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class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Traumagenic_model"> <div class="vector-toc-text"> 3.2 Traumagenic model </div> </a> <ul id="toc-Traumagenic_model-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Sociogenic_model" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Sociogenic_model"> <div class="vector-toc-text"> 3.3 Sociogenic model </div> </a> <ul id="toc-Sociogenic_model-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Children" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Children"> <div class="vector-toc-text"> 3.4 Children </div> </a> <ul id="toc-Children-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Pathophysiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Pathophysiology"> <div class="vector-toc-text"> 4 Pathophysiology </div> </a> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> 5 Diagnosis </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Diagnosis subsection </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-General_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#General_2"> <div class="vector-toc-text"> 5.1 General </div> </a> <ul id="toc-General_2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Differential_diagnoses" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Differential_diagnoses"> <div class="vector-toc-text"> 5.2 Differential diagnoses </div> </a> <ul id="toc-Differential_diagnoses-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Controversy_and_criticism_of_validity" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Controversy_and_criticism_of_validity"> <div class="vector-toc-text"> 6 Controversy and criticism of validity </div> </a> <ul id="toc-Controversy_and_criticism_of_validity-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> 7 Treatment </div> </a> <button aria-controls="toc-Treatment-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Treatment subsection </button> <ul id="toc-Treatment-sublist" class="vector-toc-list"> <li id="toc-Treatment_under_the_sociogenic_model" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Treatment_under_the_sociogenic_model"> <div class="vector-toc-text"> 7.1 Treatment under the sociogenic model </div> </a> <ul id="toc-Treatment_under_the_sociogenic_model-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatments_under_the_trauma_model" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Treatments_under_the_trauma_model"> <div class="vector-toc-text"> 7.2 Treatments under the trauma model </div> </a> <ul id="toc-Treatments_under_the_trauma_model-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> 8 Prognosis </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> 9 Epidemiology </div> </a> <button aria-controls="toc-Epidemiology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Epidemiology subsection </button> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> <li id="toc-General_3" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#General_3"> <div class="vector-toc-text"> 9.1 General </div> </a> <ul id="toc-General_3-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Historical_prevalence" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Historical_prevalence"> <div class="vector-toc-text"> 9.2 Historical prevalence </div> </a> <ul id="toc-Historical_prevalence-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-North_America" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#North_America"> <div class="vector-toc-text"> 9.3 North America </div> </a> <ul id="toc-North_America-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> 10 History </div> </a> <button aria-controls="toc-History-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle History subsection </button> <ul id="toc-History-sublist" class="vector-toc-list"> <li id="toc-Early_references" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Early_references"> <div class="vector-toc-text"> 