Defending a Diagnostic Pariah: Validatinq the Categorisation of Dissociative Identity Disorder

Abstract

In past decades and still, in contemporary society, the notion and validity of the phenomenon of multiple personalities, or dissociative identities, within a single individual, have resulted in much debate and discord among mental health care professionals. Even with diverging opinions on the subject, the current Diagnostic and Statistical Manual of Mental Disorders bears proof of the genuine nature of what is now termed Dissociative Identity Disorder (DID). In this paper, the existence of DID per se is not questioned, but rather, whether this disorder can be reliably identified and validly categorised. There are four factors that will be assessed: childhood trauma, prevalence ratings, media influences, and psycho-physiological perspectives. First, traumatic experiences in childhood are commonly held to be the primary cause of this disorder; however, issues arise with regard to the intensity, duration and kind of abuse, as well as the measures in recording such abuse. Second, the prevalence ratings highlight the dramatic increase of diagnosis in the 1980s, with perspectives supporting both an under- and over-diagnosis of the disorder. Third, vast media influences may have played a role in the over-diagnosis of DID, such that the number of cases alters per person, and rates of ritual satanic abuse increased dramatically, with subsequent sharp decline. Last, psycho-physiological experimental studies may suggest the validity of this diagnostic category, but these studies may also merely demonstrate the ability for intense concentration and/or a desire for role-play. In essence, evidence either supporting or opposing the validity of current categorisation of this disorder seems to be unconvincing and inconclusive. However, depending on the perceived ontology of this disorder, further study may be directed toward parental coping strategies to reduce child abuse or mandatory warnings to practitioners on the susceptibility of certain patients.