagnostic validity of dissociative identity disorder, dissociative disorder research paper. Clinical Psychological Review, 21 4 International Society for the Study of Dissociation. Guidelines for treating Dissociative Identity Disorder in adults.
Kaplan, B. Korol, S. Familial and Social Support as Protective Factors Against the Development of Dissociative Identity Disorder [Abstract]. Lewis-Hall, F. Psychiatric illnesses in women: Emerging treatments and research. Washington, DC: American Psychiatric Publishing. Maldonado, J.
‘Many Sides Of Jane’ Mother Sheds Light On Dissociative Identity Disorder - TODAY
, time: 6:43From Split to Psycho: why cinema fails dissociative identity disorder | Split | The Guardian
This paper reviews clinical, phenomenological, and epidemiological data regarding diagnosis in general, and illustrates possible treatment interventions for dissociative identity disorder, with a focus on psychotherapy interventions and a review of current psychopharmacology recommendations as part of a comprehensive multidisciplinary treatment A naturalistic study of Dissociative Identity Disorder and Dissociative Disorder NotOtherwise Specified patients treated by community blogger.comlogical Trauma: Theory, Research, Practice, and Policy, 1(2)– Bryant, R. (). Autobiographical memories across personalities in Dissociative Identity Disorder: A case report Treatment of Dissociative Identity Disorder DID is a treatable disorder once it is properly diagnosed. Clinicians who understand DID symptoms can diagnose DID in the clinical interview. There are also paper and pencil tests that can help clinicians diagnose DID and other dissociative disorders
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