20th Bill Cosby accuser comes forward, Bill Cosby Sued For Alleged Sexual Assault, DID valid disorder found around the globe – empirical overview
December 4, 2014 Comments Off on 20th Bill Cosby accuser comes forward, Bill Cosby Sued For Alleged Sexual Assault, DID valid disorder found around the globe – empirical overview
– Bill Cosby Sued For Alleged Sexual Assault of Teenager in 1970s
– More women detail sex abuse claims against Bill Cosby
– Dissociative identity disorder: An empirical overview
“Existing data show DID (dissociative identity disorder formerly called MPD) as a complex, valid and not uncommon disorder, associated with developmental and cultural variables, that is amenable to psychotherapeutic intervention….Because the aetiology of DID is associated with childhood relational trauma, the discomfort caused by studying DID may serve as a potent disincentive to its investigation…. to retain a comforting denial of both the occurrence of abuse and its disabling psychiatric legacy….affects approximately 1% of the general population.”
– USC study challenges traditional data: points to higher rates of child abuse
“one in 20 children in California are victims of substantiated abuse or neglect before they reach their fifth birthday.”
Bill Cosby Sued For Alleged Sexual Assault of Teenager in 1970s
By Maria Elena Fernandez and Andrew Blankstein December 3, 2014
A 55-year-old woman sued comedian Bill Cosby on Tuesday in Los Angeles Superior Court claiming sexual battery and infliction of emotional distress for allegedly molesting her in a bedroom at the Playboy Mansion when she was 15 years old.
According to the complaint, Judy Huth and a friend, who was 16 at the time, met Cosby at an outdoor film set at Lacy Park in Los Angeles County in 1974 and accepted an invitation to socialize with him at a tennis club the following week. When they got together, the lawsuit alleges, they played billiards and Cosby served them alcoholic beverages….
“When Plaintiff emerged from the bathroom, she found COSBY sitting on the bed,” the suit states. “He asked her to sit beside him. He then proceeded to sexually molest her by attempting to put his hand down her pants, and then taking her hand in his hand and performing a sex act on himself without her consent.” ….
In recent weeks, 20 other women have come forward to accuse Cosby of sexual assault — charges which began to surface a decade ago when the former director of operations for Temple’s women’s basketball team sued him for drugging her and assaulting her in 2004.
The comedian has not been criminally charged and many of the claims are so old, they are barred by statutes of limitations.
Huth’s lawsuit, however, contends that she became aware of the serious effect the abuse had on her within the past three years. California law allows victims of sex abuse when they were minors to bring a claim after adulthood if they discover later in life that they suffered psychological injuries as a result of the abuse….
More women detail sex abuse claims against Bill Cosby
By Piya Sinha-Roy and Eric Kelsey, Reuters December 3, 2014 Los Angeles
20th Bill Cosby accuser comes forward
Three women on Wednesday came together and detailed allegations that comedian Bill Cosby sexually abused and groped them decades ago, a day after Cosby was sued by a woman who said he molested her when she was a teenager in 1974.
More than a dozen women have publicly accused the comedian of sexual abuse as far back as the 1960s as the allegations have scuttled Cosby’s television projects and led to cancellations of numerous comedy performances, including two gigs in suburban New York that were scheduled for Saturday.
Dissociative identity disorder: An empirical overview
Martin J Dorahy, Bethany L Brand, Vedat Sar, Christa Krüger, Pam Stavropoulos, Alfonso Martínez-Taboas, Roberto Lewis-Fernández, Warwick Middleton, Australian & New Zealand Journal of Psychiatry 2014, Vol. 48(5) 402–417 DOI: 10.1177/0004867414527523
The overview is limited to DID-specific research in which one or more of the following conditions are met: (i) a sample of participants with DID was systematically investigated, (ii) psychometrically-sound measures were utilised, (iii) comparisons were made with other samples, (iv) DID was differentiated from other disorders, including other dissociative disorders, (v) extraneous variables were controlled or (vi) DID diagnosis was confirmed. Following an examination of challenges to research, data are organised around the validity and phenomenology of DID, its aetiology and epidemiology, the neurobiological and cognitive correlates of the disorder, and finally its treatment.
