Talk:Dissociative identity disorder/Archive 5

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Contents

Anon adding "symptoms"

That list of "symptoms" is pernicious -- it's like the infamous list from Courage to Heal -- if you checked off any item at all you were encouraged to believe that you were molested as a child ... or in this case, have DID. I'm going to remove it. Zora 02:22, 18 February 2006 (UTC)

Don't be ridiculous, just because there have been claims that a similar set of symptoms have been abused, in a totally different context, does NOT mean they should be treated as anathema, that doesn't even make the most basic common sense. --Zeraeph 04:24, 18 February 2006 (UTC)
Zerapeth, I must disagree with you. Actually, Zora, unfortunately I'm going to have to disagree as well... The largest dispute I take to the symptoms list is that the majority are not symptoms! They are related, frequently comorbid diagnoses. 'Symptoms' is a dangerous misnomer. According to the DSM and other sources, symptoms should include migraine headaches, amnesia, time lapses, depression, and others that I cannot offhand remember. A complete, unique diagnosis (e.g. eating disorders or post traumatic stress disorder) cannot and must not be given as a 'symptom'.novareproject 10:17, 26 April 2007
Can you find a source to cite for that?--Zeraeph 08:10, 27 April 2007 (UTC)
No source or citation needed, Zeraeph. And, Zora, despite a long-standing (silent) contention regards some of your positions, especially on this topic, I must agree with you, although only insofar as this list should be removed, or at least retitled.
To clarify...this list is neither one of symptoms, nor is it one of co-morbid diagnostic criteria (per novareproject). The professional nomclature for a list such as this is either "markers" or "co-occuring markers". They cannnot be referred to as co-morbid, as that would intone that they fall within the pervue of psychiatric diagnosis (e.g., you can't have GAD with co-morbid fibromialgia, because fibromialgia is not a psychiatric diagnosis...you can, however have GAD with co-occurring fibro, and most GAD suffers do.). They cannot be symptoms because they can occur independently of the primary diagnosis. There is an anecdotal label called "shadow symptoms" that might be applicable here, but it'd be a stretch. Cheers! Empacher 13:13, 27 April 2007 (UTC)
Of course you need to cite a source, this is Wikipedia, if God updated the ten commandments here he'd be expected to cite sources, without sources it is just your personal opinion, with no greater weight than anyone else's. --Zeraeph 23:41, 27 April 2007 (UTC)
My point was that this is not a symptom list and needs to be deleted...no cite needed for something that isn't there. Goose. Empacher 23:56, 27 April 2007 (UTC)
I will give you "goose"...I will stuff it up.....good to see you back, one of the best psych editors around, *zipping mouth* though I take it you weren't away at charm school? --Zeraeph 00:30, 28 April 2007 (UTC)
I have no idea what you're talking about. That said, I hope I didn't offend, mate. I am only trying to help here. Empacher 00:55, 28 April 2007 (UTC)
Seriously, you really remind me of another editor who specialises in psych, yoga etc Same unfortunate "I have spoken" manner, but if you can get past that, usually a pretty good editor underneath it. Which is also by way of a quiet hint not to be quite so...pragmatic with other editors in future? Please? --Zeraeph 21:44, 28 April 2007 (UTC)
"I have spoken"? That's harsh. "Goose" was meant to be funny...like silly Goose, silly old bear, etc. Sorry to offend. Empacher 22:14, 28 April 2007 (UTC)
"Goose" was not the problem, "goose" was found to be entertaining (which is no guarantee everybody would feel the same). But you are really being a little bit "I have spoken" in general. You may well "know stuff" but there are plenty of people around the psych articles who ALSO "know stuff" (and, bluntly, the stuff they know, and the stuff you know, does not always seem to agree either), so nobody is going to take your opinion as the last word, and it often seems as though you expect them to. --Zeraeph 23:45, 28 April 2007 (UTC)
Gee, Z, I guess "I have spoken" trumps "Holier than thou." That'd be my judgement of you, should any of us presume to stand in judgement of any other, which I would hope we wouldn't. So, we're even. I find it interesting that a quick read of your various contributions evidence you to be a rather charming fellow until you feel challenged, then you get a bit prickly, mate.
As for my opinion being the last word, that is your interpretation of my writing style, nothing more.
That said, I shall keep my apparently barbed tongue to myself, and make my edits in silence. Or maybe I will be totally childish, rather than just marginally so, and take my ball and go home. Empacher 12:43, 29 April 2007 (UTC)

Question re: "potential causes" section

It seems to be lifted entirely from the Merck Manual. Is that kosher? That is copyrighted material. I'm new, so I'm still figuring out what's what. P L Logan 03:30, 2 October 2006 (UTC)

I think that the potential causes section needs to be cleaned up a bit, another good source I have found is http://www.sidran.org/sub.cfm?contentID=75&sectionid=4 Mwv2 05:56, 11 July 2007 (UTC)

The use of the term "Alter"

The term "Alter" is used without being defined. It is my perception that 'Alter' is a slang or hip term, but it is currently being used as if 'Alter' is official mental health terminology. Recommend that it not be use without first clarifying its usage and under what context is it normally used. I suspect it is not an official term used in the DSM, more likely limited to personal identification or within small circle of individuals.

Example: Through having several alters the host personality is living through healthy alters, aggressive alters, and often alters that are children.

The term has been used for decades by mental health professionals such as Colin Ross, Ralph Allison, Frank Putnam and Richard Kluft in reports on multiple personality. It probably originated with William McDougall's writings on multiplicity where he called the people in a multiple group "alternating personalities". See http://www.survivalafterdeath.org/articles/mcdougall/alternating.htm . It may have been Cornelia Wilbur who shortened it to "alter". It's also commonly used in the publications of the International Society for the Study of Dissociation. http://www.issd.org/ Its use in the article is thus perfectly acceptable. Slang or hip terms would include things like "headmates". --Bluejay Young 09:24, 27 November 2006 (UTC)
From what I been able to determine, "alter" is a slang term for "Alternate personality" and it is not used in the DSM. The use of slang terms reduces the legitimacy of what is written. In general slang\hip terms are used by insiders and\or those who are promoting an agenda or theory. In this particular case using "Alternate personality" makes the wiki information less confusing, and eliminates the baggage that slang terms brings. —The preceding unsigned comment was added by 216.161.249.177 (talk) 04:35, 10 December 2006 (UTC).
Maybe it's a shortened form of alter ego, i.e. simply "other" in Latin? — Ashmodai (talk · contribs) 09:39, 28 January 2007 (UTC)

Another choice is alter personality (synonimous with personality state). Alter is not a shortened form of alter ego. Alter ego orignates from a different source of thought.


Well, according to the Gale Encyclopedia of Medecine, page 1501, "alters" is correct. It defines said term on the said page and then continues to use the term throughout the entry. I can't give a website, it's a book/an online subscription thing. But look up "Multiple Personality Disorder" (not DID) in the Gale encyclopedia and it is there. GoddessAgwe 20:37, 22 October 2007 (UTC)

NLP and DID/MPD

Is there any data about applying NLP psychotherapy to DID/MPD patients? Eli the Barrow-boy 20:36, 9 December 2006 (UTC)

I've found some anecdotal evidence from various therapists who used NLP about their treatment of DID/MPD with NLP approach. Also, DID/MPD is mentioned in context of Milton Erickson. If any one could expand this side, it would be useful. Eli the Barrow-boy 21:31, 23 January 2007 (UTC)

NPOV

As currently written, this article is a travesty... It looks like it was written by a hardcore pro-multiple personality advocate. It didn't used to be this biased at all. I think reverting back to an old version is far preferable than trying to salvage hat has become a horribly biased and therefore useless article. 68.190.89.38 10:44, 18 December 2006 (UTC)

Can you please log in and list the NPOV areas? This is an article on the diagnosis of Dissociative Identity Disorder, a recognized psychiatric entity. P L Logan 14:22, 4 February 2007 (UTC)

Tues Dec 19, 2006 My apollogies to everyone. I just accidentally erased a section. I'm trying to fix it but dont know how. I'm really sorry. It wasnt deliberate. (Bill)

Clarification for the layperson

Is there a better term than "reptilian complex"? Can that whole paragraph be moved to someplace more relevant, perhaps even the top? It probably answers a lot of questions, especially for people who are personally interested rather than professionally. --Kipperoo 23:51, 5 February 2007 (UTC)

NPOV, again

We've got another pro-MPD slant to the article again.

For some reason User:Empacher insists that the fact that the diagnosis is controversial be removed from the lead. I can't imagine what possible rational he/she could have for that that would at all fit in with WP:NPOV policy.

He also insists upon wording that makes the article take a POV as supporting MPD/DID's existence:

"However, various experienced psychiatrists have encountered a number of cases that do appear to confirm the reality of the existence of this condition."

Saying that they have encountered cases that *do appear* to confirm is taking a side. If some people make this claim, they need to be cited and sourced as them saying it not having the article say that. So my version, ehre I said it appeared *to them* to show that it was real wsa immediately deleted by Empacher. Perhaps it could be phrased better than what I had it, but it's clear that the current version cannot stay as it pretty directly violates WP:NPOV policy.

But of course overall the fact that some psychiatrists think that it's real is unsurprising, as the whole point behind what skeptics say is that the symptoms have been placed onto clients/patients by psychiatrists who believe in its existence.

I should also note that Empacher came to my talk page to aggressively state that he was only doing what was already clearly decided on this talk page. A quick perusal of this page shows that his claims were false, as people were objecting to the POV stance, then it was removed, then he came back and reinserted again. He also lashed out against me with words that were a clear violation of WP:AGF. I am hoping that he takles the talk page discussion to heart here and works to fix the problems with the article. DreamGuy 22:46, 23 April 2007 (UTC)

Wow, you have a lot of time on your hands. Firstly, I did not lash out. I stated that your own Talk page, and User page disclainer, clearly indicate that you have a history as someone who like to stir up controversy based on your own POV, and I asked you to, "Play nice", meaning respect the other editors. This is aggressive?
Secondly, "However, various experienced psychiatrists have encountered a number of cases that do appear to confirm the reality of the existence of this condition." are not my words,so don't attricute things to people in an accusitory fashion without evidence to back it up.
Finally, the reason that a DID controversy page exists and DID is separated from MPD is so that the DID page could speak to the disorder as it is recognized by the orthodoix medical community, not as a controversial subject. This tactic was something decided on several years ago, not just recently. Empacher 14:51, 25 April 2007 (UTC)
You don't understand how things work here. Controversial topics are still labeled as controversial in the main article even if an article specifically discussing in more detail why it's controversial exists. To do otherwise is to blatantly slant the whole nature of the article to deny such controversy. And as far as "decided on several years ago" I've been editing this article for years, the thing you claim was "decided on" simply is not so. You are misrepresenting what had been discussed here so you can slant the article to your own POV, which is not at all acceptable. DreamGuy 19:42, 29 April 2007 (UTC)
Uhm...I've been editing this article since 2001, mate. You've only been here since November 04. And I understand exactly how things work here. What you don't seem to understand is that I recognize that you are documented rabble-rouser with a history of creating conflict, specifically in the interest of your own POV. I have no interest in getting into a pissing contest with you or anyone else. Do what you wish. Empacher 21:30, 29 April 2007 (UTC)
Actually, no... I edited anonymously long before I created a user name, amd I am certainly not documented as a rabble rouser for my own POV at all, I just get people (clearly like yourself) who make such ridiculous personal attacks as an attempt to try to ignore everything I say, despite the fact that the things I am saying are exactly what Wikipedia policies clearly and overwhelmingly support. The simple fact that you are trying to hide the fact that there is a clear and undeniable controversy in the field over this diagnosis shows that you are the one with a very clear POV-pushing agenda. Your kind of edits are very specifically very clear violations of a policy that is considered one of, if nto the, most important policies on this site. DreamGuy 20:18, 1 May 2007 (UTC)
This IS a tricky call...it seems to me that mention of the related controversy surely should remain in this article, with reference to the specific controversy article. It seems that proper citations really must be provided, this is a medical article after all. However, after a lot of careful thought, it does not seem to me that the controversy should be allowed to define DID in the first few lines. What about going for accuracy? Such as:
  • Dissociative identity disorder (DID) is diagnostic category in the DSM IV, defined as the existence in an individual of two or more distinct identities or personalities, each with its own pattern of perceiving and interacting with the environment. ?

To call DSM categories "diagnoses" is a widespread misnomer on Wiki of which I have been equally guilty. --Zeraeph 01:19, 2 May 2007 (UTC)

Merge suggested between Multiple personality controversy and Dissociative identity disorder

Editors at Multiple personality controversy disagree as to whether that article should be merged back into Dissociative identity disorder, from whence it came. (The split was done by Zeraeph in February 2006, please see Talk:Multiple personality controversy#External links.) Only four people are actively discussing the issue. Two of us are in favor of a merge (Bishonen and DreamGuy), one is against (Doczilla), and one has no strong feelings either way (Sethrenn). Obviously such small numbers are no kind of proper consensus. I have filed a request for comment, to get more eyeballs, and I ask everybody here to please come to Talk:Multiple personality controversy and discuss the issue there. Oh, and I urge people to avoid fragmenting the discussion by conducting some of it here at Talk: Dissociative identity disorder. Let's keep it all in one place, if possible. Bishonen | talk 17:52, 1 May 2007 (UTC).

Changes in Potential causes of dissociative identity disorder

The information is NOT properly sourced. You can't just make up a study, it needs to be backed up properly with references. If you can find references, please put them on, but if not then stop adding the information Gmelin 07:03, 8 June 2007 (UTC)

The information is sourced, it's encapsulated by the citation at the end of the paragraph Gmelin 07:04, 8 June 2007 (UTC)
That references redirects http://www.merck.com/mmpe/index.html here], to the front page of a journal, hardly a proper source Gmelin 07:06, 8 June 2007 (UTC)
If you could be bothered looking for it you'd find it's in the article, please stop blanking large chunks of the article Gmelin 07:09, 8 June 2007 (UTC)
Then if you can find the article in the journal readd the information, if not then stop adding unsourced information to wikipedia Gmelin 07:14, 8 June 2007 (UTC)
Please assume good faith when editting wikipedia, the user who added the information has obviously not drawn it from the top of his head, the redirect is probably a technical issue that has yet to be resolved Gmelin 07:18, 8 June 2007 (UTC)
I know for a fact that the information which has been added to the article is factually incorrect, it is unsourced and could easily be the product of someone's imagination. Please stop adding it until a proper source is found, and please bear in mind that you have breached 3RR Gmelin 07:20, 8 June 2007 (UTC)
Once again the source is contained within the journal, if you could be bothered looking for it. Please stop vandalising pages Gmelin 07:26, 8 June 2007 (UTC)
It seems anything can be said if linked to the front page of a journal, moron Gmelin 07:30, 8 June 2007 (UTC)

Best vandalism ever. You should report yourself for personal attacks if you keep it up. ¬_¬ Elmo 12:03, 8 June 2007 (UTC)

Suggested Mention of the SCID-D-R and its Development by Dr. Marlene Steinberg

Editors, I am writing to suggest that a mention of the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised(SCID-D-R) be mentioned in the article as well as some mention of Dr. Marlene Steinberg's work in developing it as a tool now used to diagnose Dissociative Identity Disorder as well as other dissociative disorders. However, I would certainly understand if it is determined that this suggestion would be better covered in an article covering all of the dissociative disorders. My suggestion is merely to add more information to an article that I believe already does a good job of educating readers about DID. Thank you for considering my suggestion. Listening1 22:23, 13 June 2007 (UTC)

Write it. --DashaKat 11:25, 14 June 2007 (UTC)

Arbitration re: DreamGuy

I have opened an arbitration request on DreamGuy. Anyone who would like to contribute (in a positive, negative or neutral vein) can do so at WP:RFAR under DreamGuy. --DashaKat 18:16, 1 July 2007 (UTC)

This is a false arbitration request, as no steps were taken to resolve any conflict (in fact his recent edits here are specifically to ignore how the conflict had already been resolved here and revert to a POV-pushing one added by a suspicious first time editor (likely a sockpuppet) and Empacher (clearly from his edits merely a sockpuppet or meatpuppet). After hurling insults at me on my talk page and filing a nonsense report he wants to try to trick people here into thinking that because he made the accusation that my view should be ignored so he can bully his way into having his POV-pushing version remain. DreamGuy 22:41, 1 July 2007 (UTC)
The decision to reject arbitration was unanimous, by the way. So attempting to intimidate others by filing false claims won't get you anywhere. DreamGuy 06:36, 11 July 2007 (UTC)

Is DID real?

