Talk:Dissociative identity disorder

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Picture[edit]

I suggest we remove that artist's depiction. It is emotionally vivid, and I don't think that's the tone this article should set.

23chaosmosis (talk) 21:13, 21 May 2014 (UTC)

i agree zlouiemark [ T ] [ C ] 16:51, 15 March 2015 (UTC)
Done. --Thnidu (talk) 00:24, 18 May 2015 (UTC)
23chaosmosis (talk · contribs), Zlouiemark45546 (zlouiemark) and Thnidu, what good reason is there to remove that image? "Emotionally vivid"? So are the lead images in the Major depressive disorder and Self-harm articles, respectively (as currently seen here and here). People made similar arguments for removing the cutting image from the Self-harm article; see here for an example. The IP argued, "I have taken out the picture of the injured arm because this image could be triggering to self-harmers who view this page." I reverted, stating, "The self-harm image helps people understand this mindset, is presented in an encyclopedic manner." That person showed up again as a different IP, and was reverted again. Then Fraggle81 made a hidden note about the image, which I tweaked. Doc James has also been against its removal, as seen by the "reverted again" diff-link and currently in this discussion. If there is some valid Wikipedia:Offensive material guideline rationale for removing the lead image for the Dissociative identity disorder article, then I can agree with its removal. Either way, I don't feel strongly about its removal, but I don't think that the removal should have a WP:IDON'TLIKEIT rationale. Flyer22 (talk) 00:55, 18 May 2015 (UTC)
For anyone who comes across this discussion, this a link to the image for easy viewing. Flyer22 (talk) 01:06, 18 May 2015 (UTC)
Flyer22 (talk · contribs) i guess it's quite a vague depiction. there's something that's not in there and there's something that shouldn't be in that abstract painting. i could give you several reasons. i know its not perfect but i dont think its necessary. zlouiemark [ T ] [ C ] 01:31, 18 May 2015 (UTC)
The image has been present a long time. We need further discussion and consensus before we remove it. We often use abstract art for mental illness. And this is common practice in the field of psychiatry / psychology. Doc James (talk · contribs · email) 02:05, 18 May 2015 (UTC)
Zlouiemark45546, like I stated, I don't feel strongly about the image staying or going. But I prefer that it's there; images (especially lead images) usually make an article more welcoming to our readers (I'm speaking from personal experience editing this site). So, Doc James, I agree with your restoration of the image. Flyer22 (talk) 02:09, 18 May 2015 (UTC)
@23chaosmosis, Doc James, and Flyer22: I know a number of people, both on the web and in RealSpace™:-), for whom some topics and images are potentially triggery, and other people who routinely preface their posts with trigger warnings if appropriate. This seemed to me to be a picture that could be such a trigger: though neither of the objections mentioned that explicitly, I felt that "emotionally vivid" could refer to such a quality for that writer, and so I deleted it.
But I wasn't aware of the parallel history at Self-harm. Having read your replies, I withdraw my opposition to the picture, pending possible further discussion introducing relevant new material.
(BTW, irrelevantly to the present discussion, I feel some sympathy for the IP in the Self-harm discussion. A personal history of self-harm is a very valid reason for desiring anonymity, and the different IP could very easily be simply an artifact of anonymous login, possibly from different public computers (e.g., in a library).) --Thnidu (talk) 04:13, 18 May 2015 (UTC)
Wikipedia fills an interesting space in publishing. We are not a self help guide for patients and we are not a medical textbook for practitioners. We are sort of a bit of both. People have tried to remove the image at vertigo as they said it made them worse. People have tried to move the image at smallpox as they felt it was unpleasant. People have tried to remove the images at Mohammad as they have been deemed culturally insensitive. People have tried to remove the images at Rorschach test as they supposedly give away the tests secrets. I think Wikipedia would be a lot less educational if we were to remove a large portions of the images.
The picture here is fairly innocuous as a trigger. Doc James (talk · contribs · email) 04:24, 18 May 2015 (UTC)
Thnidu, I understand the "triggering" argument. That's why I cited an IP's "triggering" argument above. I also cited that IP's argument in this discussion at the Sexual assault talk page when debating with AThing. As you can see there, I took part of my wording from there for this dissociative identity disorder discussion. I also relented in that case, and Liesbeth98 removed the image. But "triggering" arguments are not how Wikipedia is supposed to work unless there is a valid WP:Offensive material rationale. I only relented in the case of the Sexual assault article because of the WP:Offensive material rationale that AThing put forth. Others might agree or disagree with the removal of that image. I don't care as much anymore if it stays or goes; I didn't care much then either, but, like I noted above, I think removals should be valid. Flyer22 (talk) 04:49, 18 May 2015 (UTC)
@Doc James and Flyer22: Thanks for the explanations. As I said above, I withdraw my objections to the picture. --Thnidu (talk) 14:33, 18 May 2015 (UTC)
For future reference: Since this article is on my WP:Watchlist, there is no need to WP:Ping me to it. Flyer22 (talk) 21:33, 18 May 2015 (UTC)
Thanks User:Thnidu :-) Doc James (talk · contribs · email) 00:35, 19 May 2015 (UTC)

