Exam 2 - DID (Dissociative Identity Disorder)

Question 1

Dissociative Disorders

Answer 1

1. Dissociative Amnesia
2. Dissociative Fugue
3. Dissociative Identity Disorder (aka Multiple Personality Disorder)

Question 2

Dissociative Disorders

Answer 2

Dissociative Amnesia – sudden gaps in memory

Dissociative Fugue sudden extensive memory loss

Dissociative Identity Disorder having multiple personalities

Question 3

Dissociative Identity Disorder (DID)

Definition + Disclaimer

Answer 3

used to be called: Multiple Personality Disorder

Definition: “Disruptions of identity characterized by 2 or more distinct personality states (alters)”

Disclaimer:

• Controversial
• Research is limited
• Info comes from select peopleD

Question 4

Dissociative Identity Disorder (DID)

DSM-5 Diagnostic Criteria

Answer 4

1. Disruptions of identity characterized by 2 or more distinct personality states (alters):
2. Gaps in memory of events or important personal information that is beyond ordinary forgetting

Question 5

DID Terminology

(Host, Alters, Switch, System)

Answer 5

Host ⇒ the main person (the identity that keeps other identities together)

Alters ⇒ the different Identities/ States

Switch ⇒ the transition from one personality to the other

System ⇒ collection of alters

Question 5

DID - Prevalence

Answer 5

DID Prevalence: No good data (we don’t know)

Question 6

DID - Diagnostic Age

Answer 6

• Rarely diagnosed until adulthood
• Most receive mental health treatment for ~7 years before diagnosis

Question 7

DID - Alters

Answer 7

• Most people have initially 2-4 alters identified when diagnosed
  
  • Average number of identities after diagnosis is ~10-15 different Alters

Question 8

DID - Comorbidity Rates

Answer 8

DID = High Comorbidity Rates

Comorbid with: PTST, Depression, Substance Abuse Disorders

Question 9

DID Etiology (causes)

Answer 9

Cognitive Theories: (limited research)

1. Trauma - Experiencing severe _early childhood trauma _
2. Socio-cognitive Model - DID is not naturally occurring but is caused by suggestion, reinforcement in therapy or society, and role-play.

Neurobiological Causes: super limited research

• Hippocampal + Amygdala volume differences
• Brain activation patterns?

Question 10

DID Etiology: Socio-Cognitive Model

Answer 10

Therapists Role in Development:

• DID could be caused or enhanced by post-trauma treatment.
  
  • Suggestive therapy techniques might promote symptoms in vulnerable people

Media:

• Pre Sybil = 79 DID cases → Post Sybil = thousands…
• TikTok + YouTube → increased interest and diagnoses (self-diagnosis increase)

Question 11

DID Etiology: Brain

Answer 11

Hippocampal + Amygdala volume differences

• PTSD has very similar Brain changes…
• DID is highly comorbid with PTSD
  
  • (hard to know if DID is just related to the PTSD …?)
• Brain activation patterns?
  
  • super limited research
  • most reliable info: Prefrontal
    Dysfunction

Question 12

DID Treatment - Psychodynamic Approach

Answer 12

Psychodynamic Approach:

• Believes DID comes from trying to block traumatic events from consciousness (repress)
• Treatment Goal: Overcome Repression

Phase approach:
1. Stabilize / gain trust (could take years)
2. Confront and process traumatic memories and emotions
3. Manage daily living – less reliance on dissociation

• Hypnosis = can worsen symptoms*

Overall: No well-validated treatments available