History & Pop culture
In the movie Split (2016), what was the portrayed cause of Kevin’s DID?
Severe childhood trauma, specifically physical and sexual abuse from his mother
What is a key note about the cause of symptoms in DID in adults?
The symptoms should not be a normal part of cultural/religious practice or be due to physiological effects of a substance
What is first stage of treatment for DID?
Focusing on safety issues, stabilizing DID symptoms, and establishing trust and cooperation between therapist and client
What neurotransmitter is thought to have a role in DID?
Abnormal serotonin neurotransmission in frontal and temporal regions have been connected to dissociative amnesia associated with DID
When did DID become part of the Diagnostic and Statistical Manual for Mental Disorders and what was it called?
1952 in DSM-I and was called dissociated personality
Where is DID most prevalent?
DID is consistently identified in outpatient, inpatient, and community samples around the world on every continent except Antarctica
What is the current adult treatment guidelines for DID?
The International Society for the Study of Trauma and Dissociation Guidelines for Treating Dissociative Identity Disorder in Adults, 2011 p 195-201
Why might a smaller/less functional amygdala lead to DID?
An individual with a smaller/less functional amygdala could be more likely to utilize the defense mechanism as dissociation or the creation of new alters in response to trauma and improper fear handling
When was the disorder’s name changed to dissociative identity disorder?
The disorder was changed from Multiple Personality Disorder to Dissociative Identity Disorder in 1994 in DSM-IV
What is a key note about symptoms of DID in children?
The symptoms are not better explained by imaginary playmates or other fantasy play
What is the difference between patients who are able to integrate their identities and those that are not?
Patients who are able to integrate effectively remain mostly symptom free and report fewer symptoms of substance abuse/depression and medication use. Those who do not achieve integration during treatment continue to show symptoms of DID and a number of disorders
What are the differences in brain tracts between an individual living with DID vs a healthy brain?
Individuals with DID show larger white matter tracts that affect information communication between different areas of the brain
What type of therapy did Dr. Fletcher use in the movie Split (2016) to treat Kevin’s DID?
Dr. Fletcher used Cognitive Behavior Therapy to stabilize symptoms, process traumatic memories, and integrate Kevin’s alters
What is the key characteristic of DID?
Person exhibits 2+ distinct and alternating identities marked by discontinuity in sense of self with differences in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning
What are possible reasons for not integrating fully?
Serious and chronic stress, avoiding addressing unresolved and painful life issues or traumatic memories, lack of resources for treatment, comorbid mental disorders, advanced age, etc
What are the differences in brain volumes between an individual living with DID vs a healthy brain?
Individuals with DID show smaller cortical/subcortical volumes in the hippocampus, amygdala, and parietal structures that affect perception and personal awareness and in frontal structures involved in movement and fear learning
What was a historical precursor to DID in the 19th century?
“dedoublement” or “double consciousness” which was described as a state of sleepwalking
What new criteria was added to DSM-5 for DID?
“the symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning”
What is the final fusion/complete integration part of treatment?
When all of the alters are merged and are no longer separate. It refers to the most stable treatment outcome, but many DID patients will not achieve it or find it desirable
What is thought to be the cause of smaller brain volume?
Smaller volume could be due to the brain responding to excess glucocorticoids associated with trauma