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.

Causes

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

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.”
http://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.154.12.1703

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.
http://www.ncbi.nlm.nih.gov/pubmed/8434668?dopt=Abstract

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.
http://www.ncbi.nlm.nih.gov/pubmed/2044042?dopt=Abstract

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.
https://scholarsbank.uoregon.edu/xmlui/handle/1794/1424

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.
http://psycnet.apa.org/index.cfm?fa=search.displayRecord&uid=1996-01403-003

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.”
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279


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.
http://www.ncbi.nlm.nih.gov/pubmed/3418321

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.
RESULTS:
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.
CONCLUSIONS:
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.
http://www.ncbi.nlm.nih.gov/pubmed/17008145

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.
http://www.newsweek.com/overcoming-multiple-personality-disorder-103403

Multiple personality and dissociation, 1791-1992: a complete bibliography
http://boundless.uoregon.edu/cdm4/item_viewer.php?CISOROOT=/diss&CISOPTR=38

The official journal of the International Society for the Study of Trauma and Dissociation (ISSTD), published between 1988 and 1997
https://scholarsbank.uoregon.edu/xmlui/handle/1794/1129

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.
http://us.karnacbooks.com/product/forensic-aspects-of-dissociative-identity-disorder/25876/

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
http://www.huffingtonpost.com/patrick-suraci/post_2699_b_1152241.html

Sybil and Multiple Personality Disorder
http://sybilandmpd.blogspot.com/

Review of “Sybil in her own words”
http://sybilandmpd.blogspot.com/2011/11/review-of-sybil-in-her-own-words-by.html

Twenty-Two Faces – Inside the Extraordinary Life of Jenny Hill and Her Twenty-Two Multiple Personalities Judy Byington
http://ritualabuse.us/ritualabuse/articles/twenty-two-faces-inside-the-extraordinary-life-of-jenny-hill-and-her-twenty-two-multiple-personalities-judy-byington-msw-lcsw/

Open Letter to Dr. Phil From Jenny Hill
http://ritualabuse.us/ritualabuse/articles/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
https://ritualabuse.us/research/did/basic-information-on-didmpd/

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.
http://ritualabuse.us/research/did/disinformation-and-did-the-politics-of-memory/

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

Pope updates Vatican law, criminalizing sex abuse, leaks, The case of Fran and Dan Keller – Fran’s Day Care, PTSD treatments

July 13, 2013 Comments Off on Pope updates Vatican law, criminalizing sex abuse, leaks, The case of Fran and Dan Keller – Fran’s Day Care, PTSD treatments

Pope updates Vatican law, criminalizing sex abuse, leaks
New laws apply to clergy, others in the city-state
By Nicole Winfield   Associated Press
July 12, 2013 VATICAN CITY

Pope Francis overhauled the laws that govern the Vatican city-state on Thursday, criminalizing leaks of Vatican information and specifically listing sexual violence, prostitution, and possession of child pornography as crimes against children that can be punished by up to 12 years in prison.

The legislation covers clergy and laypeople who live and work in Vatican City and is different from the canon law which covers the universal Catholic Church.

It was issued at a critical time, as the Vatican prepares for a grilling by a UN committee on its efforts to protect children under a key UN convention and prevent priests from sexually abusing children. The Vatican signed and ratified the UN Convention on the Rights of the Child in 1990 yet only now — 23 years later — has it updated its legislation to reflect some of the treaty’s core provisions….
http://www.bostonglobe.com/news/world/2013/07/11/pope-updates-vatican-law-crminalizing-sex-abuse-leaks/URHItA5fuIxJNruXaGO2jI/story.html

Fran’s Day Care Case – Randy Noblitt, PhD
The case of Fran and Dan Keller

excerpts:
“Some of the parents whose children attended the preschool became suspicious when their children returned home wearing underwear not their own, or with their clothes inside out or with their hair wet. There were always reasonable explanations: the child had an accident and was changed into clothes on hand for that purpose; or the child splashed water on herself when the children were cleaning up; and so forth. However, when one of the children made an outcry, the parents more closely scrutinized the strange behaviors some of the children had started engaging in and the aforementioned episodes, and they took their concerns to the police. The police took the concerns seriously and collected statements and evidence. The grand jury found a basis for indictment. The Kellers responded to the warrant for their arrest by fleeing the state in disguise, obtaining false identifications in their new personas, and attempting to leave the country. They were apprehended in Las Vegas, Nevada and extradited back to Travis County.”

