Misplaced Pages

Revision as of 14:18, 18 May 2012

This is the talk page for discussing improvements to the Dissociative identity disorder article. This is not a forum for general discussion of the article's subject.

Put new text under old text. Click here to start a new topic. New to Misplaced Pages? Welcome! Learn to edit; get help. Assume good faith Be polite and avoid personal attacks Be welcoming to newcomers Seek dispute resolution if needed Article policies Neutral point of view No original research Verifiability

Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL

Archives: Index, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13Auto-archiving period: 2 months

Psychology B‑class High‑importance

This article is within the scope of WikiProject Psychology, a collaborative effort to improve the coverage of Psychology on Misplaced Pages. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.PsychologyWikipedia:WikiProject PsychologyTemplate:WikiProject Psychologypsychology B This article has been rated as B-class on Misplaced Pages's content assessment scale. High This article has been rated as High-importance on the project's importance scale.

Medicine: Psychiatry B‑class Mid‑importance

This article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Misplaced Pages talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine B This article has been rated as B-class on Misplaced Pages's content assessment scale. Mid This article has been rated as Mid-importance on the project's importance scale. This article is supported by the Psychiatry task force (assessed as Mid-importance).

Archives
Start to December, 2004 January-December, 2005 January-February, 2006 February-December, 2006 January-October, 2007 November, 2007 – August, 2008 September, 2008-January, 2012 January, 2012 - present /Multiple personality controversy

Clean list of sources

Please use this section to list any sources not already in the page. Please do not use it to discuss them. Please do not add signatures or datestamps as this will cause them to be archived.

Iatrogenic model has been renamed "sociocognitive", google scholar search

• Farrell, 2011, Dissociative Identity Disorder: Medicolegal Challenges pdf
• Boysen, 2011, The scientific status of childhood dissociative identity disorder: a review of published research
• Foote, 2008, Dissociative identity disorder and schizophrenia: differential diagnosis and theoretical issues
• Manning 2009, Convergent paradigms for visual neuroscience and dissociative identity disorder
• Brand et al. 2011, A survey of practices and recommended treatment interventions among expert therapists...

Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1037/a0026487, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1037/a0026487 instead.

• Drob et al, 2009, Clinical and conceptual problems in the attribution of malingering in forensic evaluations.
• Lowenstein, in Vermetten et al., 2007 (ISBN 158562196X), Traumatic dissociation: neurobiology and treatment
• Weiner & Craighead, 2010, The Corsini Encyclopedia of Psychology
• - ISSTD advising against "truth serum" interviews
• NPR story, probably better for looking into sources rather than actual citation
• Ross, 2009, Errors of logic and scholarship concerning dissociative identity disorder (addresses Piper and Mersky)
• Kluft, 2007, The older female patient with a complex chronic dissociative disorder.
• Korol, 2008, Familial and social support as protective factors against the development of dissociative identity disorder.
• Clancy, 2010, The Trauma Myth ISBN 046501688X
• Lilienfeld & Lynn, 2003, Science and pseudoscience in clinical psychology (chapter 5)
• Lilienfeld, 2011, Distinguishing Scientific From Pseudoscientific Psychotherapies (possibly useful)
• MacDonald, 2008, Dissociative disorders unclear? Think ‘rainbows from pain blows’
• Kring, 2009, Abnormal psychology
• Lynn et al. 2010, Dissociation and dissociative identity disorder: Treatment guidelines and cautions
• 2008 Singh, A study in dualism: The strange case of Dr. Jekyll and Mr. Hyde
• 2001 Sutker, Comprehensive handbook of psychopathology
• 2006 Rieber, The bifurcation of the self
• 2011 Tavris, Multiple Personality Deception
• Bravman, 2010, Controversy: Dissociative Identity Disorder
• 1997, Lewis et al. Objective documentation of child abuse and dissociation in 12 murderers with dissociative identity disorder
• Merckelbach

Signs and symptoms

I have some issues with this paragraph:

"Despite research on DID including structural and functional magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, event-related potential and electroencephalography, no convergent neuroimaging findings have been identified regarding DID making it difficult to hypothesize a biological basis for DID. In addition, many of the studies that do exist were performed from an explicitly trauma-based position, and did not consider the possibility of iatrogenic induction of DID. Studies have shown differences between cerebral blood flow and changes in visual parameters between alters, as well as support for amnesia between alters. There is no research to date regarding the neuroimaging and introduction of false memories in DID patients."

