This paper summarizes the article, “A Longitudinal Naturalistic Study of Patient With Dissociative Disorders Treated by Community Clinicians” (Brand, McNary, Classen, Loewenstein, Myrick, Lanius & Pain). This article was published in the following journal; Psychological Trauma: Theory, Research, Practice, and Policy, 5 (4), 301-308. Reviewing this article revealed a study conducted by Brand, Classen & Lanius, et al ., 2009, that used the Progress in Treatment Questionnaire (PITQ). The PITQ measures capacities developed throughout the stages of Dissociative identity disorder (DID) and Dissociative Disorder (DD/DDNOS). Dissociative Identity Disorder (DID) presents numerous challenges for the practitioners who perform assessments for a clinical …show more content…
diagnosis. Most clinicians proceed with extreme caution due to the complexities of this disorder as well as the ongoing controversies surrounding DID. Knowing the generality, of severity, elevated magnitude relation of treatment usage and high cost connected with DD it is critical to create meticulous conclusion research with DD patients. “Severe dissociative disorders (DD) are associated with high levels of impairment, treatment utilization, and treatment costs, yet relatively little systematic research has focused on treatment for these challenging patients" (1).
What I find riveting about this research is how people cope with this disorder, and what does it take for them to heal and live a productive life. It is also interesting that severe psychological disorders (DD, in particular) did not have much treatment or research supporting it. “The goal of this naturalistic observational 30-month follow-up study of an international sample of patients with dissociative disorders was to determine if treatment provided by community providers was associated with improvements in symptoms and adaptive functioning" (1). This method involves observing participants in their natural environment. This kind of research is often utilized in situations were conducting laboratory research is cost prohibitive, impractical, or would immensely impact the participant's behavior. The reason why this research is necessary is because there has not been a lot of research on what treatment is most effective for this disorder. The existing examination relied on a practice session network methodological psychoanalysis in which residential therapists, and their patients are recruited as the participants in …show more content…
inquiry. The longitudinal naturalistic observational study recruited participants from all over to have a diverse range of participants.
“baseline participants consisted of 298 therapists and 237 patients" (2). Therapists who were used to conduct the study were from the associate registry of the “International Society for the Study of Trauma and Dissociation (ISSTD), graduates of the ISSTD’s Dissociative Disorders Psychotherapist Training Program (DDPTP), and mental health professional listserves" (2).
Each therapist gives their expertise on every aspect of participants with DD each symptom will be further examined by skillful therapists. Material that was used was a behavior checklist “patients reported how often in the last 30 days they had engaged in self-injurious behavior; suicide attempts; behaviors that were dangerous enough to result in death, alcohol, and drug consumption; and “very impulsive” behaviors.” (2). “DES. The “Dissociative Experiences Scale” that calculates each follow-up for the current study of naturalistic
observation. During this research study, there weren't any variables that were manipulated. However, researchers measured how frequent the patients displayed positive behavior throughout the study. The constructive behavior that was measured was going to school, getting a job and continuing with therapy or whether they were hospitalized or not. The odds of hospitalization was reduced each month by 31%, and the likelihood of participating in social activities went up by a 5%, thinking positive thoughts 10% and 3% for going to school/volunteering. As time went on they didn't see the effect they wanted when using statistical programming environment R (R Development Core Team, 2011), so they started a new method called PITQ, which showed significant statistical data increases. Patients with dissociative, depression, PTSD and broad psychiatric symptoms reported these symptoms reduced significantly throughout the study. However, the declines attenuated over time as designated by statistically paramount positive quadratic effects. In addition, more patients reported that there was a significant 5% decreases over time in a thirty daytime span of self- injury, doing something unsafe, and doing something very impulsive. Researchers found that treatment done on patients with DD through the naturalistic study was associated with improvements in symptoms, functioning and increasing adaptive capacities. In conclusion, the naturalistic observation method that was used to conduct this research was the optimum choice since all other methods had failed or didn't have any significant improvements for people with DD. This method would be best for people with Dissociative Disorder because treatment is done over a longitudinal time span to help DD patients cope with their illness. Moreover, researchers could conduct follow-up research studies ten to thirty years after the original study was conducted, for further in depth practices to see whether or not naturalistic observation made an impact on their symptoms
depression” as presented by the National Institute of Mental Health these are all actions and symptoms of Dissociative Identity Disorder, DID,.
