Dissociative identity disorder

Introduction Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder (MPD), is also known as dissociative personality disorder in some publications. It is a type of mental illness, a type of dissociation that is classified in the first axis in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Separate identity disorder is the result of a variety of factors: strong stress, separation of abilities (including unifying personal memory, perception and identity in consciousness), acquisition of defensive ability during growth, injury in childhood There is a lack of sympathy and soothing and a lack of ability to self-protect against noxious stimuli in the future.

Cause

Separate identity disorder is the result of a variety of factors: strong stress, separation of abilities (including unifying personal memory, perception and identity in consciousness), acquisition of defensive ability during growth, injury in childhood There is a lack of sympathy and soothing and a lack of ability to self-protect against noxious stimuli in the future. The unity of identity is not innate, it depends on the resources and experience of the day after tomorrow. In traumatic children, this development is blocked, and many of the qualities that should be combined in the same identity are still isolated. Studies in North America have shown that 97% to 98% of adult patients with isolated disorders report a history of childhood abuse, and in 85% of adult patients and 95% of children, adolescents with dissociative disorders and other similar forms of separation disorders, Verify that there is a history of abuse.

Although these data indicate that childhood abuse history is an important factor in the incidence of disease in North America (in some cultural contexts, wars and disasters play a more important role), this does not mean that all patients have a history of abuse, or The abuse experience reported by the patient did occur. Some descriptions of abuse experiences have proven to be inaccurate. At the same time, some patients without a history of abuse suffered major trauma in early childhood (such as the death of their parents), suffered from serious illness, or experienced major stress events. For example, a child with a disability who was hospitalized and operated many times in childhood, he had a clear history of trauma, but no history of abuse.

Individual development depends on the successful integration of complex information and experiences in childhood. When children gain a complex understanding of themselves and the people around them, they will successfully navigate through the different stages of separation of consciousness and emotion. Each developmental period produces a different self, and not everyone who has suffered childhood abuse and trauma develops into multiple personalities. Multiple personality patients are easily hypnotized, and this trait is closely related to the quality of separation, and it is considered to be one of the factors of separation disorders. Of course, the vast majority of children with these qualities still have normal adaptability and can not develop into separate identity disorders under the protection and comfort of adults.

an examination

Related inspection

Electroencephalogram examination

Diagnostic criteria

The diagnostic criteria for DID in the Diagnostic and Statistical Manual of Mental Disorder (DSM-1V) are as follows:

A. There are two or more different identities or personality states (each with its own relatively long-lasting perception, connection, and way of thinking about the environment and itself).

B. At least two identities or personality states repeatedly control the patient's behavior.

C. Cannot recall important personal information, the extent of which cannot be explained by the usual forgetfulness.

D. These disorders are not due to the direct physiological effects of the substance (eg, temporary loss of consciousness or chaotic behavior during alcoholism) or general medical conditions (such as complex partial seizures).

diagnosis

Diagnosis requires comprehensive physical and mental examinations, including special examinations of the separation phenomenon. Sometimes psychiatrists can use the method of prolonging conversation time, hypnosis, drug-induced hypnosis, or allowing patients to record different visitors, so that the patient changes personality during the examination. Specially developed questionnaires can also help identify isolated identity disorders.

Psychiatrists may also attempt to reach out and eliminate other personality by asking the patient to talk to a part of the consciousness that is either forgotten by the patient or experienced in a disintegrated or unrealistic way. Over.

Differential diagnosis

1, schizophrenic personality disorder: schizotypal disorder schizotypal disorder has schizophrenia-like thinking and emotional abnormalities and behavioral bizarre, but there is no typical schizophrenia disorder and exact onset, its evolution and disease course usually characterized by personality disorder . Same as: marginal schizophrenia, latent schizophrenia.

2. Paranoid personality disorder: Paranoid personality is also called delusional personality. It refers to a kind of abnormal personality with extremely stubborn stubbornness and stubbornness. It is manifested as excessive concern for yourself, self-evaluation is too high, and often causes frustration. Blame others or seduce objectively. It is one of 12 types of personality disorders in the 1980 Diagnostic Statistics Manual (DSM-III). According to the survey data, the number of people with paranoid personality disorder accounts for 5.8% of the total number of psychological disorders. Because such people are less self-aware, they have a negative attitude toward their partial implementation, and the actual situation may exceed this ratio.

3, impulsive personality disorder: also known as fulminant or aggressive personality disorder. It is a type of mental disorder that has a strong desire to perform certain behaviors and is put into practice. Because of its sudden type during episodes, similar to epilepsy, it is also called epilepsy personality. Such people tend to behave in childhood, often with tiny things and mental stimuli, and suddenly there is a strong violent act that can't control themselves, causing damage and harm to others. There are many forms of such disorders, including intermittent outbreaks, arson, stealing, plucking, and pathological gambling. There is no complete statistics on the prevalence in the population.

4. Obsessive-compulsive disorder: Obsessive-compulsive disorder is a type of neurological disorder characterized by repeated obsessions. The concept of obsession is a thought, representation or intention that repeatedly enters the field of patient consciousness in a rigid form. These thoughts, representations, or intentions are of no practical significance to the patient. They are unnecessary or redundant. The patient realizes that these are his own thoughts, and he wants to get rid of it, but he is powerless and therefore very distressed. Forced action is a repetitive stereotype or ritual action that is the result of a patient's succumbing to a forced mind to reduce inner anxiety.

5, performance personality disorder: Hisstrionic Personality Disorder (Histrionic Personality Disorder), also known as snoring type or seeking attention type personality disorder, is a personality disorder that is characterized by excessive emotional use or exaggeration of words and deeds to attract attention. People with performance personality disorder are often provocative in their behavior and they are very concerned about their appearance. These people are emotionally exposed, rich in expression, moods and sorrows are all in color, delicate and artificial, easy to lose temper, like other people's sympathy and compassion, emotional change and easy to be hinted. Self-centered, good communication and self-expression. Asking for more from others, not considering the interests of others. Superficial thinking, not accustomed to logical thinking, seem naive and childish. The incidence of women is about twice that of men.

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