Dissociative Identiy Disorder Overview

Dissociative identity disorder is a dissociative disorder characterized by the disturbance of identity in which two or more distinct identities or personality states recurrently take control of the behavior at different times. The term dissociation refers to the disruption that occurs in "the usually integrated functions of consciousness, memory, identity, and perception." It is an ongoing process in which certain information such as feelings, memories, physical sensations, etc. are kept away from other information with which is should normally be associated. (2) "The essence of dissociation is that material not in awareness influences behavior, mood, and thought. Thus, the behavioral disturbances prominently manifested in dissociative disorders are considered to be unconscious: that is, resulting from forces beyond the patient's awareness, beyond voluntary control." (3)

A person affected by DID can have several identities (referred to as ego states, alters, personalities states, or alternate identities) as few as two and as many as 100. The average number is around 10. The alternate identities are assumed involuntarily, have different names, possess a unique style of viewing and understanding the world, and display characteristics that contrast with the primary identity. They usually exhibit differences in speech, personal history, self-image, attitudes (hostile, controlling, self-destructive), thoughts, tone of voice, age, nationality, general knowledge, predominant affect, and even gender and sexual orientation. Alters can also differ in physical traits such as allergies or different reactions to medication, body posture, right or left handedness, different heart rates, blood pressure, body temperature, and pain tolerance, different blood glucose reaction to insulin, or the need for eyeglass correction. Some alters can possess remarkable capabilities and qualities, such as the ability to reproduce and create new alters, or to determine which identity is taking control over the body at a particular time. However, the alters are not necessarily humans, the psychiatric literature reporting cases when patients displayed alters such as real or stuffed animals, demons, or aliens from out of space. The alters emerge in certain situations and take control over the person's behavior (similar to the situation when several people alternately share the same body), "may deny knowledge of one another, be critical of one another, or appear to be in open conflict" (2) and even harbor aggressive tendency towards those around the person or towards other alters.

In general, the patient displays a "host" personality that usually tends to be quiet, dependent, depressed, dominated by guilt, and several alters. The process of change from the host to alters or between alters is called "switching". The time required to switch identities is usually a matter of seconds and it is accompanied by clues such as rapid blinking, facial and voice changes, or disruption in the individual's train of thoughts. The transition between identities is usually triggered by psychosocial stress.

Patients suffering from DID have "substantial relational pathologies including major problems with trust and enmeshment in violent and abusive relationships." They see themselves as shameful, damaged, and responsible for their own traumatization and perceive the world as dangerous and traumatizing. (9)

The prevalence of the disorder among the general population is highly controversial, while some studies suggest that dissociative identity disorder is not a rare condition, some researchers approach these results with skepticism claiming that the prevalence percentage is somewhat lower. Based on studies conducted on the general population, it is estimated that the disorder affects approximately 1 to 3 percent of the population. Clinical studies conducted in North America, Europe, and Turkey suggest that between one and 20 percent of the patients from general inpatient psychiatric units, adolescent inpatient units, or those treated for substance abuse, eating disorders, and obsessive compulsive disorder meat the diagnostic criteria for DID.

The condition is more common among women, the DID female to male ratio is approximately 9:1. Although, unclear why this gender imbalance, some researchers believe one cause can be the high rate of abuse among the young female population, but they do not excluded the possibility of underreported male cases of DID. Men with DID tend to act more violent than women and they are usually imprisoned rather than hospitalized and diagnosed. Also, women tend to develop more personality states than men, averaging 15 compared with 8 for men.

Some of the common problems associated with DID are: depression, substance abuse, eating disorders, suicide, and self-mutilation.

Conditions & Diseases: Psychological & Mental Health

Dissociative Identity Disorder
(formerly known as Multiple Personality Disorder)

Conditions & Diseases: Psychological & Mental Health

Dissociative Identity Disorder (formerly known as Multiple Personality Disorder)

Dissociative Identity Disorder
(formerly known as Multiple Personality Disorder)