Dissociative fugue is considered to be more common than previously thought and some estimate it to affect 1% of the population. Dissociation is present in all races but is more common in American children. More males who have been abused may experience pathological dissociation, and George was one of them. Dissociative identity disorder is typically caused by trauma occurring at less than nine years of age. Sadly, George was abused at that young age and was by both parents. Early age of abuse onset predicts a greater degree of dissociation. Another statistic about DID is that dissociative disorders were seen in 17.2% of a large inpatient group seeking treatment for substance abuse. George has a substance abuse because of how much he drinks and how frequently he
...individuals to lose sense of time, to lose sense of whom one is, to emotionally detach, and to prolong disengagement from the world. Dissociation can cause people to feel like they are a passenger in their body rather than the driver. In other words, they truly believe they have no choice. Society needs to help and accept these people for whom they are and not look upon them as some sort of maniac. My perspective, at one point in time, was that dissociating was good, because it was a way to let people numb pain and get away. After reading Stout’s essay, I know now that there are many disadvantages to dissociating that people need to be made aware of before they harm anybody.
I support the diagnostic conclusions associated with Disco Di because the symptomatology matched the research regarding MDD and BPD. Gunderson (2011) found that 6% of the population are diagnosed with BPD and of that 75% are females. He further states that most of these patients receive treatment after a suicide attempt. To be diagnosed with BPD the patient needs to display a minimum of five symptoms (Gunderson, 2011). Seven symptoms that Disco Di experienced are consistent with the clinical diagnosis of BPD which in Disco Di’s case includes: impulsive behaviour around substance use and sex, recurrent suicidal behaviours, feeling of abandonment, identity disturb...
This disorder is a serious clinical mood disorder in which feelings of sadness, frustration, loss or anger interfere with a person’s everyday life. The exact cause of major depressive disorder is not known, however many researchers believe it is linked to chemical changes in the brain, problems with a person's genes, or a combination of both. It tends to run in families, but can also occur in those with no family history of the disease. As stated in the case study, Andrea’s mother and 3 of her siblings were diagnosed with serious mood disorders or alcohol abuse. Symptoms of MDD may include: irritability, difficulty with concentration, fatigue or lack of energy, feelings of hopelessness and/or helplessness, feelings of worthlessness, guilt, or self-hate, social isolation, loss of interest in once pleasurable activities, sleep problems (insomnia or excessive sleeping) and suicidal ideation or behavior. In more severe cases of MDD, patients may experience psychotic symptoms such as delusions or hallucinations. Andrea shows signs of many of these symptoms. She is having hallucinations of people being stabbed and being possessed by the devil. She is
Frances, A., & Ross, R. (1996). DSM-IV case studies a clinical guide to differential diagnosis. Washington, DC: American Psychiatric Press, Inc.
Spiegel, D., Loewenstein, R. J., Lewis-Fernández, R., Sar, V., Simeon, D., Vermetten, E., & ... Dell, P. F. (2011). Dissociative disorders in DSM-5. Depression & Anxiety (1091-4269), 28(9), 824-852. doi:10.1002/da.20874
The following research was published in the Psychiatry (Edgemont) Journal Online in March of 2009 by Paulette Marie Gillig, MD, PhD. There are also contraindications involving the treatment of DID. Caution needs to be taken while treating people with DID with medications because any effects they may experience, good or bad, may cause the sufferer of DID to feel like they are being controlled, and therefore traumatized yet again.
