Criteria For Dissociative Identity Disorder Research Articles

The symptom criteria for the dissociative subtype of posttraumatic stress disorder.

The dissociative subtype of posttraumatic stress disorder (PTSD) was incorporated into the diagnostic criteria for PTSD in Diagnostic and Statisical Manual of Mental Disorders, Fifth Edition (DSM-5). The subtype requires the presence of persistent or recurrent depersonalization or derealization; however, several authors have suggested that a broader array of dissociative symptoms could be included in the criteria. The objective of the present study was to gather data on a wide range of dissociative symptoms in a sample of highly traumatized individuals. The authors administered a set of measures to 62 inpatients in a private psychiatric inpatient program specializing in PTSD and dissociative disorders. Almost every participant met International Classification of Diseases, 11th Edition criteria for complex PTSD, DSM-5 criteria for the dissociative subtype of PTSD, and DSM-5 criteria for dissociative identity disorder or other specified dissociative disorder; these four diagnoses seem to identify largely the same patients and may not be separate disorders. A broad range of dissociative symptoms was endorsed on the Dissociative Experiences Scale and the Dissociative Disorders Interview Schedule. The results support a recommendation that a broad array of symptoms be included in the criteria for the dissociative subtype of PTSD in future editions of the Diagnostic and Statistical Manual of Mental Disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Catholic Perspective: Dissociative Identity Disorder and Experiences of Diabolical Possession

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and its Text Revision (DSM-5-TR) include experiences of diabolical possession and human relationships with spirits as a cultural variation of dissociative identity disorder (DID). Consideration of potential cultural factors is essential to making an accurate diagnosis and employing ethical treatment. However, the DSM and existing literature offer little to assist professionals making a differential diagnosis when these “cultural factors” may be present and someone does not otherwise meet criteria for DID. A Catholic Christian perspective allows for instances of possession and dissociative disorders to be distinct or to coincide. Each diocese/bishop is required to appoint a priest to function in the role of exorcist and to minister to people who are seeking spiritual help, including for possession. When the Roman Catholic Church concludes that the rite of exorcism may be warranted, mental health professionals are appropriately tasked to assess whether the symptoms experienced by the person can be explained and treated psychologically. Given the current DSM criteria, mental health professionals in this role must be equipped to rule in or rule out a diagnosis of a dissociative disorder. This article discusses relevant history, current literature, diagnostic criteria, and assessment tools for dissociative disorders, and DID in particular, from a Catholic lens.

Reversal of Amnesia for Trauma in a Sample of Psychiatric Inpatients with Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified

ABSTRACT The authors interviewed 118 highly dissociative inpatients in a Trauma Program with the Dissociative Disorders Interview Schedule, the Dissociative Experiences Scale and the Adverse Childhood Experiences questionnaire; of the 118 participants 42 met DSM-5 criteria for dissociative identity disorder and 52 for other specified dissociative disorder. The average score on the Dissociative Experiences Scale in the sample of 118 participants was 44.7. The authors also conducted semi-structured interviews inquiring about the circumstances and triggers for reversal of amnesia for childhood trauma in the participants. Only a small minority of the reversal of amnesia took place in therapy sessions, and 24 different triggers for remembering were described. Childhood sexual abuse was by far the most common type of trauma for which amnesia was reversed. The findings are inconsistent with the view that amnesia for childhood sexual abuse is reversed primarily during psychotherapy.

Dissociative Identity Disorder: Diagnostic Accuracy and DSM-5 Criteria Change Implications

ABSTRACT The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) revised the diagnostic criteria for dissociative identity disorder (DID) to more accurately reflect the symptom profile of DID patients. No study has examined how this change affects clinical diagnosis of DID. The present study examined clinician reports of patient symptoms in relation to DSM-IV-TR and DSM-5 DID diagnostic criteria. Data were analyzed from 169 clinicians who participated in the Treatment of Patients with Dissociative Disorders Network Study with a patient they assigned a DID diagnosis. Clinicians evaluated their patients with respect to DSM-IV-TR and DSM-5 DID diagnostic criteria. Researchers determined a clinician-assigned DID diagnosis as “accurate” when the patient’s reported dissociative symptoms matched DSM-IV-TR and/or DSM-5 criteria for DID. Most of the clinicians (95.27%) accurately diagnosed DID. Of those accurately diagnosed, 83.85% of patients met DSM-IV-TR and DSM-5 DID criteria, 9.94% only met DSM-IV-TR DID criteria, and 6.21% only met DSM-5 DID criteria. Further examination of responses suggested that possible idiomatic responses to the negative wording of the DSM-5 exclusionary criteria might have accounted for the DSM-IV-TR appearing to fit for a greater number of cases in this study. Changes in the DSM criteria for DID did not substantially change the frequency or accuracy of assigned DID diagnoses, but the removal of the requirement in DSM-5 that self-states regularly take control of an individual’s behavior slightly increased the number of individuals meeting criteria for DID.