This article, IMO, seems to put a lot of emphasis on arguing if DID is real or not...using data from the 1940's and not comparing it to modern data does not seem to be a very logical way of deciding this. Here I will explain some of my recent edits.

"As a diagnosis, DID remains controversial, with many professional psychiatrists and commentators arguing that there is no empirical evidence to support the disorder, or its diagnosis. On the other hand, some psychiatrists contend that they have encountered cases that appear to confirm the existence of this condition, and some mental health institutions, such as McLean Hospital[1], have wards specifically designated for Dissociative Identity Disorder."

This entire paragraph is featured prominently towards the top of the article, which I think places undue significance on if DID is real or not (there are plenty of websites that deny the link between HIV and AIDS, but this is not a prominent portion of the HIV/AIDS wikipedia pages). There is also no cited source other than for the McLean Hospital, which I see as a useless plug.

In the "Defining the Controversy" section I added a counter statistic with a source, I see no reason for this to be deleted. I actually am not sure if I am convinced that there should even be a "Defining the Controversey" section...but that is not for now.Mwv2 05:51, 11 July 2007 (UTC)

Please read the talk page above, and also the WP:NPOV policy. If you did either you'd know your edits simply are not in line with what you can do. DreamGuy 06:27, 11 July 2007 (UTC)

The most recent edit completely misses the point:

One of the primary reasons for the ongoing recategorization of this condition is that there were once so few documented cases (research in 1944 showed only 76[2]) of what was once referred to as multiple personality.

Then this was added:

However, a more recent source states that as much as 1% of the general population, and 5 - 20% of those with psychiatric disorders have been diagnosed with DID.

Um, yeah, that's kind of the point explaining why people think the diagnosis is bogus. If something were actually real it should be diagnosed in the same percentages over time, not have an astronomical increase after it becomes popularized in pop culture. I'm sure you think your link supports the idea that DID is real, based upon the content of your other edits in pushing that POV, but since it actually works against your side I'm tempted to let it stay... Except the source you used to try to support the statement is hopeless biased and does not meet Wikipedia's rules on reliable sources. Of course some hack website trying to get customers to pay to get the heebie jeebies removed from their skulls is going to claims that heebie jeebies are real. You need an unbiased, scientific source on that or else those numbers are misleading. DreamGuy 07:36, 11 July 2007 (UTC)

This is the last I will be editing this, at least in the forseeable future anyways. To me, that statistic indicates that the disorder has become better understood and hence more patients are correctly diagnosed and more people in general are seeking help. I'm sure there were far less people seeking psychotherapy in the 1940's than today. Anyways, I am going to stop editing this article for the most part, I am far too involved with someone who has DID to understand at all how it can be considered controversial.—Preceding unsigned comment added by Mwv2 (talkcontribs)

False Memory Syndrome (FMS)

The paragraph about False Memory Syndrome in the Defining the constroversy section is balatantly POV:

<< These parents banded together in an effort to defend themselves by theorizing a new syndrome, the "False Memory Syndrome (FMS)," that asserts therapists somehow suggested abuse and dissociation to their patient (who was usually the adult child accusing her/his parent of abuse). Although there is no evidence whatsoever that FMS is an actual syndrome or condition, >>

It also contradicts both the article on False Memory and common sense, e.g., are people's recovered memories of alien abductions also real?

No kidding. But if one attempts to make ANY sort of edits, it will be reverted by an editor who has made it his business to "take control" of this article. Your intention is warranted, your efforts, I'm afraid, will be futile. --DashaKat 11:50, 19 July 2007 (UTC)

'Non-negotiable' and 'Mere disagreement is not such proof'

Information and links from the following published university and research journals/articles, were added to Wikipedia article Dissociative identity disorder, then all added edits were immediately reverted and removed by DreamGuy at 06:00, 28 July 2007 (see http://en.wikipedia.org/w/index.php?title=Dissociative_identity_disorder&action=history):

"... stability (...) [is] preserved by a dissociation or splitting of the personality into more stable subunits." (T. Fahy, published 1990)
"Dissociative symptoms may occur in acute stress disorder, posttraumatic stress disorder..." (James Elmore, published April)
"... [dissociative identity disorder] is yet another example of diagnostic neologism, the invention of new diagnostic categories to feed into the ever burgeoning diagnostic and statistical manual..." (Steven Rose, published 1998)
"... findings are consistent with the presence of smaller hippocampal and amygdalar volumes in patients with dissociative identity disorder, compared with healthy subjects." (Vermetten, Schmahl, Lindner, Loewenstein, Bremner; published 2006)
"... 1.1% of the population was diagnosed as having dissociative identity disorder (DID)." (Şara, Akyüzb, Doğanb, published 2007)
"... (14.0%) patients had dissociative identity disorder..." (Sar, Koyuncu, Ozturk, Yargic, Kundakci, Yazici, Kuskonmaz, Aksüt, published 2007)
"Patients with dissociative identity disorder (DID) reported significantly higher SCL–90 Global Severity Index (GSI) and individual subscale scores than those without dissociative disorders. It is recommended that patients who are polysymptomatic on the SCL–90 be considered for follow–up dissociative symptom assessment to aid differential diagnosis and to inform subsequent treatment." (Steinberg, Barry, Sholomskas, published 2005)
"There are no quick fixes, although many patients do respond to long-term psychotherapy (...) working through traumatic memories, helping the patient navigate current relationships with family and others, and avoiding further traumatization. The therapist needs to recognize that the patient is fragmented. Efforts to reify each fragment into a "personality" are not helpful." (David Spiegel, published 2006)
  • NON-NEGOTIABLE: Wikipedia:Deletion_guidelines_for_administrators#Rough_consensus - "Note also that the three key policies, which warrant that articles and information be verifiable, avoid being original research, and be written from a neutral point of view are held to be non-negotiable, and cannot be superseded by any other guidelines or by editors' consensus"

Standardname 01:34, 30 July 2007 (UTC)

Both myself and two different admins told you why your edits were improper, ranting and raving here trying to quote policy when it's already been pointed out to you that you do not understand what the policy even says (Deletion policy is about deleting whole articles, not about editing parts of an article, for example, as already spelled out to you.
But, for those not following your talk page, your edits are amazingly POV-pushing as they exist solely to add arguments by people you agree with and remove any and all positions (and say that they do not even exist) of people you disagree with. That's some pretty hard core POV-pushing, which is why your edits won't fly. DreamGuy 06:45, 30 July 2007 (UTC)
  • Question: which policy do you believe prevents the removal of sourced information? WP:V and WP:OR allow unsourced information to be removed, and instruct readers not to add unsourced information, but do not say that you should not remove unsourced information. JulesH 07:04, 30 July 2007 (UTC)

Recent edit warring

As an uninvolved observer, I'd appreciate it if people involved in the current edit war on this page explain their reasons for the changes they wish to make (or wish not to be made). It seems we're not going to get anywhere constantly adding and reverting information, and from an outside perspective the argument doesn't make a lot of sense.

So, User:DreamGuy, what's wrong with the additions made by User:Standardname? User:Standardname, why do you want to make these additions? JulesH 20:02, 30 July 2007 (UTC)

There is no rational reason for the edit warring on this page, as it is consistently driven by one of the editors referenced above who feels an inaproapriate and unwarranted sense of ownership regards this topic. --DashaKat 20:10, 30 July 2007 (UTC)
Actually, it's you who and Standardname here who feel like you own the article, as you ignore clear consensus established in discussion above and, most importantly, the WP:NPOV policy which states that articles simply cannot take sides. You are abusive in your comments and consistently ignore all policies in your attempt to not only take control of this article but to try to attack me personally, filing out of process requests for arbitration committee action at which all admins have unaniously told you you were out of line, yet you continue. And this deceptive characterization of your edits (and likely sockpuppeting through editors making the exact same edits on accounts with very suspicous edit histories) will not prevail here. DreamGuy 15:51, 7 August 2007 (UTC)
1) On 2 August 2007(22:12)(see diff here), I asked DreamGuy whether I could add source from Stanford University School of Medicine, and received NO reply, so I added the source on 4 August 2007(22:14)(see diff here) to article 'Dissociative identity disorder', then on 5 August 2007(16:14)(see diff here), DreamGuy reverted the addition along with 7+ recent academic findings and "verified sources" from article 'Dissociative identity disorder':
2) DreamGuy, please ONLY remove non-academic 'WP:V#Sources', in accordance to policies:
  • 'WP:Revert#Do_not' "If they contain valid information, these texts should simply be edited and improved accordingly. Reverting is not a decision which should be taken lightly", and
  • 'WP:Verifiability#Sources' "Academic and peer-reviewed publications are highly valued and usually the most reliable sources",
  • 'WP:NOT#Wikipedia_is_not_a_time_capsule'
  • WP:Vandalism "Vandalism is any addition, removal, or change of content made in a deliberate attempt to compromise the integrity of Wikipedia" (in reference to aforementioned policies and WP:V#Sources).
3) DreamGuy, please stop using incivil term "POV pushing" in edit summaries.
--Standardname 01:00, 6 August 2007 (UTC)
Standardname has brought up good points. Why has DreamGuy removed his/her edits without any suitable explanation aside from a rather useless and vague note about WP:NPOV? 66.82.9.82 19:28, 7 August 2007 (UTC)

Revert explanation

My main beef with the reverting that keeps going on is that there seems to be no desire on either side to actually improve the article. These sources are important ones and should be used within the article. If you believe that academic consensus is not shown within the article, then edit it with more varying and up to date sources regarding the controversy. If you can't find those sources, this might be evidence of an academic consensus, which is what Wikipedia should reflect. CaveatLectorTalk 20:34, 31 July 2007 (UTC)

In many cases, reverting to an old version IS an attempt to improve the article. Certainly some small part of the edits Standardname made could be useful additions, but unfortunately the overall thrust of the changes in dispute was to majorly deny that there is any controversy at all and to stack the article with sources all saying the same thing while ignoring the rest. This is not some new conflict, as we have discussed the controversy here on this talk page over and over and had a firm consensus that controversies cannot be swept under the rug (and not that that is needed anyway with the WP:NPOV policy being the fndamental building block of this encyclopedia that it is). You blindly reverted the article to a really, really massively bad version that was recently edited instead of to the longstanding consensus version. That's wrong no matter which way you slice it. If a real discussion is gong to happen here (and it's clear that Standardname is more interest n wikilawyering over policies he doesn't understand and placing false warnings, while DashaKat is just continuing his old POV-pushing ways that have been soundly opposed time and time again on this article) then the article has to stay at the CONSENSUS version in the meantime and not the massive rewriting that comes right out and declares one side to be right -- especially with the lame claim that there is no controversy because the alleged disorder is listed in the DSM, when DSM listings can be and in this case are controversial, and in the past such things as homosexuality were listed in the DSM as disorders... mere DSM stamp of approval doesn't settle anything. DreamGuy 15:47, 7 August 2007 (UTC)
This is really all you had to say, 6 days ago, instead of launching vitriol at me through your edit summary and on my talk page. Looking back, you're completely correct that User:Standarname's edits are flawed and that his behavior now is unacceptable, but if you had approached this civilly to begin with (instead of calling him and everyone else POV-pushing idiots, or throwing out baseless accusations of sockpuppetry), then those editing this article could have looked into the sources he provided and decided which ones merited inclusion in the article. Someone like me coming in sees this as merely throwing away academic sources. You could have explained why the sources were flawed, you could have explained whether or not you have some academic expertise in this area that tunes you into the current controversy, but instead, all you seemed to do was toss insults around. Honestly, do you expect to get anywhere with that attitude? (By the way, if the 'consensus' version of Intelligent design claimed that there was a controversy in the academic community, I would edit absolutely mercilessly and I gather from your talk page that you would too. Sometimes the consensus on Wikipedia needs to be evaluated and boldly editing is sometimes how to do that). Just have a little faith that some people are trying to improve the project, and they'll generally do the same for you.
On an unrelated note, User:Standardname, I've removed your um...rambling (best thing to call it really) from this talk page. Warning templates have no place on an article talk page, so I'm taking out this part of the section. If you want to make a complaint or warn a user, go through the proper channels and don't spam here. CaveatLectorTalk 21:08, 7 August 2007 (UTC)
CaveatLector, help me understand, why do you say these academic sources are flawed? --Standardname 23:40, 7 August 2007 (UTC)
There are three types of lies: Lies, damned lies, and statistics. It is not the academic sources in this case, but how you have used them in the article. You editions are flawed. Also the APA has been quite flawed itself in the past. If there is a strong movement of controversy here. it should be addressed in the article. CaveatLector Talk Contrib 04:52, 8 August 2007 (UTC)
CaveatLector wrote: "This is all you really had to say" -- It had been said already, both in edit comments here and elsewhere. Unfortunately you chose to assume bad faith instead of good faith, and you wrote an incorrect edit comment claiming I was the POV pusher, which you yourself now admit is not correct. Your attempt to blame the result of your breaking of multiple Wikipedia policies on me is completely misplaced. You should have been doing what you did to see I was right in the first place, not show up out of nowhere blind reverting the article with false and uncivil edit comments. You should be apologizing instead of further claiming that it's my fault you didn't do what you are supposed to do. But then I don't care if you apologize, just learn from your mistake. DreamGuy 20:38, 8 August 2007 (UTC)
Honestly, DreamGuy, I'm tired of living in your dream state with you. You obviously have no sense of or desire for compromise or civilized discourse of any sort. Again, in a fashion that has become rather typical of you, you accuse me of violating Wikipedia policies which you have clearly violated. Your edit comments everywhere, including in this vary 'response' to what I said, are vitriolicly uncivil. I can see there is absolutely no reasoning or even hand-shaking with you. Everyone but you is a Wikipedia policy breaker in your eyes, apparently, and everyone is a bully or a harasser as well. Pardon me while I indulge in calling a spade a spade: I'm finished dealing with you, your lies, your paranoia, and your distortion of comments, contributions, and facts. As far as you're concerned, I can see there is no possibility working with you and the mere effort distracts from actually improving articles. So I will feel free to ignore the rule of cooperation as far as you're concerned, and do my best to ignore you in my efforts to improve this project. Have a nice day. CaveatLector Talk Contrib 21:32, 8 August 2007 (UTC)

Missing info

As someone studying literature I've been looking everywhere for what appears to be well hopeless, and I feel this information would be very pertinent to your quaint little article you've got going on here and perhaps, please God almighty, one of you may be experienced enough in multi-personality knowledge to help. As multi-personalities are portrayed in pop-culture are there actual frequent occurrences of people diagnosed with this fighting with themselves physically and their multiple personalities duking it out, both sides attacking the same lone body that they occupy, or is this some kooky invention of contemporary writer's minds later adapted to Hollywood? I want to know if there's an actual factual basis for modern literature's portrayals of such behavior. Or is it merely a fabrication? And the thing is I cannot find any information on this as frequently as the behavior's portrayed in various works of fiction nobody discusses it at all from a realistic psychological point of view. So let me by all means allow you. Because I'd be very much interested.66.63.67.240 04:05, 8 August 2007 (UTC) Michael Madore

Hi Michael, it might be easier to comprehend if you think of Dissociative Identity Disorder (formerly Multiple Personality Disorder) as an extreme form of sleep-walking, although it's quite separate to sleep-walking. Here's some information with links to university articles published in the past couple of years:
  1. 1.1% of women in the general population were diagnosed as having Dissociative Identity Disorder (DID)
  2. 6% of inner-city, hospital-based psychiatric outpatients were diagnosed as having DID
  3. 14% of emergency psychiatric admissions were diagnosed as having DID
  4. Memory processing depends on the creation of associations, storage, and retrieval. Traumatic or childhood physical or sexual abuse experiences can create, especially in children, contradictory memory encoding and storage. Processing starkly different traumatic or childhood abuse associations regarding experience, implications for the self, and emotional arousal—would be difficult under the best of circumstances. Just as in depression information is selectively retrieved, selective networks of information preclude a more balanced view of the world (sometimes dangerous, sometimes safe) or of the self (good versus deserving of punishment).
  5. DID patients function as two or more Dissociative Identity States (DIS), categorized as Neutral Identity States (NIS) and Traumatic Identity States’ (TIS). NIS inhibit access to traumatic memories thereby enabling daily life functioning. TIS have access and responses to these memories. DIS have different psychobiological differences. DIS show different psychobiological reactions to trauma-related memory: regional cerebral blood flow data revealed different neural networks to be associated with different processing; psychobiological parameters tested were cardiovascular responses (heart rate, blood pressure, heart rate variability) and regional cerebral blood flow as determined with H215O positron emission tomography.
In a few days you may find this message moved nearer the bottom of this discussion page where new edits appear after using the '+' button at the top of this discussion page (old edits remain nearer the top for archiving). I didn't realise this either, until recently.
--Standardname 00:26, 10 August 2007 (UTC)

Fight club syndrome: facade or factual?

