Dissociative Identity Disorder (cont.)
What happens if dissociative identity disorder is not treated?
As with other mental-health conditions, the prognosis for people with DID
becomes much less optimistic if not appropriately treated. Individuals with a
history of being sexually abused, including those who go on to develop
dissociative identity disorder, are vulnerable to abusing alcohol as a negative
way of coping with their victimization. People with DID are also at risk for
attempting suicide more than once. Violent behavior has a high level of association with dissociation
as well. Other debilitating outcomes of DID, like that of
other severe chronic mental illnesses, include inability to obtain and maintain
employment, poor relationships with others, and therefore overall lower
productivity and quality of life.
- Dissociative identity disorder (DID), formerly called multiple personality
disorder, is an illness that is characterized by the presence of at least two
clear personality states, which may have different reactions, emotions, and body
functioning.
- How often DID occurs remains difficult to know due to disagreement among
professionals about the diagnosis itself, its symptoms, and how to best assess
the illness.
- DID is diagnosed nine times more often in females than in males.
- A history of severe abuse is thought to be associated with DID.
- There remains controversy about DID, in that some mental-health practitioners
do not believe it really exists.
- DID has been portrayed in the media in productions like The Three Faces of
Eve and Sybil.
- Signs and symptoms of DID include memory lapses, blackouts, being often
accused of lying, finding apparently strange items among one's possessions,
feeling unreal, and feeling like more than one person.
- As there is no specific diagnostic test for DID, mental-health professionals
perform a mental-health interview, ruling out other mental disorders, and
referring the client for medical evaluation to rule out a physical cause for
symptoms.
- Individuals with DID often also suffer from other mental illnesses, including
posttraumatic stress disorder, borderline and other personality disorders, and
conversion disorder.
- People who may benefit either emotionally or legally from having DID
sometimes pretend to have it, as with those who molest children or in cases of
Munchausen's syndrome.
- Some researchers are of the opinion that sex offenders who truly suffer from
DID are best identified using a structured interview.
- Psychotherapy is the mainstay of treatment of DID and usually involves helping
individuals with DID improve their relationship with others and to experience
feelings they are not comfortable with having.
- Hypnosis is sometimes used to help people with DID learn more about their
personality states in the hope of their gaining better control of those states.
- Although medications can be helpful in managing emotional symptoms that
sometimes occur with DID, caution is exercised when it is prescribed in order to
avoid making the individual feel retraumatized by feeling controlled.
- People with DID may have trouble keeping a job and maintaining relationships
and are at risk for engaging in drug and alcohol abuse as well as hurting
themselves and others.
References:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition, Text Revision (DSM-IV-TR); 2000, Washington, D.C.
Applegate, M. Multiphasic short-term therapy for dissociative identity disorder.
Journal of the American Psychiatric Nurses Association; 1997, 3(1): 1-9.
Becker-Blease, K., Freyd, J. Dissociation and memory for perpetration among
convicted sex offenders. Journal of Trauma and Dissociation; 2007, 8(2): 69-80.
Bernstein, Carlson E.M., Putnam, F.W. Development, reliability and validity of a
dissociation scale. Journal of Nervous and Mental Disease 1986; 174: 727-735.
Brown, R.J., Schrag, A., Trimble, M.R. Dissociation, childhood interpersonal trauma and
family functioning in patients with somatization disorder. American Journal of
Psychiatry; May 2005, 162: 899-905.
Carrion, V.G., Steiner, H. Trauma and dissociation in delinquent adolescents. Journal of the American Academy of Child and Adolescent Psychiatry; March 2000,
39(3): 353-359.
DeBattista, C., Solvason, H.B., Spiegel, D. ECT in dissociative identity disorder and comorbid depression.
Journal of Electroconvulsive Therapy; December 1998, 14(4):
275-279.
Dell, P.F. Axis II pathology in outpatients with dissociative identity disorder.
The Journal of Nervous and Mental Disease; June 1998, 186(6): 352-356.
Escobar, J. Transcultural aspects of dissociative and somatoform disorders. Psychiatric Times; April 15, 2004, 21(5).
Fine, C.G. Treatment stabilization and crisis prevention. Pacing the therapy of
the multiple personality disorder patient. Psychiatric Clinics of North America;
September 1991, 14(3): 661-675.