Maladaptive Daydreaming, Dissociation, and the Dissociative Disorders.

ObjectiveStudies on maladaptive daydreaming have shown that it has a number of comorbidities including dissociative disorders, yet no studies have examined the reciprocal relationship. The aim of this study was to determine the frequency of maladaptive daydreaming in a sample of psychiatric inpatients with high levels of dissociation.MethodsThe Dissociative Experiences Scale (DES), Self‐Report Dissociative Disorders Interview Schedule, Maladaptive Daydreaming Scale‐16 (MDS‐16), Structured Clinical Interview for Maladaptive Daydreaming, and the Obsessive Compulsive Inventory were administered to a sample of 100 inpatients in a psychiatric hospital program specializing in dissociative disorders.ResultsOf the 100 participants, 93 reported childhood physical and/or sexual abuse, 33 met criteria for dissociative identity disorder; 56 met criteria for other specified dissociative disorder, 49 met criteria for maladaptive daydreaming disorder, and 23 met criteria for unspecified maladaptive daydreaming. The average score on the DES was 39.1 and the average score on the MDS‐16 was 33.9. Individuals with maladaptive daydreaming disorder scored significantly higher than those without on many different symptom clusters.ConclusionsThis sample of 100 highly traumatized and dissociative inpatients reported high levels of maladaptive daydreaming along with many other forms of comorbidity. Maladaptive daydreaming is a previously under‐recognized aspect of complex dissociative disorders and requires further attention in both research and clinical practice.

Firebug! Dissociative Identity Disorder? Malingering? Or \u2026? An Intensive Case Study of an Arsonist

Courts struggle with questions of how to assess competency to stand trial (CTS) and not guilty by reason of insanity (NGRI) in dissociative identity disorder (DID). Concerns about CTS include dissociative amnesia and unpredictable switching behaviors that could cause inconsistent information transfer across self states, with the defendant unable to access important legal information about his/her defense and to collaborate with his/her attorney; DID defendants could not conform their conduct to the law or know right from wrong due to dissociative amnesia, the seemingly independent actions of self states, and the disruption of reality testing by switching. The author presents the case of a woman charged with both a witnessed and an unwitnessed burglary and arson, the latter at the home of her former therapist. The author was the fourth forensic evaluator in the case. Disagreements included whether the defendant met diagnostic criteria for DID or was malingering, and whether she was CTS and/or NGRI. In clinical work with DID, “the whole human being” is held responsible for all behavior, despite reported amnesia or lack of subjective agency. The Discrete Behavioral States (DBS) model of DID avoids reification of the DID self states and their conflation as separate “people.” This model supports evaluating the defendant at the level of specific self states, the self-state system, and that of the whole human being. The author concluded that the defendant met diagnostic criteria for DID and also was malingering its severity. She was competent to stand trial and legally sane.

Evaluating the Unified Protocol in the Treatment of Dissociative Identify Disorder

The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP; Barlow, Allen, & Choate, 2004) is a transdiagnostic cognitive behavior therapy for emotional disorders that addresses mood, anxiety, somatoform, and borderline personality disorders. Patients diagnosed with dissociative identity disorder (DID) form a nontrivial subset of patients. Extant treatment guidelines (ISSTD, 2011) emphasize the need to strive for fusion of identities (i.e., the creation of a unified sense of self). In contrast, the UP strives to inculcate an array of adaptive emotion skills, including cognitive reappraisal, emotional awareness, and affect tolerance, prior to planned exposure to traumatic memories. In this study, we provide the first assessment of the effectiveness of the UP with 5 individuals diagnosed with DID and co-occurring disorders and symptoms tracked at multiple time points. After 18–22 sessions, 4 patients exhibited significant reductions in anxiety, depression, and dissociative symptoms, and increases in emotional regulation, with significant improvements in symptomatology maintained after follow-ups of 1, 3, and 6 months. A fifth participant with prominent suicidal ideation was treated for 42 sessions and achieved comparable reductions in symptoms. None of the patients met criteria for DID or any other disorder at 6-month follow-up.