PET MRI scans prove the separateness of identity states[edit]

The entire article should be re-written in my opinion because the information garnered from PET scanning shows exactly how the brain works differently between different self states or whatever you want to call them. The entire tone of the article becomes offensive in that regard, as the author entirely ignores the last ten years of research into the subject by beginning the article with what any scientist would have to call an ignorant statement. There most certainly is empirical evidence to support this diagnosis, and treatment is therefore more successful now days as a result - provided their therapist keeps up their education. The author notes the theory regarding structural dissociation and appears to have missed the evidence of PET scans to formulate the hypothesis. 122.58.149.66 (talk) 00:49, 8 November 2014 (UTC)

Editor 122.58.149.66 while you are correct that fMRI scans have shown exacting evidence of state switching and even clusters of states present at predictable times, accompanied by specific symptoms, leaving no doubt as to the existence of and differences in DID, OSDD, PTSD, and some versions of BPD, the editors who "watch this page like vultures" refuse to detour from their personal agenda. Granted this is not the overall purpose of WP, but still the site has allowed this and gave power to those who also allow it. Here on this page the one or two editors that "rule it" are masters at manipulating the game of WP. They don't care that the page is not at all accurate; all they want is the page to reflect their personal view. They add enough information, although bent profusely as you pointed out, that they can convince "higher-ups" that the page is indeed complete, and they will quickly point out the vast number of "proper references" used, but many are from researchers of their like mind-set, who ignore evidence for reasons that are unique to each, I am sure. To come to this page equipped with fMRI scans and the most accurate information to date will do you no good. To wage and ultimately win a war here, and it would be a war, you would have to be a master at the manipulation of people and of WP, and even if you held 100 graduate degrees in neurology and psychology it would do you no good. Masters of WP proudly call us the idiots. Tiredofidiots (talk) 02:25, 30 November 2014 (UTC)
@Tiredofidiots: Wikipedia is open to dissenting voices, providing you can meet its core policies of Neutral Point of View, verifiability, and no original research. It's not -- can't be -- about "the truth", no matter how passionately you feel about it, because others will disagree with you about what "the truth" might be. You are both welcome to provide citations to reliable sources that back up your positions on this. For articles on medical topics, like this, the bar for reliable source status is higher: please read WP:MEDRS for the criteria for medical sources. However, please also read WP:FRINGE for how Wikipedia presents positions and opinions outside the mainstream.
Alas, if you can't meet these criteria, the material can't go in. Have you tried, for example, getting your results published in a peer-reviewed medical journal? If so, have they yet been the subject of an independent peer-reviewed literature survey or meta analysis? -- The Anome (talk) 18:46, 30 November 2014 (UTC)
The Anome, as editor @122.58.149.66: pointed out, "up to date material" is in peer reviewed journals, and books are available that were written by leaders in traumatology and bioneurology, and those books address the subject in full. This WP article carries with it a pervasive tone that perpetuates childish myths of DID, and it's written in a manner that misleads the public. Distinct states in DID have literally been captured on fMRI scans as they switch with each other; no other disorder has been shown, on a fMRI, to have more than one distinct state, and so on and so on. There is a difference between "truth" and a lack of understanding on a subject, and what this page shows is a pervasive and total lack of understanding. There are of course disputes in the field about many things, but literally no one of importance today promotes what is on this page. The main editor here will counter, I am sure, with the usual WP tricks and say that all researchers are equal, but that is far from the truth. We all know there is a grandiose amount of junk articles, and then there is published work by prominent leaders in any field. It is the work of leaders that should be presented, and their the evidence they present on fMRI imaging that backs up what they say. I tried to give links to examples of good and current research but WP will not allow posting of them. Tiredofidiots (talk) 22:53, 30 November 2014 (UTC)
Can you give some examples here, so I can take a look at them, please? -- The Anome (talk) 23:07, 30 November 2014 (UTC)
I will again see if WP will allow the external links here. 1 2 3 4 5 6 Tiredofidiots (talk) 23:13, 30 November 2014 (UTC)
Yes, it does. Of the papers you've cited there, [1] looks to me like a review article that probably passes WP:MEDRS, and the sentence "Psychobiological studies are beginning to identify clear correlates of DID associated with diverse brain areas and cognitive functions." from the abstract seems to support your case for mentioning it in the article, but only as currently tentative terms, as "are beginning to identify" looks pretty tentative to me at this point. What wording do you suggest? -- The Anome (talk) 15:53, 1 December 2014 (UTC)