Ok, "...think of Dissociative Identity Disorder (formerly Multiple Personality Disorder) as an extreme form of sleep-walking..." I take it from this that the notion of multiple personalities within the same body, like say Ray and Carl, would never come to blows with one another, Ray attempting to pound upon Carl, never realizing that the same body they both occupy is the one taking the abuse. Still this is a frequent portrayel of multiple personalities in the contemporary literature canon and I think this article should either corroborate that this phenomenon has a basis in reality or dismiss it saying its basis is completely fictional as those portrayels are frequent enough in mainstream culture, not just literature such as the movie Fight Club, which also was first a book. So is this behavior truth or myth? Shouldn't it be part of this article to dispell or confirm?

66.63.67.240 15:45, 16 August 2007 (UTC)Michael Madore

Michael, interesting point. There is a section in the article "In popular culture". Why don't you put together a paragraph and insert it there? If possible, try to give sources for your information. By the way, I have reinstated the heading "Missing info". I am sure you were trying to be helpful, but talk pages should not be changed, only added to. If someone is following this heading, they will think it has been archived if they can't find it in the contents. As a way round what you were trying to do, I have added a subheading with your header.--CloudSurfer 20:44, 16 August 2007 (UTC)

Suggestion for a solution

Rather than continuing the current pattern of unilateral editing of an obviously controversial subject, what about collecting references and listing them here with the points you want to make based on those references? Editors can then go to the reference, assess its credentials and read it for themselves. A discussion can then ensue and a consensus edit can then be made of the relevant section. --CloudSurfer 06:10, 8 August 2007 (UTC)

Thank you CloudSurfer, for the mediation. Below are the sources, each numbered to allow everyone to refer individually. There's quite a few sources, any more I've missed, will just be appended to the end. --Standardname 18:37, 8 August 2007 (UTC)
  1. a DES 30 as a cutoff missed 46% of the positive DDs diagnoses identified (and a DES 20 as a cutoff missed 25%)
  2. Symptom Checklist–90 (SCL-90) - Patients with DID reported significantly higher SCL-90 Global Severity Index (GSI) and individual subscale scores than those without DDs. It is recommended that patients who are polysymptomatic on the SCL-90 be considered for follow-up dissociative symptom assessment to aid differential diagnosis and to inform subsequent treatment
  3. DID patients function as two or more Dissociative Identity States (DIS), categorized as Neutral Identity States (NIS) and Traumatic Identity States’ (TIS). NIS inhibit access to traumatic memories thereby enabling daily life functioning. TIS have access and responses to these memories. DIS have different psychobiological differences. DIS show different psychobiological reactions to trauma-related memory: regional cerebral blood flow data revealed different neural networks to be associated with different processing; psychobiological parameters tested were cardiovascular responses (heart rate, blood pressure, heart rate variability) and regional cerebral blood flow as determined with H215O positron emission tomography.
  4. 6% of inner-city, hospital-based psychiatric outpatients were diagnosed as having DID
  5. 1.1% of women in the general population were diagnosed as having DID
  6. 14% of emergency psychiatric admissions were diagnosed as having DID
  7. Changing the name of MPD to DID was to place the correct emphasis on the failure to integrate aspects of identity, memory, and consciousness rather than the apparent proliferation of "personalities"
  8. There are no quick fixes, although many patients do respond to long-term psychotherapy. Working through traumatic memories, helping the patient navigate current relationships with family and others, and avoiding further traumatization. The therapist needs to recognize that the patient is fragmented. Efforts to reify each fragment into a "personality" are not helpful
  9. Hypnosis can be useful in teaching patients about the dissociative nature of their symptoms by helping them to gain control over transitions among personality states, with the goal of improving internal communication and integrating disparate aspects of their identity.
OK, This morning I have limited time and I have looked at the first reference only. It is published in the Am J Psychiatry and therefore reputable. It's methodology looks reasonable although it deals with a sample of largely hispanic inner city dwellers. It cautions that they may not represent the broader population. It is also dealing with dissociative disorders and DID is just one of these. It does not fully explain why of the 231 in the total study, only 82 were interviewed. It does however compare that subset with the broader sample and find there are no great differences in other parameters. The points you wish to make about the DES are mentioned in the discussion and do add information that is potentially useful. The question then is Standardname, how and where would you suggest incorporating this into the article? --CloudSurfer 19:36, 8 August 2007 (UTC)
Under section Dissociative_identity_disorder#Diagnosis:
  • replacing text:
A simple, quick, questionnaire that has been widely used to measure dissociative symptoms is the Dissociative Experiences Scale (DES)[2]. It has been used in hundreds of dissociative studies, and can detect dissociative experiences. It is important to be aware that the DES[2] is no more than a screening instrument, and a validation of DID[3] with SCID-D[4] could even follow a low DES[2] score.
  • with text:
Dissociative Experiences Scale (DES) - A simple, quick, questionnaire that has been widely used to measure dissociative symptoms is the DES[2]. It has been used in hundreds of dissociative studies. It is important to be aware that the DES[2] is no more than a screening instrument; a DES 30 as a cutoff missed 46% of the positive DDs diagnoses identified (and a DES 20 as a cutoff missed 25%).
--Standardname 20:18, 8 August 2007 (UTC)

The problem here is that most of these edits do not correspond at all with the POV-pushing that was going on in the article, and the existence of sources alone and claims that those sources say doesn't get at the heart of the conflict at all. We can sit here and go over these with a fine toothed comb, but the main point is that each of these were only small parts of the overall changes, and the most drastic changes (erasing the conflict section, claiming outright that there is no conflict) aren't even mentioned.

Also, another problem here is that he is providing sources for studies but leaving out the context that these are just individual studies by individuals with their own opinions and POVs. Per NPOV policy we have to be very careful about how they are mentioned. You can't just say, for example, that a name was changed for such and such a reason when that's just a claim of some outside source about why *they* think the name was changed. The name was changed by the APA for the DSM, so quoting someone else is not a reliable source on why the APA changed it. The only source that would be authoritative on stating as a fact as why it was changed would be the APA itself. We also cannot just say, oh, hey, this one study said so and so when there have been a ton of studies saying all sorts of different things. It's clear Standardname is picking and choosing which studies he wants to even mention: those who support his conclusions. That's bias through selective information, as well as giving undue weight to specific individuals over the broad spectrum of opinions on the topic.

Numbers eight and nine above are also good examples. He is focusing strongly on the Stanford study and not portraying it as Researchers involved with the Stanford Study concluded on the basis of such an such research that hypnosis or whatever did whatever and other sources disagree but outright saying this DOES happen and this IS real and then just linking to one particular source. That's not how science works, let alone the NPOV policy here. Studies have to be widely confirmed and replicated by multiple independent sources before anything becomes even approaching fact instead of just the opinions of some people based upon one survey... but, again, the most important changes he had made to the article that caused the revert are not even mentioned above, and are so off the scale biased that it makes one's head spin. DreamGuy 20:46, 8 August 2007 (UTC)

Text on controversy over the validity of diagnosis was appropriately combined with the diagnosis section (adhering to Wikipedia policy WP:Overcategorization), and NOT erased, as you can see in penultimate diff ending 17:04, which is edit made just prior to your last edit, which was at 20:00 (7 August 2007):
http://en.wikipedia.org/w/index.php?title=Dissociative_identity_disorder&diff=prev&oldid=149798841#Diagnostic_criteria_.28DSM-IV-TR.29
--Standardname 21:27, 8 August 2007 (UTC)
You can see in Wikipedia policy verifiability (WP:Verifiability#Sources) "Academic and peer-reviewed publications are highly valued and usually the most reliable sources". This is what Wikipedia is based on. Anyone in disagreement with that, has a different mission to the Wikipedia project and Jimmy Wales. Standardname 21:36, 8 August 2007 (UTC)
Yes, and picking and choosing only the sources you want is a major violation of WP:NPOV policy, which is the foundation of Wikipedia. Nobody is disputing that academic and peer reviewed publications are highly valued, we're disputing both your peculiar choices of which ones to use and presenting them as if they were facts instead of just the opinions of the people involved in that one study. Your response was in no way relevant to the problems that were pointed out to you, you just quoted policies you don't understand fully to try to support yourself while ignoring what they really say. And several admins have already pointed out what these policies mean and where to find them. You shold take the time to read them for understanding instead of looking for any snippit somewhere you think you might take out of context to try to twist to support yourself. DreamGuy 01:04, 9 August 2007 (UTC)
Can you guys just cool down for a moment. Is there a way out of this current war? What I have been suggesting is that we try to work collaboratively on this to achieve either a consensus position on a subject or a consensus edit which gives reasonable emphasis to all POVs. Let me state that I am an Australian trained psychiatrist and have never seen a case of DID and think that it is an American invention. That stated, the diagnosis of DID is in DSM and warrants an even-handed and NPOV treatment. The DSM is the collective output of an organisation that represents half of the psychiatrists on the planet. It doesn't mean they are right but it does mean that their view needs to be put reasonably.
Now, the way to go forward is not to worry too much about the past. Let us see if we can find a way out of this from here on. Dreamguy, the Am J Psychiatry is a peer reviewed journal and all articles in it are thoroughly scrutinised by a panel of experts who then suggest edits etc. before they ever get to print. Having been peripherally involved in this process I can assure you that it is arduous. Under Wikipedia policy, you can't reject articles from such reputable journals as that, even if you don't agree with them. They have something to say and they are worth using. If you want to counter what they say then produce equivalently reputable articles. There can then be a passage in the text which balances both views and gives suitable weight to each. I am less convinced though that anything from the editorial is significant but David Spiegel would not have been given the role of editor without having satisfied his peers as to his credentials to represent the APA in their journal. As the editor of the offical APA journal, what he says does represent the APA. Standardname should by NPOV select articles from both sides of the argument, but then so should we all. What is likey to occur in this case is that both of you will put forward your views and find articles that support what you say. You should then try to work collaboratively to achieve a balanced article.
One of the things I did as a medical student to while away my time in the library was to read the Lancet from the late 1800s. It was a goldmine of good reading. One impression that I was left with was that the doctors writing back then truly believed that bleeding a patient worked. They were sincere and caring. We now know that they were wrong but that doesn't change their conviction. During my student days I was taught about how various gastrectomies were the definitive treatment of peptic ulcers only to find that now we treat them with antibiotics. Alfred Wegener was for years regarded as a crank as he pursued his theory of continental drift only to be eventually vindicated. My point here is that there are generally no "rights" or "wrongs", only "what we currently believe". While I think that DID is just another variant of dissociation in the long history of such conditions first brought to fame by Charcot and that the reliability of its diagnosis varies enormously with the clinicians attempting this feat, the jury, as always, is still out. Think for a moment that what you believe is equivalent to being in favour of bleeding patients or against continental drift. From that chastened perspective, then write your copy. May I suggest though that we all, and anyone else please take a role, fine tune the article, section at a time here on the talk page, until the heat has gone from this current situation. --CloudSurfer 02:22, 9 August 2007 (UTC)
You wrote: "Under Wikipedia policy, you can't reject articles from such reputable journals as that, even if you don't agree with them." -- Actually, under WP:NPOV policy, if they are presented in such a way to describe them as if they were fact instead of just the conclusion of the researcher in the study, or if they are used to frequently or too unbalanced, then, yes, they absolutely can be rejected. It doesn't have anything to do with me not believing them. It's not like these journals present FACT, and other articles in the same journal can and do have contradictory results on the same topics. To try to treat them as some how sacrosanct is wrong. Furthermore, you said the way to respond is to add more sources to represent the opposite side... while this is true in the long term, until such time as those sources are there, the article cannot be overloaded with sources of a specific agenda. The article needs to follow WP:NPOV at all times, and not have a dueling sources where someone addds a bunch for one side and waits for someone to come and add more to another, and then back and forth. All of these journal links may be alright individually, but as a bulk, and especially the presentation that was being used to present them as absolute truth, they cannot go there at this time. When a balanced position of journal articles on all sides is assembled, then sure. DreamGuy 14:23, 9 August 2007 (UTC)
Then wouldn't it make sense to just add information from said studies and indicate that they are merely conclusions of the researcher, not necessarily absolute truth? --clpo13(talk) 18:04, 9 August 2007 (UTC)
Not by itself, no... because if an article presents one side over and over and over without the other side, or tries to present only one side as being in academic journals when the other is as well, that's inherently biased. See the WP:NPOV policy. It's comparable to doing an article on scandals within the Republican party and only quoting Democrats over and over... Or, for a more academic minded discussion, an article about whether Pluto is a planet and only mentioning the claims of those people who opposed removing it from the list. The inherent bias in those sorts of situations should be obvious if you think about it. Standardname is trying to cherry pick only those studies that support his side, and even if we make it clear that it's the side of the person behind that study, not including studies and articles from the journals that disagree with those views is still hugely biased. (By the way, why are you on this article now? If you have a conflict with me, as seen from the RFC you instituted, following me around all over the project is an act of bad faith.) DreamGuy 18:14, 9 August 2007 (UTC)
To assume I'm following you around is an act of bad faith in and of itself. I have interests in many articles, including ones you happen to be involved in. Don't flatter yourself by thinking my actions are all about you.
Anyways, it does make sense to have an opposing view, but that should be easy to include. DID is a very controversial thing. There should be a good deal of studies against it, as well as for it. Standardname's sources seem to be of good quality, even if they're showing only one side. It should be easy to find good quality sources for the other side to counter his additions. But I see your point anyways. The comment I replied to made it seem like the problem was presenting opinions as fact, but your clarification shows the real problem is bias due to heavy leanings towards one side or another, which I can completely understand. --clpo13(talk) 18:30, 9 August 2007 (UTC)
I suppose we're supposed to believe you suddenly out of nowhere insert yourself into articles for the first time to argue with me right after you filed an RFC completely by accident. Sorry, but no. That's not assuming bad faith, it's just not being blind to the obvious. But at least you admitted your concerns were misplaced. DreamGuy 13:30, 14 August 2007 (UTC)

Having just spent several hours going through PubMed looking at DID it is obvious that the literature presents some difficulties. The vast majority of references are slanted in favour of DID as a valid condition with lots of scholarly studies to back this view up. Scattered amongst these is a handful of sceptical papers. Sadly, most of the letters in response to both sides are generally unavailable. Thus, the impression from the sheer weight of numbers would favour DID as a valid diagnosis. There is no problem in providing ample references to support this view and I have collected many citations. The other side of the argument is very poorly represented. However, two key studies address psychiatrists’ views towards DID in Canada and the US, seemingly the region of the world that produces most of the literature and patient numbers and thus the region where one would expect to find the highest level of support.

