On Fri, 10 Apr 2009 03:51:04 -0700, James K. Denson wrote: >One of my students asked me a question about the following DID video >from the popular Showtime series The United States of Tara. If you >follow the below link, the video states that possibly 5 out of 100 >people may have DID. Is this an accurate statistic? Do you think this >is accurate information to show the students?
I didn't watch the video you linked to but I would state a "first priniciple" regarding media presentation of things scientific and psychopathological: Don't believe what is presented because it will often be oversimplified and skewed to support an artistic sensibility in contract to a scientific sensibility (that is, if there is a concern with truth, it will be with "poetic truth" [however the artist defines that] and not "scienfitic truth" or factual accuracy. To reinforce this point, consider the way in which amnesia has been portrayed in movies. An article by Sallie Baxendale in the British Medical Journal (BMJ) highlights the magnitude of the failure of films to accurately represent memory disorders. See: http://www.bmj.com/cgi/pdf_extract/329/7480/1480 Getting back to your origin point, consider looking at the following reference: Kilhstrom, J. (2005) Dissociative disorders. Annual Review of Clinical Psychology, 1, 227-253. Quoting some relevant passages (note: one should distinguish between incidence and prevalence of a disorder): |Good data on the incidence and prevalence of the dissociative disorders |is hard to come by. These syndromes were excluded from the Epidemiological | Catchment Area survey (Regier et al. 1984, Robins et al. 1984), presumably |because of their assumed rarity, and the lack of appropriate standardized |diagnostic instruments and criteria. At the height of clinical interest in the |dissociative disorders, the Clinton administration's Task Force on Health |Care Financing Reform received a report claiming a prevalence of dissociative |disorder of "about ten percent in the general population" (Loewenstein 1994, p. 3), |including a rate of 7% for psychogenic amnesia and 1.3% for multiple personality |disorder. On the other hand, a study of a large acute psychiatric hospital, |employing the SCID-D to diagnose DID, yielded an estimated rate of only |1% among recent admissions (Rifkin et al. 1998). If this figure is representative, |of course, the prevalence of DID in the population as a whole is likely to be |considerably lower. | |An interesting feature of the DID "epidemic" is an increase not just in the |number of cases but also in the number of alter egos reported per case. In |the classic literature, the vast majority of cases were of dual personality |(Sutcliffe & Jones 1962, Taylor & Martin 1944). By contrast, most of the |new cases compiled by Greaves (1980) presented at least three personalities; |in two other series, the average number of alter egos was more than 13 |(Kluft 1984, Putnam et al. 1986). As Kenny (1986) noted, it was almost |as if there were some kind of contest to determine who could have (or be) |the patient with the most alter egos. The famous Eve, of course, appeared to |have three personalities (Osgood & Luria 1954, Thigpen & Cleckley 1954). |But when popular and professional interest in MPD was stimulated by the |case of Sibyl, who was reported to possess 16 different personalities |(Schreiber 1973), Eve replied with her own account of her illness, eventually |claiming 22 (Sizemore & Huber 1988). Despite the almost-infinite number |of possible synaptic connections in the brain, one might say that the mind |simply is not big enough to hold so many personalities. The proliferation of |alter egos within cases, as well as the proliferation of cases, has been one |of the factors leading to skepticism about the disorder itself. A point that I believe that has not been made is the confusion of DID or Multiple Personality Disorder (MPD) with "Multiple Role Delusion", that is, people who present with MPD often act as though they are playing a character from a play or novel -- it is assumed that "personality" is like a "character" in literature but it should be clear that theories of personality range from positions where it plays almost no role (i.e., where the "power of the situation" controls the individual's behavior regardless of whatever their personality is; see Milgram's obedience to authority studies, Zimbardo's Stanford Prison experiment, Darley and Latane's studies on bystander apathy as well as other research on the topic) to theories that personality is some sort of elaborate construction of congitive processing, schemas, and memories. Given that the definition of "personality" depends upon one's definition of it (artists, I assume, would have the greatest affinity to personality being defined as a character in a play/novel), defining what "multiple personalities" is quite problematic. However, almost everyone knows what it means to play a role or a character in a play. The problem might be not there are multiple personalities but a single personality that chooses to play different roles or characters. I think this is a big difference unless we're willing to say that actors all suffer from MPD. Finally, I suggest examing the following reference and follow-up article: Piper, A., & Merskey, H. (2004). The persistence of folly: A critical examination of dissociative identity disorder. part I. the excesses of an improbable concept. The Canadian Journal of Psychiatry / La Revue Canadienne De Psychiatrie, 49(9), 592-600. The abstract follows: |Objective: To examine the concept of dissociative identity disorder (DID). |Method: We reviewed the literature. Results: The literature shows that 1) there |is no proof for the claim that DID results from childhood trauma; 2) the condition |cannot be reliably diagnosed; 3) contrary to theory, DID cases in children are |almost never reported; and 4) consistent evidence of blatant iatrogenesis appears |in the practices of some of the disorder's proponents. Conclusions: DID is best |understood as a culture-bound and often iatrogenic condition. (PsycINFO |Database Record (c) 2008 APA, all rights reserved) However, I'll defer to any research clinicians who have more up-to-date information. -Mike Palij New York University [email protected] --- To make changes to your subscription contact: Bill Southerly ([email protected])