Let's look at it not from a WP stance, but from an evolutionary view.

  • Nijenhuis, E. R. S.; Van Der Hart, O. (2011). "Defining Dissociation in Trauma". Journal of Trauma & Dissociation." The authors bring back Janet's definition, with a few updates. The basically says that dissociation is an illness, and is caused by an overwhelming leading to a divide of the personalty keeping unprocessed trauma occurrence from the rest.
  • Frewen, P. A.; Lanius, R. A. (2014). "Trauma-Related Altered States of Consciousness: Exploring the 4-D Model". Journal of Trauma & Dissociation." Now other researchers struggled to catch up with Nijenhuis and van der Hart as is seen in this article and a plethora of others. Lanius is a powerhouse, but playing the underdog here as he educates others.
  • Dorahy, M. J.; Brand, B. L.; Ar, V.; Kruger, C.; Stavropoulos, P.; Martinez-Taboas, A.; Lewis-Fernandez, R.; Middleton, W. (2014). "Dissociative identity disorder: An empirical overview." I threw this one in just because I know it's what WP prefers, but it again shows how others are struggling to catch up with van der Hart and Nijenhuis. Dorhay is bringing the others slowly along. Of course you are probably getting the idea of where to go for the best research on this subject.
  • Kluemper, N. S.; Dalenberg, C. (2014). "Is the Dissociative Adult Suggestible? A Test of the Trauma and Fantasy Models of Dissociation." This I had to throw it to show the same old tired stuff that the editors on the DID page here like to find because they will take the intro that dismisses suggestibility and built that into a case for controversy. I hope soon these types of articles fade away. It's sad.
  • Reinders, A. A. T. S.; Willemsen, A. T. M.; Den Boer, J. A.; Vos, H. P. J.; Veltman, D. J.; Loewenstein, R. J. (2014). "Opposite brain emotion-regulation patterns in identity states of dissociative identity disorder: A PET study and neurobiological model". Here we have authors that have been paying attention. They provide some very good information and imaging. The proof is in the pudding, and these guys are showing it to you in black and white pictures.
  • Schlumpf, Y. R.; Reinders, A. A. T. S.; Nijenhuis, E. R. S.; Luechinger, R.; Van Osch, M. J. P.; Jäncke, L. (2014). "Dissociative Part-Dependent Resting-State Activity in Dissociative Identity Disorder: A Controlled fMRI Perfusion Study". There he is, Nijenhuis. Don't think he has been sitting on his laurels while all the others have been researching. He is carefully bringing the rest of the world along with he and van der Hart. Much more is known that has been published, but of course WP does not care about that, but it's time they move forward an inch or two so they don't look so foolish in the day to come. Notice the image that catches the distinct state in the process of switching. Of course this is only telling a short story of what we actually know, but once you get that there is no turning back to the sort of thing on the WP page. Tiredofidiots (talk) 18:58, 1 December 2014 (UTC)
Hi -- the issue here is that all of this looks good, but is primary research, and not eligible to meet the WP:MEDRS criteria, which is explicitly designed with an abundance of caution to stop cutting-edge scientific research from being included in medical articles until it has had a chance to be digested by the wider medical community. When this research is reported on in more detail by more peer-reviewed secondary sources -- perhaps quite soon, given the apparent quality of this work -- this entire line of research will become eligible for inclusion in the article. In the meantime, it can't be used directly. However, I don't see any problem at all with adding some information taken from the review article, which can be used right now. If you can find other review articles covering the same line of research, you can reference those, too. -- The Anome (talk) 19:47, 1 December 2014 (UTC)
Hello Anome, Here is a link to a free version of the complete article for those who would like to do this work. I too have little doubt that review articles will be written soon, just because of stipulations like this. Tiredofidiots (talk) 05:40, 2 December 2014 (UTC)
Thanks. I'll read it later. -- The Anome (talk) 12:00, 3 December 2014 (UTC)

