Dissociative Identity Disorder (DID) Created by: Wilberth Reyes

Definition… Dissociative Identity Disorder: “A mental illness that involves the sufferer experiencing at least two clear identities or personality states, also called alters, each of which has a fairly consistent way of viewing and relating to the world.”

Definition cont… Main identity known as the host and the others are known as alters. Before the 80s, it was known as Multiple Personality Disorder.

Associated features… DID patients have personalities with different ways of reacting in terms of emotions, pulse, blood pressure and blood flow to the brain. The alters are usually different ages, races, have different levels of intelligence, and even opposite genders. Sufferers go through depersonalization, derealization, and identity disturbances.

Associated features cont… Original identity usually denies any awareness of the other identities. Also sometimes form amnesia for years, decades or even longer.

DSM-IV-TR… 4 diagnostic criteria: Traumatic stressor: exposed to a catastrophic event involving actual or threatened death or injury, or serious physical threat. During exposed trauma, the person’s emotional response is marked by intense fear, feelings of helplessness, or horror. In general, the stressors caused intentionally by human beings ( genocide, rape, torture, abuse, etc.) are experienced as more traumatic than accidents, natural disasters, or “acts of God”. Demonstration of two or more distinct identities in an individual. Each identity must have their own way of thinking, perceiving, relating to and interacting with the environment and their self.

DSM-IV-TR cont… Two identities that assume control of behavior, one at a time and repeatedly. Extended periods of forgetfulness lasting too long to be considered ordinary forgetfulness. Determination the above symptoms are not due to drug, alcohol, or other substances attributed to other general medical condition. Its also necessary to rule out fantasy play or imaginary friends when considering a diagnosis of DID in a child.

Etiology… Although not yet scientifically proven, DID usually occurs from severe trauma. Once trauma becomes extreme, DID becomes the result. Also believed to be caused by variation of Post- Traumatic Stress Disorder (PTSD). Some doctors believe it comes from family genes.

Etiology cont… Develops as reaction to childhood trauma. Most patients recall physical, sexual, and/or emotional abuse as children. Its been theorized children create identities to dissociate from torture, sexual abuse and/or neglection. This strategy displaces suffering on other identity or identities.

Prevalence… It occurs in women 9 times more than in men. 50% of patients have less than 11 identities. 3% of patients in psychiatric hospitals are diagnosed with DID. It usually occurs around age 6, then later on more identities are created.

Prevalence cont… Since 70s, reports of DID patients increased to the thousands. More people with DID in North America than rest of world. Some countries DID is believed to be fake (Britain, India and Japan).

Treatment… Individual psychotherapy Uncover and “map” patients alters Treat traumatic memories “fuse” alters Consolidate patient’s newly integrated personality Family therapy Group therapy

Treatment cont… Medication Tranquilizers and antidepressants Most keep medication to a minimum Patients may become psychologically dependent on drugs Hypnosis Not always necessary Recover repressed ideas/memories Control problematic behaviors Ex: self-mutilization or eating disorders “fuse” alters Patient’s personality integration process

Prognosis… No systematic studies of long term outcome currently exist. Some doctors believe prognosis for recovery excellent for children and good for adults. Treatment takes several years The earlier the patient is diagnosed and properly treated, the better the prognosis

Prognosis cont… Patients are bothered less by symptoms as they advance to middle ages Relief around 40s Stress and substance abuse Can cause relapse of symptoms at any time Prevention Intervention in abusive families Treat children as early as possible

References… Myers, D.G. (2010). Myer’s psychology for AP, New York, NY: Worth Publishers. Dryden-Edwards, R. (2010). Dissociative identity disorder. Retrieved from ticle.htm ticle.htm (2011). Dissociative identity disorder. Retrieved from disorder.html disorder.html

Discussion Question… Do you think DID occurs because of family genes or from trauma?