1. Multiple Personality Disorder

2. Multiple personality disorder is more formally known as dissociative identity disorder.

3. Traits Alterations or detachments in consciousness or identity. May include derealization –feeling detached from one’s surroundings. May include depersonalization –feeling detached from oneself

4. Dissociation (continued) Most likely to happen after an extremely stressful event, when very tired, or when under significant physical or mental pressure. Ex: –students who stay up all night cramming for exams –journalists who witnessed execution

5. Other Dissociative Disorders Dissociative Amnesia –One or more episodes of inability to recall important personal information, usually of a traumatic nature, that is too extensive to be explained by ordinary forgetfulness –Can be Generalized Localized (selective)

6. Other Dissociative Disorders (continued) Dissociative Fugue –DSM-IV-TR criteria include Sudden, unexpected travel away from home or one’s place of work, with inability to recall one’s past Confusion about identity or assumption of new identity –person leaves home and later finds himself. – in a new place, unable to remember how or why he got there. –fugue state usually ends abruptly, person returns home, and is able to recall most (if not all) of what happened.

7. Dissociative Identity Disorder (aka MPD) Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. Not due to direct effects of a substance or general medical condition.

8. Clinical Description In most cases, the “original” personality possesses little or no direct awareness of the alternate personalities. –may be aware of substantial periods of lost time “Alters” typically have some awareness of the original personality or each other. Transitions from one personality to another typically occur quite rapidly –within seconds to minutes.

9. Clinical Description (continued) Quite often, personalities are polar opposites. Number of personalities within a single individual can range from 2-100. –Average number is 15.

10. Clinical Description (continued) personalities have been reported to differ in… –Age –Gender –Race –Ethnicity –Psychological test results –Eyeglass prescriptions –Handedness –Allergies –IQ –Susceptibility to alcohol

11. Prevalence 3-6% of severely disturbed inpatients. 0.5--1% of general population. Ratio of females to males is 9:1. Note: data suggest prevalence is increasing.

12. Course Onset is almost always in childhood. –Often as young as 4 yrs of age On average, about 7 years pass between when the symptoms first appear and when the person is formally diagnosed. Disorder tends to last a lifetime in the absence of treatment. Different personalities may emerge in response to new life situations.

13. Causes Majority of patients with MPD (97%) report histories of significant early trauma. –Sexual or physical abuse Individual who is born with capacity to dissociate uses this to psychologically escape from the abuse. Child doesn’t receive adequate protection or support. Dissociated memories and emotional responses eventually develop into alters.

14. Treatment Long-term psychotherapy. Goal is to integrate personalities. Treatment involves –Identify cues that provoke memories of trauma and/or dissociation and neutralize them. –Re-expose patient to trauma (imaginally). –Work through terrible feelings and memories. –Often involves hypnosis to help patient access unconscious memories.

15. Treatment (continued) No controlled studies Clinical reports suggest approximately 20% achieve full integration of identities –May take years