DID was found to be a complex yet valid disorder across a range of markers. It can be accurately discriminated from other disorders, especially when structured diagnostic interviews assess identity alterations and amnesia. DID is aetiologically associated with a complex combination of developmental and cultural factors, including severe childhood relational trauma. The prevalence of DID appears highest in emergency psychiatric settings and affects approximately 1% of the general population. Psychobiological studies are beginning to identify clear correlates of DID associated with diverse brain areas and cognitive functions. They are also providing an understanding of the potential metacognitive origins of amnesia. Phase-oriented empirically-guided treatments are emerging for DID.
The empirical literature on DID is accumulating, although some areas remain under-investigated. Existing data show DID as a complex, valid and not uncommon disorder, associated with developmental and cultural variables, that is amenable to psychotherapeutic intervention….
Because the aetiology of DID is associated with childhood relational trauma, the discomfort caused by studying DID may serve as a potent disincentive to its investigation. Thus avoiding study of DID protects mainstream social institutions – at the expense of the children who are violated by them – as well as enabling researchers, clinicians and the public to retain a comforting denial of both the occurrence of abuse and its disabling psychiatric legacy. Hence avoidance of the central issues associated with DID operates not only in the patient, but in society at large….
Both universal and cultural processes influence the development and phenomenology of DID (Dorahy, 2001a). Dissociation and DD can be found in all cultural settings (e.g. Spiegel et al., 2013; Stein et al., 2013). DID has been documented in Turkey, Puerto Rico, Scandinavia, Japan, Canada, Australia, the USA, the Philippines, Ireland, the UK and Argentina, among many other cultural and geographical contexts (Rhoades and Sar, 2005)….
Every study that has systematically examined aetiology has found that antecedent severe, chronic childhood trauma is present in the histories of almost all individuals with DID….
It is important to consider health costs associated with DID. A Canadian treatment study of DID concluded that annual costs dropped from C$75,000 to C$36,000 in the 3 years after treatment for DID (Ross and Dua, 1993). This and other studies document considerable cost savings even for those who had been chronically ill before being appropriately treated for DID (Lloyd, 2011)….
The empirical literature on DID emerging over the past 30 years shows that, beyond the rhetoric and controversy, DID is a valid disorder characterised by amnesia, identity confusion and coexistence of dissociative identities which can be differentiated from other psychiatric disorders as well as from feigned presentations of DID. Characteristic features include a complex array of co-existing symptoms associated with psychosis, mood, anxiety, affect regulation and personality functioning. A mix of subtle and overt developmental, interpersonal and cultural drivers produce DID, with childhood attachment-based trauma appearing to be a universal factor, while social idioms of self produce components of cultural specificity.
DID is found around the globe in almost every culture in which researchers have carefully assessed for the range of dissociative symptoms. Orbitofrontal, cortico-limbic and temporal anomalies are evident in DID, with different neurobiological profiles found across identities than those in simulation….
USC study challenges traditional data: points to higher rates of child abuse
New research from the University of Southern California’s Children’s Data Network shows that approximately one in 20 children in California are victims of substantiated abuse or neglect before they reach their fifth birthday.
The study separately found that about 1 in 7 California children are reported to county Child Protective Services agencies over suspected abuse before they reach age 5….
Evidence that Dissociative Identity Disorder (Multiple Personality Disorder or MPD) is caused by Childhood Trauma
November 7, 2014 Comments Off on Evidence that Dissociative Identity Disorder (Multiple Personality Disorder or MPD) is caused by Childhood Trauma
Conclusive evidence that Dissociative Identity Disorder (formerly called Multiple Personality Disorder or MPD) is caused by extensive childhood trauma and not iatrogenically (resulting from the activity of physicians) or socially. Individual identities have been shown to have clear physiological differences. These are only a few of the many studies available in professional journals and research books.
Child Abuse Wiki – Dissociative Identity Disorder
Dissociative identity disorder (formerly called Multiple Personality Disorder or MPD) is defined in the DSM-IV-TR as the presence of two or more personality states or distinct identities that repeatedly take control of one’s behavior. The patient has an inability to recall personal information. The extent of this lack of recall is too great to be explained by normal forgetfulness. The disorder cannot be due to the direct physical effects of a general medical condition or substance.
DID entails a failure to integrate certain aspects of memory, consciousness and identity. Patients experience frequent gaps in their memory for their personal history, past and present. Patients with DID report having severe physical and sexual abuse, especially during childhood. The reports of patients with DID are often validated by objective evidence.
