Dissociative Identity Disorder Flashcards
What is the prevalence of DID?
1-3% (not rare!)
What is the prevalence of DID?
1-3% (not rare!)
What is DID?
A disorder characterised by:
▪️Two or more distinct personality states
▪️Memory gaps beyond ordinary forgetfulness
Personality states have their own pattern of…
▪️Perception
▪️Reaction
▪️Thinking (about the envrionment and self)
Personality states coincide with…
▪️Fluctuating states of consciousness
▪️Changing access to autobiographical memory
What are the two main types of personality state?
▪️Trauma-related identity
▪️Neutral identity
What is the TIS/TPS?
▪️The emotional part of the personality
▪️Fixed in past trauma
▪️Has access and emotionally responds to traumatic memories (fixated on them)
What is the NIS/NPS?
▪️The apparently normal part of the personality
▪️Functions detached from past trauma
▪️Limited or no access to traumatic memories (avoidant and amnestic of them and TIS)
Which type of personality state usually exhibits child-like behaviours and subjective sense of age?
Trauma-related Identity State
How does consciousness in the TIS compared to the NIS?
Both retracted and at a lower level than healthy minds but the TIS is more so
How does personification and presentification in TIS and NIS?
▪️Major lack of in TIS
▪️Lack of in NIS of traumatic past and associated TIS - protective mechanism?
What are “self-states”?
The current term for the fluctuating states of consciousness that change with time in DID
What is the TSDP?
Theory of Structural Dissociation of Personality
What are the two main prototypical dissociative parts of the personality according to the TSDP?
▪️The emotional part (EP)
▪️The apparently normal part (ANP)
What are the three dimensions of Trauma-related Dissociation?
- Primary Dissociation (e.g. PTSD, simple sensorimotor dissociative disorder)
- Secondary Dissociation (e.g. complex PTSD, disorders of extreme stress)
- Tertiary Dissociation (e.g. DID)
According to the DID theoretical framework, what dimension is DID?
Tertiary Dissociation
What is Primary Structural Dissociation?
▪️One ANP/NIS/NPS - for functioning of daily life and survival of species
▪️One EP/TIS/TPS - defense from major threat, survival of individual
▪️Overlap = shared access to implicit and explicit memory
What is Secondary Structural Dissociation?
▪️One ANP/NIS/NPS
▪️More than one EP/TIS/TPS - e.g. freeze, fight, and submit?
What is Tertiary Structural Dissociation?
▪️More than one ANP/NIS/NPS (e.g. care taking, job, energy management)
▪️More than one EP/TIS/TPS
(DID)
What is the main form of treatment currently available for DID?
Psychotherapeutic intervention
What psychopharmacological treatments are currently available for DID?
▪️Nothing for reducing symptoms
▪️Only for treating comorbid symptoms such as depression, anxiety, sleep disturbance etc
What is the most widely used psychotherapeutic intervention for DID?
Phase-oriented treatment of DID
How long does phase-oriented treatment of DID take?
Many years
What is the first phase of phase-oriented treatment of DID?
Establishing safety, stabilisation, and symptom reduction
What is the second phase of phase-oriented treatment of DID?
Confronting, working through, and Integrating traumatic memories
What is the third phase of phase-oriented treatment of DID?
Identity reintegration and rehabilitation
What was found in the first ever functional brain imaging study of an individual with DID?
Hyperfusion in the right temporal lobe
(with PET)
What brain area has been identified as a possible neurostructural biomarkers for DID?
Temporal lobes
Are NIS and TIS psychobiologically different?
Yes!
What are the two main models of dissociation?
▪️The trauma model
▪️The fantasy model
What is the trauma-related model of DID?
The “Trauma Model” :
▪️DID = severe form of PTSD originating from severe, chronic traumatisation
▪️Usually in childhood
▪️Includes the TSDP
What is the non-trauma related model of DID?
The “Fantasy Model” :
▪️Originates from suggestion (media or therapist) or role-playing
▪️Facilitated by high level of suggestibility and/or fantasy proneness
▪️Includes socio-cognitive model, and the iatrogenic model
