dissociative identity disorder (did) earlier known as multiple personality disorder

Dissociative Identity Disorder (DID)- a brief presentation

• Background

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• Dissociative Identity Disorder (DID) is an Axis I Mental Disorder

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• DID was formerly known as “Multiple Personality Disorder” (MPD)

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• DID is codified 300.14 in DSM IV

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• DID is characterized by identity fragmentation

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• Diagnostic Criteria

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• For a person to be diagnosed for DID, the following four criteria must be met…

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• Criterion A: There are present two or more distinct identities or personal states in one individual.

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• The number of identities in such an individual is reported to be from 2 to 100.

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• The individual finds it challenging to integrate the different aspects of their identity, memory and consciousness.

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• Each of the identity states has its own distinct personal history, self-image, and identity – including different age, different gender, and also a different name.

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• Criterion B: These distinct identities take control over the behavior recurrently.

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• There usually exists a main, primary identity which carries the individual’s given name.

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• When this primary identity takes control of the consciousness, the individual usually has a passive, dependent, guilty and depressed personality.

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• On the other hand, some of the alternate identities may be hostile, dominating, aggressive, etc.

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• The alternative identities emerge and take control over the individual’s consciousness due to some trigger such as psychosocial stress.

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• The time required to switch between two identities may be a few seconds; or it may be gradual.

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• Others around may discern that the switch has happened, through specific symptoms such as rapid blinking, facial changes, changes in voice or demeanor, or sudden change of track of the individual’s thoughts.

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• The alternate identities take control in sequence, one after another.

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• The alternate identities may deny knowledge of the existence of the other alternate identities altogether.

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• Or, they may be aware of and be critical of the other alternate identities.

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• Criterion C: The individual is unable to recall important personal information, and this inability is too severe to be attributed to ordinary forgetfulness.

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• The individual’s primary identity appears to experience gaps in memory both in recent and remote episodes.

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• The memory gap may include an overall loss of biographic memory for an extended period of childhood, adolescence, or even adulthood.

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• The passive identity state has the most constricted memory recall. The hostile, controlling, or protecting identity state has near-complete memory recall.

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• Criterion D: The disturbance is not an outcome of substance abuse or general medical condition.

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• While differentially diagnosing for DID, it is prudent to ascertain whether the symptoms are manifesting as an episodic outcome of either substance abuse disorder or some general medical condition.

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• Course of the disorder

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• DID has a fluctuating clinical course with tendency to be chronic and recurrent.

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• The average time elapsed between the first time the symptoms present themselves – to actual diagnosis, is 6 to 7 years.

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• The disorder may become less manifest in the late 40s and beyond.

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• However, there may still be relapse due to stressors of trauma, Substance Abuse, etc.

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• Specific Culture, Age, and Gender Features

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• DID has been found in individuals in different cultures.

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• Females tend to have more identities than do males. • A DID female may

have up to 15+ identities, compared to about 8 in males.

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• Familial Pattern

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• DID is more common among 1st-degree biological relatives of the individual with the disorder.

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• Introducing - The Movie

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•Movie “The Three Faces of Eve” is based on the true story of Ms. Chris Costner Sizemore.

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• Ms. Sizemore receiving fans on the occasion of the 51st anniversary of the premiere of the movie, in 2008.

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• The case was studied by Dr. Corbett H. Thigpen and Dr. Hervey M. Cleckley.

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• The movie was made in 1957.• It stars Joanne

Woodward in the lead role.

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• The movie was directed by Nunnally Johnson.• It has a running

time of 91 minutes (about 1.5 hours).

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• The Movie Plot

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• The movie is about a homemaker and mother who keeps experiencing severe headaches and blackouts very often.

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• During a session with the psychiatrist, a new personality of the protagonist emerges.

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• The psychiatrist diagnoses the case as DID.• The movie revolves

around how continued therapy brings out all her other identities, and how she is cured.

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- Sanjay Agrawal, MSCP, Kuvempu University, Karnataka, India