The Persistence of Folly: Critical Examination of Dissociative Identity Disorder. Part II. The Defence and Decline of Multiple Personality or Dissociative Identity Disorder

Piper, August; Merskey, Harold

doi:10.1177/070674370404901005

Cited by 61 publications

(35 citation statements)

References 49 publications

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“…This model accommodates the fact that more than 90% of the DID patients meet the criteria for PTSD (Rodewald et al, 2011). Conversely, the non-trauma-related model (Lilienfeld et al, 1999;Merckelbach and Muris, 2001;Piper and Merskey, 2004;Giesbrecht et al, 2008), which is also referred to as the sociocognitive (Spanos, 1996) or fantasy model (Dalenberg et al, 2012), assumes that DID is due to simulation, suggestive psychotherapy and/or sociocultural influences and is mediated by high fantasy proneness. Neurobiological research testing these models has been called for by proponents of both models (Brand, 2012;Paris, 2012) as it can help clarify the etiology and nature of DID, which will eventually help diagnoses and treatment of these patients.…”

Section: Introductionmentioning

confidence: 99%

Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder

Chalavi

Vissia

Giesen

et al. 2015

Psychiatry Research: Neuroimaging

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Neuroanatomical evidence on the relationship between posttraumatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16 patients with PTSD but without DID (PTSD-only), and 32 healthy controls (HC), and compared their whole-brain cortical and subcortical gray matter (GM) morphological measurements. Associations between GM measurements and severity of dissociative and depersonalization/derealization symptoms or lifetime traumatizing events were evaluated in the patient groups. DID-PTSD and PTSD-only patients, compared with HC, had similarly smaller cortical GM volumes of the whole brain and of frontal, temporal and insular cortices. DID-PTSD patients additionally showed smaller hippocampal and larger pallidum volumes relative to HC, and larger putamen and pallidum volumes relative to PTSD-only. Severity of lifetime traumatizing events and volume of the hippocampus were negatively correlated. Severity of dissociative and depersonalization/derealization symptoms correlated positively with volume of the putamen and pallidum, and negatively with volume of the inferior parietal cortex. Shared abnormal brain structures in DID-PTSD and PTSD-only, small hippocampal volume in DID-PTSD, more severe lifetime traumatizing events in DID-PTSD compared with PTSD-only, and negative correlations between lifetime traumatizing events and hippocampal volume suggest a trauma-related etiology for DID. Our results provide neurobiological evidence for the side-by-side nosological classification of PTSD and DID in the DSM-5.

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Section: Introductionmentioning

confidence: 99%

Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder

Chalavi

Vissia

Giesen

et al. 2015

Psychiatry Research: Neuroimaging

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show abstract

“…By contrast, other writers have argued, equally forcibly, that dissociative amnesia and dissociative identity disorder are not valid diagnostic entities at all [11,12] . For example, McNally [13] has described dissociative amnesia as a 'piece of psychiatric folklore devoid of convincing empirical support' (p. 275) and Piper and Merskey [14,15] have characterized dissociative identity disorder as 'the persistence of folly'. Similar controversy exists in the psychiatric community as a whole; surveys have shown a wide range of opinion about the scientifi c validity of both dissociative amnesia and dissociative identity disorder among psychiatrists in the United States [16] and Canada [17] .…”

mentioning

confidence: 99%

Tracking Scientific Interest in the Dissociative Disorders: A Study of Scientific Publication Output 1984–2003