The causes of dissociative identity disorder are theoretically linked with the interaction of overwhelming stress, traumatic antecedents, insufficient childhood nurturing, and an innate ability to dissociate memories or experiences from consciousness. Prolonged child abuse is frequently a factor, with a very high percentage of patients reporting documented abuse often confirmed by objective evidence. The Diagnostic and Statistical Manual of Mental Disorders states that patients with DID often report having a history of severe physical and sexual abuse. The reports of patients suffering from DID are “often confirmed by objective evidence,” and the DSM notes that the abusers in those situations may be inclined to “deny or distort” these acts. Research has consistently shown that DID is characterized by reports of extensive childhood trauma, usually child abuse. Dissociation is recognized as a symptomatic presentation in response to psychological trauma, extreme emotional stress, and in association with emotional dysregulation and borderline personality disorder. A study of 12 murderers established the connection between early severe abuse and DID. A recent psychobiological study shows that dissociative identity disorder (DID) sufferers’ “origins of their ailment stem more likely from trauma” than sociogenic or iatrogenic origins.
There is strong evidence that DID is not a culture bound phenomenon. Dissociative disorders have been found in more than a dozen countries. DID has been found in China and Turkey.
Physiological evidence has provided additional evidence to back the existence of DID. One review of the literature found “physiologic and ocular differences across alter personalities.” Additional studies have been found showing optical differences in DID cases. One study found that “eight of the nine MPD subjects consistently manifested physiologically distinct alter personality states.” Other reviews have found additional physiological differences. Brain mapping has also found physiological differences in alternate personalities. A variety of psychiatric rating scales found that multiple personality is strongly related to childhood trauma rather than to an underlying electrophysiological dysfunction. Dissociative identity disorder patients have been found to have smaller hippocampal and amygdalar volumes than healthy subjects. The involvement of the orbitalfrontal cortex has been proposed in the development of DID, suggesting a possible neurodevelopmental mechanism that would be responsible for the development of “multiple representations of self.” More recent research presents psychobiological evidence indicating actual physical alter states not found in controls.
with permission from http://childabusewiki.org/index.php?title=Dissociative_Identity_Disorder
Research Evidence showing a connection between Dissociative Identity Disorder and Trauma
Objective Documentation of Child Abuse and Dissociation in 12 Murderers With Dissociative Identity Disorder
“Signs and symptoms of dissociative identity disorder in childhood and adulthood were corroborated independently and from several sources in all 12 cases; objective evidence of severe abuse was obtained in 11 cases. The subjects had amnesia for most of the abuse and underreported it. Marked changes in writing style and/or signatures were documented in 10 cases. CONCLUSIONS: This study establishes, once and for all, the linkage between early severe abuse and dissociative identity disorder.”
Multiple personality disorder in The Netherlands: a clinical investigation of 71 patients.
The presenting characteristics of the patients showed a striking resemblance to those in several large North American series. Patients had spent an average of 8.2 years in the mental health system prior to correct diagnosis. Patients presented with many different symptoms and frequently received other psychiatric or neurological diagnoses. A history of childhood physical and/or sexual abuse was reported by 94.4% of the subjects, and 80.6% met criteria for posttraumatic stress disorder.
Patients with multiple personality disorder have a stable set of core symptoms throughout North America as well as in Europe.
Abuse histories in 102 cases of multiple personality disorder.
The authors interviewed 102 individuals with clinical diagnoses of multiple personality disorder at four centres using the Dissociative Disorders Interview Schedule. The patients reported high rates of childhood trauma: 90.2% had been sexually abused, 82.4% physically abused, and 95.1% subjected to one or both forms of child abuse. Over 50% of subjects reported initial physical and sexual abuse before age five. The average duration of both types of abuse was ten years, and numerous different perpetrators were identified. Subjects were equally likely to be physically abused by their mothers or fathers. Sexual abusers were more often male than female, but a substantial amount of sexual abuse was perpetrated by mothers, female relatives, and other females. Multiple personality disorder appears to be a response to chronic trauma originating during a vulnerable period in childhood.
Evidence Against Iatrogenic and Sociocognitive Models of Dissociative Identity Disorder
Evidence against the iatrogenesis of multiple personality disorder
The authors present data which argue against the iatrogenesis of multiple personality disorder (MPD). Twenty-two cases reported by one Canadian psychiatrist, 23 cases reported by a second Canadian psychiatrist, 48 cases seen by 44 American psychiatrists specializing in MPD, and 44 cases seen by 40 Canadian general psychiatrists without a special interest in MPD are compared. The Canadian general psychiatrists had seen an average of 2.2 cases of MPD, while the Americans had seen an average of 160. There were no differences between these groups on the diagnostic criteria, for MPD or the number of personalities identified. Specialists in MPD are not influencing their patients to create an increased number of personalities or to endorse more diagnostic criteria. Exposure to hypnosis does not appear to influence the phenomenology of MPD.