Dorahy should be integrated, it is a recent review article. It shouldn't be integrated the way it was - as a "nuh-uh" article used to reference the idea that the non-trauma model is wrong. The paper didn't verify the text that accompanied it. And a pure OR observation - it doesn't seem to cite any critical sources. Piper, Merskey, Paris, Lilienfeld, none were mentioned in the references as far as I can tell. Nothing can be done about this - but it does make me dislike the article. WLU (t) (c) Wikipedia's rules:simple/complex 17:19, 21 January 2015 (UTC)

Addition to disorder definition (edit)[edit]

As I was reading through the introduction to the disorder, I realized there was one possible important aspect not mentioned. This disorder, as said in my edit, does not necessarily imply the creation of new personalities. DID is more related to bringing forward some charactheristics already existent in the patient's character. A patient may develop a "shy personality", yet in reality, it is just a shy-er version of themselves, something that might have been repressed. This is my proposed edit:

DID is a disorder of identity fragmentation, it does not imply the creation of new found personalities within the patient. Rather, the dissorder causes a separation, and forward bringing, of the different charactheristics already existing within the patient's character.[2]


References:

  1. ^ Dorahy, M. J.; Brand, B. L.;  Ar, V.; Kruger, C.; Stavropoulos, P.; Martinez-Taboas, A.; Lewis-Fernandez, R.; Middleton, W. (2014). "Dissociative identity disorder: An empirical overview". Australian & New Zealand Journal of Psychiatry 48 (5): 402–17. doi:10.1177/0004867414527523. PMID 24788904.  edit
  2. ^ http://www.psychologytoday.com/conditions/dissociative-identity-disorder-multiple-personality-disorder

Vferrer00 (talk) 02:17, 8 December 2014 (UTC)

To be more accurate what you propose could be written like this: DID is a mental disorder resulting from "structural dissociation of the personality" which results in the creation of personality states that are verified by fMRI scans. Try reading Neurobiology and Treatment of Traumatic Dissociation by Lanius, Paulesn and Corrigan rather than visiting a blog for information. I went to the link you provided and what is there is correct but their terminology confused you. Memory loss means "true amnesia," as opposed to "dissociative amnesia," and it is the switching between distinct states, as has been shown on fMRI that dictates DID. What the author is trying to say is that DID is not caused by a "split in the personality." Imagine how silly that sounds to a neurologist. The personality is a group of neurons, and you can't split them. Anyway, the author is trying to point out that DID is caused by the creation of personality states, (the author used the term personalities, but with the understanding that readers know what that means. It's one of many states that make up the personality) rather than what was once thought, which is that it was caused by the silly idea that a personality could split. Tiredofidiots (talk) 01:57, 10 December 2014 (UTC)
The problem is, FMRI scans only show changes in blood flow/activity, not content. Currently you can't distinguish between, say, a switch between personalities, and a switch of attention from behaving normally to behaving in a social role. Doesn't mean it shouldn't be mentioned or referenced - just that it shouldn't be taken as absolute proof that DID is realy and caused by trauma. WLU (t) (c) Wikipedia's rules:simple/complex 17:22, 21 January 2015 (UTC)

Mania — Preceding unsigned comment added by 2602:30A:2C34:6A50:C3F:6ED4:6546:4DFA (talk) 09:59, 20 February 2015 (UTC)

Consider adding depth through a section on cultural variations[edit]

Though I understand this to be a very Empirical article in reference to Dissociative Identity Disorder, the DSM-V clearly mentions cultural variation as an implication for clinical diagnosis. I believe as cultural sensitivity and its addition to our clinical repertoire increases, one must undoubtedly understand phenomenon which occur in other cultures that are congruent with DID.

Here is my proposed edit, to be under Society and Culture(I am an undergraduate Psychology student, currently a 4th year, and would definitely appreciate any input, I am also new to this):

Cultural Variation of DID[edit]

One of the controversial aspects of DID which was was not taken into consideration until its inclusion within the DSM-V, is possession as a cultural variation of DID.[1]

Janice Boddy from the Department of Anthropology, University of Toronto stated [2]:

Spirit Possession commonly refers to the hold exerted over a human being by external forces or entities more powerful than she. These forces may be ancestors or divinities, ghosts of foreign origin, or entities both ontologically and ethnically alien. Some societies evince multiple spirit forms. Depending on cultural and etiological context such spirits may be exorcised, or lodged in relatively permanent relationship with their host (or medium), occasionally usurping primacy of place in her body (even donning their own clothes and speaking their own languages) during bouts of possession trance.

