The simulation of multiple personalities: A case report.

Abstract

The realistic simulation of Multiple Personality Disorder (MPD) has become much more possible as a result of the recent proliferation of information about MPD in the professional and popular press. Such simulation has been documented most frequently as malingering in a forensic context. However, outside a forensic context where the motivation may not be obvious, the detection of simulated MPD can be a difficult task. IntroductionDespite some ongoing professional skepticism, Multiple Personality Disorder (MPD) is a recognized disorder, and is a part of the American Psychiatric Association's DSM-III-R classification (1987). Since 1980, when the first comprehensive descriptions of MPD began to appear in modern psychiatric literature (Bliss, 1980;Coons, 1980;Greaves, 1980), there has been a rapid growth in the amount of professional information available to clinicians. The public has also been heavily exposed to information about MPD, beginning with books about MPD such as The Three Faces of Eve (Thigpen & Cleckley, 1957) and Sybil (Schreiber, 1973), more recent first-person accounts of sexual abuse and dissociation (Bass & Davis, 1988), and frequent appearances of both mental health professionals and patients on radio and television talk shows. As with any other diagnosis which captures public and professional attention, MPD may be simulated.This paper concerns instances where persons deliberately fabricate the signs and symptoms of

Changes in identity and self-organization in psychotherapy of multiple personality disorder.

“…This patient was admitted for inpatient treatment of MPD following this history, a fairly typical background for adults diagnosed with this disorder ( Brick & Chu, 1991; Kluft, 1985b; Putnam, 1989). This included many years of treatment under a variety of psychiatric and medical diagnoses, psychopharmacological and somatic therapies.…”

“…About six months prior to admission for specific MPD treatment, secondary personalities were identified. At admission he met DSM-III-R criteria for MPD with episodes of amnesia ( see Armstrong & Loewenstein, 1990) as well as NIMH criteria and exclusionary criteria for simulation of MPD ( see , e.g., Brick & Chu, 1991).…”

“…The case study and clinical series continue to be important vehicles for advancing understanding of diagnosis and treatment of MPD (e.g., Alpher, 1991a, 1992; Brick & Chu, 1991; Coons, Bowman & Milstein, 1988; Franklin, 1990; Miller, 1989; Price, 1987; Schacter et al, 1989; Silberman et al, 1985). The purpose of the present intensive case study is to examine an approach to the assessment of change in identity and self-organization during treatment of an MPD patient.…”

On the misdiagnosis of multiple personality disorder

“…Several discussions of this particular differential diagnosis appear in the literature (Orne, Dirges, & ()rne, 1984;Watkins, 1984;Kluft, 1987b;Brick & Chu, 1991). In brief, the deliberate and realistic simulation of MPD over a brief period of lime is not difficult.…”

“…He also found malingerers had stereotyped good/bad personalities and tended to " play up" their symptoms (p. 112). Finally, Brick & Chu (1991) have suggested that the availability of information A 29-year-old male in panel) t was evaluated for reported MPD. tie reported no problems irr childhood or adulthood prior to a traumatic accident two years previously.…”