A new study supports the notion that multiple personality disorder is rooted in traumatic experiences, such as neglect or abuse in childhood.
Multiple personality disorder, more recently known as dissociative identity disorder (DID), is thought to affect about one percent of the general population, similar to levels reported for schizophrenia.
People who are eventually diagnosed with DID have often had several earlier misdiagnoses, including schizophrenia or bipolar disorder, according to researchers at King’s College London.
DID is characterized by the presence of two or more distinct identities or “personality states” — each with their own perception of the environment and themselves.
Despite being recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), controversy remains around the diagnosis.
Some experts argue that DID is linked to trauma, such as chronic emotional neglect and/or emotional, physical, or sexual abuse from early childhood. Others hold a non-trauma related view of DID, believing the condition is related to a proneness to fantasy, suggestibility, simulation, or enactment, researchers explain.
The new study, published in Acta Psychiatrica Scandinavica, provides support for the trauma model of DID and challenges the core hypothesis of the fantasy model.
For the study, researchers compared 65 women on a variety of questionnaires that measured traumatic experiences, suggestibility, fantasy proneness, and malingering of psychiatric symptoms.
The sample included women with a genuine diagnosis of DID, female actors who were asked to simulate DID, women with post traumatic stress disorder (PTSD), and a healthy control group.
The researchers found that patients with DID were not more fantasy prone or suggestible and did not generate more false memories compared to patients with PTSD, DID simulating controls, and healthy controls.
The researchers discovered a continuum of the severity of trauma-related symptoms across the groups, with the highest scores in patients with DID, followed by patients with PTSD. Those in the healthy control group had the lowest scores.
This supports the theory that there is an association between severity of trauma-related psychopathology and the age at onset, severity and intensity of traumatization, according to the researchers.
“Our findings correspond with research in other areas of psychology and psychiatry, which increasingly implicate trauma with mental health disorders such as psychosis, depression and now, dissociative identity disorder,” said Dr. Simone Reinders from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London.
“We hope these insights into the causes and nature of DID will inform, among others, clinicians and forensic experts regarding differences between simulated and genuine DID. Ultimately this would lead to faster diagnosis and treatment for patients and greater recognition of DID as a mental health disorder.”
“We now want to understand the neurobiological underpinnings of DID and whether psychological or pharmacological therapies are more effective in treating the disorder,” she concluded.
Source: King’s College London