Causes of Somatoform, Dissociative, and Personality Disorders

Causes of Somatoform, Dissociative, and Personality Disorders.

Dissociative identity disorder, formerly known as multiple personality disorder is a mental disorder characterized by at least two different identities and relatively durable and dissociated states of personality that alternately control the behavior of a person, and is accompanied by deterioration memory for important information not explained by ordinary forgetfulness. These symptoms are not explained by substance abuse, attacks, other medical conditions or imaginative play of children. The diagnosis is often difficult, since there is considerable comorbidity with other mental disorders. Simulation should consider whether it is possible to obtain financial or forensic gain and factitious disorder if the help-seeking behavior is important.

DID is one of the most controversial psychiatric disorders with a clear consensus on diagnosis or treatment. Research on the effectiveness of treatment is still focused primarily on clinical criteria and case studies. Dissociative symptoms ranging from common failures in attention, distracted by something else, and daydreaming with pathological dissociative disorders. There is no systematic and empirically supported definition of "dissociation".

Although neither epidemiological studies and longitudinal studies have been done, DID believes rarely resolves spontaneously. Symptoms are said to vary with time. In general, the prognosis is poor, especially for people with comorbid disorders. There are few systematic data on the prevalence of DID. The International Society for the Study of Trauma and Dissociation indicates that the prevalence is between 1 and 3% in the general population and between 1 and 5% in groups of hospitalized patients in Europe and North America. DID is diagnosed more frequently in the United States than in the rest of the world, and is three to nine times more common in women than in men. DID prevalence increased significantly in the last half of the 20th century, along with the number of identities claimed by patients.

Dissociative disorders including DID have been attributed to memory disorders caused by trauma and other forms of stress, but research on this hypothesis has been characterized by a lack of methodology. So far, scientific studies usually focus on memory, have been few and the results have been inconclusive. An alternative to the etiology of DID hypothesis is as a result of the techniques employed by some therapists, especially those who use hypnosis, and disagreement between the two positions is characterized by an intense debate. DID became a popular diagnosis in the 1970s, 80s and 90s, but it is unclear whether the actual incidence of disease increased, if it was more recognized by physicians, or sociocultural factors caused an increase in iatrogenic presentations. The unusual number of diagnoses after 1980, grouped around a small number of physicians and feature suggestion for people with DID, support the hypothesis that I is induced therapist. The unusual grouping of diagnoses has also been explained as due to lack of awareness and education among physicians to recognize cases of DID.

Definitions

Dissociation, the term underlying dissociative disorders such as DID, lacks precision, empirical and general agreement on the definition. A large number of diverse experiences have been called dissociative, ranging from normal inattentive to breakdowns in the processes of dissociative disorders characterized by memory. Therefore, it is unknown whether there is a common root that underlies all dissociative experiences, or if the range of mild to severe symptoms are the result of different etiologies and biological structures. Other terms used in the literature, such as personality, personality status, identity, ego state and amnesia, have also agreed not definitions. There are many competing models that incorporate some of the dissociative symptoms not excluding dissociative. The most widely used model of dissociation conceptualized did what at one end of a continuum of dissociation, with the flow at the other end, although this model is being challenged.

Some terms have been proposed with respect to dissociation. Paulette Gillig psychiatrist draws a distinction between an "ego state" and the term "altered" commonly used in discussions of DID. Ellert Nijenhuis and colleagues suggest that there are differences between the personalities responsible for daily operations and emerging in survival situations. "The structural dissociation of the personality" is used by van der Hart and colleagues to distinguish dissociation attributed to traumatic or pathological condition, which in turn is divided into primary, secondary and tertiary dissociation. According to this hypothesis, primary dissociation involves ANP and EP, while the secondary dissociation involves ANP and several EPs and tertiary dissociation, which is unique for DID, described as having several of each. Others have suggested dissociation can be separated in two different ways, detachment and compartmentalization, the last of which imply a lack of control processes or actions usually controllable, is more evident in DID. Efforts have been made to distinguish between normal and pathological dissociation psychometrically, but have not been universally accepted.

Signs and symptoms

According to the Diagnostic and Statistical Manual of Mental Disorders, DID includes "the presence of two or more distinct identities or personality states" that alternative control individual behavior, accompanied by the inability to recall personal information beyond what expected by normal forgetfulness. In each individual, the clinical presentation is variable and performance level can be changed from severely impaired to the right. The symptoms of dissociative amnesia, dissociative fugue and depersonalization disorder are subsumed under the DID diagnosis and are not diagnosed separately. People with DID may experience distress both symptoms of DID, and the consequences of the symptoms that accompany it. Most patients with DID report childhood sexual and / or physical abuse, although the accuracy of these reports is controversial. The identities may not be aware of each other and compartmentalize knowledge and memories, resulting in chaotic personal life. People with DID may be reluctant to talk about the symptoms due to the association with abuse, shame and fear. DID patients may also experience frequent and intense temporary shocks.

Shrines number varies widely, with most patients identified ten, although all 4,500 have been reported. The average number of alters has increased in recent decades, from two or three now averaging about 16 - However it is unclear whether this is due to an actual increase in altered, or simply that the psychiatric community has come to accept more than a high number of alters. The primary identity, often named as the patient tends to be "passive, dependent, guilty and depressed" with other personalities or "alters" be more active, aggressive or hostile fuller memories, and they often contain. Most identities of ordinary people, have also been reported, although fictional, mythical, celebrities and animals altered.