It seems to contradict itself, although that might be a deficiency in my understanding of the scientific concepts being explained. It says there are no findings and then two sentences later talks about findings. I don't have problems with the "did not consider the possibility of iatrogenic induction of DID" but do think this all needs to be reworded to be more clear. Additionally, the last line seems to not fit and I can't find anywhere in the article it specifically mentions there is no research - WLU can you point me to it, it's very possible I am overlooking it. Of course that may be a fact but it seems sort of out of left field to be stuck on the end like that, know what I mean? Forgotten Faces (talk) 21:12, 4 February 2012 (UTC)

I would say a 2008 review article over-rules a 2003 and 1996 review article and am comfortable with removing everything not verified by reference 14 (Reinders). I only added the Reinders info, when I gutted that section a couple weeks ago, those were the only sources that were not primary. I assumed they were legit, but haven't actually read them.

The only "finding" is amnesia between alters, and that's not neuroimaging I would say - but I'd need to re-read Reinders for her exact wording.

Re: last sentence, see page 49, final paragraph starting with "Besides (inter-identity) amnesia..." I think that covers it, but I'm doing this quickly. WLU (t) (c) Misplaced Pages's rules:/_complex 21:36, 4 February 2012 (UTC)

I have all these articles so I will read them today and let you know what I think. 2003 is not that old, and it seems taking it out would be not showing all sides of the research, it's not ancient or anything. I'm more concerned about the wording, if it's not contradiction (and I trust you here). Let's put this on hold until I read it and I'll suggest any content/clarity changes (and of course you are free to do the same). Thanks Forgotten Faces (talk) 21:52, 4 February 2012 (UTC)

Oh and as for the last sentence, I'm ok with it now. Forgotten Faces (talk) 21:55, 4 February 2012 (UTC)

Reinders 2008 states on pg 50 states "...Neuroimaging has been shown to be a powerful tool revealing that genuine dissociative identity disorder is related to deviant amygdalar and hippocampal volumes..." which seems like a significant finding that should be documented in this section, no? Am I missing it somehow or does it say this now (re: as well as support for amnesia between alters.)and just not go into detail? I'd like to put it in there and/or go into slightly more detail but I'm not sure exactly what is correct.Forgotten Faces (talk) 22:58, 4 February 2012 (UTC)

About the only way you'd know would be to look up the references it uses for the statement. "Genuine" obviously refers to traumatic DID, non-genuine is obviously pseudogenic, but where does iatrogenic fall? WLU (t) (c) Misplaced Pages's rules:/_complex 14:21, 5 February 2012 (UTC)

Good point. Not sure how to reconcile that - is iatrogenic DID "genuine"? I'd say no - you can induce alters and the thought of having DID but you can't create amnesia afaik - and hypothetically they would "fail" any physical tests, don't you think? I'm open to rewording this line but would like to keep the general info in there. I still need to look up the references for those statements and have a lot of IRL work to do today but I will get to it probably late today. Forgotten Faces (talk) 17:38, 6 February 2012 (UTC)

Pseudogenic means faked. Iatrogenic would generally be considered a category of it's own, but if you must choose: the term iatrogenesis implies the disorder in question is not faked and the word "genuine" allows any cause as long as the disorder isn't faked... But there is a significant difference in the level of development of alters between traumagenic and iatrogenic DID and also for research purposes it is important to differentiate between the three categories.

Regarding the deviations in the amygdalar and hippocampal volumes: these are also seen in PTSD which is why traumagenesis is considered the leading theory for DID. If a patient with iatrogenic DID does have childhood trauma you may still find these abnormalities on an MRI. On the other hand, war veterans may not have these abnormalities but may have traumagenic DID nonetheless. The cerebral bloodflow changes are DID specific but also do not seem very valuable for diagnostic purposes.

