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DID entails a failure to integrate certain aspects of memory, consciousness and identity. Patients experience frequent gaps in their memory for their personal history, past and present. Patients with DID report having severe physical and sexual abuse, especially during childhood. There is controversy around these reports, because childhood memories may be exposed to distortion and some patients with DID are highly hypnotizable and vulnerable to suggestive influences. But, the reports of patients with DID are often validated by objective evidence. People that are responsible for acts of sexual and physical abuse may be prone to distorting or denying their behavior. (American Psychological Association, 2000)
DID is found in a variety of cultures around the world. It is diagnosed three to nine times more often in adult females than males. Females average 15 or more identities, males eight identities. The sharp rise in the reported cases of DID in the U.S. may be due the greater awareness of DID’s diagnosis, which has caused an increased identification of those that were previously undiagnosed. Others believe it has been overdiagnosed in those that are highly suggestible. (American Psychological Association, 2000)
This paper will delineate the etiological antecedents of Dissociative Identity Disorder (DID) and enumerate upon the scientific evidence proving the existence of DID. (I will use the term DID for MPD to avoid confusion, even when the original author cited may have used the original term MPD.) This paper will explain the diagnostic criteria of DID, its incidence rates and cross-cultural characteristics,[link widoczny dla zalogowanych], present arguments to counter the idea that suggestibility may be a factor in its misdiagnosis and delineate the data that shows a clear connection between traumatic wartime experiences and dissociation and trauma and DID. It will also consider the historical development of the debate surrounding DID, including its increased diagnosis around the turn of the last century, reasons for its decline in diagnosis in the mid part of the last century and reasons for its increased diagnosis toward the end of the 20th century. It will deliberate upon the claims made by several researchers that DID can be created in the laboratory as well as the critiques surrounding those claims. I will also discuss the neurobiological evidence proving the connection between DID and certain neurobiological indicators. Included will be a discussion of the modern theory of iatrogenic DID and a critique of this theory. A debate about the creation of DID as a social construction and critiques of this theory are presented as well. To conclude, I will present the argument that the research on DID showing it to be a valid psychiatric diagnosis which robustly meets all the necessary validity requirements.
Pezdek and Roe investigated some misinformation suggestibility studies and found that the misinformation suggestibility effect may not be easily generalizable to false memories caused by therapeutic suggestions. Pezdek and Grand in separate papers state that there are no independent cases of false memory. Pezdek and Roe found that strong
DID is defined in the DSM-IV-TR as the presence of two or more personality states or distinct identities that repeatedly take control of one’s behavior. The patient has an inability to recall personal information. The extent of this lack of recall is too great to be explained by normal forgetfulness. The disorder cannot be due to the direct physical effects of a general medical condition or substance. (American Psychological Association, 2000).
Physical evidence may include variations in physiological functions in different identity states, including differences in vision, levels of pain tolerance,[link widoczny dla zalogowanych], symptoms of asthma, the response of blood glucose to insulin and sensitivity to allergens. Other physical findings may include scars from physical abuse or self-inflicted injuries, headaches or migraines,[link widoczny dla zalogowanych], asthma and irritable bowel syndrome. (American Psychological Association, 2000)