Pope¹,

Barry²,

Bodkin³

et al. 2005

Psychother Psychosom

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Objective: We attempted to track scientific interest in dissociative amnesia and dissociative identity disorder by estimating the annual output of publications regarding these entities over the last 20 years. Methods: Using a standard medical index, PsycINFO, we counted the number of indexed publications involving dissociative amnesia and dissociative identity disorder listed for each year. We then compared these rates with those of well-established diagnoses such as anorexia nervosa, alcohol abuse, and schizophrenia. We also systematically reviewed all publications involving dissociative amnesia that appeared in 2003. Results: Annual publications involving dissociative amnesia and dissociative identity disorder rose from low levels in the 1980’s to a sharp peak in the mid 1990’s, followed by an equally sharp decline to only about one quarter of their peak levels by 2002 and 2003. In contrast, all of the 25 comparison diagnoses in our survey showed constant or steadily rising publication rates; none showed the ‘bubble’ pattern of the dissociative disorders. Of the 34 papers involving dissociative amnesia identified by PsycINFO for 2003, 10 (32%) appeared skeptical of the validity of dissociative amnesia and/or recovered-memory therapy. Despite a detailed search using multiple medical indices and search terms, we could find only 13 explicit cases of individuals with dissociative amnesia worldwide in the 2003 literature. Conclusions: Dissociative amnesia and dissociative identity disorderhave not generated consistent scientific interest over the years, but instead apparently enjoyed a brief period of fashion that now has waned. Overall, our observations suggest that these diagnostic entities presently do not command widespread scientific acceptance.

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“…• 'a person whose evidence is intended to be tendered before a court and who has relevant skill or knowledge achieved through research, experience or professional application within a specific field sufficient to entitle them to give evidence of their opinion and upon which the court may require independent, impartial assistance' -Crown Prosecution Service (2006 A doctor competent to testify to the medical examination carried out, but not to the theory of the scientific tests used -Gaudiuso v Walker (1989) Doctors with and without sufficient expertise regarding whether wounds were self-inflicted -R v Anderson [2000] An exceptional example is the area of multiple personality or dissociative identity disorder, in relation to which Piper & Merskey (2004) have cogently argued that it is impossible to make a diagnosis reliably, and so have suggested that the US and Canadian courts cannot responsibly accept testimony in favour of dissociative identity disorder. Somewhat similarly, in R v Gilfoyle [2001], evidence on 'psychological autopsy' was ruled inadmissible partly because there were no criteria by which the court could test the quality of the opinions expressed by the expert and partly because there was no substantial body of academic writing approving his methodology.…”

Section: Box 3 Who Is An Expert?mentioning

confidence: 99%

Danger in deep water or just ripples in the pool: Has thePooljudgment changed the law on expert evidence?

Rix¹,

Haycroft²,

Eastman³

2017

BJPsych advances

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SummaryThe professional regulatory cases of the psychiatrist Dr Richard Pool and the neuropathologist Dr Waney Squier have given rise to concerns among expert psychiatric witnesses, and indeed medical experts in general. Here we restate the law on expert evidence with particular reference to the judgment of the Supreme Court in the case ofKennedy v Cordia.We emphasise thatPooldoes not change the law regarding ‘what is expertise’; in particular, the case does not establish restrictive, status-based tests governing the admissibility of expert evidence such as according to whether an expert psychiatric witness has undergone higher training, is on the specialist register as a specialist in a particular field or is a consultant. Rather, expertise continues to be legally defined in terms of a combination of qualification, knowledge and experience. Crucially, the test of medical expertise in legal proceedings is a legal test and not one determined within a medical paradigm.Learning Objectives• Understand the law defining admissible expert evidence, in particular the distinction between ‘admissibility’ of evidence as ‘expert’ and the evidential ‘weight’ that courts may accord to admissible expert evidence• Understand the issues that arose from the cases of Dr Pool and Dr Squier, and why they caused (unnecessary) medical concern• Understand the factual relevance to being an expert witness of having undergone higher training, being on the specialist register as a specialist in a particular field, and being a consultant

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The Persistence of Folly: Critical Examination of Dissociative Identity Disorder. Part II. The Defence and Decline of Multiple Personality or Dissociative Identity Disorder

Cited by 61 publications

References 49 publications

Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder

Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder

Tracking Scientific Interest in the Dissociative Disorders: A Study of Scientific Publication Output 1984–2003

Danger in deep water or just ripples in the pool: Has thePooljudgment changed the law on expert evidence?

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