“The case ended with the conviction of the Kellers and their sentencing to 48 years in prison each. They are in prison still, any efforts for appeal having failed to date.”

“the perspective was one of advocacy for falsely accused, persecuted, prosecuted, and convicted victims of a malicious or inept legal system that places too much trust in the stories children tell. A particular flaw in this story was the story. It was certainly not founded on anything I witnessed during my participation in the case. Evidence was not withheld from the prosecution to my knowledge. The defense was left flat-footed by their own conviction that the children would not be believed. And the advice I offered may have helped to prevent influence or contamination of the children’s testimony. The children’s stories were credible – Fran and Dan Keller’s defense was not.”

“One of the child victims, Veejay Staelin, a now 21-year old…re-asserted that he had been abused by Fran and Dan Keller.”
http://ritualabuse.us/ritualabuse/articles/frans-day-care/

Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Authors Watts BV, et al

Journal
J Clin Psychiatry. 2013 Jun;74(6):e541-50. doi: 10.4088/JCP.12r08225.

Abstract
OBJECTIVE: Posttraumatic stress disorder (PTSD) is an important mental health issue in terms of the number of people affected and the morbidity and functional impairment associated with the disorder. The purpose of this study was to examine the efficacy of all treatments for PTSD….

RESULTS: Effective psychotherapies included cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing (g = 1.63, 1.08, and 1.01, respectively). Effective pharmacotherapies included paroxetine, sertraline, fluoxetine, risperidone, topiramate, and venlafaxine (g = 0.74, 0.41, 0.43, 0.41, 1.20, and 0.48, respectively)….

CONCLUSIONS: Our findings suggest that patients and providers have a variety of options for choosing an effective treatment for PTSD. Substantial differences in study design and study participant characteristics make identification of a single best treatment difficult. Not all medications or psychotherapies are effective.
http://www.ncbi.nlm.nih.gov/m/pubmed/23842024/

Embattled Childhoods May Be the Real Trauma for Soldiers With PTSD

November 22, 2012 Comments Off on Embattled Childhoods May Be the Real Trauma for Soldiers With PTSD

Embattled Childhoods May Be the Real Trauma for Soldiers With PTSD

ScienceDaily (Nov. 19, 2012) — New research on posttraumatic stress disorder (PTSD) in soldiers challenges popular assumptions about the origins and trajectory of PTSD, providing evidence that traumatic experiences in childhood — not combat — may predict which soldiers develop the disorder….

“Most studies on PTSD in soldiers following service in war zones do not include measures of PTSD symptoms prior to deployment and thus suffer from a baseline problem. Only a few studies have examined pre- to post-deployment changes in PTSD symptoms, and most only use a single before-and-after measure,” says Berntsen….

Rather than following some sort of “typical” pattern in which symptoms emerge soon after a particularly traumatic event and persist over time, Berntsen and colleagues found wide variation in the development of PTSD among the soldiers.

The vast majority of the soldiers (84%) were resilient, showing no PTSD symptoms at all or recovering quickly from mild symptoms.

The rest of the soldiers showed distinct and unexpected patterns of symptoms. About 4% showed evidence of “new-onset” trajectory, with symptoms starting low and showing a marked increase across the five timepoints. Their symptoms did not appear to follow any specific traumatic event.

Most notably, about 13% of the soldiers in the study actually showed temporary improvement in symptoms during deployment. These soldiers reported significant symptoms of stress prior to leaving for Afghanistan that seemed to ease in the first months of deployment only to increase again upon their return home.

What could account for this unexpected pattern of symptoms?

Compared to the resilient soldiers, the soldiers who developed PTSD were much more likely to have suffered emotional problems and traumatic events prior to deployment. Childhood experiences of violence, especially punishment severe enough to cause bruises, cuts, burns, and broken bones actually predicted the onset of PTSD in these soldiers. Those who showed symptoms of PTSD were more likely to have witnessed family violence, and to have experienced physical attacks, stalking or death threats by a spouse. They were also more likely to have past experiences that they could not, or would not, talk about. And they were less educated than the resilient soldiers….

The findings challenge the notion that exposure to combat and other war atrocities is the main cause of PTSD.