Iatrogenic DID-An Evaluation of the Scientific Evidence: D. Brown, E. Frischholz & A. Scheflin” from The fall-winter 1999 issue of “The Journal of Psychiatry & Law – “Conclusions…At present the scientific evidence is insufficient and inadequate to support plaintiffs’ complaints that suggestive influences allegedly operative in psychotherapy can create a major psychiatric disorder like MPD per se…there is virtually no support for the unique contribution of hypnosis to the alleged iatrogenic creation of MPD in appropriately controlled research.….alter shaping is not to be confused with alter creation.” p. 624
The sociocognitive model of dissociative identity disorder: A reexamination of the evidence.
According to the sociocognitive model of dissociative identity disorder (DID; formerly, multiple personality disorder), DID is not a valid psychiatric disorder of posttraumatic origin; rather, it is a creation of psychotherapy and the media….No reason exists to doubt the connection between DID and childhood trauma. Treatment recommendations that follow from the sociocognitive model may be harmful because they involve ignoring the posttraumatic symptomatology of persons with DID.
Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States
The findings are at odds with the idea that differences among different types of dissociative identity states in DID can be explained by high fantasy proneness, motivated role-enactment, and suggestion. They indicate that DID does not have a sociocultural (e.g., iatrogenic) origin. For the first time, it is shown using brain imaging that neither high nor low fantasy prone healthy women, who enacted two different types of dissociative identity states, were able to substantially simulate these identity states in psychobiological terms. These results do not support the idea of a sociogenic origin for DID.”
Physiological Evidence Showing Physical Differences Between Dissociative Identity Disorder Identity States
Multiple personality disorder. A clinical investigation of 50 cases.
To study the clinical phenomenology of multiple personality, 50 consecutive patients with DSM-III multiple personality disorder were assessed using clinical history, psychiatric interview, neurological examination, electroencephalogram, MMPI, intelligence testing, and a variety of psychiatric rating scales. Results revealed that patients with multiple personality are usually women who present with depression, suicide attempts, repeated amnesic episodes, and a history of childhood trauma, particularly sexual abuse. Also common were headaches, hysterical conversion, and sexual dysfunction. Intellectual level varied from borderline to superior. The MMPI reflected underlying character pathology in addition to depression and dissociation. Significant neurological or electroencephalographical abnormalities were infrequent. These data suggest that the etiology of multiple personality is strongly related to childhood trauma rather than to an underlying electrophysiological dysfunction.
Psychobiological characteristics of dissociative identity disorder: a symptom provocation study.
Dissociative identity disorder (DID) patients function as two or more identities or dissociative identity states (DIS), categorized as ‘neutral identity states’ (NIS) and ‘traumatic identity states’ (TIS). NIS inhibit access to traumatic memories thereby enabling daily life functioning. TIS have access and responses to these memories. We tested whether these DIS show different psychobiological reactions to trauma-related memory.
Psychobiological differences were found for the different DIS. Subjective and cardiovascular reactions revealed significant main and interactions effects. Regional cerebral blood flow data revealed different neural networks to be associated with different processing of the neutral and trauma-related memory script by NIS and TIS.
Patients with DID encompass at least two different DIS. These identities involve different subjective reactions, cardiovascular responses and cerebral activation patterns to a trauma-related memory script.
One Brain, Two Selves
Our findings reveal the existence of different regional cerebral blood flow patterns for different senses of self. We present evidence for the medial prefrontal cortex (MPFC) and the posterior associative cortices to have an integral role in conscious experience. http://www.ncbi.nlm.nih.gov/pubmed/14683715
Research Articles and Books about Dissociative Identity Disorder and MPD
Overcoming Multiple Personality Disorder By Anne Underwood
Multiple personality disorder is a perplexing phenomenon to outside observers, believed to be brought on by persistent childhood abuse. What is it like living with MPD? And how does a sufferer function, with so many alternate personalities—or “alters”—some of them adults and some children? NEWSWEEK’s Anne Underwood spoke with Karen Overhill—a former sufferer and the subject of a new book, “Switching Time,” by Dr. Richard Baer.