Co-Occurrence of Dissociative Identity Disorder and Borderline Personality Disorder

The literature indicates that, among individuals with borderline personality disorder, pathological dissociation correlates with a wide range of impairments and difficulties in psychological function. It also predicts a poorer response to dialectical behavior therapy for borderline personality disorder. We hypothesized that (a) dissociative identity disorder commonly co-occurs with borderline personality disorder and vice versa, and (b) individuals who meet criteria for both disorders have more comorbidity and trauma than individuals who meet criteria for only 1 disorder. We interviewed a sample of inpatients in a hospital trauma program using 3 measures of dissociation. The most symptomatic group was those participants who met criteria for both borderline personality disorder and dissociative identity disorder on the Dissociative Disorders Interview Schedule, followed by those who met criteria for dissociative identity disorder only, then those with borderline personality disorder only, and finally those with neither disorder. Greater attention should be paid to the relationship between borderline personality disorder and dissociative identity disorder.

Are symptoms of spirit possessed patients covered by the DSM-IV or DSM-5 criteria for possession trance disorder? A mixed-method explorative study in Uganda

As in many cultures, spirit possession is a common idiom of distress in Uganda. The DSM-IV contains experimental research criteria for dissociative and possession trance disorder (DTD and PTD), which are under review for the DSM-5. In the current proposed categories of the DSM-5, PTD is subsumed under dissociative identity disorder (DID) and DTD under dissociative disorders not elsewhere classified. Evaluation of these criteria is currently urgently required. This study explores the match between local symptoms of spirit possession in Uganda and experimental research criteria for PTD in the DSM-IV and proposed criteria for DID in the DSM-5. A mixed-method approach was used combining qualitative and quantitative research methods. Local symptoms were explored of 119 spirit possessed patients, using illness narratives and a cultural dissociative symptoms' checklist. Possible meaningful clusters of symptoms were inventoried through multiple correspondence analysis. Finally, local symptoms were compared with experimental criteria for PTD in the DSM-IV and proposed criteria for DID in the DSM-5. Illness narratives revealed different phases of spirit possession, with passive-influence experiences preceding the actual possession states. Multiple correspondence analysis of symptoms revealed two dimensions: 'passive' and 'active' symptoms. Local symptoms, such as changes in consciousness, shaking movements, and talking in a voice attributed to spirits, match with DSM-IV-PTD and DSM-5-DID criteria. Passive-influence experiences, such as feeling influenced or held by powers from outside, strange dreams, and hearing voices, deserve to be more explicitly described in the proposed criteria for DID in the DSM-5. The suggested incorporation of PTD in DID in the DSM-5 and the envisioned separation of DTD and PTD in two distinctive categories have disputable aspects.

Assessing Dissociative Symptoms and Dissociative Disorders in College Students in the Philippines

This study is part of a larger project (Gingrich, 2004) that examined dissociation in a student sample in the Philippines. High and low-moderate dissociators were identified from a sample of 459 freshman university students based on cutoff scores on two brief screening instruments. The Multidimensional Inventory of Dissociation (MID) and Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) were then used to determine if any of the participants met diagnostic criteria for dissociative identity disorder (DID) or other dissociative disorders (DDs). Comparisons were made between the frequency of specific DDs diagnosed by each instrument and an evaluation done of the usefulness of the MID and SCID-D as diagnostic tools in a Filipino student sample.

Testing the Diagnosis of Dissociative Identity Disorder Through Measures of Dissociation, Absorption, Hypnotizability and PTSD: A Norwegian Pilot Study

A total of 14 women meeting criteria for dissociative identity disorder (DID) based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM–IV]) were compared to a group of women (n = 10) with other dissociative diagnoses and a group of normal controls (n = 14) with regard to dissociativity, absorption, trauma related symptoms and hypnotizability. Both of the clinical groups reported histories of childhood trauma and attained high PTSD scores. The DID group differed significantly from the group with other dissociative diagnoses and the non-diagnosed comparison group with regard to hypnotizability, the variety of dissociative symptomatology, and the magnitude of dissociative symptomatology. However, no significant differences between the two clinical groups were detected with regard to absorption, general dissociative level, or symptoms related to traumatic stress. Results support the notion that DID can be regarded as a clinical entity which is separable from other dissociative disorders. Results also indicated that hypnotizability is the most important clinical feature of DID.