Diagnosing an individual with DID can take several years. “Due to the variety of [Sophia’s] symptoms, accurate diagnosis puzzled not only her but also the practitioners from whom she sought help.” (Fox, et. al., 2013) It is estimated that people with dissociative disorders have spent more than seven years in the mental health system prior to receiving an accurate diagnosis. With this complex psychological disorder, misdiagnosis is common because the series of symptoms that cause an individual with a dissociative disorder to search for treatment is very comparable to those of multiple other psychiatric diagnoses. As a matter of fact, many people who are diagnosed with dissociative disorders also struggle with secondary diagnoses of depression, anxiety, or panic disorders. (Goldberg, 2014) For example, “dissociative symptoms commonly co-occur with borderline personality disorder (BPD) and the prevalence of DID among outpatients with borderline personality disorder (BPD) was 24% in two separate studies.” (Chelbowski & Gregory, 2012) Again referring to the case study Recovering Identity, Sophia describes her diagnosis, “I was diagnosed with everything. I was schizophrenic, schizoaffective, borderline, bi-polar, ADHD.” (Fox, et. al., 2013) Clinicians perceived her unwillingness to accept
Dissociative Disorders are dysfunctions that cause a disruption in a person’s memory, perception, identity, awareness, etc. These disorders are also referred to as derealization, a change that was made in the DSM-5. Also, another change for Dissociative Disorders in the DSM-5 is now dissociative amnesia and dissociative fugue are not considered separate in diagnosing, but dissociative fugue is a characteristic of dissociative amnesia. Dissociative Amnesia is the inability to recall important personal information (Barlow and Durand 2009). Dissociative Fugue is the unexpected travel away from home or one’s customary workplace (Barlow & Durand, 2011). Thesis Statement: Dissociative Disorders come in many forms but the focus will be on Dissociative Identity Disorder and Shirley Ardell Mason (also known as Sybil), highlighting her sixteen personalities.
My topic of choice for this research paper is Dissociative Identity Disorder or DID. This appellation is rather new; therefore, most are more familiar with the disorder's older, less technical name: Multiple Personality Disorder or MPD. When first presented with the task of selecting a topic on which to center this paper, I immediately dismissed Dissociative Identity Disorder (which for the sake of brevity will be referred to as DID for the remainder of this paper) as a viable topic due to the sheer scope of the disorder. However after an exhaustive examination of other prospective topics, I found myself back at my original choice. There are several reasons why I chose DID. The foremost of which is the widespread fascination of this disorder by many different types of people; most of whom otherwise have no interest in psychology or its associated fields. One would be hard pressed to find someone who hasn’t been captivated at one time or another by the extraordinary, all too well known symptoms of this disorder. This fascination… dare I say ‘allure’ to this disorder is exemplified by the myriad of motion pictures that have been produced based on cases, real or fictitious, of DID. Another reason for my choice is what I feel is the insufficiency of effective treatments for DID. Despite what is known about this disorder, (which is relatively a lot) there are only two chief treatments for DID; the first and most prevalent is psychotherapy; also known as ”talk therapy”, the second is medication. The third and final reason for my choice is my own enchantment with DID. I must admit that ever since I read about Sue Tinker, a woman who was diagnosed with over 200 different personalities. In writing this paper I hope to discover more about this disorder and perhaps be able to identify a few areas that I feel might require more research on the part of psychologists specializing in DID.
Coon, Dennis, and John O. Mitterer. "Dissociative Disorders." Psychology A Journey. 5e ed. Belmont: John David Hague, 2014, 2011. 512. Print.
Grohol, J. M. (n.d.). Psych Central: Dissociative Identity Disorder Treatment. Psych Central - Trusted mental health, depression, bipolar, ADHD and psychology information. Retrieved May 24, 2011, from http://psychcentral.com/disorders/sx18t.htm
In a study with a sample of 20 psychiatry patients who have either been diagnosed with dissociative identity disorder or dissociative disorder not otherwise specified (DDNOS). The DID patients scored an average of 11 while those with DDNOS only scored 2.2 (Ross, 1997). The items of the scale have been integrated into the MMPI-2 which includes questions such as, “I often feel as if things are not real” and “My memory seems to be alright” (Ross, 1997). This integration is a positive one because prior to the Phillips Dissociation scale, the issue of differentiating DID from borderline personality disorder was highly problematic; furthermore there was no scoring system for the diagnosis of DID. The issue would have been evident if the MMPI were used to assess Halime, she likely would have received an erroneous diagnosis because of the ambiguity of her presentation. Such misdiagnosis would have resulted in potentially harmful treatment – treatment that may have worsened her symptoms (Levy & Swanson,
Do you ever feel like you just can’t take reality anymore? You just want to escape it and in order to do so, your conscious awareness becomes separated from all the painful things you can’t stand, including your painful memories. Then suddenly you’re a totally different person. Another identity takes your place in suffering all the painful things you want to escape. Today, I’m going to talk to you about dissociative identity disorder (DID). I will be talking about what DID is, what causes DID and how it affects the individual (host/core). I will also mention a famous case in psychology.