Whether or not this first sentence is contradictory hangs a bit on the word "convergent." I would suggest checking if this sentence was based on a tertiary source to weigh it against the other sources if there would have been a source supplied... JGM73 (talk) 04:05, 7 March 2012 (UTC)

Personally, I don't usually worry too much about 2003 sources, but I understand that nine years ago is actually a long time ago in neuroimaging. So it might be best to focus on the very most recent sources in this field. WhatamIdoing (talk) 21:57, 6 February 2012 (UTC)

Involvement in the DID Misplaced Pages page

Hi everyone, let me start by saying that I am new to Misplaced Pages editing, and so I apologize in advance if this is not the correct forum for my question here. One of my courses is going to begin updating a number of Misplaced Pages pages related to repression, false memories, etc. In other words, post-graduate students will be assigned pages to update to accurately reflect the most recent literature in psychological science. I'd like to assign sections of the DID page (primarily the section on latrogenesis, but I believe updates on the introduction, and epidemiology would also be involved). However, I'm concerned about assigning this article to a student given the personal attacks I have been reading that have taken place here recently. I'm wondering if this is something that happens frequently on this topic—given the topics obvious divisiveness—and, more to the point, whether it would be wise to assign a student to this page.Jlfosternz (talk) 01:16, 10 February 2012 (UTC)

Hi Jlfosternz. I think your course is a great idea, but I do think there is no guarantee that personal attacks won't happen on this subject - indeed anywhere on wikipedia, but definitely here. Right now we seems to be collaboratively editing well, but just a week ago that wasn't so. It may be unfair to give a student this topic with the amount of emotional drain it may take to not only make the edits but make sure they don't get reverted. As it is right now, I don't think any student would have a problem editing without personal attacks, but I can't see it necessarily staying that way. If you look at the archives, there has been a lot of it over the years.

Then again, a student who could successfully navigate all the issues with this topic would deserve a good grade indeed and I personally want all the (constructive) help we can get to expand the article. I too am currently wanting to expand the causes section more (already have a lot recently), including more about iatrogenesis and just more info in general on both hypothesis. Another good faith editor actually reading the literature and adding appropriately would be great.

Also, new posts like this should go on the bottom of pages and not the topic. If you can't figure out how to move it let me know. Welcome to wikipedia. Forgotten Faces (talk) 01:32, 10 February 2012 (UTC)

Thanks ForgottenFaces, I may just look around for an eager student that is intersted in tackling this page, but I probably won't assign this page to anyone who doesn't volunteer. That being said, if no one volunteers, I may just have to start jumping in myself. Jlfosternz (talk) 02:39, 10 February 2012 (UTC)

Sounds good to me, Jlfosternz. :) Forgotten Faces (talk) 09:20, 10 February 2012 (UTC)

The issue in the past was editors who were only willing to acknowledge one set of opinions on DID. Misplaced Pages is about verfiability, not truth. In other words, the community does not care whether DID is caused by iatrogenesis, childhood trauma, or both - what we care is what reliable sources have said about the causes (and treatments, epidemiology, etc.) of DID.

If students are going to be editing here, they must understand our core content policies, including no original research (i.e. they can't analyze, discard or comment on sources, only summarize them), verifiability (i.e. all information must be verified by a reliable source), neutrality (i.e. the issue must be summarized based on the notable opinions within the scientific community as a whole, not just the parts someone agrees with, and we must represent these opinions according to their weight within said community), and what a reliable source is (medical statements require higher-quality sources; self-published sources are normally not allowed; use mostly or in this case only secondary sources such as review articles, books and textbooks on the article page). WP:NOT would also be a good page to read.

