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Annual Review of Clinical Psychology 2013The rationale, research literature, and proposed changes to the dissociative disorders and conversion disorder in the fifth edition of the Diagnostic and Statistical... (Review)
Review
The rationale, research literature, and proposed changes to the dissociative disorders and conversion disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are presented. Dissociative identity disorder will include reference to possession as well as identity fragmentation, to make the disorder more applicable to culturally diverse situations. Dissociative amnesia will include dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia but does not always include confused wandering or loss of personality identity. Depersonalization disorder will include derealization as well, since the two often co-occur. A dissociative subtype of posttraumatic stress disorder (PTSD), defined by the presence of depersonalization or derealization in addition to other PTSD symptoms, is being recommended, based upon new epidemiological and neuroimaging evidence linking it to an early life history of adversity and a combination of frontal activation and limbic inhibition. Conversion disorder (functional neurological symptom disorder) will likely remain with the somatic symptom disorders, despite considerable dissociative comorbidity.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Humans
PubMed: 23394228
DOI: 10.1146/annurev-clinpsy-050212-185531 -
The Journal of Nervous and Mental... Mar 2024Dissociative identity disorder (DID) has historically been one of the most controversial topics in the study of psychopathology. Building on a previous review of... (Review)
Review
Dissociative identity disorder (DID) has historically been one of the most controversial topics in the study of psychopathology. Building on a previous review of empirical research on DID from 2000 to 2010, the present review examined DID research from 2011 to 2021. The research output included 56 case studies and 104 empirical studies. Within the empirical studies, approximately 1354 new cases of DID emerged, which resulted in an average samples of approximately 20. Reanalysis of previous samples was standard in the literature with only 40% of reported cases being new. Studies emerged from dozens of countries across the world, but the majority of cases were from Western counties, especially the United States. Diagnosis primarily relied upon validated measures, but 74% of all new cases came from six research groups. Overall, research on DID is steady but methodologically limited in ways that make generalization, especially about etiology, difficult.
Topics: Humans; Dissociative Identity Disorder; Dissociative Disorders
PubMed: 38412243
DOI: 10.1097/NMD.0000000000001764 -
Journal of Trauma & Dissociation : the... 2021A total of 491 participants from four previous studies, 443 of whom were diagnosed with dissociative identity disorder (DID) on the Dissociative Disorders Interview...
A total of 491 participants from four previous studies, 443 of whom were diagnosed with dissociative identity disorder (DID) on the Dissociative Disorders Interview Schedule, completed the Dissociative Experiences Scale (DES). Their results were analyzed to determine how many were in the dissociative taxon (DES-T) on the DES. Of the 443 individuals with DID, 419 (94.6%) were in the taxon, 13 (2.9%) were out of the taxon and 11 (2.5%) were indeterminate. The DES-T is therefore very effective at identifying people with DID as being in the dissociative taxon, although it does have a false negative rate of 5.4%. Out of 48 people with no dissociative disorder on the Dissociative Disorders Interview Schedule, the DES-T identified 26 (54.2%) as being in the taxon and 22 (45.8%) as being out of the taxon with no indeterminate cases. The clinical diagnoses of these 48 individuals are unknown: all were inpatients in the same Trauma Program. Thus, the sensitivity of the DES-T for confirming that individuals with DID are in the dissociative taxon was 94.6% and the specificity of the DES-T for confirming that individuals with no dissociative disorder are not in the dissociative taxon was 45.8%. It is possible that the DES-T yields false positives for taxon membership; this possibility should be investigated in future research.
Topics: Dissociative Disorders; Dissociative Identity Disorder; Humans; Psychiatric Status Rating Scales
PubMed: 33522454
DOI: 10.1080/15299732.2020.1869645 -
Psychiatria Polska Feb 2022Ganser syndrome (GS) is one of afew eponyms that have survived in psychiatry until the present day. GS is a little-known and rare disorder. It is most often described as... (Review)
Review
Ganser syndrome (GS) is one of afew eponyms that have survived in psychiatry until the present day. GS is a little-known and rare disorder. It is most often described as a response to a stressor (e.g. incarceration), that is why it is an important issue in forensic psychiatry. Organic causes are taken into consideration. The basic symptoms of the syndrome are: approximate answers, visual and auditory hallucinations, clouding of consciousness and conversion symptoms. Additionally, patients may perform activities in an awry manner and suffer from insensitivity to painful stimuli.GS is usually acute and subsides spontaneously. Usually patients do not remember they had an episode of the disease. Diagnostic criteria of GS are imprecise and its classification has been changed over the years. GS was not listed in the DSM-5 classification, although in the DSM-IV it was classified as a dissociative disorder. Currently some authors tend to classify it rather as a factitious disorder. WHO (ICD-10 and ICD-11) classifies GS as a dissociative and conversion disorder, which seems to be appropriate in the light of current knowledge. The presented case report describes apatient with a nearly identical pattern of full-blown GS, which occurred twice. The symptoms appeared shortly after the patient was incarcerated. The course of the disorder was chronic and recurrent. The patient was insensitive to pain stimuli. Somatic causes were excluded in the diagnostic process.
Topics: Conversion Disorder; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Factitious Disorders; Humans; International Classification of Diseases
PubMed: 35569148
DOI: 10.12740/PP/129012 -
European Journal of Psychotraumatology 2022Most individuals with dissociative disorders (DDs) report engaging in self-injury.
BACKGROUND
Most individuals with dissociative disorders (DDs) report engaging in self-injury.
OBJECTIVE
The present study aimed to understand the reasons for self-injury among a clinical sample of 156 DD patients enrolled in the TOP DD Network study.
METHOD
Participants answered questions about self-injury, including a prompt asking how often they are aware of the reasons they have urges to self-injure, as well as a prompt asking them to list three reasons they self-injure.