“We were surprised that stressful experiences during childhood seemed to play such a central role in discriminating the resilient versus non-resilient groups,” says Berntsen. “These results should make psychologists question prevailing assumptions about PTSD and its development.”

http://www.sciencedaily.com/releases/2012/11/121119140625.htm

Peace and War Trajectories of Posttraumatic Stress Disorder Symptoms Before, During, and After Military Deployment in Afghanistan

Dorthe Berntsen, Kim B. Johannessen, Yvonne D. Thomsen, Mette Bertelsen, Rick H. Hoyle and David C. Rubin

Abstract
In the study reported here, we examined posttraumatic stress disorder (PTSD) symptoms in 746 Danish soldiers measured on five occasions before, during, and after deployment to Afghanistan. Using latent class growth analysis, we identified six trajectories of change in PTSD symptoms. Two resilient trajectories had low levels across all five times, and a new-onset trajectory started low and showed a marked increase of PTSD symptoms. Three temporary-benefit trajectories, not previously described in the literature, showed decreases in PTSD symptoms during (or immediately after) deployment, followed by increases after return from deployment. Predeployment emotional problems and predeployment traumas, especially childhood adversities, were predictors for inclusion in the nonresilient trajectories, whereas deployment-related stress was not.

These findings challenge standard views of PTSD in two ways. First, they show that factors other than immediately preceding stressors are critical for PTSD development, with childhood adversities being central. Second, they demonstrate that the development of PTSD symptoms shows heterogeneity, which indicates the need for multiple measurements to understand PTSD and identify people in need of treatment.

http://pss.sagepub.com/content/early/2012/11/02/0956797612457389

Hippocampal and Amygdalar Volumes in Dissociative Identity Disorder

June 18, 2011 Comments Off on Hippocampal and Amygdalar Volumes in Dissociative Identity Disorder

Eric Vermetten, M.D., Ph.D. Christian Schmahl, M.D.
Sanneke Lindner, M.Sc. Richard J. Loewenstein, M.D. J. Douglas Bremner, M.D. (Am J Psychiatry 2006; 163:1–8)

Objective: Smaller hippocampal volume has been reported in several stress-related psychiatric disorders, including posttraumatic stress disorder (PTSD), borderline personality disorder with early abuse, and depression with early abuse.

Patients with borderline personality disorder and early abuse have also been found to have smaller amygdalar volume. The authors examined hippocampal and amygdalar volumes in patients with dissociative identity disorder, a disorder that has been associated with a history of severe childhood trauma….

Results: Hippocampal volume was 19.2% smaller and amygdalar volume was 31.6% smaller in the patients with dissociative identity disorder, compared to the healthy subjects. The ratio of hippocampal volume to amygdalar volume was significantly different between groups.

Conclusions: The findings are consistent with the presence of smaller hippocampal and amygdalar volumes in patients with dissociative identity disorder, compared with healthy subjects….

In clinical studies, most patients with dissociative identity disorder have also been found to meet the DSM-IV-TR criteria for posttraumatic stress disorder (PTSD). In epidemiological studies of the general population, the prevalence of dissociative identity disorder has been found to range from 1% to 3%.

Numerous studies have shown an association between a dissociative identity disorder diagnosis and an antecedent history of childhood trauma, usually multiple, sustained forms of maltreatment beginning in early childhood….

Magnetic resonance imaging (MRI) studies have shown that adults with PTSD related to combat or to childhood physical/sexual abuse have smaller hippocampal size, relative to healthy comparison subjects or to comparison subjects who experienced trauma but did not develop PTSD.

Borderline personality disorder is also commonly associated with exposure to childhood trauma. Patients with borderline personality disorder and a history of early abuse have been found to have smaller hippocampal and amygdalar volumes, compared to healthy subjects. Smaller hippocampal volume has been found in patients with major depressive disorder and a history of early childhood trauma, compared to major depressive disorder patients without early life trauma. A consistent finding of these studies is smaller hippocampal volume in patients with a history of exposure to traumatic stress and an accompanying stress-related psychiatric disorder….

All patients with dissociative identity disorder in this study also had a diagnosis of PTSD according to the DSMIV-TR criteria and the Clinician-Administered PTSD Scale….