Foote, B., Smolin, Y., Neft, D., Lipschitz, D. Dissociative disorders and suicidality
in psychiatric outpatients. The Journal of Nervous and Mental Disease; January
2008, 196(1): 29-36.
Friedrich, W.N., Gerber, P.N., Koplin, B., Davis, M., Giese, J., Mykelbust, C., Franckowiak, D.
Multimodal assessment of dissociation in adolescents: Inpatients and juvenile
sex offenders. Sexual Abuse: A Journal of Research and Treatment; 2001, 13(3):
167-177.
Griffin, M.G., Resick, P.A., Mechanic, M.B. Objective assessment of peritraumatic
dissociation: psychophysiological indicators. American Journal of Psychiatry;
1997, 154: 1081-1088.
Klanecky, A.K., Harrington, J., McChargue, D.E. Child sexual abuse, dissociation and
alcohol: implications of chemical dissociation via blackouts among college
women. American Journal of Drug and Alcohol Abuse; 2008, 34(3): 277-284.
Lewis, D.O., Yeager, C.A., Swica, Y., Pincus, J.H., Lewis, M. Objective documentation of
child abuse and dissociation in 12 murderers with dissociative identity
disorder. American Journal of Psychiatry; June 1999, 156(6): 976.
McMinn, M.R., Wade, N.G. Beliefs about the prevalence of dissociative identity
disorder, sexual abuse, and ritual abuse among religious and nonreligious
therapists. Professional Psychology: Research and Practice; June 1995, 26(3):
257-261.
Moskowitz, A. Dissociation and violence: a review of the literature. Trauma,
Violence and Abuse; 2004, 5(1): 21-46.
Piper, A., Merskey, H. The persistence of folly: a critical examination of
dissociative identity disorder: Part I. The excesses of an improbable concept.
Canadian Journal of Psychiatry; September 2004, 49(9): 592-600.
Ramsland, K., Kuter, R. Multiple personalities: crime and defense. Turner
Broadcasting System; 2008.
Ross, C.A., Keyes, B.B., Yan, H., Wang, Z., Zou, Z., Xu, Y., Chen, J., Zhang, H., Xiao, Z. A
cross-cultural test of the trauma model of dissociation. Journal of Trauma
Dissociation; 2008, 9(1): 35-49.
Sar, V., Akyuz, G., Kundakc, T., Kazaltan, E., Dogan, O. Childhood trauma, dissociation
and psychiatric comorbidity in patients with conversion disorder. American
Journal of Psychiatry; December 2004, 161: 2271-2276.
Sar, V., Kundakci, T., Kiziltan, E., Yargic, I., Tutkun, H., Bakim, B., Bozkurt, O., Ozpulat,
T., Keser, V., Ozdemir, O. The axis I dissociative disorder comorbidity of
borderline personality disorder among psychiatric outpatients. Journal of Trauma
and Dissociation; 2003, 4(1): 119-136.
Simone Reinders, A.A.T., Nijenhuis, E.R.S., Quaka, J., Korfa, J., Haaksmab, J., Paans, A.M.J.,
Willemsen, A.T.M., den Boer, J.A. Psychobiological characteristics of dissociative
identity disorder: a symptom provocation study. Biological Psychiatry; October
2006, 60(7): 730-740.
Spiegel, D. Recognizing traumatic dissociation. American Journal of Psychiatry;
April 2006, 163: 566-568.
Spitzer, C., Klauer, T., Grabe, H.J., Lucht, M., Stieglitz, R.D., Schneider, W., Freyberger,
H.J. Gender differences in dissociation: a dimensional approach. Psychopathology;
2003, 36(2).
Welburn, K.R., Fraser, G.A., Jordan, S.A., Cameron, C., Webb, L.M., Raine, D. Discriminating
dissociative identity disorder from schizophrenia and feigned dissociation on
psychological tests and structured interview. Journal of Trauma and
Dissociation; 2003, 4(2): 109-130.
Last Editorial Review: 6/17/2009
- Psychotherapy - Mental Health: Psychotherapy To Treat Depressionin teens and adults
- Anxiety - Read about anxiety (generalized anxiety disorder, GAD) causes, physical symptoms and signs, medications and treatment. Learn about symptoms (worry, fear) and other types of anxiety disorders.
- Electroconvulsive Therapy (ECT) -
Latest Medical News
Mental Health RSS