Jeffrey, your user page says you are a researcher in memory, which might mean you hold the opinion that DID is nonsense and traumatic memories are neither dissociated or repressed (or you may think the opposite). It is fine to personally hold that opinion - but what TomCloyd got blocked for was allowing that personal opinion to dictate his edits to the actual article and attempting to, based on his personal opinion, use the talk page to advocate for a specific perspective to be preferred. So long as you and your students limit your edits to identifying, summarizing and discussing reliable sources in compliance with the policies and guidelines, there should be no issue. ForgottenFaces and I disagree on what causes DID and how it should be treated - but both of us admit the other side has a place on the page, and accordingly don't argue. WLU (t) (c) Misplaced Pages's rules:/_complex 14:44, 10 February 2012 (UTC)

Hi WLU, nice to meet you. I understand your concern, but I, and anyone who might work on this page under our guidance, am fully aware of what Misplaced Pages is and is not a place for. Regardless of my side of the debate, I am also aware that within the scientific literature DID is still presently a debated topic, and I personally believe that both sides of DID debate should be well established on the page. That being said, I was specific in which topics of the page I would be looking at, and I have no intention of stretching to anything beyond my personal expertise. Which means most sections I wouldn't even touch. Also, I've looked at some of the debates in the history here, and I do feel like some people who hold similar opinions to my own have gone quite a bit too far in what they've tried to claim. In short, focus here would be updating the sections related to iatrogenesis, and I do think there should be a section specifically on the debate on DID which presents the evidence on both sides of the fence. I do hope that those are things we can all agree need to be done, but I'm all ears if you disagree with that. Jlfosternz (talk) 23:25, 10 February 2012 (UTC)

I certainly agree with that, I've sort of attempted to start that recently with the section already there on developmental theory, and WLU and I have talked about it a bit off this page. That kind of depth would do a great service to wikipedia users, I think we all agree that this is a complex topic that deserves to be explained fairly and thoroughly. The whole article could be expanded in many ways and this is surely an important one. Forgotten Faces (talk) 23:48, 10 February 2012 (UTC)

Wow, you worked with Elizabeth Loftus (PMID 22257711)? Damn. I've actually corresponded with her, tried (unsuccessfully) to get a picture for her wikipedia page.

You found that article pretty fast, I don't think Acta has even sent that issue out yet! With Beth, I do imagine she would be unlikely to want a picture of herself on Wiki. She has enough problems with certain types of people (I'm assuming you know at least some of that history) as it is without one more source showing her picture (even though it takes about 2 seconds to find a picture of her with a google search).Jlfosternz (talk) 21:53, 11 February 2012 (UTC)

Literally wrote the page on that (then it got erased). I actually found a full-text version but for some reason the site has been blacklisted. WLU (t) (c) Misplaced Pages's rules:/_complex 22:36, 11 February 2012 (UTC)

'ware Dunning-Kruger effect Jeff, which makes the ignorant confident and the educated doubtful. Anyone can edit wikipedia, even me. All that is required is access to sources, of which you have plenty, and I encourage you to look beyond your areas of direct expertise. One question you might be able to answer (ideally with a, or several sources) is the split regarding DID and memory in general. I believe there's a vast divide between experimentalists (such as yourself) and clinicians who treat DID due to their differing educations and expectations regarding the science of memory, neurology and related topics. Are you aware of this split, and (more importantly) do you know of any reliable sources on the topic? The page should discuss the controversy as explicitly as possible, and a sociological or historical study of the topic would be invaluable. WLU (t) (c) Misplaced Pages's rules:/_complex 10:38, 11 February 2012 (UTC)

I think it's also important not to give it too much weight... and consider that not everyone with DID has or claims to have recovered memories (like myself for example, I don't mind showing my bias because I can work around it pretty well). I would very much like the article not to assume 100% that it is necessarily a part of psychotherapy for DID clients. I don't know exactly how to work around that, and I know I need a source, so Jeffrey I know you are on the opposite side of where I am (but I don't doubt false memories and iatrogenesis can and do happen btw, and they are not mutually exclusive either - someone could have iatrogenic alters and genuine ones, in theory) but if we could get this in the article somehow that would do a service to it, I think. Thoughts? Also of note is many people with DID have only brief amnesias and the other dissociative symptoms are way more noticeable and bothersome - for example I personally, if somehow I don't really have DID, definitely have DDNOS without question - and many if not most people with DID are like this. There is a lot more to the syndrome than amnesia and alters. This should be easier to find sources for, today is reading day so I hope to expand some... these are just a couple things to keep in mind in case any of us come across them in literature. Just some ideas. Forgotten Faces (talk) 14:04, 11 February 2012 (UTC)