Pope’s study in the US and published in 1999, mailed a one page questionnaire to a randomly selected 397 board certified psychiatrists to which 82% responded. To the question, "If DSM-IV were to be revised today, how should it treat the diagnosis of dissociative identity disorder?" Respondents had three choices, "Should not be included at all" (15%), "Should be included only with reservations (e.g., only as a 'proposed diagnosis')." (43%), "Should be included without reservations." (35%), and "No opinion." (7%). To the question, "In your opinion, what is the status of scientific evidence regarding the validity of Dissociative identity disorder?" 20% of respondents chose "Little or no evidence of validity", 51% selected "Partial evidence of validity", 21% selected "Strong evidence of validity", and 9% had no opinion.[5]

Two years later a similar study was published based on mailing 550 questionnaires to Canadian psychiatrists with 80% responding. Fewer than one-third replied that dissociative identity disorder should be included without reservations in the DSM-IV; fewer than 1 in 7 felt that the validity of these diagnoses was supported by strong scientific evidence.[6]

What these figures show is that US psychiatrists are fairly evenly divided on the subject while Canadians would appear to be less supportive of the diagnosis.

Two papers by Piper and Mersky[7][8] conclude that DID is a culture-bound and often iatrogenic condition which harms the patients.

Now, of course there is another side to the argument and that also needs to be put using the substantial literature available. Standardname, I have not forgotten your edit above in all this but rather this was my background read to get me up to speed in this subject.

  • original text:
A simple, quick, questionnaire that has been widely used to measure dissociative symptoms is the Dissociative Experiences Scale (DES)[2]. It has been used in hundreds of dissociative studies, and can detect dissociative experiences. It is important to be aware that the DES[2] is no more than a screening instrument, and a validation of DID[3] with SCID-D[4] could even follow a low DES[2] score.
  • Your edit:
Dissociative Experiences Scale (DES) - A simple, quick, questionnaire that has been widely used to measure dissociative symptoms is the DES[2]. It has been used in hundreds of dissociative studies. It is important to be aware that the DES[2] is no more than a screening instrument; a DES 30 as a cutoff missed 46% of the positive DDs diagnoses identified (and a DES 20 as a cutoff missed 25%).

It is late at night and I have not put in all the references that could sensibly be used but here is a revised edit.

Standard instruments - The Dissociative Experiences Scale (DES)[2] is a simple, quick, questionnaire that has been widely used to screen for dissociative symptoms with the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D) then used to make a diagnosis. In one study a DES with a cutoff of 30 missed 46% of the positive SCID-D diagnoses and a DES with a cutoff of 20 missed 25%.

Standardname, you will note that there is now less repetition. The first sentence puts the subject, the DES, at the beginning. You need to be careful about your use of bold to follow the WP:MOS. I have not looked at the heading in terms of style. Clearly the references need to be done properly and the SCID-D updated to the current version, whatever that is, but how does everyone feel about the paragraph now? --CloudSurfer 12:20, 9 August 2007 (UTC)

Dreamguy, for the most part I agree with your lastest post, which you have put above a post of mine which I think deals with what you are saying. Let's try to do a number of things. Firtly, let's try to achieve balance in the article, secondly, let's get the references up to WP standards and give the reader leads to full text articles on important subjects, finally, let's try to improve the writing style and make the article accessible to the average reader.--CloudSurfer 20:46, 9 August 2007 (UTC)
DreamGuy, you claim, "major violation of WP:NPOV policy", however, the WP:NPOV policy says, "all significant views (that have been published by reliable sources)", and the journals listed above are published by reliable sources. Perhaps there's a misinterpretation about WP:NPOV. Let me clarify: the WP:NPOV policy doesn't say, "all significant views by the average person in the street", because "the average person in the street" has not researched the subject for many days and years, and this is why the Wikipedia project says "Academic and peer-reviewed publications are highly valued and usually the most reliable sources".
I can't word it better than the editor's comment seen above in section Revert explanation on 31 July 2007 in (see diff here in green) "If you believe that academic consensus is not shown within the article, then edit it with more varying and up to date sources regarding the controversy. If you can't find those sources, this might be evidence of an academic consensus, which is what Wikipedia should reflect." As you have been unable to come up with academic sources, I will reinstate the academic sources listed above. --Standardname 21:55, 9 August 2007 (UTC)
You really need to actually read theWP:NPOV policy instead of taking fragments of sentences out of it completely without context to try to abuse them to your own ends. This has nothing to do with "average person in the street" -- hell, it's the average person on the street who saw bad fiction and hyped pop psych who is MORE likely to believe in multiple personalities than academics. The editor who left the comment you quote above to try to support your side has since admitted his revert wa incorrect and very clearly said your edits were a violation of the WP:NPOV policy as well, so to try to focus only on the opinion of someone who you KNOW changed his mind once he took the time to look at things is extremely deceptive. If you feel the need to add a lot of sources for one side, then, per NPOV, you must also add sources for the other side. To do otherwise is to massively slant the article. This much is clear to everyone here except you. DreamGuy 13:30, 14 August 2007 (UTC)
Standardname, please don't unilaterally edit the article. This is likely to start another edit war. Let us all work on it collaboratively. You might like to respond to my suggested modifications above as a starter. If we can all come to a consensus on the text then it is likely to be best for the project. --CloudSurfer 22:27, 9 August 2007 (UTC)
No-one's objected to it in over ten hours, let's put the modification in:
Standard instruments - The Dissociative Experiences Scale (DES)[2] is a simple, quick, questionnaire that has been widely used to screen for dissociative symptoms with the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D) then used to make a diagnosis. In one study a DES with a cutoff of 30 missed 46% of the positive SCID-D diagnoses and a DES with a cutoff of 20 missed 25%.
-Standardname 22:35, 9 August 2007 (UTC)
Now that consensus agrees on first source, here's the second source for everyone to discuss:
Symptom Checklist–90 (SCL-90) - Patients with DID reported significantly higher SCL-90 Global Severity Index (GSI) and individual subscale scores than those without DDs. It is recommended that patients who are polysymptomatic on the SCL-90 be considered for follow-up dissociative symptom assessment to aid differential diagnosis and to inform subsequent treatment
--Standardname 22:45, 9 August 2007 (UTC)
Whoa! Slowly, slowly. Please continue this discussion below to make editing easier. --CloudSurfer 22:54, 9 August 2007 (UTC)
Agreed, discussion continues below in section "Discussion continued under a new heading".
--Standardname 23:11, 9 August 2007 (UTC)
CloudSurfer, you say you're a psychiatrist (see diff here 9 August 02:22); you suggest many psychiatrists don't accept DID, which I disagree, many psychiatrists do accept DID; you reject (see diff here 12 August 06:18) Absentis' excellent proposal (see diff here of proposal 12 August 02:50) of Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) deciding the entire Wikipedia Dissociative identity disorder article, and headings;
  • WP:MEDMOS has been developed through the consensus of many editors;
  • In the past couple of years, academic publications predominantly endorse DID;
  • Please refrain from removing ANY text from article Dissociative identity disorder;
  • And no more new 'mediators', please;
  • Please cease getting distracted by other new separate suggestions, until resolution on WP:MEDMOS completes, as WP:MEDMOS for the Article Template is agreed by two editors on 12 August 02:50 and 12 August 03:35 (see diff here);
  • Please resume the incomplete discussion on Article Template, as there was agreement by two editors (see diff here).
--Standardname 23:28, 12 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 23:54, 12 August 2007 (UTC)

Discussion continued under a new heading

Time to look at references. The text below produces a standard WP reference that then will format correctly and then appear in the reference list:

<ref name="Piper 2004a">Piper A, Merskey H., (2004) The persistence of folly: a critical examination of dissociative identity disorder. Part I. The excesses of an improbable concept. ''Can J Psychiatry'', 49(9):592-600. PMID 15503730 [http://ww1.cpa-apc.org:8080/Publications/Archives/CJP/2004/september/piper.pdf Full Text]</ref>

If you want to refer to the reference later in the article then you can simply refer to the name:

<ref name="Piper 2004a" />

The Schizophrenia article is a good example. By putting in the PMID number as shown, the reader can verify the reference and by putting in a "Full Text" link, the reader can verify that the contents justify the text in the article. --CloudSurfer 21:30, 9 August 2007 (UTC)

OK, continuing the discussion from the last section. At present the article under Diagnosis in the second part is:

The diagnosis of DID can be made with the use of various interviews and scales. One that is widely used, especially in research settings, is the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). This interview takes about 30 minutes to 1.5 hours, depending on individual's experiences.

A simple, quick, questionnaire that has been widely used to measure dissociative symptoms is the Dissociative Experiences Scale (DES)[2]. It has been used in hundreds of dissociative studies, and can detect dissociative experiences. It is important to be aware that the DES[2] is no more than a screening instrument, and a validation of DID[3] with SCID-D[4] could even follow a low DES[2] score.

The Dissociative Disorders Interview Schedule (DDIS) is a highly structured interview which makes DSM-IV diagnoses of Somatization Disorder (DSM-IV Somatoform Disorders 300.81), Borderline Personality Disorder (DSM-IV Personality Disorders 301.83) and major depressive disorder (DSM-IV Dysthymic Disorder 300.4), as well as all the Dissociative Disorders. It inquires about positive symptoms of schizophrenia, secondary features of DID, extrasensory experiences, substance abuse and other items relevant to the Dissociative Disorders. The DDIS can usually be administered in 30-45 minutes. The full text and scoring rules of the DDIS can be found here, with the permission to copy and distribute granted by Colin A. Ross, M.D.

Now, this section is all about Standard instruments and really deserves section of its own. All of the refences need to be formatted correctly and fit WP policy. The hurried suggestion I have put in the section above needs to be put into the context of the article section. Others may have seen the suggestion but no one has yet to comment on it. It is however a draft and requires further work. I know this is labourious but if we can get a collaborative effort going now, it will pay off in the future.
My plan now is to spend the next hour or so sorting out this one section and then come back to you all with a revision suggestion. --CloudSurfer 23:02, 9 August 2007 (UTC)

OK, here is my suggested revision of that section with references now all pointing to articles in peer reviewed journals rather than individual websites. I have removed some information on the Dissociative Disorders Interview Schedule which could easily go into an article on that subject. There is no current page for this on WP.

Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 23:58, 12 August 2007 (UTC)

Screening and diagnostic instruments

The Dissociative Experiences Scale (DES)[9] is a simple, quick, questionnaire that has been widely used to screen for dissociative symptoms.

The Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D)[10] may be used to make a diagnosis. This interview takes about 30 minutes to 1.5 hours, depending on the subject's experiences.

The Dissociative Disorders Interview Schedule (DDIS)[11] is a highly structured interview which discriminates between various DSM-IV diagnoses. The DDIS can usually be administered in 30-45 minutes.

Tests such as the DES provide a quick method of screening patients so that the more time-consuming structured clinical interview can be used in the group with high DES scores. Depending on where the cutoff is set, people who would subsequently be diagnosed can be missed. In one study a DES with a cutoff of 30 missed 46% of the positive SCID-D diagnoses and a DES with a cutoff of 20 missed 25%.[12]

Comments please. --CloudSurfer 00:19, 10 August 2007 (UTC)

Hi CloudSurfer, looks good. Although, I would prefer DES sentences at top and bottom to be combined, because people reading the top sentence need to be aware of DES limitations, and could skip reading the vital bottom sentence. --Standardname 00:35, 10 August 2007 (UTC)
With or without the formatting, how about:
  • The Dissociative Disorders Interview Schedule (DDIS)[11] is a highly structured interview which discriminates between various DSM-IV diagnoses. The DDIS can usually be administered in 30-45 minutes.
  • The Dissociative Experiences Scale (DES)[9] is a simple, quick, questionnaire that has been widely used to screen for dissociative symptoms. Tests such as the DES provide a quick method of screening patients so that the more time-consuming structured clinical interview can be used in the group with high DES scores. Depending on where the cutoff is set, people who would subsequently be diagnosed can be missed. In one study a DES with a cutoff of 30 missed 46% of the positive SCID-D diagnoses and a DES with a cutoff of 20 missed 25%.[12]
What do you think? --Standardname 01:06, 10 August 2007 (UTC)
Standardname, my original thinking was to put the screening first then the structured interviews, hence the first suggestion. However, I take your point that keeping them together makes sense and agree with the version you have above. You love your formatting! heheh. Personally, I think the section works better without the bullets and will sit better with the rest of the article. Could you have a look at the references in this example and have a go at putting your collection of references into that format. Since there is a "Reference" section at the bottom of this page, it will act as a bit of a sandbox. Let's wait to see what others think and what further improvements they might add before we migrate this to the article. I will now have a look at the next reference in your list. --CloudSurfer 05:00, 10 August 2007 (UTC)
By the way, if you go to the paper for the DES you will see that the original researches found, "Results indicate that a DES cutoff score of 15-20 yields good to excellent sensitivity and specificity as a screening instrument. However, for higher cutoff points the sensitivity can be much lower." It is almost tempting to rewrite the last paragraph as:
The Dissociative Experiences Scale (DES)[9] is a simple, quick, questionnaire that has been widely used to screen for dissociative symptoms. Tests such as the DES provide a quick method of screening patients so that the more time-consuming structured clinical interview can be used in the group with high DES scores. Depending on where the cutoff is set, people who would subsequently be diagnosed can be missed. The orginal recommended cutoff was 15-20[9] and in one study a DES with a cutoff of 30 missed 46% of the positive SCID-D diagnoses and a cutoff of 20 missed 25%.[12]
Yes, I'm fine with no bullets. I haven't changed the text, but added links, and agree with CloudSurfer's compromise text. Anyone else?
--Standardname 18:42, 10 August 2007 (UTC)
The Dissociative Experiences Scale (DES)[9] is a simple, quick, questionnaire[13] that has been widely used to screen for dissociative symptoms. Tests such as the DES[14] provide a quick method of screening[15] patients so that the more time-consuming structured clinical interview can be used in the group with high DES scores. Depending on where the cutoff is set, people who would subsequently be diagnosed can be missed. The orginal recommended cutoff was 15-20[9] and in one study a DES with a cutoff of 30 missed 46% of the positive SCID-D diagnoses and a cutoff of 20 missed 25%.[12]
I mean to come back and critique this further but that won't be until tomorrow so I thought it best to give some comments now. Some more references have slipped into the paragraph that I had not noticed. Each reference that is used needs to be put there to back us some statement in the text. As an example Standardname, you have put a reference after the second mention of the DES. I have had a look at this reference. Firstly, there is no great difference in the paragraph between the two mentions of the DES that would require the second one to have a separate reference. Secondly, the reference you have used pertains to problems found when screening the general population and the reference suggests a modification to the DES to overcome this. This information is nowhere in the paragraph. I need to look at the other references to see what they say but that will have to wait until tomorrow. What we are writing is a critical analysis of the topic backed by references. Have some fun with that. Happy editing. --CloudSurfer 05:27, 11 August 2007 (UTC)
It would be interesting to see the suggested alternative.
--Standardname 06:48, 11 August 2007 (UTC)
Current consensus. --Standardname 07:07, 11 August 2007 (UTC)
The Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D)[10] may be used to make a diagnosis. This interview takes about 30 minutes to 1.5 hours, depending on the subject's experiences.
The Dissociative Disorders Interview Schedule (DDIS)[11] is a highly structured interview which discriminates between various DSM-IV diagnoses. The DDIS can usually be administered in 30-45 minutes.
The Dissociative Experiences Scale (DES)[9] is a simple, quick, questionnaire[13] that has been widely used to screen for dissociative symptoms. Tests such as the DES[14] provide a quick method of screening[15] patients so that the more time-consuming structured clinical interview can be used in the group with high DES scores. Depending on where the cutoff is set, people who would subsequently be diagnosed can be missed. The orginal recommended cutoff was 15-20[9] and in one study a DES with a cutoff of 30 missed 46% of the positive SCID-D[10] diagnoses and a cutoff of 20 missed 25%.[12]