Multiple personality and dissociation, 1791-1992: a complete bibliography
The official journal of the International Society for the Study of Trauma and Dissociation (ISSTD), published between 1988 and 1997
Forensic Aspects of Dissociative Identity Disorder
This ground-breaking book examines the role of crime in the lives of people with Dissociative Identity Disorder, formerly known as Multiple Personality Disorder, a condition which appears to be caused by prolonged trauma in infancy and childhood. This trauma may be linked with crimes committed against them, crimes they have witnessed, and crimes they have committed under duress.
Trauma And Dissociation in a Cross-cultural Perspective: Not Just a North American Phenomenon
An international look at the similarities and differences of long-lasting trauma – Trauma and Dissociation in a Cross-Cultural Perspective examines the psychological, sociological, political, economic, and cultural aspects of trauma and its consequences on people around the world. Dispelling the myth that trauma-related dissociative disorders are a North American phenomenon, this unique book travels through more than a dozen countries to analyze the effects of long-lasting traumatization-both natural and man-made-on adults and children. http://www.amazon.com/Trauma-Dissociation-Cross-cultural-Perspective-Phenomenon/dp/0789034077
Sybil in Her Own Words Patrick Suraci Psychologist
Sybil and Multiple Personality Disorder
Review of “Sybil in her own words”
Twenty-Two Faces – Inside the Extraordinary Life of Jenny Hill and Her Twenty-Two Multiple Personalities Judy Byington
Open Letter to Dr. Phil From Jenny Hill
Basic Information on DID
Basic Information on Dissociative Identity Disorder with sections on Basic Information on DID from the DSM-IV-TR, The History of DID/MPD, Diagnosing DID, Responses to those that state that DID is iatrogenic or a social construct, MPD/DID connection to severe abuse, Recent information and DID resources,
Physiological studies showing differences between DID patients and non-DID patients
Research and Information on Dissociative Identity Disorder (formerly called Multiple Personality Disorder) http://ritualabuse.us/research/did/
Disinformation and DID: the Politics of Memory – Brian Moss, MA, MFT
Information on the False Memory Syndrome, Mind Control, Dissociative Identity Disorder, The Media, Ritual Abuse, The Nazis and Programming.
Secret Weapons – Two Sisters’ Terrifying True Story of Sex, Spies and Sabotage by Cheryl and Lynn Hersha with Dale Griffis, Ph D. and Ted Schwartz. New Horizon Press ISBN 0-88282-196-2 Is a well-documented, verifiable account of not one, but two childrens’ long untold stories of being CHILD subjects of Project MKUltra. Quotes from the book: “By the time Cheryl Hersha came to the facility, knowledge of multiple personality was so complete that doctors understood how the mind separated into distinct ego states,each unaware of the other. First, the person traumatized had to be both extremely intelligent and under the age of seven, two conditions not yet understood though remaining consistent as factors. The trauma was almost always of a sexual nature…” p. 52 “The government researchers,aware of the information in the professional journals, decided to reverse the process (of healing from hysteric dissociation). They decided to use selective trauma on healthy children to create personalities capable of committing acts desired for national security and defense.” p. 53 – 54 0
Recovered Memories of Child Abuse: Accuracy and Veracity, 110 Corroborated Cases of Recovered Memory
November 4, 2014 Comments Off on Recovered Memories of Child Abuse: Accuracy and Veracity, 110 Corroborated Cases of Recovered Memory
110 Corroborated Cases of Recovered Memory:
53 Cases from Legal Proceedings
25 Clinical Cases and other Academic/Scientific Case Studies
33 Other Corroborated Cases of Recovered Memory
Recovered Memories of Sexual Abuse Scientific Research & Scholarly Resources
Amnesia for childhood sexual abuse is a condition.
The existence of this condition is beyond dispute.
Repression is merely one explanation
– often a confusing and misleading one –
for what causes the condition of amnesia.
Some people sexually abused in childhood
will have periods of amnesia for their abuse,
followed by experiences of delayed recall.
Research on the Effect of Trauma on Memory
Research has shown that traumatized individuals respond by using a variety of psychological mechanisms. One of the most common means of dealing with the pain is to try and push it out of awareness. Some label the phenomenon of the process whereby the mind avoids conscious acknowledgment of traumatic experiences as dissociative amnesia . Others use terms such as repression , dissociative state , traumatic amnesia, psychogenic shock, or motivated forgetting . Semantics aside, there is near-universal scientific acceptance of the fact that the mind is capable of avoiding conscious recall of traumatic experiences.