Too much weight on what, the divide between experimentalists and clinicians? If it's a significant point of acrimony, the important thing to do is to avoid giving the appearance of reaching a decision; we should merely tell both sides in detail. But no matter what, the traumagenic and iatrogenic positions both deserve considerable discussion, irrespective which we personally think is correct. WLU (t) (c) Misplaced Pages's rules:/_complex 15:28, 11 February 2012 (UTC)

I agree, bad wording on my part. I guess what I'm saying is it's more nuanced than then just genuine/iatrogenic (and I'd also add factitious/malingered to that list)... the prototypical DID patient who has repressed most of their memories and only knows they were abused because of Courage to Heal type symptom lists is not really prototypical at all. I'm just hoping I can find something that goes into the other details thoroughly so we can include them, that's all, and wanted to ask anyone to give me a heads up if they find any material discussing this type of thing, or just to keep an eye out in general. Forgotten Faces (talk) 18:44, 11 February 2012 (UTC)

Yeah, I would venture much more mish-mashed, almost certainly with a mixture of "true" DID (i.e. like the extremely rare numbers found before Eve or Sybil), borderline patients who get misdiagnosed, and almost certainly some iatrogenic cases. However, when two sides aren't talking, most of that nuance goes out the window - and we end up with January's talk page. If you do see such a source that makes the case, please tell me! I read Try To Remember by Paul R. McHugh a while back and I think it went into a "his version" of the history of DID and touched on some of this, but I can't find my copy anymore. I'm hoping Jeff might know something. WLU (t) (c) Misplaced Pages's rules:/_complex 19:28, 11 February 2012 (UTC)

Glad we are on the same page. I just moved so I really need to get a library card and get some stuff, it would be nice to normalize DID symptoms a little more on the page for sure. I'll definitely let you know whatever I find. And just as an aside, I believe the numbers are greater than was described say in the 1800s (was under-diagnosed), but that it is a rare mental illness, and I personally attribute non-genuine DID to more of a combo of factitious/borderline/ptsd than iatrogenesis. Neither here nor there, but that's my opinion based on personal experience. I would never attempt to figure out what is what, far be it from me to try to figure out someone else's reality and coming back to DDNOS, most of these folks (ime) do have obvious DDNOS if they don't have complete DID. I have in fact never met a DID patient who did not have other severe dissociative symptoms, so it's definitely a shame there is not more info going around. I think the Stranger in the Mirror might have went into it more, I don't own it anymore unfortunately but should grab it when I get to the library. Forgotten Faces (talk) 19:43, 11 February 2012 (UTC)

I do think one of the things that needs to be worked on here is the differentiation between DID and other Dissociative disorders (not just DDNOS, but all of the other dissociative disorders). I don't think you could find many experts who would argue that people don't dissociate—although there is debate on how the dissociation works and whether it occurs at the time of trauma or whether it is a memory issue—the entire debate on DID is because it is separate from other Dissociative disorders in that it is characterized by 1)A split of the identity so that a person has multiple personalities, 2) Memories of at least one personality are 'repressed' while at least one other personality is 'in charge', and 3) Those repressed memories can be recalled later.

I bring this up now, because this is where one of the problems is going to come in with updating the Wiki page. Most of the scientific literature doesn't focus on DID itself. Instead, it focuses on the required (and distinctive) characteristics of repression and later recall of repressed information. Also, I wanted to bring it up because this is where I think some people who have argued from 'my side of the fence' have, I think, stepped a bit out of bounds with what they had to say. Jlfosternz (talk) 21:53, 11 February 2012 (UTC)

Since we all seem to be on the same page, I'm sure we can do this all justice. There definitely is a pretty giant leap from chronic dissociative states involving simple identity alteration to full on alters with time loss. So I do see where you are coming from there and can see the value of discussing that and similar things in the article. Definitely have a lot to learn from you in this regard. Forgotten Faces (talk) 22:12, 11 February 2012 (UTC)

