An Exploration of Young Adults' Progress in Treatment for Dissociative Disorder

Myrick, Amie C.; Brand, Bethany L.; McNary, Scot; Classen, Catherine; Lanius, Ruth A.; Loewenstein, Richard J.; Pain, Clare; Putnam, Frank W.

doi:10.1080/15299732.2012.694841

Cited by 25 publications

(16 citation statements)

References 47 publications

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“…Indeed, the clinical utility of targeting dissociation has already been demonstrated by Myrick et al (2012), who found that in a naturalistic study, "self-destructive behaviour" reduced following treatment for dissociative disorders in a sample of 18 to 30 year olds. An expansion of this research into the adolescent age range-with the specific objective of reducing ADSH-would be useful to clinicians working with these presentations.…”

Section: Discussionmentioning

confidence: 98%

What is the relationship between dissociation and self‐harming behaviour in adolescents?

Černis¹,

Chan

Cooper³

2019

Clin Psychology and Psychoth

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Deliberate self‐harm in adolescents is an increasing clinical problem, but there is a limited understanding of the mechanisms causing or maintaining this behaviour. One proposed mechanism is that of dissociation. However, the role this mechanism may play is unclear: although some suggest that adolescents engage in self‐harm to end the aversive experience of dissociation, others propose that self‐harm is used to purposefully trigger a dissociative state to avoid emotional pain. This systematic review is the first to evaluate the available evidence regarding the relationship between dissociation and deliberate self‐harm in adolescents (aged 18 or younger). Nineteen relevant studies were identified. These studies were limited by cross‐sectional design and poor methods of measurement, but some important conclusions could be drawn. The majority of studies found a positive correlation between the severity of dissociation and the severity and frequency of deliberate self‐harm in adolescents, and a small number of results suggest that dissociation mediates the relationship between childhood trauma and adolescent self‐harm.

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Section: Discussionmentioning

confidence: 98%

What is the relationship between dissociation and self‐harming behaviour in adolescents?

Černis¹,

Chan

Cooper³

2019

Clin Psychology and Psychoth

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“…Because these participants demonstrated improvements in dissociative, posttraumatic, and depressive symptoms, decreased rates of hospitalization and suicidality, and increased adaptive functioning over the course of the study (e.g. Brand & Loewenstein, 2014; Brand et al, 2013; Brand & Stadnik, 2013; Myrick et al, 2012), we hypothesized that inpatient and outpatient treatment estimated costs would decrease over time. Furthermore, we expected that patients in the earlier stages of treatment, who struggle with safety issues such as self-injurious behaviour and suicidality (e.g.…”

Section: Highlightsmentioning

confidence: 99%

Treatment of dissociative disorders and reported changes in inpatient and outpatient cost estimates

Myrick

Webermann

Langeland

et al. 2017

European Journal of Psychotraumatology

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Background: Interpersonal trauma and trauma-related disorders cost society billions of dollars each year. Because of chronic and severe trauma histories, dissociative disorder (DD) patients spend many years in the mental health system, yet there is limited knowledge about the economic burden associated with DDs. Objective: The current study sought to determine how receiving specialized treatment would relate to estimated costs of inpatient and outpatient mental health services. Method: Patients’ and individual therapists’ reports of inpatient hospitalization days and outpatient treatment sessions were converted into US dollars. DD patients and their clinicians reported on use of inpatient and outpatient services four times over 30 months as part of a larger, naturalistic, international DD treatment study. The baseline sample included 292 clinicians and 280 patients; at the 30-month follow-up, 135 clinicians and 111 patients. Missing data were replaced in analyses to maintain adequate statistical power. The substantial attrition rate (>50%) should be considered in interpreting findings. Results: Longitudinal and cross-sectional analyses of cost estimates based on patient reported inpatient hospitalization significantly decreased over time. Longitudinal cost estimates based on clinician-reported outpatient services also significantly decreased over time. Cross-sectional cost estimates based on patient and clinician reported inpatient hospitalization were significantly lower for patients in later stages of treatment compared to those struggling with safety and stabilization. Cross-sectional cost estimates based on clinician-reported outpatient services were significantly lower for patients in later stages of treatment compared to those in early stages. Conclusions: This pattern of longitudinal and cross-sectional reductions in inpatient and outpatient costs, as reported by both patients and therapists, suggests that DD treatment may be associated with reduced inpatient and outpatient costs over time. Although these preliminary results show decreased mental health care utilization and associated estimated costs, it is not clear whether it was treatment that caused these important changes.

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“…Delay in recognition and adequate treatment of DID likely prolongs the suffering and disability of DID patients. Younger DID patients appear to respond more rapidly to treatment than do older adults, 167 which suggests that years of misdirected treatment exact a high personal cost from patients. 166 Needless to say, if clinicians do not recognize the disorder, they cannot provide treatment consistent with expert guidelines for DID.…”

Section: The Cost Of Myths and Ignorance About Didmentioning

confidence: 99%

Separating Fact from Fiction: An Empirical Examination of Six Myths About Dissociative Identity Disorder

Brand

Şar

Stavropoulos

et al. 2016

Harv Rev Psychiatry

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112

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Dissociative identity disorder (DID) is a complex, posttraumatic, developmental disorder for which we now, after four decades of research, have an authoritative research base, but a number of misconceptualizations and myths about the disorder remain, compromising both patient care and research. This article examines the empirical literature pertaining to recurrently expressed beliefs regarding DID: (1) belief that DID is a fad, (2) belief that DID is primarily diagnosed in North America by DID experts who overdiagnose the disorder, (3) belief that DID is rare, (4) belief that DID is an iatrogenic, rather than trauma-based, disorder, (5) belief that DID is the same entity as borderline personality disorder, and (6) belief that DID treatment is harmful to patients. The absence of research to substantiate these beliefs, as well as the existence of a body of research that refutes them, confirms their mythical status. Clinicians who accept these myths as facts are unlikely to carefully assess for dissociation. Accurate diagnoses are critical for appropriate treatment planning. If DID is not targeted in treatment, it does not appear to resolve. The myths we have highlighted may also impede research about DID. The cost of ignorance about DID is high not only for individual patients but for the whole support system in which they reside. Empirically derived knowledge about DID has replaced outdated myths. Vigorous dissemination of the knowledge base about this complex disorder is warranted.

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An Exploration of Young Adults' Progress in Treatment for Dissociative Disorder

Cited by 25 publications

References 47 publications

What is the relationship between dissociation and self‐harming behaviour in adolescents?

What is the relationship between dissociation and self‐harming behaviour in adolescents?

Treatment of dissociative disorders and reported changes in inpatient and outpatient cost estimates

Separating Fact from Fiction: An Empirical Examination of Six Myths About Dissociative Identity Disorder

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