OK, time to look at the references you have added Standardname. The first one is the Carlson 1993 reference which you have added after the word "questionnaire". This reference validates the DES as a screening instrument across various centres. It is thus best placed directly after something saying this. The next added reference is Wright 1999 (after the second mention of "DES") which I have already mentioned above. It looks at the validity of the DES in non patient populations and suggests and alternative test, the DES-C. If this reference is to be used at all, it needs to be in that context. The next reference is Stockdale 2002 after the word "screening". This paper discusses "the utility of this DES model for screening both dissociative pathology and elevated normal dissociative behavior in clinical and nonclinical populations". Sadly, it does not state their conclusions in the abstract. Unless you have access to the full article, this reference is pretty useless other than to say that people have researched the DES in clinical and nonclinical populations, and this is not really worth saying. If you can get a copy of the full article and look at the conclusions then this would be a valuable reference. I have edited the paragraph accordingly and put this over to the Talk:Dissociative_identity_disorder/ArticleSandbox version. --CloudSurfer 19:02, 11 August 2007 (UTC)

CloudSurfer, some people might consider what you removed as, the most interesting additions. Although, I am glad you, at least, retained the one reference I consider the most interesting. Reluctantly I will, for this week, agree to CloudSurfer's removal of my contributions. --Standardname 02:28, 12 August 2007 (UTC)
  • Academics practise academia and research.
  • Wikipedia is based on academia, which endorses Dissociative identity disorder. Wikipedia is not based just on what anyone thinks.
Therefore, Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) should decide the entire Wikipedia Dissociative identity disorder article, and headings. It's as simple as that.
--Standardname 17:39, 12 August 2007 (UTC)
You've made the exact same claims in multiple sections, but they arecomplete nonsense. Please go read through WP:NPOV and other policies. And academia as a whole most certainly does not endorse DID, only a subset of American psychiatrists support it to any large degree, throughout academia as a whole in other countries and psychologist who aren't psychiatrists and so forth yo'll find widespread skepticism. DreamGuy 13:24, 14 August 2007 (UTC)
CloudSurfer, you say you're a psychiatrist (see diff here 9 August 02:22); you suggest many psychiatrists don't accept DID, which I disagree, many psychiatrists do accept DID; you reject (see diff here 12 August 06:18) Absentis' excellent proposal (see diff here of proposal 12 August 02:50) of Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) deciding the entire Wikipedia Dissociative identity disorder article, and headings;
  • WP:MEDMOS has been developed through the consensus of many editors;
  • In the past couple of years, academic publications predominantly endorse DID;
  • Please refrain from removing ANY text from article Dissociative identity disorder;
  • And no more new 'mediators', please;
  • Please cease getting distracted by other new separate suggestions, until resolution on WP:MEDMOS completes, as WP:MEDMOS for the Article Template is agreed by two editors on 12 August 02:50 and 12 August 03:35 (see diff here);
  • Please resume the incomplete discussion on Article Template, as there was agreement by two editors (see diff here).
--Standardname 23:31, 12 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 23:55, 12 August 2007 (UTC)

SCL-90

Abstract:

The purpose of this study was to examine the SCL–90 profiles of adult outpatients with and without dissociative disorders. A total of 194 participants were administered the Structured Clinical Interview for DSM–IV Dissociative Disorders–Revised (SCID–D–R) and the Symptom Checklist–90 (SCL–90). Patients with dissociative identity disorder (DID) reported significantly higher SCL–90 Global Severity Index (GSI) and individual subscale scores than those without dissociative disorders. It is recommended that patients who are polysymptomatic on the SCL–90 be considered for follow–up dissociative symptom assessment to aid differential diagnosis and to inform subsequent treatment.

Standardname, your next reference is interesting, but what information does it add for the average encyclopaedia reader? This is aimed at psychologists/doctors who are routinely administering the SCL-90. My view is that this is not relevant to this article but would be relevant to the article on the SCL-90, if indeed there is one. If there isn't, then by all means start a stub and include this information in the list. What do others think? --CloudSurfer 05:22, 10 August 2007 (UTC)

Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 23:59, 12 August 2007 (UTC)

Symptom provocation study

Abstract: Background Dissociative identity disorder (DID) patients function as two or more identities or dissociative identity states (DIS), categorized as 'neutral identity states' (NIS) and 'traumatic identity states' (TIS). NIS inhibit access to traumatic memories thereby enabling daily life functioning. TIS have access and responses to these memories. We tested whether these DIS show different psychobiological reactions to trauma-related memory.

Methods A symptom provocation paradigm with 11 DID patients was used in a two-by-two factorial design setting. Both NIS and TIS were exposed to a neutral and a trauma-related memory script. Three psychobiological parameters were tested: subjective ratings (emotional and sensori-motor), cardiovascular responses (heart rate, blood pressure, heart rate variability) and regional cerebral blood flow as determined with H215O positron emission tomography.

Results Psychobiological differences were found for the different DIS. Subjective and cardiovascular reactions revealed significant main and interactions effects. Regional cerebral blood flow data revealed different neural networks to be associated with different processing of the neutral and trauma-related memory script by NIS and TIS.

Conclusions Patients with DID encompass at least two different DIS. These identities involve different subjective reactions, cardiovascular responses and cerebral activation patterns to a trauma-related memory script.

Interesting study Standardname, how do you propose to use it in the DID article? This is a highly technical article. Have you found any replication of this study? --CloudSurfer 06:15, 10 August 2007 (UTC)

To enable people to understand the disparities with DID/dissociation/trauma, I would like to include these:
  • [[[PubMed Identifier|PMID]] 16929711] - Disparate brain patterns between Dissociative Identity States (DIS)
  • [[[PubMed Identifier|PMID]] 15865912] - Cognitive inhibition and attentional processing in dissociative identity disorder
  • [[[PubMed Identifier|PMID]] 16585437] - Smaller hippocampal and amygdalar volumes in patients with dissociative identity disorder, compared with healthy subjects
  • [[[PubMed Identifier|PMID]] 17137559] - There is a distinct pattern of hypothalamic-pituitary-adrenal (HPA)-axis dysregulation in dissociative disorders (DDs): collecting urine and blood sampling, the DD group had significantly elevated urinary cortisol compared with the healthy comparison (HC) group; the DD group demonstrated significantly greater resistance to, and faster escape from, dexamethasone suppression; the psychiatric groups demonstrated a significant inverse correlation between dissociation severity and cortisol reactivity.
  • [[[PubMed Identifier|PMID]] 12136507] - Altered brain development
But for the sake of this week's discussion, the one below could be included, for the moment. The source should append to the end of sentence, "The presumption is that at least two personalities may routinely take control of the individual's behavior." Anyone else?
--Standardname 01:33, 11 August 2007 (UTC)
  • DID patients function as two or more Dissociative Identity States (DIS), categorized as Neutral Identity States (NIS) and Traumatic Identity States’ (TIS). NIS inhibit access to traumatic memories thereby enabling daily life functioning. TIS have access and responses to these memories. DIS have different psychobiological differences. DIS show different psychobiological reactions to trauma-related memory: regional cerebral blood flow data revealed different neural networks to be associated with different processing; psychobiological parameters tested were cardiovascular responses (heart rate, blood pressure, heart rate variability) and regional cerebral blood flow as determined with H215O positron emission tomography.[16]
Have a look at Talk:Dissociative_identity_disorder/ArticleSandbox and you will see a heading for Pathophysiology. These references would appropriately go there. Have a go at writing a passage that includes each of these references but remains relatively simple and does not go into extreme depth. There are references out there that do not find any differences between the brains of DID and non DID people. You need to quote these as well in the interests of NPOV. Just off the top of my head, and without looking at each of your references this is the sort of thing I mean:
While some studies demonstrate brain imaging differences consistent with the theoretical basis of DID(insert those references here) other fail to find any difference.(insert those references here)
That is about all that is necessary in this encyclopaedia article. The level of detail your paragraph goes into is excessive. Also, you need to give a context. If you want to mention the smaller hippocampal and amygdala findings then you need to put it into the context that these results are found in other anxiety states. Remember that people who have the strongest views that DID is invalid would not say that the DID sufferer does not have a mental health disorder. Again, the issue is NPOV and providing an article that is accessible to an encyclopaedia reader. --CloudSurfer 05:18, 11 August 2007 (UTC)
There are six journals listed above. At the moment, I haven't time to write about the smaller hippocampal and amygdala findings, but intend to sometime. So, for the moment, below is all the text there is for this mini-thread. Regarding context. The source should append to end of sentence, "The presumption is that at least two personalities may routinely take control of the individual's behavior." Anyone else?
--Standardname 06:17, 11 August 2007 (UTC)
  • DID patients function as two or more Dissociative Identity States (DIS), categorized as Neutral Identity States (NIS) and Traumatic Identity States’ (TIS). NIS inhibit access to traumatic memories thereby enabling daily life functioning. TIS have access and responses to these memories. DIS have different psychobiological differences. DIS show different psychobiological reactions to trauma-related memory: regional cerebral blood flow data revealed different neural networks to be associated with different processing; psychobiological parameters tested were cardiovascular responses (heart rate, blood pressure, heart rate variability) and regional cerebral blood flow as determined with H215O positron emission tomography.[16]
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 00:00, 13 August 2007 (UTC)

Incidence studies

The next three references on your list all give incidences. Standardname, where and how do you want to use these? --CloudSurfer 06:27, 10 August 2007 (UTC)

Below is a suggestion for the epidemiology section. It is currently unreferenced but I have all of the references to justify each figure.

The true prevalence of the disorder is hard to determine. The DSM notes the sharp rise in reported cases and states that, "Some believe that the greater awareness of the diagnosis among mental health professionals has resulted in the identification of cases that were previously undiagnosed. In contrast, others believe that the syndrome has been overdiagnosed in individuals who are highly suggestive." The DSM does not give a figure. Reports in the literature are often given by advocates for the condition and figures from psychiatric populations (inpatients and outpatients) show a wide diversity from different countries: India (0.015% per year), China (0.4%), Germany (0.9%), Dutch (2%), Canada (6-8%), U.S. (approx. 6%, 6-8%, 10%), and Turkey (14%). Figures from the general population show less diversity: China (0%), Turkey (0.4% for a general sample and 1.1% for a female sample), and Canada (1%).

Before I go through the pain of doing the references I would like to canvas comments and suggested changes. --CloudSurfer 11:13, 10 August 2007 (UTC)

CloudSurfer, thank you for the suggested compromise text. As recent academic journals indicate DID is underdiagnosed than overdiagnosed, I would prefer more underdiagnosed facts reflected in the text, and less mention of overdiagnosed DID. Reluctantly I will, for this week, agree to CloudSurfer's compromise text. Anyone else?
--Standardname 00:36, 11 August 2007 (UTC)
The true prevalence of the disorder is hard to determine. The DSM notes the sharp rise in reported cases and states that, "Some believe that the greater awareness of the diagnosis among mental health professionals has resulted in the identification of cases that were previously undiagnosed. In contrast, others believe that the syndrome has been overdiagnosed in individuals who are highly suggestive." The DSM does not give a figure. Reports in the literature are often given by advocates for the condition and figures from psychiatric populations (inpatients and outpatients) show a wide diversity from different countries: India (0.015% per year), China (0.4%), Germany (0.9%), Dutch (2%), Canada (6-8%), U.S. (approx. 6%, 6-8%, 10%), and Turkey (5.4-2.5%). Figures from the general population show less diversity: China (0%), Turkey (0.4% for a general sample and 1.1% for a female sample), and Canada (1%).
Standardname, thanks for the "reluctant" vote. I have tried to write the above as NPOV. This is the reason for quoting directly from the DSM and then giving a set of figures. I have also tried to express that most academics who offer prevalence rates are the academics who believe that DID is a valid diagnosis. Remember there is a significant proportion of psychiatrists and academics who do not believe it is valid and this must be reflected in the article. The disbelievers are unlikely to do the sort of arduous research that is required to check its prevalence since they don't believe it exists in the first place. --CloudSurfer 05:01, 11 August 2007 (UTC)
See Talk:Dissociative_identity_disorder/ArticleSandbox for this section with references. --CloudSurfer 18:11, 11 August 2007 (UTC)
  • Wikipedia is not based on what psychiatrists may think besides, many psychiatrists accept Dissociative identity disorder.
  • Psychiatrists practise psychiatry. Academics practise academia and research.
  • Wikipedia is based on academia, which endorses Dissociative identity disorder. Wikipedia is not based just on what anyone thinks.
Therefore, Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) should decide the entire Wikipedia Dissociative identity disorder article, and headings. It's as simple as that.
--Standardname 17:37, 12 August 2007 (UTC)
Rarely have I seen such nonsense. Academia as a whole does not endorse DID, many in academia do not. Wikipedia covers all topics fairly, giving all sides, and not trying to slant things toward one view or another. And the idea that a term that is only defined as such by the American Psychiatric Association should not use psychiatrists as sources is just absurd. I can't believe anyone would even try to make such an argument. If we toss out psychiatrists and go to academia we'll have LESS support for DID, *not* more. You're wikilawyering to such an absurd degree that your arguments actually go against what you want to happen. DreamGuy 13:20, 14 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 00:01, 13 August 2007 (UTC)

Prevalence of DID is 5.4% among inpatients and 2.5% among outpatients according two studies in Turkey. The 14.0% is for emergency psychiatric ward.--Belowthewings 20:28, 14 August 2007 (UTC)

Article Template

Since this is a psychiatric/medical/psychological disorder it may well be best to follow the medical condition article template. This would then create a sensible heading for epidemiological data. --CloudSurfer 06:44, 10 August 2007 (UTC)

There is now a sandbox page with the article as it was at the time of this edit. It is reordered to fit the medical template. Many of the headings are empty. None of the suggested edits have yet to be put in but will be in time if you guys agree to this. --CloudSurfer 08:38, 10 August 2007 (UTC)
Since there have been no negative comments on the sandbox article, I am planning to incorporate some of the edits above that have also not collected negative comments and then to migrate the new page to the actual article to see whether that is accepted. Standardname, given the recent edit war, it would best if a neutral party did this, and I hope I am perceived as such. I also hope you understand. --CloudSurfer 05:32, 11 August 2007 (UTC)
I understand --Standardname 06:22, 11 August 2007 (UTC)

I'd like to mention that WP:MEDMOS would be useful in not only deciding the headings to follow, but also for writing the entire article. Absentis 02:50, 12 August 2007 (UTC)

I agree with Absentis, Wikipedia's "Manual of Style (medicine-related articles)" (WP:MEDMOS) should decide the entire Wikipedia "Dissociative identity disorder" article, and headings. Especially as "WP:MEDMOS" has been developed through the consensus of many editors. --Standardname 03:35, 12 August 2007 (UTC)
CloudSurfer, you say you're a psychiatrist (see diff here 9 August 02:22); you suggest many psychiatrists don't accept DID, which I disagree, many psychiatrists do accept DID; you reject (see diff here 12 August 06:18) Absentis' excellent proposal (see diff here of proposal 12 August 02:50) of Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) deciding the entire Wikipedia Dissociative identity disorder article, and headings;
  • WP:MEDMOS has been developed through the consensus of many editors;
  • In the past couple of years, academic publications predominantly endorse DID;
  • Please refrain from removing ANY text from article Dissociative identity disorder;
  • And no more new 'mediators', please;
  • Please cease getting distracted by other new separate suggestions, until resolution on WP:MEDMOS completes, as WP:MEDMOS for the Article Template is agreed by two editors on 12 August 02:50 and 12 August 03:35 (see diff here);
  • Please resume the incomplete discussion on Article Template, as there was agreement by two editors (see diff here).
--Standardname 23:33, 12 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 00:02, 13 August 2007 (UTC)

Diagnostic criteria (DSM-IV-TR)

The current article has the following:

The diagnostic criteria defined in DSM-IV Dissociative Disorders[17] section 300.14[3] of the Diagnostic and Statistical Manual of Mental Disorders are as follows:
Defined as the occurrence of two or more personalities within the same individual, each of which during sometime in the person's life is able to take control. This is not often a mentally healthy thing when the personalities vie for control.
Symptoms are of course somewhat self-explanatory, but it is important to note that often the personalities are very different in nature, often representing extremes of what is contained in a normal person. Sometimes, the disease is asymmetrical, which means that what one personality knows, the others inherently know.
  1. The patient has at least two distinct identities or personality states. Each of these has its own, relatively lasting pattern of sensing, thinking about and relating to self and environment.
  2. At least two of these personalities repeatedly assume control of the patient's behavior.
  3. Common forgetfulness cannot explain the patient's extensive inability to remember important personal information.
  4. This behavior is not directly caused by substance use (such as alcoholic blackouts) or by a general medical condition.

