A Review of Published Research on Adult Dissociative Identity Disorder

Abstract

The purpose of this study was to assess the scientific and etiological status of dissociative identity disorder (DID) by examining cases published from 2000 to 2010. In terms of scientific status, DID is a small but ongoing field of study. The review yielded 21 case studies and 80 empirical studies, presenting data on 1171 new cases of DID. A mean of 9 articles, each containing a mean of 17 new cases of DID, emerged each year. In terms of etiological status, many of the central criticisms of the disorder's validity remain unaddressed. Most cases of DID emerged from a small number of countries and clinicians. In addition, documented cases occurring outside treatment were almost nonexistent. Finally, people simulating DID in the laboratory were mostly indistinguishable from individuals with DID. Overall, DID is still a topic of study, but the research lacks the productivity and focus needed to resolve ongoing controversies surrounding the disorder.

Beyond the Impasse – Reflections on Dissociative Identity Disorder from a Freudian–Lacanian Perspective

“…Scanning the literature shows that often authors make caricatures of the views and arguments of the other party, thus polarizing the discussion into an infertile battle. Recently, a more nuanced appreciation of the different standpoints has been reached (e.g., Dalenberg et al, 2012; Boysen and VanBergen, 2013; Lynn et al, 2014) and both models seem to depict a more complex picture of the etiology of DID. However, as these publications indicate, the debate is far from settled.…”

“…In this respect, multiple identities are considered to be cultural role enactments or social constructions without a causal link with trauma (Spanos, 1994; Sarbin, 1995). The role of leading treatment models and therapist’ suggestion, together with media influences and broader socio-cultural expectations are proposed as central in the creation of DID (Lynn et al, 2012; Boysen and VanBergen, 2013). Such role-enactment is not considered as deception or faking, but as arising spontaneously with little or no conscious effort (Spanos, 1994; Lilienfeld et al, 1999; Boysen and VanBergen, 2013).…”

“…The main difference with the DSM-IV-TR (American Psychiatric Association, 2000) is the omission of the necessity for the diagnostician to observe the presence of different personality states him or herself (Spiegel et al, 2011). Across diagnostic systems, the most remarkable feature of DID is the existence of seemingly independent personalities with amnesia of the primary identity for the existence and behavior of (some) other identities (Putnam et al, 1986; Boysen and VanBergen, 2013). Given James’s apparent amnesia, and the observation that his behavior during dissociative states was radically uncharacteristic his usual functioning, he meets the DSM criteria for DID.…”

Ego, drives, and the dynamics of internal objects

“…DID manifests as disruptions in identity characterized by two or more “distinct personality states” (possibly experienced as “possession”) and is associated with recurring gaps in remembering of events including trauma (APA, 2013, p. 292). While DID finds inclusion in the DSM-5 there is nevertheless persistent controversy as to whether DID is in fact an authentic disorder (see, for instance, Piper and Merskey, 2004a, b; Boysen and VanBergen, 2013, 2014; for recent examples of the controversy surrounding fantasy and trauma models, see Dalenberg et al, 2012, 2014; Lynn et al, 2014). One major theoretical problem within this controversy concerns how best to conceptualize personality within DID, an issue that also impacts upon clinicians working with DID with respect to conceptualizing the personalities (“alters”) and then engaging with them in therapy: “Among the major issues that arise in the treatment of DID are the relationship of the alters to the personality that the therapist may experience as his or her patient, and the relationship of the therapist to the alters” (Kluft, 2000, p. 266).…”

Sociocognitive and Posttraumatic Models of Dissociation Are Not Opposed

“…In fact, several studies screening for DID, both before and during Boysen and VanBergen's (2013) data window (2000-2010, listed only cases diagnosed as such for the first time (e.g. Akyuz et al, 1999;Dorahy, Mills, Taggart, O'Kane, & Mulholland, 2006;Sar et al, 2003Sar et al, , 2006Tutkun et al, 1998), recruited from the general population (e.g.…”