Yup, in agreement in principle, specifics will depend on sources. Unfortunately the two sides making extreme claims and refusing to collaborate (or even cite each others' works) makes our job harder. But science marches on. WLU (t) (c) Misplaced Pages's rules:/_complex 22:36, 11 February 2012 (UTC)

So I did find something, only skimmed so far but looks like it might really help us re: other symptoms besides amnesia/alters. PDF is findable on google, but I won't link it here. Or let me know, I can send it to anyone. Forgotten Faces (talk) 01:59, 12 February 2012 (UTC)

Scientific history

I'm torn on the idea, but I'm leaning towards it. I think it might be worth splitting the history section, or perhaps having a completely separate section just discussing the scientific controversy. Though the trauma/iatro information should be interstitched throughout the appropriate sections, I think there's definitely enough reliable sources and material to include a discussion of solely DID's place in the scientific community. The information on the research "bubble" could go there, as well as the DSM's various iterations of DID/MPD. I think the scientific community's history and understanding of DID is sufficiently different from the more popular attention found in most History sections that it deserves its own place. Any thoughts? WLU (t) (c) Misplaced Pages's rules:/_complex 15:24, 11 February 2012 (UTC)

100% agree, I was thinking about how the history section is too mish-mashed now - I'm on board. Forgotten Faces (talk) 18:46, 11 February 2012 (UTC)

It might be worth bringing this up at WT:MED as a "we both agree something needs to be done" (so they don't think it's "we're arguing and we want someone to decide who is right") and ask if there they have any ideas. I can't think of any other pages that are similar in the breakdown of popular versus scientific discussions. WLU (t) (c) Misplaced Pages's rules:/_complex 19:30, 11 February 2012 (UTC)

I agree with the idea of a Research History section to address both the clinical and non-clinical research history of DID. I do think it is separate enough of an idea from it's general history to warrant a split. By the way, our semester here doesn't start for 3 more weeks, so while I think I'll be able to find an interested student to start contributing here, there probably won't be much for 4 or 5 weeks. Hopefully you two haven't already made this article perfect before then!Jlfosternz (talk) 22:41, 11 February 2012 (UTC)

I posted an inquiry on WT:MED. :) Forgotten Faces (talk)

The possible connection between having an alter ego and having Dissociative Identity Disorder.

I am trying to clean up and revitalize the "alter ego" article and i am trying to state the possibility of there being a link between Dissociative Identity Disorder and having an alter ego. I am having trouble and i was wondering if i am to research this, what qualify as an acceptable resource ? I have started gathering information, and I think that this would be an amazing contribution to both articles. Help would be appreciated, Thank you in advance. Your opinion matters.

Tj1224 (talk) 22:16, 28 February 2012 (UTC)

AFAIK, alter egos are more in the vein of being the complete opposite of the normal "ego" of the person, whereas "alters" (alternate personalities in DID) are more distinct and not generally "completely opposite" of the host personality - although Jekyll and Hyde does come up in both articles and a google scholar search will give you a lot of information based on that. Sorry I can't help more. Forgotten Faces (talk) 01:07, 29 February 2012 (UTC)

This article is the one used in the DID article, and it does say it's used now as a classic case of DID in literature, but does not call them alter egos anywhere in the text. Forgotten faces (talk) 01:26, 29 February 2012 (UTC)

Paranoia

I can't see a reason to remove "paranoia" from the list of signs and symptoms. There's a source, is it misrepresented? A brief search on google found several other more recent sources also citing paranoia as something expressed by patients with DID, suggesting it's still a concern. WLU (t) (c) Misplaced Pages's rules:/_complex 14:18, 18 May 2012 (UTC)

• B-Class psychology articles
• High-importance psychology articles
• WikiProject Psychology articles
• B-Class medicine articles
• Mid-importance medicine articles
• B-Class psychiatry articles
• Mid-importance psychiatry articles
• Psychiatry task force articles
• All WikiProject Medicine pages