What about Recovered Memories?
Jennifer J. Freyd, University of Oregon
The Recovered Memory Project
Research discussing corroboration and accuracy of recovered memories
Recovered memory corroboration rates
“Between 31 and 64 percent of abuse survivors in six major studies reported that they forgot “some of the abuse.” Numbers reporting severe amnesia ranged from under 12% to 59%….Studies report 50-75% of abuse survivors corroborating the facts of their abuse through an outside source.”
Memory disturbances and dissociative amnesia in Holocaust survivors http://blogs.brown.edu/recoveredmemory/scholarly-resources/holocaust/
The following articles provide compelling scientific evidence in support of the phenomena of dissociation and recovered memory in Holocaust survivors.
Recovered Memory Data
Recovered Memories – Child Abuse Wiki
Recovered memories have been defined as the phenomenon of partially or fully losing parts of memories of traumatic events, and then later recovering part or all of the memories into conscious awareness. They have also been defined as the recollections of memories that are believed to have been unavailable for a certain period of time. There is very strong scientific evidence that recovered memories exist. This has been shown in many scientific studies. The content of recovered memories have fairly high corroboration rates.
There are many studies that have proven that the recovered memories of traumatic events exist. Brown, Scheflin and Hammond found 43 studies that showed recovered memories for traumatic events. The Recovered Memory Project has collected 101 corroborated cases of recovered memories. Hopper’s research shows that amnesia for childhood sexual abuse is “beyond dispute.” He states that “at least 10% of people sexually abused in childhood will have periods of complete amnesia for their abuse, followed by experiences of delayed recall”  In one study of women with previously documented histories of sexual abuse, 38% of the women did not remember the abuse that had happened 17 years before. Most recovered memories either precede therapy or the use of memory recovery techniques. One studied showed that five out of 19 women with histories of familial sexual abuse either forgot specific details or had “blank periods” for these memories. Another study showed that “40% reported a period of forgetting some or all of the abuse”. Herman and Harvey’s study showed that 16% of abuse survivors had “complete amnesia followed by delayed recall”. Corwin’s individual case study provides evidence of the existence of recovered memories on videotape.
Other researchers state:
Research has shown that traumatized individuals respond by using a variety of psychological mechanisms. One of the most common means of dealing with the pain is to try and push it out of awareness. Some label the phenomenon of the process whereby the mind avoids conscious acknowledgment of traumatic experiences as dissociative amnesia. Others use terms such as repression, dissociative state, traumatic amnesia, psychogenic shock, or motivated forgetting. Semantics aside, there is near-universal scientific acceptance of the fact that the mind is capable of avoiding conscious recall of traumatic experiences.
A body of empirical evidence indicates that it is common for abused children to reach adulthood without conscious awareness of the trauma
There is scientific evidence in support of the phenomena of dissociation and recovered memory in Holocaust survivors.                      
Many studies show high corroboration rates for recovered memories of traumatic events. These rates vary from 50 – 75%, 64%, 77%, 50%, 75% 68% 47%, and 70% . One study showed amnesia in 12 murderers, with “objective evidence of severe abuse…obtained in 11 cases”. There are also additional studies showing the corroboration of recovered memories.
excerpt used with permission from http://childabusewiki.org/index.php?title=Recovered_Memories
Growing Not Dwindling: Worldwide Phenomenon of Dissociative Disorders, Disinformation About Dissociation Dr Joel Paris’s Notions About Dissociative Identity Disorder
April 4, 2013 Comments Off on Growing Not Dwindling: Worldwide Phenomenon of Dissociative Disorders, Disinformation About Dissociation Dr Joel Paris’s Notions About Dissociative Identity Disorder
LETTERS TO THE EDITOR The Journal of Nervous and Mental Disease & Volume 201, Number 4, April 2013 http://www.jonmd.com p. 353 – 358
Growing Not Dwindling: Worldwide Phenomenon of Dissociative Disorders
To the Editor:
In the December 2012 issue of the Journal, Joel Paris, MD, wrote an article about the current status of dissociative identity disorder (DID) and the dissociative disorder field in general. He suggests that DID is merely a ‘‘fad’’ and that there is no credible evidence to connect traumatic experiences with the development of DID. We refute several of the claims made by Dr Paris.