Given that we cannot use the exact wording of the the DSM criteria we need to give a summary. The article must reflect this.

In summary, the diagnostic criteria in DSM-IV Dissociative Disorders[18] section 300.14[3] of the Diagnostic and Statistical Manual of Mental Disorders require the occurrence of two or more personalities within the same individual, each of which during some time in the person's life is able to take control. This must be combined with extensive areas of memory loss that cannot be explained as within normal limits. The symptoms must not be better explained by substance use or another medical condition.
The personalities are often very different in nature and may represent extremes of what is contained in a normal person. Memories may be asymmetrical with dominant identities remembering more than passive identities.

I realized after doing this edit that the numbered criteria are rewording of the DSM ones. They may then be ok to use but not saying that they are the DSM definitions. --CloudSurfer 21:53, 11 August 2007 (UTC)

This suggestion halves the text and information, further minimalising the disorder. Reluctantly I will, for this week, agree to CloudSurfer's compromise text. --Standardname 02:30, 12 August 2007 (UTC)
  • Academics practise academia and research.
  • Wikipedia is based on academia, which endorses Dissociative identity disorder. Wikipedia is not based just on what anyone thinks.
Therefore, Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) should decide the entire Wikipedia Dissociative identity disorder article, and headings. It's as simple as that.
--Standardname 17:35, 12 August 2007 (UTC)
CloudSurfer, you say you're a psychiatrist (see diff here 9 August 02:22); you suggest many psychiatrists don't accept DID, which I disagree, many psychiatrists do accept DID; you reject (see diff here 12 August 06:18) Absentis' excellent proposal (see diff here of proposal 12 August 02:50) of Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) deciding the entire Wikipedia Dissociative identity disorder article, and headings;
  • WP:MEDMOS has been developed through the consensus of many editors;
  • In the past couple of years, academic publications predominantly endorse DID;
  • Please refrain from removing ANY text from article Dissociative identity disorder;
  • And no more new 'mediators', please;
  • Please cease getting distracted by other new separate suggestions, until resolution on WP:MEDMOS completes, as WP:MEDMOS for the Article Template is agreed by two editors on 12 August 02:50 and 12 August 03:35 (see diff here);
  • Please resume the incomplete discussion on Article Template, as there was agreement by two editors (see diff here).
--Standardname 23:34, 12 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 00:03, 13 August 2007 (UTC)

Sandbox version

After going through the current sandbox version, I have found no major problems with it so far, but of course reserve the right to change my mind upon a re-read. I do, however, object to the controversy section being moved toward the end and also (as in the existing article too) the wording throughout that assumes it is real instead of taking more neutral language. It seems especially odd with the controversy moved to the end to spend so much time saying "it exists, it's this, it's like that, it does this other thing, oh, and it might not really exist". That's definitely slanting the whole thrust of the article to bury it like that. DreamGuy 00:11, 12 August 2007 (UTC)

If you look at schizophrenia (FA) you'll see the 'alternative approaches' section (which deals with the controversial elements of the disorder) close to the bottom of the list of contents. As well, there is a paragraph in the introduction that deals with the controversy, as well as a link to multiple personality disorder, so I see that as fairly balanced. Absentis 01:02, 12 August 2007 (UTC)
I agree with Absentis; controversial elements shouldn't be near the top, or the middle. --Standardname 01:42, 12 August 2007 (UTC)
The difference between schizophrenia and DID is that the vast majority of the world's psychiatrists accept that schizophrenia is a valid diagnosis whereas it would seem that the majority of the world's psychiatrists do not accept DID as valid. From my reading of the literature, North American psychiatrists seem relatively evenly divided on the subject. The paucity of articles from the rest of the world would suggest that they do not take it seriously. From my experience of Australian psychiatry, that is the situation there. The issue is, how to approach this appropriately in the article. My view is to let the facts speak for themselves. Present the information that is published and let the reader decide. The article has been ordered as it is for quite some time. DreamGuy is right that there is a lot of reference to doubts throughout the article that only make sense once you have read the controversy section, hence his argument for putting this section at the top. If we follow the schizophrenia article ordering as it is currently shown in the sandbox version, what I believe we need to do is to strenghthen the doubts area in the introduction. The best way to do this would be to state the world level of support for the diagnosis in the introduction and back this up with references. That will then orientate the reader to a world view consensus. Intelligent design, a view held by a substantial minority, is an interesting example of how its editors structure a subject like this. The controversy is led in the introduction and then there is an overview and history of the subject. The medical template leaves history to the end and that is how the current sandbox article is structured. I am still swayed to leave it like this but with a strenghened level of doubt in the introduction. I will have a go at this and get back here. --CloudSurfer 06:18, 12 August 2007 (UTC)
  • Wikipedia is not based on what psychiatrists may think besides, many psychiatrists accept Dissociative identity disorder.
  • Psychiatrists practise psychiatry. Academics practise academia and research.
  • Wikipedia is based on academia, which endorses Dissociative identity disorder. Wikipedia is not based just on what anyone thinks.
Therefore, Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) should decide the entire Wikipedia Dissociative identity disorder article, and headings. It's as simple as that.
--Standardname 17:32, 12 August 2007 (UTC)
How many different sections did you place the exact same fallacious argument? Please, don't fill up the page with copy and pastes of the same claim over and over, it wastes everyone's time. I have responded to the errors in your claims below, and I see others have responded to your argument in this section and others. Suffice it to say your views are not accepted by other editors here. DreamGuy 13:34, 14 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 00:04, 13 August 2007 (UTC)
Academia does not endorse DID. To be honest, I don't think academia ever endorse anything. There are things for which there is greater and lesses consensus. DID is on the lesser side. Academia is rather more likely to teach the existence of the controversy (which in my experience, it does). Which side it comes down to supporting probably depends on the bias of the academic concerned. The existence of the controversy is also clearly discussed in undergraduate textbooks. This suggests to me that it's a rather fundamental disagreement, rather than a small minority. --Limegreen 08:24, 13 August 2007 (UTC)

Introduction paragraph on controversy

OK folks. The current introduction paragraph is:

As a diagnosis, DID remains controversial, with many professional psychiatrists and commentators arguing that there is no empirical evidence to support the disorder, or its diagnosis. On the other hand, some psychiatrists contend that they have encountered cases that appear to confirm the existence of this condition [19], and some mental health institutions, such as McLean Hospital[20], have wards specifically designated for Dissociative Identity Disorder.

How is this for a rewrite?

As a diagnosis, DID remains controversial. For many years DID was regarded as a North American phenomenon[21][7] with the bulk of the literature still arising there. However, research demonstrates a lack of consensus belief in the validity of DID amongst North American psychiatrists.[5][6] Psychiatrists who do accept DID as a valid disorder have produced an extensive literature and there are treatment centres specifically aimed at treating it.[22] Piper and Merskey describe the diagnosis of DID as a culture bound and often iatrogenic condition which they believe is in decline.[7][8] (I forgot to put a signature on this --CloudSurfer 09:15, 12 August 2007 (UTC))

After drafting the above, I went to look at the McLean link only to find that it is a dissociative disorders and trauma programme. It does not mention either MPD or DID. It describes a programme but does not say that a ward is dedicated to DDs although the photograph on the site suggests that a building is dedicated to it. I have therefore removed this from the paragraph. If anyone can come up with a reference for a dedicated ward then please let us know.

As a diagnosis, DID remains controversial. For many years DID was regarded as a North American phenomenon[21][7] with the bulk of the literature still arising there. However, research demonstrates a lack of consensus belief in the validity of DID amongst North American psychiatrists.[5][6] Psychiatrists who do accept DID as a valid disorder have produced an extensive literature with some of the more recent papers originating outside North America. However criticism of the diagnosis continues with Piper and Merskey describing it as a culture bound and often iatrogenic condition which they believe is in decline.[7][8]

Sorry I didn't sign the above. --CloudSurfer 09:15, 12 August 2007 (UTC)

  • Wikipedia is not based on what psychiatrists may think besides, many psychiatrists accept Dissociative identity disorder.
  • Psychiatrists practise psychiatry. Academics practise academia and research.
  • Wikipedia is based on academia, which endorses Dissociative identity disorder. Wikipedia is not based just on what anyone thinks.
Therefore, Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) should decide the entire Wikipedia Dissociative identity disorder article, and headings. It's as simple as that.
--Standardname 17:33, 12 August 2007 (UTC)
Firstly, DID largely owes its existence to psychiatrists in North America who have given it prominence in the DSM, diagnosed numerous cases, and produced many papers. Most of the "academics" who have written articles are doctors and most are psychatrists. The two papers that look at psychatrists' attitudes in North America are academic papers. Academic papers are largely supportive of DID. There are some that are not. Most of the academic papers come from regions that have relatively high levels of DID compared with the rest of the world. The preponderance of papers supporting DID need to be balanced by the general world level of support from experts in the field and that is psychiatrists and psychologists, some of whom are academics. No one is denying that people with DID have problems. The controversy is over whether DID is the correct diagnosis. --CloudSurfer 19:49, 12 August 2007 (UTC)
Please offer a revision of the draft paragraph above. Remember that this is a short paragraph intended for the introduction. --CloudSurfer 20:07, 12 August 2007 (UTC)
I'd replace "Firstly, DID" with "The diagnosis of dissociative identity disorder". I'm not sure why academics is in brackets, maybe change that with 'authors'? Other than that, I think this draft will set up the section very well. Absentis 21:01, 12 August 2007 (UTC)
Sorry for the confusion Absentis. The "paragraph above" I am referring to is the one commencing "As a diagnosis, DID remains ..." several paragraphs above. That is the draft paragraph that Standname is objecting to. The one you have commented on is my post in response to his post. --CloudSurfer 21:29, 12 August 2007 (UTC)
Well, putting my feelings of embarrassment aside, I have only a stylistic suggestion. Perhaps the first mention of the disorder should be it's elongated form instead of the abbreviation. Other than that, it's definitely an improvement over the current introductory paragraph. Absentis 21:45, 12 August 2007 (UTC)
No need to be embarrassed. I was the one who wasn't clear. Remember that this paragraph is the third paragraph in the introduction. The acronym "DID" has already been introduced in the first paragraph. --CloudSurfer 22:00, 12 August 2007 (UTC)
CloudSurfer, you say you're a psychiatrist (see diff here 9 August 02:22); you suggest many psychiatrists don't accept DID, which I disagree, many psychiatrists do accept DID; you reject (see diff here 12 August 06:18) Absentis' excellent proposal (see diff here of proposal 12 August 02:50) of Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) deciding the entire Wikipedia Dissociative identity disorder article, and headings;
  • WP:MEDMOS has been developed through the consensus of many editors;
  • In the past couple of years, academic publications predominantly endorse DID;
  • Please refrain from removing ANY text from article Dissociative identity disorder;
  • And no more new 'mediators', please;
  • Please cease getting distracted by other new separate suggestions, until resolution on WP:MEDMOS completes, as WP:MEDMOS for the Article Template is agreed by two editors on 12 August 02:50 and 12 August 03:35 (see diff here);
  • Please resume the incomplete discussion on Article Template, as there was agreement by two editors (see diff here).
--Standardname 23:35, 12 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 00:05, 13 August 2007 (UTC)

Moving recent comments down discussion page, to the correct place

Recently, I realised new comments should append to the bottom of the discussion page, which automatically happens when using the '+' button, as old comments at the top get archived. So, I'll move the top recent comments down, to the correct places, where they should be.

--Standardname 18:25, 12 August 2007 (UTC)

The only problem with using the '+' button is if you intend to put in a draft paragraph with references. In that case it is best to put any new drafts just above the reference section as I am doing. By the way, this page needs some serious archiving. It is getting very big. --CloudSurfer 21:23, 12 August 2007 (UTC)
CloudSurfer, you suggested archiving Talk:Dissociative identity disorder. Please refrain from archiving Talk:Dissociative identity disorder, as Wikipedia:Requests_for_comment/DreamGuy_2 may need to refer to it, and there is a risk of losing information, if you archive Talk:Dissociative identity disorder. Thanks.
--Standardname 01:45, 13 August 2007 (UTC)

Pathophysiology

Below is a draft of a section on this subject.

Reviews of the literature have discussed the findings of various psychophysiologic investigations of DID.[23][24] Many of the investigations include testing and observation in the one person but with different alters. Different alter states show distinct physiological markers.[25] EEG studies have shown distinct differences between alters,[26][27] findings another study failed to replicate.[28] Another study concluded that the differences involved intensity of concentration, mood changes, degree of muscle tension, and duration of recording, rather than some inherent difference between the brains of persons with multiple personalities and those of normal persons.[29] One EEG study comparing DID with hysteria showed differences between the two diagnoses.[30] A postulated link between epilepsy and DID has been disputed by a number of authors.[31][32] Some brain imaging studies have shown differing cerebral blood flow with different alters[33][16] while another has failed to replicate this finding.[34] A different imaging study showed that findings of smaller hippocampal volumes in patients with a history of exposure to traumatic stress and an accompanying stress-related psychiatric disorder were also demonstrated in DID.[35] This study also found smaller amygdala volumes. Studies have demonstrated various changes in visual parameters between alters.[36][37][38] One twin study showed hereditable factors were present in DID.[39]

Comments please. --CloudSurfer 20:00, 12 August 2007 (UTC)

I'll admit that I only read the abstracts of the cited articles, but the way you set them up is great. The studies showing significant results are balanced by those that don't. To me, this draft is a great start for any editor to expand upon (if they feel the need). Absentis 21:21, 12 August 2007 (UTC)
CloudSurfer, you say you're a psychiatrist (see diff here 9 August 02:22); you suggest many psychiatrists don't accept DID, which I disagree, many psychiatrists do accept DID; you reject (see diff here 12 August 06:18) Absentis' excellent proposal (see diff here of proposal 12 August 02:50) of Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) deciding the entire Wikipedia Dissociative identity disorder article, and headings;
  • WP:MEDMOS has been developed through the consensus of many editors;
  • In the past couple of years, academic publications predominantly endorse DID;
  • Please refrain from removing ANY text from article Dissociative identity disorder;
  • And no more new 'mediators', please;
  • Please cease getting distracted by other new separate suggestions, until resolution on WP:MEDMOS completes, as WP:MEDMOS for the Article Template is agreed by two editors on 12 August 02:50 and 12 August 03:35 (see diff here);
  • Please resume the incomplete discussion on Article Template, as there was agreement by two editors (see diff here).
--Standardname 23:38, 12 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 00:06, 13 August 2007 (UTC)

Prevention/screening

Here is a draft for this section:

Strategies to prevent the development of DID depend upon how the etiology of the disorder is perceived. Early childhood trauma is frequently attributed as an etiology of DID, and so from this viewpoint, prevention of childhood trauma should reduce the incidence of DID. Those who believe the disorder is iatrogenic recommend clinician caution.
Many authors have recommended increased screening for dissociative disorders to increase the recognition of DID.[21][9][40][41]

