Dissociative Identity Disorder
Dissociative identity disorder was formerly known as multiple personality disorder. An individual with this disorder exhibits two or more distinct personality states or identities (sometimes called alters, or alter identities), each appearing at different times and governing the individual's behaviour at that time. It is a serious, chronic, and potentially disabling or fatal condition.
Each alternate personality state or identity has its own characteristic way of thinking, feeling, and perceiving. Each may have a different name, mannerisms, speech, mood, social preferences, age, race, habits, and memories. Each personality state determines the individual's behaviour and attitudes while it is dominant. One personality state may appear normal, another hostile and aggressive, and yet another shy and withdrawn. Each identity is usually unaware of events that occurred when another identity was in charge. One personality state, however, may have full knowledge of all the others. The other personality states may only have a sense of another individual, with a directing voice, coming from inside and taking control of them. The average number of personality states is between five and ten, but there may be as few as two or as many as a hundred. About 50% of cases report 10 or fewer identities (DSM-IV-TR 527). Females with this disorder average 15 separate identities, while males report 8 on average.
Frequent memory gaps in personal history (dissociation) are prominent features of dissociative personality disorder. Dissociation is a psychological defense mechanism where the individual's identity, memories, ideas, feelings, or perceptions are separated from conscious awareness and can't be remembered or experienced voluntarily. The fragmentation or splitting into multiple identities may be to protect the individual from memories of unbearably painful events such as incest or physical abuse.
Substance abuse, significant stress, or pain (headache) can trigger a shift among identities. This shift may occur suddenly in a matter of seconds or more gradually over hours or days. Sudden frightening memories (flashbacks) can intrude on any of the identities.
Criteria for diagnosing Dissociative Identity Disorder:
Each alternate personality state or identity has its own characteristic way of thinking, feeling, and perceiving. Each may have a different name, mannerisms, speech, mood, social preferences, age, race, habits, and memories. Each personality state determines the individual's behaviour and attitudes while it is dominant. One personality state may appear normal, another hostile and aggressive, and yet another shy and withdrawn. Each identity is usually unaware of events that occurred when another identity was in charge. One personality state, however, may have full knowledge of all the others. The other personality states may only have a sense of another individual, with a directing voice, coming from inside and taking control of them. The average number of personality states is between five and ten, but there may be as few as two or as many as a hundred. About 50% of cases report 10 or fewer identities (DSM-IV-TR 527). Females with this disorder average 15 separate identities, while males report 8 on average.
Frequent memory gaps in personal history (dissociation) are prominent features of dissociative personality disorder. Dissociation is a psychological defense mechanism where the individual's identity, memories, ideas, feelings, or perceptions are separated from conscious awareness and can't be remembered or experienced voluntarily. The fragmentation or splitting into multiple identities may be to protect the individual from memories of unbearably painful events such as incest or physical abuse.
Substance abuse, significant stress, or pain (headache) can trigger a shift among identities. This shift may occur suddenly in a matter of seconds or more gradually over hours or days. Sudden frightening memories (flashbacks) can intrude on any of the identities.
Criteria for diagnosing Dissociative Identity Disorder:
- The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
- At least two of these identities or personality states recurrently take control of the person's behaviour.
- Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
- The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behaviour during alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.