Dissociative Identity Disorder

Question 1

DSM -5 -> Dissociative Disorders

Answer 1

• disruption in the normal integration of consciousness, identity, memory, perception
• criteria A disruption of identity = 2 + distinct personality states
• Criteria B = gaps in recall of everyday events , personal info

Question 2

sybil - social Phenomenon

Answer 2

-16 personalities
- most alters had limited/ no knowledge of each other

Question 3

Rise of DID

Answer 3

• First included in DSM 3 as Multiple personality disorder + Seen as extremely rare
• Braun, kluft + Putman join DSM committee + discovered over 800 new cases of DID
• Began to rise rapidly till 1986

Question 4

Fall of DID

Answer 4

-Main journal for DID ceased publication
- DSM -4 moved DID from No 1 to No 4
-sharp rise in cases has many iterpretations
- some believe its due to greater awareness = identification of previously undiagnosed cases
-others believe there was overdiagnosis

Question 5

sybil exposed

Answer 5

• she was coached + encouraged to produce multiple personalities during therapy
• Frequently doubled prescription

Question 6

Fantasy of DID

Answer 6

-DID is a fantasy/suggestbity phenomenon
-is culture-bound + iatrrogenic (caused by therapists leading questions)
- Giesbrecht et aI enhancing propensity towards pseudo-memories mediated by heightened levels of interrogative suggestibility + fantasy proneness

Question 7

sociocognitive/ fantasy Model

Answer 7

-Dalenberg et al-> fantasy proneness +suggestibility are intrinsic characteristics of some indivs which with inappropriate therapy = false memories + multiple personalities
-DID is false
- inappropriate therapy = leading questions, amplification over time

Question 8

suggestibility As intrinsic feature - implantation of false memories

Answer 8

-Loftus + Pickrell -> Chris supplied with 3 true events + fake event of being lost in a shopping mall
- wrote about all 4 events
- begun to remember more + more about the false memory
- provided rich details about where he got lost + what he thought
- when told to select false memory he selected a real one
-repeated + 1/3 thought they remembered the false memory

Question 9

suggestibility + amplification of disorder over time

Answer 9

-spanos-> early 20th century rarely displayed more than 2/3 identities
- modern patients displayed 15 - 100 aLters
-suggests DID alter pattern of recall as understanding expectations + diagnosing procedures create rather than discover the disorder

Question 10

Trauma Model

Answer 10

-real adverse traumatic experience = defence Mechanisms = True DID or DTSD
- Defence Mechanisms dissociation fantasy proneness
-extreme dissoc fantasy pronness = DID , less extreme=PTSD
mediators increasing likelihood of dissociation = stress , low social support, young age, env + genetics

Question 11

Dissociation defence Mechanism

Answer 11

-Dalenberg + carison -> avoidance techniques (derealisation depersonalisation) reflect effort to reduce distress through distancing
-relief reinforces efforts = increase in frequency
- Allen et al -> higher mean score childhood trauma associated with higher probability of dissociative tendencies in adulthood

Question 12

fantasy proneness defence mechanism

Answer 12

-Merckleback et al- fuelled by need to escape adverse childhood experiences + function as a defensive reaction
Van Herten et al-> PTSD + DID ppts showed much higher levels of dissociation + fantasy proneness than controls

Question 13

suggestibility + leading questions study

Answer 13

-vassia et al-> DID ppts NIS = neutral identity state
-DID ppts Tis = trauma
-DID -S = ppts stimulate DID
- PTSD
- controls
- Told a story then interviewed with leading q’s
- found DID weren’t more vulnerable to leading q’s
-Tis least suggestible

Question 14

Neuropsychology of DID

Answer 14

-Sar et al >
- baseline cerebral blood flow measurements were lower in DID in orbitofrontal regions

Question 15

fantasy proneness contrasting evidence

Answer 15

• compared DID ppts with high-fantaSY prone non-DID controls
  -Reinders
  -DID showed larger response to trauma identity state US neutral compared to control
• shows differences aren’t due to fantasy proneness

Question 16

Criteria B- working memory N back test

Answer 16

• Vissia et al >
  -DID ppts performed poorly when in TIS
• controls + perf DID-s performed similarly whether in NIS or TIS

Question 17

Pattern recognition techniques

Answer 17

• Reinders et al->
• able to identify DID to an accuracy of 74 %
• found widespread grey + white matter spatially dependent patterns of abnormal morphology in indivs with DID compared to controls

Question 18

Treatment survey

Answer 18

• Brand et al surveyed 36 experts
• 4 stage process:
  1 ) feeling safe + building AlIiance
  2) CBT
  3) Direct trauma based work
  4) Increasing daily functioning skills + emotional regulation

Question 19

Treatment outcome

Answer 19

• Brand + Loewenstein
• somewhat reduced symptoms of DID following long term therapy
• Although theres improvement ,not cured

Question 20

Etiology of depersonalisation/ derealisation disorder

Answer 20

• Guralnick et al-> PET study of indivs with disorder showed atypical activity in regions integrating info from sensory cortex + bodily cues
  -Renaud -> brief symptoms induced in healthy indivs by providing mismatched sensory experiences by wearing goggles that distort visual info

Question 21

DID symptoms can be role played

Answer 21

• when instructed to generate a second personality, many are able to do this
• indicates people can role-play DID

Question 22

Therapists reinforcing DiD
symptoms

Answer 22

-powell + Gee-> therapists hypnosis to urge clients to unbury unremembered experiences
- most patients unaware of having alternative personality states until after treatment begins
- As treatment begins report more personalities

Question 23

Alternate personalities share memories

Answer 23

-defining feature of DID = inability to recall info experienced by 1 personality when in another
- Postma et al-> explicit memory tests
- Taught initial word list then asked to complete implicit test
-21 ppts claim no memory of 1 St session however performed similar to those without DID
-shows memories transferred through personalities

Question 24

Psychoeducation treatment

Answer 24

• Myrick et Al
  -help understand dissociation + identify triggers in day-to-day life

Question 25

Psychodynamic treatment

Answer 25

-MacGreggor-> overcome repressions
- However some use hypnosis which encourages them to go back into early childhood trauma memories = age regression
- Hope it will help them realise childhood threats no longer present in adult life
- However Lilenfeld says it can exacerbate symptoms