Spirit Possession is seen in a variety of cultures around the world. Not limited to but including African traditions, African Diaspora traditions, Asian traditions, Oceanic traditions, Christianity, Islam, Judaism, Wicca, and Shamanism.

Main article: Spirit possession

References

  1. ^ "Highlights of Changes from DSM-IV-TR to DSM-5" (PDF). American Psychiatric Association. 2013-05-17. Retrieved 2015-05-16. 
  2. ^ Boddy, Janice (1994). "Spirit Possession Revisited: Beyond Instrumentality". Annual Review of Anthropology 23 (23): 407. Retrieved 14 March 2015. 

Beyondthecloud9 (talk) 06:12, 16 March 2015 (UTC)Beyondthecloud9 (talk) 06:06, 16 March 2015 (UTC)

Those sources do not seem to make a connection between the two phenomena. Samsara 09:41, 16 March 2015 (UTC)
Spirit possession is already mentioned in § History of the DSM diagnosis. The DSM also states that "the majority of possession states around the world are normal, usually part of spiritual practice, and do not meet criteria for dissociative identity disorder," which is why we should avoid WP:SYNTH with sources that do not explicitly mention DID (like your second source). KateWishing (talk) 11:52, 16 March 2015 (UTC)
Thank you for the input. I will reformulate the factoids I used. Even though it does mention that the majority of possession states around the world are normal, in the Highlights of Changes from the DSM-IV-TR to DSM-5 issued by APA Publishing in 2013, page 10, under Dissociative Disorders, it does state that: "Also, experiences of pathological possession in some cultures are included in the description of identity disruption". Would it then be more appropriate to delineate some of these pathological possession states as seen through empirical evidence? Or would this then be a more appropriate addition to Dissociative disorder not otherwise specified? As well as mentioning that the clinical presentation be a pathological possession rather than one attributed to culturally accepted spiritual practices involving the same? I'm having a hard time with this assignment. Thanks in advance.Beyondthecloud9 (talk) 02:39, 17 March 2015 (UTC)
Per our policy against synthesizing sources, every source you cite must specifically mention DID. This material would not be appropriate in its current form for Dissociative disorder not otherwise specified, either. However, you might be able to contribute to that page by updating it with information from the DSM-5 entry for "Other Specified Dissociative Disorder". KateWishing (talk) 04:15, 18 March 2015 (UTC)

Would this be a better edit then under Diagnosis? (this extract is less than 400 words so its doesnt violate APA copywrite)

Issues Affecting Diagnosis[edit]

Culture-Related

The DSM 5 elaborates on cultural background as an influence for some clinical presentations of DID.[1]

Many features of dissociative identity disorder can be influenced by the individual's cultural background. Individuals with this disorder may present with prominent medically unexplained neurological symptoms, such as non-epileptic seizures, paralyses, or sensory loss, in cultural settings were such symptoms are common. Similarly, in settings where normative possession is common (e.g., rural areas in the developing world, among certain religious groups in the United States and Europe), the fragmented identities may take the form of possessing spirits, deities, demons, animals, or mythical figures. Acculturation or prolonged intercultural contact may shape the characteristics of other identities(e.g., identities in India may speak English exclusively and wear Western clothes). Possession-form dissociative identity disorder can be distinguished from culturally accepted possession states in that the former is involuntary, distressing, uncontrollable, and often recurrent or persistent; involves conflict between the individual and his or her surrounding family, social,or work milieu; and is manifested at times and in places that violate the norms of the culture or religion.

Beyondthecloud9 (talk) 07:09, 18 March 2015 (UTC)

  1. ^ Association], [American Psychiatry (2013). Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed. ed.). Washington [etc.]: American Psychiatric Publishing. p. 295. ISBN 978-0-89042-555-8. 

Verification in Sar et al. 2011[edit]

In § Developmental trauma the sentence

[People diagnosed with DID] report more historical psychological trauma than those diagnosed with any other mental illness.

was flagged "failed verification" in August 2012. I looked at the source, which is a secondary source, and found ample verification for the sentence: see the diff. I removed the tag and added a quote, and a reference to another section of the paper. --Thnidu (talk) 00:21, 18 May 2015 (UTC)