Clinical Assessment of Dissociative Identity Disorder Among College Counseling Clients

College counseling professionals address a wide range of complex student mental health concerns. Among these, accurately identifying client presentations of dissociative identity disorder (DID) can be especially challenging because students with DID sometimes present as if they are experiencing another problem, such as a mood, anxiety, or psychotic disorder. This article reviews DID diagnostic criteria, introduces assessment strategies for use during intake and subsequent counseling sessions, and presents case illustrations.

Developmental Needs Meeting Strategy: A New Treatment Approach Applied to Dissociative Identity Disorder

ABSTRACT This article describes the use of the Developmental Needs Meeting Strategy (DNMS) for the treatment of dissociative identity disorder (DID). The DNMS is an ego state therapy which guides a client's own internal resources to meet developmental needs that were not met in childhood. After 17 months of DNMS treatment, a client with DID reported a near total elimination in frequency and severity of symptoms of depression, anxiety and suicidal thoughts, her Trauma Symptom Inventory scores indicated no trauma-related symptoms, and her Multidimensional Inventory of Dissociation scores indicated she no longer met the diagnostic criteria for DID. She was functioning well without any medication. Further research concerning this treatment strategy is warranted.

Set This House in Order: A Romance of Souls

Back to table of contents Previous article Next article Book ReviewsFull AccessSet This House in Order: A Romance of SoulsAnn L. Hackman, M.D.Ann L. HackmanSearch for more papers by this author, M.D.Published Online:1 Dec 2003https://doi.org/10.1176/appi.ps.54.12.1660AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Set This House in Order is about two people with diagnoses of dissociative identity disorder. Andy Gage, who "broke in pieces" after being subjected to horrendous abuse as a child, has been through therapy with Dr. Danielle Grey. The purpose of the therapy was to help Andy manage his condition, become more organized, avoid uncontrolled switching, and establish order. Thus at the opening of the book, Andrew, the sometimes narrator, explains that he was born two years previously to "run the body" after his father, Aaron, built a house in Andy's head for the personalities, or "souls."A number of souls live fairly cooperatively in the house, including Adam, Jake, Aunt Sam, and Seferis. Julie, who is Andy's employer at a small computer firm specializing in virtual reality software, introduces Andy to Penny. Penny also has dissociative identity disorder—and brings with her another complete set of characters—but she has limited understanding of her situation and eventually asks Andy for help. What follows involves Andy's and Penny's getting to know each other's various personalities and then taking a trek halfway across the country to uncover events from Andy's past.As a psychiatrist, I had some concerns about this book. I was bothered by the consistent use of the term "multiple personality disorder," although a parenthetical note indicates that the diagnosis is now referred to as dissociative identity disorder. I was also somewhat dismayed by the book's depiction of psychiatrists. There are two psychiatrists, who are generally portrayed as helpful, but each demonstrates a somewhat dubious understanding of boundaries. Furthermore, Andrew tells the reader that "the average multiple" sees eight psychiatrists before receiving a correct diagnosis. However, his friend Penny's diagnosis is immediately recognized by Julie, who has no mental health expertise. Andrew also briefly describes his experience in attempting treatment with a succession of psychiatrists who believed in a national conspiracy of satanic cults, past-life regression, and sexual assault by extraterrestrials. Finally, although I am not an expert in this area, the patients I have treated who meet criteria for dissociative identity disorder have been among the most tortured individuals I have ever worked with. Andy and Penny both have backgrounds of serious abuse, but the symptoms they experience during the course of the novel are often portrayed more as inconvenient than devastating.However, as a reader of novels I found much to enjoy about Set This House in Order. It is well written, fast paced, quirky, and sometimes quite funny. Although he has clearly done some research on dissociative identity disorder, the author, Matt Ruff, is a novelist who claims no expertise in mental health. One review posted on Ruff's Web site indicates that his two previous novels are works of science fiction. Set This House in Order may best be viewed as something of a fantasy in which the realities of this illness and its treatment are revised a bit to fit the plot.Dr. Hackman is assistant professor at the University of Maryland School of Medicine in Baltimore.by Matt Ruff; New York, Harper Collins, 2003, 479 pages, $25.95 FiguresReferencesCited byDetailsCited ByNone Volume 54Issue 12 December 2003Pages 1660-1660 Metrics PDF download History Published online 1 December 2003 Published in print 1 December 2003