Comments please.--CloudSurfer 20:59, 12 August 2007 (UTC)

Could you further explain clinician caution? I think would be helpful to give guidelines or examples. Absentis 21:08, 12 August 2007 (UTC)
Is this clearer?
Strategies to prevent the development of DID depend upon how the etiology of the disorder is perceived. Early childhood trauma is frequently attributed as an etiology of DID, and so from this viewpoint, prevention of childhood trauma should reduce the incidence of DID. Those who believe that DID is often caused by suggestions from the clinician to suggestible people, caution clinicians against contributing to the diagnosis.[42][8]
Comments please.--CloudSurfer 21:15, 12 August 2007 (UTC)
Much clearer, thanks. Absentis 21:22, 12 August 2007 (UTC)
CloudSurfer, you say you're a psychiatrist (see diff here 9 August 02:22); you suggest many psychiatrists don't accept DID, which I disagree, many psychiatrists do accept DID; you reject (see diff here 12 August 06:18) Absentis' excellent proposal (see diff here of proposal 12 August 02:50) of Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) deciding the entire Wikipedia Dissociative identity disorder article, and headings;
  • WP:MEDMOS has been developed through the consensus of many editors;
  • In the past couple of years, academic publications predominantly endorse DID;
  • Please refrain from removing ANY text from article Dissociative identity disorder;
  • And no more new 'mediators', please;
  • Please cease getting distracted by other new separate suggestions, until resolution on WP:MEDMOS completes, as WP:MEDMOS for the Article Template is agreed by two editors on 12 August 02:50 and 12 August 03:35 (see diff here);
  • Please resume the incomplete discussion on Article Template, as there was agreement by two editors (see diff here).
--Standardname 23:39, 12 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 00:07, 13 August 2007 (UTC)

Social impact

This section is currently empty. I was thinking that an article on legal implications would fit here. What else? --CloudSurfer 22:07, 12 August 2007 (UTC)

CloudSurfer, you say you're a psychiatrist (see diff here 9 August 02:22); you suggest many psychiatrists don't accept DID, which I disagree, many psychiatrists do accept DID; you reject (see diff here 12 August 06:18) Absentis' excellent proposal (see diff here of proposal 12 August 02:50) of Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) deciding the entire Wikipedia Dissociative identity disorder article, and headings;
  • WP:MEDMOS has been developed through the consensus of many editors;
  • In the past couple of years, academic publications predominantly endorse DID;
  • Please refrain from removing ANY text from article Dissociative identity disorder;
  • And no more new 'mediators', please;
  • Please cease getting distracted by other new separate suggestions, until resolution on WP:MEDMOS completes, as WP:MEDMOS for the Article Template is agreed by two editors on 12 August 02:50 and 12 August 03:35 (see diff here);
  • Please resume the incomplete discussion on Article Template, as there was agreement by two editors (see diff here).
--Standardname 23:40, 12 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 00:07, 13 August 2007 (UTC)

Notable cases

Anyone got any suggestions for this section? Obviously "Sybil" should go here. Any others? Anyone want to write a paragraph or two or should it just be a list?--CloudSurfer 22:07, 12 August 2007 (UTC)

CloudSurfer, you say you're a psychiatrist (see diff here 9 August 02:22); you suggest many psychiatrists don't accept DID, which I disagree, many psychiatrists do accept DID; you reject (see diff here 12 August 06:18) Absentis' excellent proposal (see diff here of proposal 12 August 02:50) of Wikipedia's Manual of Style (medicine-related articles) (WP:MEDMOS) deciding the entire Wikipedia Dissociative identity disorder article, and headings;
  • WP:MEDMOS has been developed through the consensus of many editors;
  • In the past couple of years, academic publications predominantly endorse DID;
  • Please refrain from removing ANY text from article Dissociative identity disorder;
  • And no more new 'mediators', please;
  • Please cease getting distracted by other new separate suggestions, until resolution on WP:MEDMOS completes, as WP:MEDMOS for the Article Template is agreed by two editors on 12 August 02:50 and 12 August 03:35 (see diff here);
  • Please resume the incomplete discussion on Article Template, as there was agreement by two editors (see diff here).
--Standardname 23:41, 12 August 2007 (UTC)
Discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS) continues below in new section heading titled "Article Template (continued)".
--Standardname 00:08, 13 August 2007 (UTC)

Article Template (continued)

Here we must resume the discussion on Article Template and Manual of Style (medicine-related articles) (WP:MEDMOS), which was forgotten by the (ex-) mediator CloudSurfer. WP:MEDMOS for the Article Template is agreed by two editors, Absentis on 12 August 02:50 and Standardname on 12 August 03:35 (see diff here). --Standardname 00:24, 13 August 2007 (UTC)

Standardname, as you would know, I was the one who suggested the use of the medical template structure. I don't understand what it is you are complaining about since the article in the [Talk:Dissociative_identity_disorder/ArticleSandbox|sandbox] follows that template. You will need to be specific about your objections. What appears to be the problem is my draft of a paragraph introducing the issue of controversy which was meant to go in the introduction. I reproduce that below for convenience.
As a diagnosis, DID remains controversial. For many years DID was regarded as a North American phenomenon[21][7] with the bulk of the literature still arising there. However, research demonstrates a lack of consensus belief in the validity of DID amongst North American psychiatrists.[5][6] Psychiatrists who do accept DID as a valid disorder have produced an extensive literature with some of the more recent papers originating outside North America. However criticism of the diagnosis continues with Piper and Merskey describing it as a culture bound and often iatrogenic condition which they believe is in decline.[7][8]
Your main concern seems to be based on your statement, "you suggest many psychiatrists don't accept DID, which I disagree, many psychiatrists do accept DID."
  • DID is primarily a North American phenomenon. Most experts in the field (psychiatrists and psychologists) in other parts of the world do not use the diagnosis. Try finding articles that support the diagnosis in the British Journal of Psychiatry or the Australian & New Zealand Journal of Psychiatry for instance.
  • North American psychiatrists polled on their views of the disorder respond evenly suggesting that they are 50:50 on the subject.
  • North American psychiatrists make up about half the world's psychiatrsts.
If we combine the two groups we arrive at the conclusion that most psychiatrists in the world do not support the diagnosis of DID. I agree with you, many psychiatrists do accept DID, it's just that most do not. This needs to be reflected in the article and that was my attempt in the draft above. Using NPOV, the article needs to express both points of view with citations to back them up. The article should not dismiss DID but it should be balanced. --CloudSurfer 01:09, 13 August 2007 (UTC)
CloudSurfer, you've suddenly "appeared" and dismissed the excellent suggestion of Manual of Style (medicine-related articles) (WP:MEDMOS), which was agreed by two editors on 12 August 02:50 and on 12 August 03:35 (see diff here). You've also missed commenting on some journal sources I mentioned above, and whilst dismissing them, you suggest more controversial text. I disagree with your suggestions. Do you agree to refrain from removing text from article Dissociative identity disorder?
--Standardname 02:27, 13 August 2007 (UTC)
Standardname, I am unable to respond on the MedMOS issue until you explain to me how I have dismissed it. The article in the sandbox follows it heading by heading.
I apologise for not moving further on your list of references. I have meant to do this but I have been working down your list of references and down the list of headings from the MedMOS template. The list of references is I presume the one we have been discussing which is under the heading of "Suggestions for a solution". To date I have addressed points 1-6 and explained to you why I have not used all of them in my suggested texts.
Reference 7 is 'Changing the name of MPD to DID was to place the correct emphasis on the failure to integrate aspects of identity, memory, and consciousness rather than the apparent proliferation of "personalities"'. David Spiegel writes, 'The best known was changing the name of multiple personality disorder to dissociative identity disorder to place the correct emphasis on the failure to integrate aspects of identity, memory, and consciousness rather than the apparent proliferation of "personalities." Indeed, the problem is not having more than one personality, it is having less than one.' This is a valuable reference and needs to be included in the article. The obvious place is in the "The DSM redress" where the sentence, "The controversial nature of the dissociation hypothesis is shown quite clearly by the manner in which the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) has addressed, and re-dressed, the categorization over the years." needs to be reframed to use this reference. The sentence as it currently stands is POV in my view.
References 8 and 9 are about treatment. I haven't even looked at that section yet. While the summary you have given for each suggests that they have a place in the article, the links both go to the Spiegel article for ref 7. Perhaps you could post the correct links here. --CloudSurfer 05:06, 13 August 2007 (UTC)

Page displays 'Sign in / create account' when you'd expect it to display 'log out'

  • When I am logged in at this discussion page, the top right-hand corner sometimes incorrectly displays 'Sign in / create account' when it should actually display 'log out', as I am logged in. However, when previewing a comment, it displays my username, which confirms I am logged in. And after posting my comment, my username is posted along with my text. I'm wondering whether to report this problem, that there might be something wrong with 'Sign in / create account' and 'log out' signs, in the top right-hand corner of this page, in case it gets worse. Is anyone else experience this, or is it just me?
  • Also, I noticed there is a delay in displaying my contributions in both the article and discussion pages, is this usual? I noticed some of my previous contributions to the article page sometimes took up to three days to appear.

--Standardname 00:32, 13 August 2007 (UTC)

Whilst logged in at discussion page Talk:Dissociative identity disorder, does any other editor get automatically logged out, at times? --Standardname 02:30, 13 August 2007 (UTC)

Request to CloudSurfer from StandardName

The text below was put into my UserTalk. Since it is about my edits here I have copied it here:

CloudSurfer, you suddenly turn up at Talk:Dissociative identity disorder, and suggest removing text supporting the disorder Dissociative identity disorder, and suggest adding more controversial text;
--Standardname 02:52, 13 August 2007 (UTC)

Wikipedia is about improving the encyclopaedia, not blocking edits. Standardname, I remain happy to work with you collaboratively to improve this article. You are obviously a keen editor and have searched out many references. I have tried to offer you guidance in understanding the use of references and how best to include them in the text. I remain happy to continue with this process. I am not happy to agree to any of your above requests. For the last week or so I have been searching references and writing copy. I have submitted these to the talk page to seek feedback and ultimately consensus. To date we have agreed to structure the article on the medical template and there is a sandbox page with an article that so far has obtained consensus. There are still outstanding items on the talk page that await transfer to the sandbox. After these transfers have put text in each of the headings, my plan was then to migrate this to the main article.

In my opinion there is still much to be done with the rest of the text in the article. It needs to be cleaned up considerably and some of the stronger anti-DID stuff in the controversy section needs to be sourced or removed. It remains a work in progress. I note on your user page that you have been warned by admins not to be disruptive about the editing of this article. Trying to stop me from editing may be considered disruptive.

Instead of asking me to refrain from editing certain elements, what about collaborating on the passages I have suggested? --CloudSurfer 04:13, 13 August 2007 (UTC)

You were much too polite to someone who clearly wants to skew the article to his own viewpoint instead of treating the topic fairly. If anything the current edits still underplay the controversy, as all through the article it discusses it like it's real instead of saying what source says what about it, so that it'sclear that it's their opinion and not fact. DreamGuy 13:17, 14 August 2007 (UTC)
Being civil is not only good manners and WP policy but the best way to achieve a satisfactory outcome. --CloudSurfer 01:10, 15 August 2007 (UTC)

Status of article 21:00 13 Aug 07

Current sandbox version of article

Things have become rather busy here on the page so I thought it best to concentrate everything to date in this section.

Diagnostic criteria (DSM-IV-TR)

Current consensus draft:

In summary, the diagnostic criteria in DSM-IV Dissociative Disorders[43] section 300.14[3] of the Diagnostic and Statistical Manual of Mental Disorders require the occurrence of two or more personalities within the same individual, each of which during some time in the person's life is able to take control. This must be combined with extensive areas of memory loss that cannot be explained as within normal limits. The symptoms must not be better explained by substance use or another medical condition.
The personalities are often very different in nature and may represent extremes of what is contained in a normal person. Memories may be asymmetrical with dominant identities remembering more than passive identities.

Pathophysiology

Current consensus draft:

Reviews of the literature have discussed the findings of various psychophysiologic investigations of DID.[23][24] Many of the investigations include testing and observation in the one person but with different alters. Different alter states show distinct physiological markers.[25] EEG studies have shown distinct differences between alters,[26][27] findings another study failed to replicate.[28] Another study concluded that the differences involved intensity of concentration, mood changes, degree of muscle tension, and duration of recording, rather than some inherent difference between the brains of persons with multiple personalities and those of normal persons.[29] One EEG study comparing DID with hysteria showed differences between the two diagnoses.[30] A postulated link between epilepsy and DID has been disputed by a number of authors.[31][32] Some brain imaging studies have shown differing cerebral blood flow with different alters[33][16] while another has failed to replicate this finding.[34] A different imaging study showed that findings of smaller hippocampal volumes in patients with a history of exposure to traumatic stress and an accompanying stress-related psychiatric disorder were also demonstrated in DID.[35] This study also found smaller amygdala volumes. Studies have demonstrated various changes in visual parameters between alters.[36][37][38] One twin study showed hereditable factors were present in DID.[39]

Prevention/screening

Current consensus draft:

Strategies to prevent the development of DID depend upon how the etiology of the disorder is perceived. Early childhood trauma is frequently attributed as an etiology of DID, and so from this viewpoint, prevention of childhood trauma should reduce the incidence of DID. Those who believe that DID is often caused by suggestions from the clinician to suggestible people, caution clinicians against contributing to the diagnosis.[42][8]

I have moved these over to the Sandbox version and have moved the sandbox over to the main article with the empty headings deleted.

Introduction

The following paragraph meant to replace paragraph three in the introduction remains in a draft stage. It has yet to have edits suggested but Standardname appears to object to it. What do others think?