Electrical stimulation of the hippocampus and adjacent regions in patients with epilepsy resulted in a number of dissociative-like symptoms, including feelings of déjà vu, depersonalization, derealization, and memory alterations. Administration of ketamine, an antagonist of N-methyl-D-aspartic acid (NMDA) receptors, which are highly concentrated in the hippocampus, resulted in dissociative symptoms in healthy subjects, including feelings of being out of body and of time standing still, perceptions of body distortions, and amnesia. On the basis of these findings, we have hypothesized that stress, acting through NMDA receptors in the hippocampus, may mediate symptoms of dissociation….

Clinical studies have found comorbid PTSD or a lifetime history of PTSD in 80%–100% of dissociative identity disorder patients. Davidson and Foa, in their summary of work by members of the APA DSM-IV Advisory Committee on PTSD, included multiple personality disorder/dissociative identity disorder among the disorders related to “abnormal stress reaction[s].”….

There are several possible explanations for the current study findings. Previous studies have shown that dissociative identity disorder patients essentially universally report high rates of exposure to repeated stressful experiences in early life. The hippocampus is a major target organ for glucocorticoids, which are released during stressful experiences. It has been hypothesized that prolonged exposure to glucocorticoids could lead to progressive atrophy of the hippocampus.

Smaller hippocampal volume in dissociative identity disorder could thus be related to stress exposure and could represent a neurobiological finding that dissociative identity disorder shares with other stress-related psychiatric disorders such as PTSD….

These findings suggest that early abuse associated with a stress-related psychiatric disorder may be related to smaller amygdalar volume. In addition, these findings are in contrast to findings from studies of depression that have shown no differences or larger amygdalar volume in depressed patients, compared with healthy subjects….

This finding suggests that dissociative identity disorder is associated with relatively greater volume reductions in the amygdala than in the hippocampus….

full text
http://userwww.service.emory.edu/~jdbremn/papers/DID_MRI.pdf

brain differences in DID/MPD patients, child abuse changes the brain

June 12, 2011 Comments Off on brain differences in DID/MPD patients, child abuse changes the brain

Hippocampal and Amygdalar Volumes in Dissociative Identity Disorder
The neurobiological consequences of early stress and childhood maltreatment
Recent findings regarding brain development and childhood abuse/adversity
Does Child Abuse Permanently Alter the Brain?
The Psychobiology of Posttraumatic Stress Disorder (including physical and sexual abuse)

Hippocampal and Amygdalar Volumes in Dissociative Identity Disorder
Eric Vermetten, M.D., Ph.D., Christian Schmahl, M.D., Sanneke Lindner, M.Sc., Richard J. Loewenstein, M.D., and J. Douglas Bremner, M.D.
Am J Psychiatry 163:630-636, April 2006
doi: 10.1176/appi.ajp.163.4.630….

METHOD: The authors used magnetic resonance imaging to measure the volumes of the hippocampus and amygdala in 15 female patients with dissociative identity disorder and 23 female subjects without dissociative identity disorder or any other psychiatric disorder. The volumetric measurements for the two groups were compared.

RESULTS: Hippocampal volume was 19.2% smaller and amygdalar volume was 31.6% smaller in the patients with dissociative identity disorder, compared to the healthy subjects. The ratio of hippocampal volume to amygdalar volume was significantly different between groups.

CONCLUSIONS: The findings are consistent with the presence of smaller hippocampal and amygdalar volumes in patients with dissociative identity disorder, compared with healthy subjects.
http://ajp.psychiatryonline.org/cgi/content/abstract/163/4/630

full text
“The patients with dissociative identity disorder in our study showed a 19.2% smaller hippocampal volume and a 31.6% smaller amygdalar volume, compared with the healthy subjects.”
http://ajp.psychiatryonline.org/cgi/content/full/163/4/630

The neurobiological consequences of early stress and childhood maltreatment
Martin H. Teicher, Susan L. Andersena, Ann Polcarib, Carl M. Andersona, Carryl P. Navaltae, and Dennis M. Kima

Abstract
Early severe stress and maltreatment produces a cascade of neurobiological events that have the potential to cause enduring changes in brain development. These changes occur on multiple levels, from neurohumoral (especially the hypothalamic–pituitary–adrenal {HPA} axis) to structural and functional. The major structural consequences of early stress include reduced size of the mid-portions of the corpus callosum and attenuated development of the left neocortex, hippocampus, and amygdala.