Why the Diagnostic Criteria for Dissociative Identity Disorder Should Be Changed

This paper examines the psy chi at ricdiagnosis of dissociative identity disorder (DID)inlightofthedevelopmentsinpsychi at ricclassification that have guided the last four re vi sions of the Diagnostic and Sta tis ti calMan ualforMen talDis or ders (DSM) (Amer i can Psychiatric Association, 1980, 1987, 1994, 2000). The author argues that multiple per son al ity 's pas sage from DSM-III, through DSM-III-R, to its current form as DID in DSM-IV-TR has left the di ag no sis out of step with the state of the art of psy chi atric classification. Ten dis advantages of the Diagnostic and Sta tis ti calMan ual of Men talDis or ders, Fourth Edi tion- Text Revision (DSM-IV-TR) cri te riafor DID are iden ti fied. The DSM-IV-TR cri te ria for DID: (1) are out of step with the state of the art of psy chi at ric clas si fi cation; (2) are not based on taxometric anal y sis of the symp toms of DID; (3) in correctly im ply that DID is a closed con cept; (4) have poor con tent valid ity; (5) throw away im portantinformation; (6) dis courage taxonomic research; (7) have poor reliability and cause frequent misdiagnoses; (8) are not “user-friendly”; (9) are un nee es sar ily con tro versial; and (10) along with pre vi ous ver sions of the DSM, have pro duced an artifactually low base-rate of DID for the past 20 years. In an effort to remedy these disadvantages, a re liable, user-friendly, polythetic set of diagnostic criteria for “Major Dissociative Disorder” is proposed for DSM-V. Using these polythetic cri te ria, the dissociative dis or ders (presently con cep tu al ized as Dissociative Am ne sia, Dissociative Fugue, DID, Depersonalization Disorder, and Dissociative Disorder Not Otherwise Spec ified) can be re struc tured into an eas ily un der stood and more re liable set of di ag nos tic en ti ties. This al ter nate nosology of the dissociative disorders consists of Sim pie Dissociative Dis or der (with at least three). sub types), Gen er al ized Dissociative Dis or der, Major Dissociative Disorder (with two subtypes), and Dissociative Disorder Not Otherwise Specified.

The objective assessment of amnesia in dissociative identity disorder using event-related potentials

Assessment of amnesia in Dissociative Identity Disorder (DID) typically relies on self-report, the veracity of which cannot often be independently verified. Memory in DID was therefore assessed using an objective method that involved event-related potentials (ERPs) as well as indirect behavioral measures of memory, and that provided statistically supported assessments for each participant. Four participants who met DSM-IV criteria for DID participated in an ERP memory assessment task, in which words learned by one identity (identity A) were then presented to a second identity (identity B). All four participants — tested as identity B — produced ERP and behavioral evidence consistent with recognition of the material learned by identity A. While it would be premature to generalize all cases of DID, the results suggest that there may be reasons to question the veracity of reports by individuals who meet diagnostic criteria for DID on the basis of a structured clinical interview.

Dissociative identity disorder: an Australian series.

Series of patients fulfilling diagnostic criteria for Dissociative Identity Disorder (DID), otherwise known as multiple personality disorder, have particularly been reported on in North America and increasingly in other countries. The present study investigated the trauma and past treatment histories, symptom profiles and dissociative phenomenology of 62 patients fulfilling diagnostic criteria for DID seen in Brisbane (Queensland, Australia). From 1992, systematic assessments, including the Dissociative Experience Scale and the Dissociative Disorders Interview Schedule, were performed with a personal series of 57 patients with DID seen by one of the authors (WM) and five patients seen by the second author (JB). The histories of childhood trauma, the clinical profiles and dissociative indices of these patients closely approximate those described in series reported in other countries. Patients fulfilling diagnostic criteria for DID are regularly seen in Australian inpatient and outpatient settings. The dissociative symptomatology of the patients examined in the present study represents a significant component of a complex syndrome associated with a history of severe ongoing developmental trauma dating from early childhood.

