Dissociative Identity Disorder

Host

________- the identity that keeps other identities together.

Mechanism

________: Dissociation offers an opportunity to escape from the impact of trauma.

Alters

________- different identities or personalities.

Switch

quick transition from one personality to another

Prevalence

not well known, perhaps 1 to 2%

Treatment: Focus is on

reintegration of identities

Treatment: Identify and neutralize

cues/triggers that provoke memories of trauma/dissociation

Treatment: Patient may have

to relive and confront the early trauma

Treatment: Some achieve through

hypnosis

Causes: Typically linked to

a history of severe, chronic trauma, often abuse in childhood

Causes: Risk increases if

there is no social support after the trauma

Causes: Closely related to

PTSD, possibly an extreme subtype

Causes: Biological vulnerability possible but

not well understood; almost all risk is environmental

More common in

females

Onset is

almost always in childhood or adolescence

High comorbidity rates with

other psychological disorders

Typically follows

lifelong, chronic course

Some patients presenting with DID symptoms are

faking (possibly subconsciously)

Example: Patients more likely to “produce” a fake alter when

therapist suggests this possibility

Case studies reveal changes in

physiological and brain function when switching between alters

DSM-5 Criteria: A. Disruption of identity characterized by

two or more distinct personality states, which may be described in some cultures as an experience of possession.

DSM-5 Criteria: The disruption of marked discontinuity in sense of self and sense of agency, accompanied by

related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning.

DSM-5 Criteria: These signs and symptoms may be

observed by others or reported by the individual.

DSM-5 Criteria: B. Recurrent gaps in the

recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.

DSM-5 Criteria: C. The symptoms cause clinically significant

distress or impairment in social, occupational, or other important areas of functioning.

DSM-5 Criteria: D. The disturbance is not a normal part of

a broadly accepted cultural or religious practice. Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.

DSM-5 Criteria: E. The symptoms are not attributable to

the physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures).

Formerly known as

multiple personality disorder

Defining feature is

dissociation of personality

Adoption of

several new identities (as many as 100; may be just a few; average is 15)

Identities display

unique behaviors, voice, and postures