10.1 Early references </div> </a> <ul id="toc-Early_references-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-20th_century" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#20th_century"> <div class="vector-toc-text"> 10.2 20th century </div> </a> <ul id="toc-20th_century-sublist" class="vector-toc-list"> <li id="toc-The_Three_Faces_of_Eve" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#The_Three_Faces_of_Eve"> <div class="vector-toc-text"> 10.2.1 The Three Faces of Eve </div> </a> <ul id="toc-The_Three_Faces_of_Eve-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-History_in_the_DSM" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#History_in_the_DSM"> <div class="vector-toc-text"> 10.3 History in the DSM </div> </a> <ul id="toc-History_in_the_DSM-sublist" class="vector-toc-list"> <li id="toc-Book_and_film_Sybil" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Book_and_film_Sybil"> <div class="vector-toc-text"> 10.3.1 Book and film Sybil </div> </a> <ul id="toc-Book_and_film_Sybil-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Re-classifications" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Re-classifications"> <div class="vector-toc-text"> 10.3.2 Re-classifications </div> </a> <ul id="toc-Re-classifications-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-21st_century" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#21st_century"> <div class="vector-toc-text"> 10.4 21st century </div> </a> <ul id="toc-21st_century-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> 11 Society and culture </div> </a> <button aria-controls="toc-Society_and_culture-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Society and culture subsection </button> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> <li id="toc-In_popular_culture" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#In_popular_culture"> <div class="vector-toc-text"> 11.1 In popular culture </div> </a> <ul id="toc-In_popular_culture-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Legal_issues" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Legal_issues"> <div class="vector-toc-text"> 11.2 Legal issues </div> </a> <ul id="toc-Legal_issues-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Online_subculture" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Online_subculture"> <div class="vector-toc-text"> 11.3 Online subculture </div> </a> <ul id="toc-Online_subculture-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Advocacy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Advocacy"> <div class="vector-toc-text"> 11.4 Advocacy </div> </a> <ul id="toc-Advocacy-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 12 References </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> 13 External links </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Dissociative identity disorder</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 56 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-56" aria-hidden="true" > 56 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A7%D8%B6%D8%B7%D8%B1%D8%A7%D8%A8_%D8%A7%D9%84%D9%87%D9%88%D9%8A%D8%A9_%D8%A7%D9%84%D8%AA%D9%81%D8%A7%D8%B1%D9%82%D9%8A" title="اضطراب الهوية التفارقي – Arabic" lang="ar" hreflang="ar" data-title="اضطراب الهوية التفارقي" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%DA%86%D9%88%D8%AE%D9%84%D9%88_%DA%A9%DB%8C%D9%85%D9%84%DB%8C%DA%A9_%D8%A8%D9%88%D8%B2%D9%88%DA%A9%D9%84%D9%88%DA%AF%D9%88" title="چوخلو کیملیک بوزوکلوگو – South Azerbaijani" lang="azb" hreflang="azb" data-title="چوخلو کیملیک بوزوکلوگو" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target">تۆرکجه</a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%AC%E0%A6%BF%E0%A6%9A%E0%A7%8D%E0%A6%9B%E0%A6%BF%E0%A6%A8%E0%A7%8D%E0%A6%A8%E0%A6%95%E0%A6%BE%E0%A6%B0%E0%A6%95_%E0%A6%AA%E0%A6%B0%E0%A6%BF%E0%A6%9A%E0%A6%AF%E0%A6%BC_%E0%A6%B0%E0%A7%8B%E0%A6%97" title="বিচ্ছিন্নকারক পরিচয় রোগ – Bangla" lang="bn" hreflang="bn" data-title="বিচ্ছিন্নকারক পরিচয় রোগ" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target">বাংলা</a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Disocijativni_poreme%C4%87aji" title="Disocijativni poremećaji – Bosnian" lang="bs" hreflang="bs" data-title="Disocijativni poremećaji" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target">Bosanski</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Trastorn_dissociatiu_de_la_identitat" title="Trastorn dissociatiu de la identitat – Catalan" lang="ca" hreflang="ca" data-title="Trastorn dissociatiu de la identitat" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Disociativn%C3%AD_porucha_identity" title="Disociativní porucha identity – Czech" lang="cs" hreflang="cs" data-title="Disociativní porucha identity" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Anhwylder_Hunaniaeth_Datgysylltiol" title="Anhwylder Hunaniaeth Datgysylltiol – Welsh" lang="cy" hreflang="cy" data-title="Anhwylder Hunaniaeth Datgysylltiol" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target">Cymraeg</a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Personlighedsspaltning" title="Personlighedsspaltning – Danish" lang="da" hreflang="da" data-title="Personlighedsspaltning" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Dissoziative_Identit%C3%A4tsst%C3%B6rung" title="Dissoziative Identitätsstörung – German" lang="de" hreflang="de" data-title="Dissoziative Identitätsstörung" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Dissotsiatiivne_identiteedih%C3%A4ire" title="Dissotsiatiivne identiteedihäire – Estonian" lang="et" hreflang="et" data-title="Dissotsiatiivne identiteedihäire" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target">Eesti</a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%94%CE%B9%CE%B1%CF%83%CF%87%CE%B9%CF%83%CF%84%CE%B9%CE%BA%CE%AE_%CE%B4%CE%B9%CE%B1%CF%84%CE%B1%CF%81%CE%B1%CF%87%CE%AE_%CF%84%CE%B1%CF%85%CF%84%CF%8C%CF%84%CE%B7%CF%84%CE%B1%CF%82" title="Διασχιστική διαταραχή ταυτότητας – Greek" lang="el" hreflang="el" data-title="Διασχιστική διαταραχή ταυτότητας" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target">Ελληνικά</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Trastorno_de_identidad_disociativo" title="Trastorno de identidad disociativo – Spanish" lang="es" hreflang="es" data-title="Trastorno de identidad disociativo" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Identitate_disoziatuaren_nahasmendu" title="Identitate disoziatuaren nahasmendu – Basque" lang="eu" hreflang="eu" data-title="Identitate disoziatuaren nahasmendu" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target">Euskara</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A7%D8%AE%D8%AA%D9%84%D8%A7%D9%84_%D8%AA%D8%AC%D8%B2%DB%8C%D9%87_%D9%87%D9%88%DB%8C%D8%AA" title="اختلال تجزیه هویت – Persian" lang="fa" hreflang="fa" data-title="اختلال تجزیه هویت" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Trouble_dissociatif_de_l%27identit%C3%A9" title="Trouble dissociatif de l'identité – French" lang="fr" hreflang="fr" data-title="Trouble dissociatif de l'identité" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%ED%95%B4%EB%A6%AC%EC%84%B1_%EC%A0%95%EC%B2%B4%EC%84%B1_%EC%9E%A5%EC%95%A0" title="해리성 정체성 장애 – Korean" lang="ko" hreflang="ko" data-title="해리성 정체성 장애" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B1%D5%B6%D5%B0%D5%A1%D5%BF%D5%A1%D5%AF%D5%A1%D5%B6%D5%B8%D6%82%D5%A9%D5%B5%D5%A1%D5%B6_%D5%A4%D5%AB%D5%BD%D5%B8%D6%81%D5%AB%D5%A1%D5%BF%D5%AB%D5%BE_%D5%AD%D5%A1%D5%B6%D5%A3%D5%A1%D6%80%D5%B8%D6%82%D5%B4" title="Անհատականության դիսոցիատիվ խանգարում – Armenian" lang="hy" hreflang="hy" data-title="Անհատականության դիսոցիատիվ խանգարում" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%AC%E0%A4%B9%E0%A5%81%E0%A4%B5%E0%A5%8D%E0%A4%AF%E0%A4%95%E0%A5%8D%E0%A4%A4%E0%A4%BF%E0%A4%A4%E0%A5%8D%E0%A4%B5_%E0%A4%B5%E0%A4%BF%E0%A4%95%E0%A4%BE%E0%A4%B0" title="बहुव्यक्तित्व विकार – Hindi" lang="hi" hreflang="hi" data-title="बहुव्यक्तित्व विकार" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target">हिन्दी</a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Disocijativni_poreme%C4%87aji_osobnosti" title="Disocijativni poremećaji osobnosti – Croatian" lang="hr" hreflang="hr" data-title="Disocijativni poremećaji osobnosti" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target">Hrvatski</a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Perturbo_di_disociiv_identeso" title="Perturbo di disociiv identeso – Ido" lang="io" hreflang="io" data-title="Perturbo di disociiv identeso" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target">Ido</a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Gangguan_identitas_disosiatif" title="Gangguan identitas disosiatif – Indonesian" lang="id" hreflang="id" data-title="Gangguan identitas disosiatif" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Disturbo_dissociativo_dell%27identit%C3%A0" title="Disturbo dissociativo dell'identità – Italian" lang="it" hreflang="it" data-title="Disturbo dissociativo dell'identità" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%94%D7%A4%D7%A8%D7%A2%D7%AA_%D7%96%D7%94%D7%95%D7%AA_%D7%93%D7%99%D7%A1%D7%95%D7%A6%D7%99%D7%90%D7%98%D7%99%D7%91%D7%99%D7%AA" title="הפרעת זהות דיסוציאטיבית – Hebrew" lang="he" hreflang="he" data-title="הפרעת זהות דיסוציאטיבית" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%98%E1%83%93%E1%83%94%E1%83%9C%E1%83%A2%E1%83%A3%E1%83%A0%E1%83%9D%E1%83%91%E1%83%98%E1%83%A1_%E1%83%93%E1%83%98%E1%83%A1%E1%83%9D%E1%83%AA%E1%83%98%E1%83%90%E1%83%AA%E1%83%98%E1%83%A3%E1%83%A0%E1%83%98_%E1%83%90%E1%83%A8%E1%83%9A%E1%83%98%E1%83%9A%E1%83%9D%E1%83%91%E1%83%90" title="იდენტურობის დისოციაციური აშლილობა – Georgian" lang="ka" hreflang="ka" data-title="იდენტურობის დისოციაციური აშლილობა" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target">ქართული</a></li><li class="interlanguage-link interwiki-rw mw-list-item"><a href="https://rw.wikipedia.org/wiki/Dissociative_identity_disorder_(DID)" title="Dissociative identity disorder (DID) – Kinyarwanda" lang="rw" hreflang="rw" data-title="Dissociative identity disorder (DID)" data-language-autonym="Ikinyarwanda" data-language-local-name="Kinyarwanda" class="interlanguage-link-target">Ikinyarwanda</a></li><li class="interlanguage-link interwiki-lb mw-list-item"><a href="https://lb.wikipedia.org/wiki/Dissoziativ_Pers%C3%A9inlechkeetsst%C3%A9ierung" title="Dissoziativ Perséinlechkeetsstéierung – Luxembourgish" lang="lb" hreflang="lb" data-title="Dissoziativ Perséinlechkeetsstéierung" data-language-autonym="Lëtzebuergesch" data-language-local-name="Luxembourgish" class="interlanguage-link-target">Lëtzebuergesch</a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Disociacinis_tapatyb%C4%97s_sutrikimas" title="Disociacinis tapatybės sutrikimas – Lithuanian" lang="lt" hreflang="lt" data-title="Disociacinis tapatybės sutrikimas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target">Lietuvių</a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Disszociat%C3%ADv_identit%C3%A1s" title="Disszociatív identitás – Hungarian" lang="hu" hreflang="hu" data-title="Disszociatív identitás" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target">Magyar</a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%B5%E0%B4%BF%E0%B4%AD%E0%B4%95%E0%B5%8D%E0%B4%A4%E0%B4%B5%E0%B5%8D%E0%B4%AF%E0%B4%95%E0%B5%8D%E0%B4%A4%E0%B4%BF%E0%B4%A4%E0%B5%8D%E0%B4%B5%E0%B4%82" title="വിഭക്തവ്യക്തിത്വം – Malayalam" lang="ml" hreflang="ml" data-title="വിഭക്തവ്യക്തിത്വം" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target">മലയാളം</a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%97%E0%A5%81%E0%A4%AA%E0%A5%8D%E0%A4%A4%E0%A4%B9%E0%A5%87%E0%A4%B0" title="गुप्तहेर – Marathi" lang="mr" hreflang="mr" data-title="गुप्तहेर" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target">मराठी</a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Kecelaruan_identiti_disosiatif" title="Kecelaruan