Our biggest concern as non-North American researchers is that Dr Paris does not reference a single international study related to dissociative disorders and DID, despite the considerable and increasing empirical literature from around the world. His speculation that DID is not diagnosed outside clinics that specialize in treating dissociation is not consistent with current data. DID and dissociative disorders have been reliably found in general psychiatric hospitals; psychiatric emergency departments; and private practices in countries including England, the Netherlands, Turkey, Puerto Rico, Northern Ireland, Germany, Finland, China, and Australia, among many others….
Much of the international research, using sophisticated epidemiological and clinical research methods, has replicated dozens of times the finding that dissociative processes and disorders (including DID) can be reliably detected in a wide spectrum of different societies. Epidemiological general population studies indicate that 1.1% to 1.5% meet diagnostic criteria for DID; and 8.6% to 18.3%, for any DSM-IV dissociative disorder (Johnson et al., 2006; Sar et al., 2007a). The international literature on DID and dissociative disorders has been widely published in mainstream journals of psychiatry and psychopathology and is inconsistent with Dr Paris’s conclusions….
Dr Paris also opines that there is only a ‘‘weak link’’ between child abuse and psychopathology, quoting an article published 17 years ago. Current research illustrates a very different picture. Persons with early abusive experiences demonstrate increased illnesses (Green and Kimerling, 2004), impaired work functioning (Lee and Tolman, 2006), serious interpersonal difficulties (Van der Kolk and d’Andrea, 2010), and a high risk for traumatic revictimization (Rich et al., 2004). The Adverse Childhood Experiences Study, an American epidemiological study, has provided retrospective and prospective data from more than 17,000 individuals on the effects of traumatic experiences during the first 18 years of life.
In conclusion, Dr Paris’s assessment of the supposedly dwindling fad of DID and dissociative disorders is not in keeping with current peer-reviewed international research. The dissociative disorder field has been producing solid and consistent evidence that provides guidance to clinicians and researchers about the epidemiology, phenomenology, diagnosis, and treatment of DID (and closely related conditions).
Alfonso Marti´nez-Taboas, PhD Department of Psychology
Carlos Albizu University San Juan, Puerto Rico
Martin Dorahy, PhD Department of Psychology University of Canterbury
Christchurch, New Zealand
Vedat Sar, MD Department of Psychiatry Istanbul University Istanbul, Turkey
Warwick Middleton, MD Department of Psychiatry University of Queensland
St Lucia, Australia
Christa Kru¨ger, MD Department of Psychiatry University of Pretoria
Pretoria, South Africa
Journal of Nervous & Mental Disease: April 2013 – Volume 201 – Issue 4 – p 353–354 doi: 10.1097/NMD.0b013e318288d27f
Letters to the Editor
Disinformation About Dissociation Dr Joel Paris’s Notions About Dissociative Identity Disorder
To the Editor:
We write to record our objections to both the form and the content of Dr Joel Paris’s recent article entitled The Rise and Fall of Dissociative Identity Disorder (Paris, 2012). His claim that dissociative identity disorder (DID) is a ‘‘medical fad’’ is simply wrong, and he provides no substantive evidence to support his claim. From the mistaken identification of Pierre Janet as a psychiatrist in the first line (Janet was the most famous psychologist of his day), it is replete with errors, false claims, and lack of scholarship and just plainly ignores the published literature. Dr Paris provided a highly biased article that is based on opinion rather than on science. His review of the literature is extremely selective. Of 48 references, Dr Paris cites exactly 7 peer-reviewed articles published from 2000 onward (7/48 references equals 14%) and only 8 peer-reviewed, data-driven articles from before 2000 (8/48 equals 16%). Rather than relying on the recent peer-reviewed, scientific literature, Paris relied almost entirely on the non-peer-reviewed books, including a popular press book written by a journalist whose methods and conclusions have been strongly challenged.
He claims that interest and research in DID have waned, yet he fails to cite the multitude of studies that have been conducted about it. In fact, Dalenberg et al. (2007) documented evidence of the exact opposite pattern described by Paris: ‘‘A search of the PILOTS database offered by the National Center for Posttraumatic Stress Disorder for articles on dissociation reveals 64 studies in 1985-1989, 236 published in 1990-1994, 426 published in 1995-1999 and 477 in the last 5-year block (2000-2004)’’ (p. 401)….
