DID

Question 1

2 symptoms of DID

Answer 1

Two or more distinct personality states

Gaps in the recall of everyday events and personal information that are inconsistent with forgetting

Question 11

Classification timeline of DID

Answer 11

DID first included in DSM-III as ‘multiple personality disorder’:
Believed at first to be extremely rare
In 1987 the DSM stated that recent reports showed it to be more common that originally thought

Question 12

The rise in cases of DID

Answer 12

Cases rapidly rose in the 80s possibly due to a greater awareness of the disorder but potentially also due to over diagnosis in those who were highly suggestible

Question 13

Support of the fantasy model of DID - Patritia Burgus treated by Dr Braun

Answer 13

20 personalities before treatment
Following therapy and medication she recalled an upbringing in a satanic cult and her parents cannibalism
By end of therapy she had 300 personalities

Question 14

Loss of credibility for DID

Answer 14

Many patients were put on drugs that are now known to cause restlessness, confusion and panic which may have been the cause of the symptoms
Shirley Mason confessed that she had been lying and did not have multiple personalities, through drugs, coaching and leading questions
Many cases may have been due to the patients having a good mind for fantasy
Iatrogenic - caused by a therapists leading questions

Question 15

Support for fantasy model - implanting a false episodic memory

Answer 15

A 14-year-old boy named Chris was supplied with descriptions of 3 true events that supposedly happened in his childhood and one fake event being lost in a shopping mall.
Instructed to write about all four events every day for 5 days. Chris remembered more and more about getting lost.
A few weeks later, Chris was reinterviewed. For the false shopping mall memory, he provided rich details about the toy store where he got lost and his thoughts at the time
Chris was told that one of the memories was false and to identify which one it was He selected one of the real memories.

They repeated the ‘Lost in Shopping Mall’ technique with 24 participants.About a third of participants thought they remembered the false memory

Question 16

Trauma model of DID

Answer 16

Freudian defence mechanism to escape traumatic experiences and stress

Allen et al - higher mean score of childhood trauma associated with higher probability of dissociative tendencies in adulthood

Question 17

Fantasy model of DID

Answer 17

fuelled by a need to escape adverse childhood experiences and childhood trauma

Question 18

Are people with DID more suggestible?

Answer 18

People with DID were not more vulnerable to the ‘Leading Questions Test’, in fact when in their TIS they were inclined to be the least suggestible group - goes against fantasy model

Ps were read a passage and later interviewed twice with leading questions e.g. “Did the woman’s glasses break in the struggle?” when glasses weren’t mentioned in the passage.

Question 19

Working memory in people with DID - N-back task

Answer 19

1-back - Press a button if 2 consecutive numbers are the same
2-back - press button if number 2 previous was the same

People with genuine DID had normal scores in resting state, bad scores in trauma state, suggests DID is the cause of poor memory

Question 20

Diagnosing DID using scans

Answer 20

pattern recognition technology used to identify people with DID to an accuracy level of around 74%

found widespread grey and white matter and patterns of abnormal brain morphology in individuals with DID as compared with healthy controls

Question 21

Treatment of DID

Answer 21

establishing a feeling of safety, and building an alliance between the patient and clinician.

cognitive-behavioural therapy (CBT) to change distorted cognitions.

direct trauma-based work, e.g. recall of earlier traumatic events. trauma-related cognitions may be challenged and reconsidered.

Question 22

Is treatment of DID effective?

Answer 22

Treatment and long term therapy can reduce symptoms of DID but is not a cure

Decline in identity alteration and amnesia scores over 30 months of treatment

Question 23

Neurological differences in control vs DID brains

Answer 23

Less blood flow in some frontal regions
Increases in other regions