Major functional consequences include increased electrical irritability in limbic structures and reduced functional activity of the cerebellar vermis. There are also gender differences in vulnerability and functional consequences. The neurobiological sequelae of early stress and maltreatment may play a significant role in the emergence of psychiatric disorders during development.
http://www.sciencedirect.com/science/article/pii/S0149763403000071

Dr. Martin H. Teicher – Recent findings regarding brain development and childhood abuse/adversity
https://drteicher.wordpress.com/

https://drteicher.wordpress.com/2010/11/
Keynote: Pierre Janet memorial lecture ISSTD
Does Child Abuse Permanently Alter the Brain?
Martin H. Teicher, M.D., Ph.D. (PowerPoint)

Annals of the New York Academy of Sciences
New York Academy of Sciences June 1997
Volume 821 Psychobiology of Posttraumatic Stress Disorder, The Pages xi–xv, 1–548
http://onlinelibrary.wiley.com/doi/10.1111/nyas.1997.821.issue-1/issuetoc
includes:
Psychobiological Effects of Sexual Abuse : A Longitudinal Study (pages 150–159)
FRANK W. PUTNAM and PENELOPE K. TRICKETT
DOI: 10.1111/j.1749-6632.1997.tb48276.x

Preliminary Evidence for Abnormal Cortical Development in Physically and Sexually Abused Children Using EEG Coherence and MRI (pages 160–175)
MARTIN H. TEICHER, YUTAKA ITO, CAROL A. GLOD, SUSAN L. ANDERSEN, NATALIE DUMONT and ERIKA ACKERMAN
DOI: 10.1111/j.1749-6632.1997.tb48277.x

Implicit and Explicit Memory for Trauma-Related Information in PTSD (pages 219–224) RICHARD J. MCNALLY
DOI: 10.1111/j.1749-6632.1997.tb48281.x

Trauma, Dissociation, and Memory (pages 225–237)
DAVID SPIEGEL DOI: 10.1111/j.1749-6632.1997.tb48282.x

 

Childhood Trauma and Risk for Chronic Fatigue Syndrome

May 9, 2011 Comments Off on Childhood Trauma and Risk for Chronic Fatigue Syndrome

Childhood Trauma and Risk for Chronic Fatigue Syndrome: Association With Neuroendocrine Dysfunction – Journal: Arch Gen Psychiatry. 2009;66(1):72-80 Authors: Christine Heim, PhD; Urs M. Nater, PhD; Elizabeth Maloney, MS, DrPH; Roumiana Boneva, MD, PhD; James F. Jones, MD; William C. Reeves, MD, MSc

Context
Childhood trauma appears to be a potent risk factor for chronic fatigue syndrome (CFS). Evidence from developmental neuroscience suggests that early experience programs the development of regulatory systems that are implicated in the pathophysiology of CFS, including the hypothalamic-pituitary-adrenal axis. However, the contribution of childhood trauma to neuroendocrine dysfunction in CFS remains obscure.

Objectives
To replicate findings on the relationship between childhood trauma and risk for CFS and to evaluate the association between childhood trauma and neuroendocrine dysfunction in CFS.
Design, Setting, and Participants
A case-control study of 113 persons with CFS and 124 well control subjects identified from a general population sample of 19 381 adult residents of Georgia….

Results
Individuals with CFS reported significantly higher levels of childhood trauma and psychopathological symptoms than control subjects. Exposure to childhood trauma was associated with a 6-fold increased risk of CFS. Sexual abuse, emotional abuse, and emotional neglect were most effective in discriminating CFS cases from controls. There was a graded relationship between exposure level and CFS risk. The risk of CFS conveyed by childhood trauma further increased with the presence of posttraumatic stress disorder symptoms. Only individuals with CFS and with childhood trauma exposure, but not individuals with CFS without exposure, exhibited decreased salivary cortisol concentrations after awakening compared with control subjects.

Conclusions
Our results confirm childhood trauma as an important risk factor of CFS. In addition, neuroendocrine dysfunction, a hallmark feature of CFS, appears to be associated with childhood trauma. This possibly reflects a biological correlate of vulnerability due to early developmental insults. Our findings are critical to inform pathophysiological research and to devise targets for the prevention of CFS.
http://www.endfatigue.com/health_articles_c/Cfs_fm-child_abuse_can_lead_to_cfs_fibromyalgia.html

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