In addition, he fails to cite a variety of neurobiological and psychophysiological studies of DID documenting similar brain morphology abnormalities in patients with DID to those of other traumatized patients (Reinders et al., 2006; Vermetten et al., 2006). Despite failing to review this and other relevant research, Dr Paris made the claim that ‘‘Neither the theory behind the diagnosis nor the methods of treatment are consistent with the current preference for biological theories’’ (p. 1078). Furthermore, he fails to cite any research that has been done by researchers outside North America. For example, Vedat Sar, MD, in Turkey has published more than 70 articles and chapters on dissociative disorders and trauma (http://vedatsar.com/ index_2.htm), but Dr Paris failed to mention a single one….
A recent review in Psychological Bulletin by 2012) found strong support for the etiological relationship of trauma and dissociation. These included several large meta-analyses, some of which focused on patients with DID. Dalenberg et al. (2012) found an effect size of r = 0.52 and 0.54 for the relationship between childhood physical abuse and sexual abuse, respectively, in studies that compared individuals with dissociative disorders with those without dissociative disorders. In addition, Dalenberg et al. (2012) tested eight different predictions of the trauma versus the fantasy (sociocognitive/iatrogenic) model of dissociation. On each, careful of reviews of the literature, including meta-analyses, on memory, suggestibility, and neurobiology, among others, Dalenberg et al. (2012) found minimal scientific evidence to support the fantasy model. Further, reviews have shown that there are no research studies in the literature in any population studied to support the iatrogenic/sociocognitive etiology of DID promulgated by Dr Paris (Brown et al., 1999; Loewenstein, 2007)….
Dr Paris’s article does not provide scholarly criticism based upon peer reviewed research, scientific data, or accurate discussion of the history of psychiatry. His point of view is incorrect and outmoded. It is the so-called false-memory, iatrogenesis model of the dissociative disorders that is the fallen fad, buried under the weight of rigorous data that contradict it. Dissociative disorders have not risen and fallen. These existed before the fields of psychiatry and psychology did….
Bethany Brand, PhD Department of Psychology Towson University, MD
Richard J. Loewenstein, MD The Trauma Disorders Program Sheppard Pratt Health System Baltimore, MD Department of Psychiatry University of Maryland School of Medicine Baltimore
David Spiegel, MD Department of Psychiatry and Behavioral Sciences
Stanford University School of Medicine CA
Journal of Nervous & Mental Disease: April 2013 – Volume 201 – Issue 4 – p 354–356 doi: 10.1097/NMD.0b013e318288d2ee Letters to the Editor
December 3, 2012 Comments Off on Evaluation of the Evidence for the Trauma and Fantasy Models of Dissociation
Evaluation of the Evidence for the Trauma and Fantasy Models of Dissociation
“there is strong empirical support for the hypothesis that trauma causes dissociation, and that dissociation remains related to trauma history when fantasy proneness is controlled. We find little support for the hypothesis that the dissociation–trauma relationship is due to fantasy proneness or confabulated memories of trauma.”
Constance J. Dalenberg, Bethany L. Brand, David H. Gleaves, Martin J. Dorahy, Richard J. Loewenstein, Etzel Cardeña, Paul A. Frewen, Eve B. Carlson, and David Spiegel Psychological Bulletin Online First Publication, March 12, 2012. doi: 10.1037/a0027447
The relationship between a reported history of trauma and dissociative symptoms has been explained in 2 conflicting ways. Pathological dissociation has been conceptualized as a response to antecedent traumatic stress and/or severe psychological adversity. Others have proposed that dissociation makes individuals prone to fantasy, thereby engendering confabulated memories of trauma. We examine data related to a series of 8 contrasting predictions based on the trauma model and the fantasy model of dissociation. In keeping with the trauma model, the relationship between trauma and dissociation was consistent and moderate in strength, and remained significant when objective measures of trauma were used. Dissociation was temporally related to trauma and trauma treatment, and was predictive of trauma history when fantasy proneness was controlled. Dissociation was not reliably associated with suggestibility, nor was there evidence for the fantasy model prediction of greater inaccuracy of recovered memory. Instead, dissociation was positively related to a history of trauma memory recovery and negatively related to the more general measures of narrative cohesion. Research also supports the trauma theory of dissociation as a regulatory response to fear or other extreme emotion with measurable biological correlates. We conclude, on the basis of evidence related to these 8 predictions, that there is strong empirical support for the hypothesis that trauma causes dissociation, and that dissociation remains related to trauma history when fantasy proneness is controlled. We find little support for the hypothesis that the dissociation–trauma relationship is due to fantasy proneness or confabulated memories of trauma.