Multiple Personality disorder is now known as Dissociative Identity Disorder. Dissociative identity disorder is a severe form of dissociation, a mental process which produces a lack of connection in a person’s thoughts, memories, feelings, actions, or sense of identity. Dissociative identity disorder is thought to stem from a combination of factors that may include trauma experienced by the person with the disorder. The dissociative aspect is thought to be a coping mechanism — the person literally dissociates himself from a situation or experience that’s too violent, traumatic, or painful to assimilate with his conscious self. Dissociative identity disorder is characterized by the presence of two or more distinct or split identities or personality states that continually have power over the person’s behavior. With dissociative identity disorder, there’s also an inability to recall key personal information that is too far-reaching to be explained as mere forgetfulness. With dissociative identity disorder, there are also highly distinct memory variations, which fluctuate with the person’s split personality. Some symptoms of this are depression, mood swings, suicidal tendencies, sleep disorders (insomnia, night terrors, and sleep walking), anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or “triggers”), alcohol and drug abuse, compulsions and rituals, psychotic-like symptoms (including auditory and visual hallucinations), and eating disorders. Other symptoms of dissociative identity disorder may include headache, amnesia, time loss, trances, and “out of body experiences.” Some people with dissociative disorders have a tendency toward self-persecution, self-sabotage, and even violence (both self-inflicted and outwardly directed). As an example, someone with dissociative identity disorder may find themselves doing things they wouldn’t normally do, such as speeding, reckless driving, or stealing money from their employer or friend, yet they feel they are being compelled to do it. Some describe this feeling as being a passenger in their body rather than the driver. In other words, they truly believe they have no choice. The distinct personalities may serve diverse roles in helping the individual cope with life’s dilemmas. For instance, there’s an average of two to four personalities present when the patient is initially diagnosed. Then there’s an average of 13 to 15 personalities that can become known over the course of treatment. While unusual, there have been instances of dissociative identity disorder with more than 100 personalities. Environmental triggers or life events cause a sudden shift from one alter or personality to another. While the causes of dissociative identity disorder are still vague, research indicates that it is likely a psychological response to interpersonal and environmental stresses, particularly during early childhood years when emotional neglect or abuse may interfere with personality development. As many as 99% of individuals who develop dissociative disorders have recognized personal histories of recurring, overpowering, and often life-threatening disturbances at a sensitive developmental stage of childhood (usually before age 9). Dissociation may also happen when there has been persistent neglect or emotional abuse, even when there has been no overt physical or sexual abuse. Findings show that in families where parents are frightening and unpredictable, the children may become dissociative.
The DSM-5 provides the following criteria to diagnose dissociative identity disorder:
- Two or more distinct identities or personality states are present, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.
- Amnesia must occur, defined as gaps in the recall of everyday events, important personal information, and/or traumatic events.
- The person must be distressed by the disorder or have trouble functioning in one or more major life areas because of the disorder.
- The disturbance is not part of normal cultural or religious practices.
- The symptoms can not be due to the direct physiological effects of a substance (such as blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (such as complex partial seizures).