As a diagnosis, DID remains controversial. For many years DID was regarded as a North American phenomenon[21][7] with the bulk of the literature still arising there. However, research demonstrates a lack of consensus belief in the validity of DID amongst North American psychiatrists.[5][6] Psychiatrists who do accept DID as a valid disorder have produced an extensive literature with some of the more recent papers originating outside North America. However criticism of the diagnosis continues with Piper and Merskey describing it as a culture bound and often iatrogenic condition which they believe is in decline.[7][8]

Comments please. --CloudSurfer 21:09, 13 August 2007 (UTC)

Very good, big improvement. Just lose the redundant and repetitious second "However," please. Bishonen | talk 22:59, 13 August 2007 (UTC).
Thanks Bishonen, "However" is gone. In the meantime I have found another excellent reference which summarises the history of dissociation and focuses on DID. I now have the full text of it to support a world view that DID has been seen as "American". The text is thus revised to add this reference and remove the "however".
As a diagnosis, DID remains controversial. For many years DID was regarded as a North American phenomenon[21][44][7] with the bulk of the literature still arising there. However, research demonstrates a lack of consensus belief in the validity of DID amongst North American psychiatrists.[5][6] Psychiatrists who do accept DID as a valid disorder have produced an extensive literature with some of the more recent papers originating outside North America. Criticism of the diagnosis continues with Piper and Merskey describing it as a culture bound and often iatrogenic condition which they believe is in decline.[7][8]
Comments please. --CloudSurfer 09:09, 14 August 2007 (UTC)

The opinion that DID is a merely North American phenomenon is no more valid. An increasing number of articles(e.g. from Turkey,Germany,Netherlands,Australia ) published in peer reviewed journals in the last decade have disproven this.--Belowthewings 20:48, 14 August 2007 (UTC)

The text states, "For many years DID was regarded as a North American phenomenon with the bulk of the literature still arising there." The first part of this sentence is in the past tense and the present tense statement is that the bulk of literature is still from N. Am. If you have references or facts that counter these two statements, please provide them. The paragraph then goes on to state, "Psychiatrists who do accept DID as a valid disorder have produced an extensive literature with some of the more recent papers originating outside North America." This acknowledges that there are now some papers supporting the diagnosis of DID coming from outside N. Am. Please offer an alternative paragraph, including references to back up what you write. --CloudSurfer 01:05, 15 August 2007 (UTC)

A recent review about peer reviewed publications on DID outside North America: Sar V(2006) The scope of dissociative disorders:an international perspective. Psychiatr Clin North Am, 29(2):227-244. I will provide a more explicite list of international references.--Belowthewings 06:26, 18 August 2007 (UTC)

Archiving

I have archived every post I could find that did not have a post later than 31Dec2006. A search for 2007 returns only the page update date. My apologies if I have archived undated posts that are more recent. These discussions are now in Talk:Dissociative_identity_disorder/Archive_2006-2. --CloudSurfer 00:46, 14 August 2007 (UTC)

Defining the controversy

The entire history section has now been moved to the beginning of the article which goes against the medical template. DreamGuy has a point in wanting to have this up front in a topic that is as controversial as DID is, thus orientating the reader before they wade into the topic. However, the history section, needs to be where it is in the medical template, at the end of the article. The article on the multiple personality controversy has a chronology that I would like to move or copy to the history section of this article. This could be fleshed out with some prose paragraphs. While this is helpful to the controversy article, it really belongs with the main subject article. Comments please. --CloudSurfer 04:46, 15 August 2007 (UTC)

I believe the section that covers the controversy should be placed at the end of the article. As I've said before the introduction does alert the reader to the controversy, so they have that in mind when they read the article. They need to develop an understanding of the condition, and the elements that are disputed, before they can truly understand the controversy.
I agree that the timeline belongs in the main DID article. Absentis 11:40, 15 August 2007 (UTC)
But the problem is that "understanding of the condition" is all POV opinions of one side, the pro-existence side, so any "understanding" that would come as a result of all that would by its nature be slanted. Once someone hears all the pro from the supporters of the concept for paragraphs and paragraphs and paragraphs it's way past the point where it should be discussed whether it's even real or not. This is not a case where only a few crackpots dispute its existence, it's a very widespread notion of well respected scholars (and in many cases the supporters are largely considered to be more on the crackpot end) and needs to be covered right away. Furthermore, it's simply impossible for an average reader to understand the condition with the level of academic detail and jargon in this article, so that's not even an issue. DreamGuy 13:21, 16 August 2007 (UTC)
Excuse ignorance; where can I take a look at this medical template, please? Bishonen | talk 13:28, 16 August 2007 (UTC).
WP:MEDMOS for the template. --CloudSurfer 13:43, 16 August 2007 (UTC)
Thanks. Bishonen | talk 13:46, 16 August 2007 (UTC).
DreamGuy, having recently contributed many of the academic references, I am concerned about your comment above. Could you please give some examples of "academic detail" and "jargon" that you feel make the article incomprehensible?--CloudSurfer 13:54, 16 August 2007 (UTC)
I... honestly wouldn't even know where to start. The average reader isn't going to be able to follow most of the article. The people who can follow the article should already know about DID. I'll see if I have time to dig through it all and explain, but I'd think it should be pretty obvious. Certainly you can remember a time when you first took Intro to Psych or the equivalent, would you have been able to follow this article then? DreamGuy 16:41, 18 August 2007 (UTC)

(Outdenting.) Wow, CloudSurfer, I think you have taken MEDMOS far too prescriptively there! No, the history section doesn't "need to be where it is in the medical template" — it's not even a template, in that sense. Look at this very reasonable introduction to the MEDMOS "Sections" section: "The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition. Do not discourage potential readers by placing a highly technical section near the start of your article." DID, whose very existence is disputed, clearly has very good reasons (enumerated by both you and DreamGuy above) for varying the suggested order of sections — a suggestion which is based on the "ordinary" kind of condition; on, as it might be, Influenza or Multiple Sclerosis. Please use your own judgment for what section order this article needs. Please be bolder. Bishonen | talk 14:01, 16 August 2007 (UTC).

I am pretty flex on the whole thing actually. I take DreamGuy's points as quite valid. Of course, the pro DID people want any discussion of the controversy buried at the back. A few days ago we had resolved to follow the MedMOS headings as a consensus and I was happy with that. But, as I say, I am pretty flex about it all. My view is that if we provide the reader with enough information in each of the sections then the conclusions will be obvious. Having now written the history section, I am wondering if it might actually be better up front to give the reader a background into this difficult topic.
One thing we don't seem to cover at present is that, whether you believe in the validity of DID or not, there are obviously many people out there who are living with DID. By that I mean, that there are thousands of people out there who demonstrate multiple personalities. Now, if you are an advocate of DID then you say they have always been there, or something like that. If you are a sceptic then you say that it is iatrogenic and that the media and clinicians have created it. Either way, they are out there (and drawn to this article and thus to edit it).--CloudSurfer 14:19, 16 August 2007 (UTC)
Oh, I see, I didn't know about the consensus, sorry. What a very... odd option to agree on, though. That's my opinion. Bishonen | talk 14:23, 16 August 2007 (UTC).
It was at the time an attempt to settle a heated argument that had resulted in an edit war and seemed reasonable at the time. The main antagonist has gone away for the moment. --CloudSurfer 20:34, 16 August 2007 (UTC)
I don't really think it's fair to call that a consensus, personally, as I certainly didn't explicitly agree to it, especially as I don't know what agreeing to do so would even entail. I'll judge what's good for this article based upon this article and not some outside standards that may or may not apply here. If they do apply just fine that that should happen naturally. DreamGuy 16:39, 18 August 2007 (UTC)
And as a P.S., treating this as a medical condition in itself is a quite POV view, so insisting upon a medical template seems like it would be counterproductive on the face of it. DreamGuy 16:46, 18 August 2007 (UTC)
According to WP:NPOV, explicit consent isn't necessary since 'silence gives consent'. If you'd like to know what we're talking about, you can read about it in the medical manual of style. Also, the diagnosis of DID was created by the American Psychiatric Association, the people that treat DID are usually psychiatrists (who get their education at medical school). Using the medical manual of style makes sense to me, and its certainly the most applicable of any MOS. Absentis 17:01, 18 August 2007 (UTC)
Er... I'm not sure who you're addressing there, who should go read MEDMOS to find out what you're talking about? If it's me, I appreciate the reference and the thought, but I already did. Do you see me quote and discuss MEDMOS above...? Bishonen | talk 19:53, 18 August 2007 (UTC).
I was addressing the person directly above me, DreamGuy. It was my understanding that placing a comment directly below another person (along with an extra ":"), along with addressing his specific comment, would make it pretty clear... I guess not. Absentis 20:15, 18 August 2007 (UTC)
Silence can give temporary consent, assuming it isn't completely at odds without something already discussed on the talk page, but people can stop being silent at any time. I am fully aware that psychiatrists have medical training, but psychiatric conditions are still quite a bit different from normal biological ailments and have different needs for coverage. Being the most applicable out of what's out there doesn't mean it's going to be right. Consensus typically requires a 2/3 majority or so, and with the objections already stated there simply isn't any at this time. I don't object with TRYING to use it where it fits, but agreeing to follow it to the letter is never a good thing if article needs outweigh the MOS on any MOS criteria. In fact, it's been my experience that lots of people writing MOS subpages are doing so with very little input from others and trying to impose personal preferences over lots of articles at once where individual page by page discussion certainly would not have agreed. DreamGuy 19:03, 18 August 2007 (UTC)
Alright, it sounds like we're in agreement on those points. Is the next step to identify the problem with a specific section, and then work on it? Absentis 20:15, 18 August 2007 (UTC)

Article status

Below are my personal views on the status of the current article. Have written some of the article, I feel a bit close to those sections to comment.

Introduction: The first paragraph gives a summary of the DSM-IV criteria which is given later under that heading. This seems excessive information for the introduction. The third paragraph mentions other disorders where dissociation occurs. This seems unnecessary in the introduction which is about DID, not dissociation.

Defining the controversy: Where is the citation to back up, "One of the primary reasons for the ongoing recategorization of this condition is that there were once so few documented cases (research in 1944 showed only 76[10]) of what was once referred to as multiple personality." Sure there is evidence that there has been a surge of cases but where is the evidence that this is the "the primary reasons for the ongoing recategorization"? The second sentence is fine (Dissociation is recognised …). The third sentence is goobledegook and the original source used to justify it does not mention this and in fact makes no mention of either DID or MPD.

The DSM re-dress: The first three sentences are fine. "The controversial nature of the dissociation hypothesis is shown quite clearly by the manner in which the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) has addressed, and re-dressed, the categorization over the years." Where are the citations to support this statement? It seems heavy handed and POV to me. There is citational support for a much less inflamatory reason for the name change from MPD to DID. The second paragraph is a simple documentation of what happened and is OK.

The MPD/DID epidemic in North America: Since I wrote this it is difficult to comment on it. There could be more put into this section.

Other positions: I am not happy with the clarity of, "Who should primarily define the experience, therapists, or those who believe that they have multiple personalities." Somehow the first comma seems inadequate to separate the ideas and make the sentence clear.

Defining the terms:

Dissociation: This is a wooly section and I believe it needs a total rewrite. I have started to look at references for this process.

Alter: Having written this, I am happy with it.

Symptoms: This is a huge list that could be grouped and some sense made of it all. However, the big question is, are these just an expression of the human condition rather than specific to DID? The sentence, " Again, doctors must be careful not to assume that a client has MPD or DID simply because they exhibit some or all of these symptoms. For example, someone may have severe PTSD and self mutilate with suicidal ideas, which are two of the symptoms listed above, but in order for DID to be diagnosed, there must be two or more distinctly present personalities." is mistargeted as the article is written for an encyclopaedia reader, not doctors. It also goes over a subject, diagnosis using the DSM criteria, which would be better addressed under that heading, if at all. The final paragraph is a restatement of the diagnostic criterion of amnesia but with more examples. If it is going to be mentioned then it needs to be introduced linked to the word "amnesia".

Causes/etiology: I believe this should be divided into a sceptic's view of causes and a believer's veiw of causes. Further down the paragraph, stats from "North American studies" are given with no citation! War is attributed as a major cause in some cultures. Which cultures and where's the citation? Much of this section is attributed to the Merck Manual. There are better sources of information! I believe it needs a total rewrite.

Diagnosis: I think this section is ok. The screening and diagnostic instruments section needs to have a caution put into it that the screens are based on the assumption of the validity of the diagnosis and do not, of themselves, validate the diagnosis. I have a reference for this statement.

Pathophysiology: Having written this, I think it's fine. J

Treatment/management: I have not delved into the literature on this to see if what is being said reflects current practices. However, it seem correct. The last paragraph appears to have been added by a totally different author and needs to be properly referrenced and some grammar fixed.

Prognosis: This section seems OK although a copyedit would be appropriate.

Prevention/screening: Again, having written it, I think it's fine.

Epidemiology: Having written it, I think it's fine, but perhaps it could have a narrative summary appended.

History: Having written this, I am largely happy with it, but I do wonder how accessible it is to the average encyclopaedia reader. The problem is, explaining it more would make it considerably larger unless some information, most of which I think is relevant, was discarded.

Social impact and Notable cases: These two are MEDMOS headings and there is nothing in either at present and the headings are not in the main article.

In popular culture: Not enough in here.

OK, that's my summary of the current article with some suggestions of what needs doing. --CloudSurfer 01:12, 19 August 2007 (UTC)

Defining the terms

I have replaced the following text:

Dissociation is defined as a complex mental process that provides a coping mechanism for individuals confronting painful and/or traumatic situations. It is characterized by a disintegration of the ego. Ego integration, or more properly ego (core personality) integrity, can be defined as a person's ability to successfully incorporate external events or social experiences into their perception, and to then present themselves consistently across those events or social situations. A person unable to do this successfully can experience emotional dysregulation[45], as well as a potential collapse of ego integrity. In other words, this state of emotional dysregulation is, in some cases, so intense that it can precipitate ego dis-integration, or what, in extreme cases, has come to be referred to diagnostically as dissociation.[46]

Dissociation describes a collapse in ego integrity so profound that the personality is considered to break apart.[citation needed] For this reason, dissocation is often referred to as splitting or altering. Less profound presentations of this condition are often referred to clinically as disorganization or decompensation. The difference between a psychotic break and a dissociation, or dissociative break, is that, while someone who is experiencing a dissociation is technically pulling away from a situation that he or she cannot manage, some part of the person remains connected to reality.[citation needed]

Because the person suffering a dissociation does not completely disengage from reality, she or he may appear to have multiple personalities to deal with different situations. When an alter cannot cope with stress, the consciousness of the person is believed to be given over to another personality to eliminate the trigger or pressure causing the stress.[47]

Dissociation is not sociopathic or compulsive. The biological stress caused by the original trauma is relieved by partially shunting the emotional response, which causes the reptilian complex to learn to dissociate reactively.[citation needed] This makes recovery from DID a matter of re-training the reptilian complex rather than a function of the more social neo-cortex.[dubious ] Because the trigger is biological stress rather than specific external events, the exact causes of later reactive dissociation are difficult to trace to events.

With:

Dissociation at its simplest means that "two or more mental processes or contents are not associated or integrated." This definition assumes that these elements should normally be associated or integrated in conscious awareness, memory, or identity.[48]

The DSM-IV characterizes dissociation as "disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment" while the ICD-10 defines it as "partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements."[49]

To dissociate is to sever the association of one thing from another. [50]

Multiple personalities occur when the identity of a person dissociates to the extent that they have separate existences with their own "identities, life histories, and enduring patterns of perceiving, thinking about and relating to the environment which is distinct from the habitual personality's mode of being in the world."[51]

Given that it is about definitions, I have moved it above the section on defining the controversy.--CloudSurfer 19:51, 19 August 2007 (UTC)

By the way, some of what I took out could easily go into "Etiology", which is where it really belongs. --CloudSurfer 05:11, 20 August 2007 (UTC)

History

The history section is now written and included in the main article. Given the quietness on these talk pages, and the fact that much of what is in the history section is a reporting of what happened, I have put it straight into the main article. --CloudSurfer 12:13, 16 August 2007 (UTC)

Edit war and request for comments

Note: The Request for Comments link on this page from http://en.wikipedia.org/wiki/Wikipedia:Requests_for_comment/Society%2C_sports%2C_law%2C_and_sex refers to section "Edit Warring," however it appears that the controversy which additional editors could comment on is really spread throughout the article or at least throughout the talk page. Would it be possible to collect all comments about controversial or disputed portions of the article, where third party RFC is sought, into a single section of the talk page? (Or one section per key point or theme or area in dispute?) It is quite confusing to try to figure out what items are still open as issues where existing editors would appreciate a third party perspective. It would also be very helpful for advocates of all sides to consider how to be concise, courteous, and assume good faith all around, when advocating for a particular perspective about DID to be included in the article. Thank you. VisitorTalk 09:00, 27 August 2007 (UTC)

After an edit war a little while ago, this page has settled down again and has been stable for a while. My summary of the events is that one editor, with a strong "pro DID" view came to the page with a lot of references and wanted to use them to justify the validity of the diagnosis. This led to reversions of his/her attempts to include these once they reached a point where they were biasing the article. I came along and offered to mediate. That led me to research the literature and use the references I found as a basis for rewriting several of the sections. I have intended to return to the sections that are still patchy but I have been busy over the last week. Various minor edits and the page's current stability would suggest that people are generally happy with it as being NPOV at present. --CloudSurfer 18:15, 27 August 2007 (UTC)


References

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Ambiguity in wording

The article states:

This condition is not an equivalent for schizophrenia (DSM-IV Schizophrenia and Other Psychotic Disorders), as is a common misconception. The term schizophrenia comes from root words for "split mind," but refers more to a fracture in the normal functioning of the brain, than the personality. It makes people think they are two or more different people

It (in bold) refers to DID, not schizophrenia? If so, that should be made clearer, the "It" replaced with the name of the condition. --Chriswaterguy talk 17:31, 27 October 2007 (UTC)