RESULTS
Six themes of reasons for self-injury, each with subthemes, were identified in the qualitative data: (1) Trauma-related Cues, (2) Emotion Dysregulation, (3) Stressors, (4) Psychiatric and Physical Health Symptoms, (5) Dissociative Experiences, and (6) Ineffective Coping Attempts. Participants reported that they were able to identify their reasons for self-injuring sometimes (60.26%) or almost always (28.85%), with only 3.20% unable to identify any reasons for their self-injury.
CONCLUSION
Results suggest that the vast majority of DD patients (92.31%) reported being at least partially unaware of what leads them to have self-injury urges, and many individuals with DDs experience some reasons for self-injury that are different from those with other disorders. The treatment implications of these findings are discussed.
Topics: Adult; Cues; Dissociative Disorders; Female; Health Status; Humans; Male; Self-Injurious Behavior; Stress, Psychological; Surveys and Questionnaires; Wounds and Injuries
PubMed: 35126883
DOI: 10.1080/20008198.2022.2026738 -
Seishin Shinkeigaku Zasshi =... 2011Dissociative disorder is both an old and a new mental disorder. Its forerunner, hysteria, was a poorly understood and often grossly misconceived notion that might date... (Review)
Review
Dissociative disorder is both an old and a new mental disorder. Its forerunner, hysteria, was a poorly understood and often grossly misconceived notion that might date back as far as human societies existed, but it has been treated as a new disorder since it emerged in the DSM-III. A century ago, Sigmund Freud and Pierre Janet, two giants in the history of dynamic psychiatry, were deeply influenced by dissociative phenomena, and created their own theory of human mind with very different orientations. The reemergence of dissociative disorders in the current psychiatry has several implications. It helps clinicians understand mental conditions that they did not know how to define and classify based on the traditional psychiatry. It also allows clinicians to identify a population that was misdiagnosed with other diagnostic categories, such as borderline personality disorder and schizophrenia.
Topics: Diagnostic Errors; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; History, 19th Century; History, 20th Century; Humans
PubMed: 22117394
DOI: No ID Found -
Medecine Sciences : M/S Apr 2023The category of dissociative identity disorder (DID) has puzzled medical science and fascinated popular culture for almost 200 years. Its occurrence in young people...
The category of dissociative identity disorder (DID) has puzzled medical science and fascinated popular culture for almost 200 years. Its occurrence in young people raises at least two new questions addressed by science studies and embedded philosophy: self-diagnosis (related to cyberchondria and mass media-induced illness) and transient disease (related to looping effect and identity claim specific to adolescence). In an attempt to refine the sociocognitive model, we analyze the impact of these notions in understanding the local ecological niche in which contemporary adolescent DID occurs.
Topics: Humans; Adolescent; Dissociative Identity Disorder; Dissociative Disorders
PubMed: 37094271
DOI: 10.1051/medsci/2023042 -
Sleep Medicine Clinics Mar 2024In sleep-related dissociative disorders, phenomena of the psychiatrically defined dissociative disorders emerge during the sleep period. They occur during sustained... (Review)
Review
In sleep-related dissociative disorders, phenomena of the psychiatrically defined dissociative disorders emerge during the sleep period. They occur during sustained wakefulness, either in the transition to sleep or following an awakening from sleep. Behaviors during episodes vary widely, and can result in injury to self or others. Daytime dissociative episodes and a background of trauma are almost always present; there is typically major co-existing psychopathology. Diagnosis is based on both clinical history and polysomnography; differential diagnosis primarily involves other parasomnias and nocturnal seizures. Information available about treatment is limited; in a few reported cases, psychological interventions have proven effective.
Topics: Humans; Parasomnias; Sleep Wake Disorders; Dissociative Disorders; Sleep, REM; Sleep
PubMed: 38368062
DOI: 10.1016/j.jsmc.2023.10.003 -
Psychosomatics 2007Pseudoneurological symptoms (i.e., conversion disorder), historically subsumed within the "hysteria" concept alongside phenomena such as psychogenic amnesia and multiple... (Review)
Review
Pseudoneurological symptoms (i.e., conversion disorder), historically subsumed within the "hysteria" concept alongside phenomena such as psychogenic amnesia and multiple personality disorder, have been classified as somatoform disorders since DSM-III. Since then, there have been repeated calls to reclassify conversion disorder with the dissociative disorders, as in ICD-10. The authors review issues such as the high correlations between pseudoneurological and dissociative symptoms, the high rates of trauma reported for both groups, and the position that these phenomena share underlying processes. Although reintegrating pseudoneurological symptoms with the dissociative disorders is not without complications, there is a strong case for such a reclassification.
Topics: Conversion Disorder; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Humans; Terminology as Topic
PubMed: 17878494
DOI: 10.1176/appi.psy.48.5.369 -
Current Psychiatry Reports Jun 2008Schizophrenia and dissociative identity disorder (DID) are typically thought of as unrelated syndromes--a genetically based psychotic disorder versus a trauma-based... (Review)
Review
Schizophrenia and dissociative identity disorder (DID) are typically thought of as unrelated syndromes--a genetically based psychotic disorder versus a trauma-based dissociative disorder--and are categorized as such by the DSM-IV. However, substantial data exist to document the elevated occurrence of psychotic symptoms in DID; awareness of these features is necessary to prevent diagnostic confusion. Recent research has also pointed out that schizophrenia and DID overlap not only in psychotic symptoms but also in terms of traumatic antecedents, leading to a number of suggestions for revision of our clinical, theoretical, and nosologic understanding of the relationship between these two disorders.
Topics: Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Humans; Psychological Theory; Schizophrenia; Schizophrenic Psychology
PubMed: 18652789
DOI: 10.1007/s11920-008-0036-z