Dr. Ross and Ms. Ellason Reply

Back to table of contents Previous article Next article Letter to the EditorFull AccessDr. Ross and Ms. Ellason ReplyCOLIN A. ROSS, M.D., and JOAN W. ELLASON, M.A., L.P.C., COLIN A. ROSSSearch for more papers by this author, M.D., and JOAN W. ELLASONSearch for more papers by this author, M.A., L.P.C., Dallas, Tex.Published Online:1 Sep 1998https://doi.org/10.1176/ajp.155.9.1304aAboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: We agree with most of the methodological limitations pointed out by Drs. Powell and Howell. Our study lacked controls and a standardized treatment protocol, and subjects were recruited at their most symptomatic. Some of the improvement was probably due to spontaneous remission. The efficacy of psychotherapy for dissociative identity disorder is not a scientific fact.We disagree that a tautology occurred because of our use of outcome measures to assign subjects to integrated versus nonintegrated groups. Only the DSM-IV criteria for dissociative identity disorder from the Dissociative Disorders Interview Schedule were used in this assignment. No other outcome measures influenced this assignment.On the basis of our data, it seems unlikely that properly conducted therapy for dissociative identity disorder causes deterioration or chronic illness. Many people who receive this diagnosis make remarkable recoveries, given their degree of baseline comorbidity. Our data support allocation of resources to more rigorous prospective treatment outcome studies. In light of the methodological limitations of our study, one can no more attribute therapeutic causality to medications than to psychotherapy or spontaneous remission. There are many ethical, logistical, and methodological problems in designing and conducting rigorous treatment outcome studies for dissociative identity disorder. Treatment to stable integration often takes 4 or 5 years. It would be unethical to randomly assign subjects to a placebo group for that long. Therapists who believe in the specificity of psychotherapy for dissociative identity disorder would be unlikely, as a matter of personal conscience, to participate in a study that involved random assignment to 5 years of placebo treatment. Therefore, one could not recruit therapists to the study. The likelihood that patients would stay in the study in the placebo control condition for that long without dropping out is minimal.Prospective random assignment to placebo or waiting-list control groups in a treatment study for dissociative identity disorder is impractical. We suggest that different schools of thought should be compared to each other. At present, our school of thought is the only one that has provided prospective treatment outcome data with scientific methodology of any kind. The burden is now on competing schools of thought to match or exceed this level of methodology and to demonstrate a superior outcome.We plan to initiate a prospective treatment outcome study beginning at the time of initial diagnosis. It will include measures of health care utilization, employment status, clinical variables, and treatment modalities employed.Another approach would be to screen a large population base, such as all individuals covered by a major managed care company. Subjects with undiagnosed dissociative identity disorder could be identified with the test battery used in our study. Half could be randomly assigned to the treatment we recommend, and half could be left undiagnosed and tracked as they receive conventional treatment for other comorbid disorders.We hope that such studies are completed over the next decade and subjected to rational, reasonable methodological scrutiny such as that provided by Drs. Powell and Howell. FiguresReferencesCited byDetailsCited By Volume 155Issue 9 September 1998Pages 1304a-1305 Metrics History Published online 1 September 1998 Published in print 1 September 1998

Handbook of Dissociation: Theoretical, Empirical, and Clinical Perspectives

Handbook of Dissociation: Theoretical, Empirical, and Clinical Perspectives

TREATMENT OF DISSOCIATIVE IDENTITY DISORDER WITH NEUROTHERAPY AND GROUP SELF-EXPLORATION

The efficacy of integrating Neurofeedback techniques with internal self-exploration was evaluated as a procedure for the treatment of Dissociative Identity Disorder (DID). These procedures employed a modification of the alpha/theta neurofeedback procedures previously described by Peniston and Kulkosky (1991). Eleven female subjects meeting DSM-121-R (1987) criteria for DID were provided with 30 sessions of Neurofeedback and 10 group sessions as treatment. Subjects were administered the Millon Clinical Multiaxial Inventory-II (Millon, 1987) and the Global Assessment of Functioning scale (DSM-III-R, 1987) before and after 30 neurofeedback sessions. One to three years post treatment, subjects completed a Dissociative Experience Scale questionnaire (Bernstein and Putnam 2986) to assess the long term efficacy of treatment. Neurofeedback training coupled with internal self-exploration served as an effective treatment modality for the unification of patients with DID. Of 11 patients treated, 11 were assessed as unified post treatment. All subjects scored as normal on the Dissociative ExperienceScale (Bernstein and Putnam, 1986) for at least one year post treatment.