Dissociative identity disorder DIDpreviously known as multiple personality disorder MPD[7] is a mental disorder characterized by the maintenance of at least two distinct and relatively enduring personality states. DID is associated with overwhelming traumas, or abuse during childhood.
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Treatment generally involves supportive care and psychotherapy. DID is controversial within both psychiatry and the legal system. Dissociationthe term that underlies the dissociative disorders including DID, lacks a precise, empirical, and generally agreed upon definition. A large number of diverse experiences have been termed dissociative, ranging from normal failures in attention to the breakdowns in memory processes characterized by the dissociative disorders.
Thus it is unknown if there is a common root underlying all dissociative experiences, or if the range of mild to severe symptoms is a result of different etiologies and biological structures. Some terms have been proposed regarding dissociation. One is ego state behaviors and experiences possessing permeable boundaries with other such states but united by a common sense of selfwhile the other term is alters each of which may have a separate autobiographical memoryindependent initiative and a sense of ownership over individual behavior. Ellert Nijenhuis and colleagues suggest a distinction go here personalities responsible for day-to-day functioning associated with blunted physiological responses and reduced emotional reactivityreferred read article as the "apparently normal part of the personality" or ANP and those emerging in survival situations involving fight-or-flight responsesvivid traumatic memories Idfntity strong, painful Disspciative, the "emotional part of the personality" or EP.
Efforts to psychometrically distinguish between normal and pathological dissociation have been made. According to the fifth Diagnostic and Statistical Manual of Mental Disorders DSM-5DID symptoms include "the presence of two or more distinct personality states" Dissociqtive by the inability to recall personal information, beyond what is expected through normal forgetfulness. Other DSM-5 symptoms include a loss of identity as related to individual distinct personality states, and loss referring to time, sense of self and consciousness. Around half of people with DID have fewer than 10 identities and most have fewer than ; as many as 4, have been reported. However, it is unclear whether this is due to an actual increase in identities, Dissociative Identity Disorder Dissociative Personality simply that the psychiatric community has become more accepting of a high number of Dissociative Identity Disorder Dissociative Personality memory components.
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The psychiatric history frequently contains multiple previous diagnoses of various disorders and treatment failures. Comorbid disorders can include substance abuseeating disordersanxiety disorderspost-traumatic stress disorder PTSDand personality disorders. The DSM-IV-TR states that acts of self-mutilationimpulsivityand rapid changes in interpersonal relationships "may warrant a concurrent diagnosis of borderline personality disorder.
Their conclusions about the empirical proof of DID were echoed by a second group, who still believed the diagnosis existed, but while the knowledge to date did not justify DID as a separate diagnosis, it also did not disprove its existence. DID is aetiologically complex. Whereas psychosocial etiologies of DID include developmental traumatization and sociocognitive sequelae, Didsociative factors include trauma-generated neurobiological responses. Biologically derived traits and epigenetic mechanisms are also likely to be at play.
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At this point, no direct examination of genetics has occurred in DID. However, it is likely to exist, given the genetic link to dissociation in general and in relation to childhood adversity in particular. There Dissociative Identity Disorder Dissociative Personality currently two competing theories regarding the relationship between trauma and dissociation: the trauma-related model and the fantasy-prone model.
People diagnosed with DID https://amazonia.fiocruz.br/scdp/essay/writing-practice-test-online/a-brief-note-on-older-care-and.php report that they have experienced physical or sexual abuse during childhood [4] although the accuracy of these reports has been disputed [21] ; others report overwhelming stress, serious medical illness or other traumatic events during childhood.
What may be expressed as post-traumatic stress disorder PTSD in adults may become DID when article source in children, possibly due to their greater use of imagination as a form of coping. Delinking early trauma from the etiology of dissociation has been explicitly rejected by those supporting the early Dissociative Identity Disorder Dissociative Personality model. However, a review article supports the hypothesis that current or recent trauma may affect an individual's assessment of the more distant past, changing the experience of the past and resulting in dissociative states.
Evidence is increasing that dissociative disorders are related both to a trauma history and to "specific neural mechanisms". Paris states that the Dissiciative model of DID increased the appeal of the diagnosis among health care providers, patients and the public as it validated the idea that child abuse had lifelong, serious effects.
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There is very little experimental evidence supporting the trauma-dissociation hypothesis, and no research showing that dissociation consistently links to long-term memory disruption. The prevailing post-traumatic model of dissociation and dissociative disorders is contested. This model posits that behavior is enhanced by media portrayals of DID. Proponents of the SCM note that the bizarre dissociative symptoms are rarely present before intensive therapy by specialists in the treatment of DID who, through the process of eliciting, conversing with and identifying Dissociative Identity Disorder Dissociative Personality, shape or possibly create the diagnosis. While proponents note that DID is accompanied by genuine suffering and the distressing symptoms, and can be diagnosed reliably using the DSM criteria, they are skeptical of the traumatic etiology suggested by proponents. These various cultural and therapeutic causes occur within a context of pre-existing psychopathology, notably borderline personality disorderwhich is commonly comorbid with DID.
Proponents of psychotherapy as a cause of DID state that DID is strongly linked to possibly suggestive psychotherapy, often involving recovered memories memories that the person previously had amnesia for or false memoriesand that such therapy could cause additional identities.]
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