identiti disosiatif – Malay" lang="ms" hreflang="ms" data-title="Kecelaruan identiti disosiatif" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target">Bahasa Melayu</a></li><li class="interlanguage-link interwiki-min mw-list-item"><a href="https://min.wikipedia.org/wiki/Palainan_kakobeh" title="Palainan kakobeh – Minangkabau" lang="min" hreflang="min" data-title="Palainan kakobeh" data-language-autonym="Minangkabau" data-language-local-name="Minangkabau" class="interlanguage-link-target">Minangkabau</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Dissociatieve_identiteitsstoornis" title="Dissociatieve identiteitsstoornis – Dutch" lang="nl" hreflang="nl" data-title="Dissociatieve identiteitsstoornis" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%A7%A3%E9%9B%A2%E6%80%A7%E5%90%8C%E4%B8%80%E6%80%A7%E9%9A%9C%E5%AE%B3" title="解離性同一性障害 – Japanese" lang="ja" hreflang="ja" data-title="解離性同一性障害" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Dissosiativ_identitetsforstyrrelse" title="Dissosiativ identitetsforstyrrelse – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Dissosiativ identitetsforstyrrelse" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%A1%E0%AC%BF%E0%AC%B8%E0%AD%8B%E0%AC%B8%E0%AC%BF%E0%AC%8F%E0%AC%9F%E0%AC%BF%E0%AC%AD_%E0%AC%86%E0%AC%87%E0%AC%A1%E0%AD%87%E0%AC%A3%E0%AD%8D%E0%AC%9F%E0%AC%BF%E0%AC%9F%E0%AC%BF_%E0%AC%A1%E0%AC%BF%E0%AC%9C%E0%AC%85%E0%AC%B0%E0%AD%8D%E0%AC%A1%E0%AC%B0" title="ଡିସୋସିଏଟିଭ ଆଇଡେଣ୍ଟିଟି ଡିଜଅର୍ଡର – Odia" lang="or" hreflang="or" data-title="ଡିସୋସିଏଟିଭ ଆଇଡେଣ୍ଟିଟି ଡିଜଅର୍ଡର" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target">ଓଡ଼ିଆ</a></li><li class="interlanguage-link interwiki-nds mw-list-item"><a href="https://nds.wikipedia.org/wiki/Dissoziative_Identit%C3%A4tsst%C3%B6ren" title="Dissoziative Identitätsstören – Low German" lang="nds" hreflang="nds" data-title="Dissoziative Identitätsstören" data-language-autonym="Plattdüütsch" data-language-local-name="Low German" class="interlanguage-link-target">Plattdüütsch</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Zaburzenie_dysocjacyjne_to%C5%BCsamo%C5%9Bci" title="Zaburzenie dysocjacyjne tożsamości – Polish" lang="pl" hreflang="pl" data-title="Zaburzenie dysocjacyjne tożsamości" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Transtorno_dissociativo_de_identidade" title="Transtorno dissociativo de identidade – Portuguese" lang="pt" hreflang="pt" data-title="Transtorno dissociativo de identidade" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Dedublarea_personalit%C4%83%C8%9Bii" title="Dedublarea personalității – Romanian" lang="ro" hreflang="ro" data-title="Dedublarea personalității" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target">Română</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%94%D0%B8%D1%81%D1%81%D0%BE%D1%86%D0%B8%D0%B0%D1%82%D0%B8%D0%B2%D0%BD%D0%BE%D0%B5_%D1%80%D0%B0%D1%81%D1%81%D1%82%D1%80%D0%BE%D0%B9%D1%81%D1%82%D0%B2%D0%BE_%D0%B8%D0%B4%D0%B5%D0%BD%D1%82%D0%B8%D1%87%D0%BD%D0%BE%D1%81%D1%82%D0%B8" title="Диссоциативное расстройство идентичности – Russian" lang="ru" hreflang="ru" data-title="Диссоциативное расстройство идентичности" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-scn mw-list-item"><a href="https://scn.wikipedia.org/wiki/Dis%C3%B2rdini_di_dintitati_dissuciata" title="Disòrdini di dintitati dissuciata – Sicilian" lang="scn" hreflang="scn" data-title="Disòrdini di dintitati dissuciata" data-language-autonym="Sicilianu" data-language-local-name="Sicilian" class="interlanguage-link-target">Sicilianu</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Dissociative_identity_disorder" title="Dissociative identity disorder – Simple English" lang="en-simple" hreflang="en-simple" data-title="Dissociative identity disorder" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Disociativna_motnja_identitete" title="Disociativna motnja identitete – Slovenian" lang="sl" hreflang="sl" data-title="Disociativna motnja identitete" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target">Slovenščina</a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Disocijativni_poreme%C4%87aj_identiteta" title="Disocijativni poremećaj identiteta – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Disocijativni poremećaj identiteta" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target">Srpskohrvatski / српскохрватски</a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Dissosiatiivinen_identiteettih%C3%A4iri%C3%B6" title="Dissosiatiivinen identiteettihäiriö – Finnish" lang="fi" hreflang="fi" data-title="Dissosiatiivinen identiteettihäiriö" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target">Suomi</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Dissociativ_identitetsst%C3%B6rning" title="Dissociativ identitetsstörning – Swedish" lang="sv" hreflang="sv" data-title="Dissociativ identitetsstörning" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Karamdaman_sa_di-sosyal_na_pagkakakilanlan" title="Karamdaman sa di-sosyal na pagkakakilanlan – Tagalog" lang="tl" hreflang="tl" data-title="Karamdaman sa di-sosyal na pagkakakilanlan" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target">Tagalog</a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%AA%E0%AE%B2%E0%AF%8D%E0%AE%B5%E0%AE%95%E0%AF%88_%E0%AE%86%E0%AE%B3%E0%AF%81%E0%AE%AE%E0%AF%88_%E0%AE%A8%E0%AF%8B%E0%AE%AF%E0%AF%8D" title="பல்வகை ஆளுமை நோய் – Tamil" lang="ta" hreflang="ta" data-title="பல்வகை ஆளுமை நோய்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target">தமிழ்</a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%AE%E0%B0%B2%E0%B1%8D%E0%B0%9F%E0%B0%BF%E0%B0%AA%E0%B1%81%E0%B0%B2%E0%B1%8D_%E0%B0%AA%E0%B0%B0%E0%B1%8D%E0%B0%B8%E0%B0%A8%E0%B0%BE%E0%B0%B2%E0%B0%BF%E0%B0%9F%E0%B1%80_%E0%B0%A1%E0%B0%BF%E0%B0%9C%E0%B0%BE%E0%B0%B0%E0%B1%8D%E0%B0%A1%E0%B0%B0%E0%B1%8D" title="మల్టిపుల్ పర్సనాలిటీ డిజార్డర్ – Telugu" lang="te" hreflang="te" data-title="మల్టిపుల్ పర్సనాలిటీ డిజార్డర్" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target">తెలుగు</a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Disosiyatif_kimlik_bozuklu%C4%9Fu" title="Disosiyatif kimlik bozukluğu – Turkish" lang="tr" hreflang="tr" data-title="Disosiyatif kimlik bozukluğu" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target">Türkçe</a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%94%D0%B8%D1%81%D0%BE%D1%86%D1%96%D0%B0%D1%82%D0%B8%D0%B2%D0%BD%D0%B8%D0%B9_%D1%80%D0%BE%D0%B7%D0%BB%D0%B0%D0%B4_%D1%96%D0%B4%D0%B5%D0%BD%D1%82%D0%B8%D1%87%D0%BD%D0%BE%D1%81%D1%82%D1%96" title="Дисоціативний розлад ідентичності – Ukrainian" lang="uk" hreflang="uk" data-title="Дисоціативний розлад ідентичності" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target">Українська</a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%D8%AA%D9%81%D8%A7%D8%B1%D9%82%DB%8C_%D8%B4%D9%86%D8%A7%D8%AE%D8%AA%DB%8C_%D8%A7%D8%B6%D8%B7%D8%B1%D8%A7%D8%A8" title="تفارقی شناختی اضطراب – Urdu" lang="ur" hreflang="ur" data-title="تفارقی شناختی اضطراب" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target">اردو</a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/R%E1%BB%91i_lo%E1%BA%A1n_%C4%91a_nh%C3%A2n_c%C3%A1ch" title="Rối loạn đa nhân cách – Vietnamese" lang="vi" hreflang="vi" data-title="Rối loạn đa nhân cách" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target">Tiếng Việt</a></li><li class="interlanguage-link interwiki-zh-yue mw-list-item"><a href="https://zh-yue.wikipedia.org/wiki/%E8%A7%A3%E9%9B%A2%E6%80%A7%E8%BA%AB%E4%BB%BD%E9%9A%9C%E7%A4%99" title="解離性身份障礙 – Cantonese" lang="yue" hreflang="yue" data-title="解離性身份障礙" data-language-autonym="粵語" data-language-local-name="Cantonese" class="interlanguage-link-target">粵語</a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E8%A7%A3%E9%9B%A2%E6%80%A7%E8%BA%AB%E5%88%86%E7%96%BE%E6%82%A3" title="解離性身分疾患 – Chinese" lang="zh" hreflang="zh" data-title="解離性身分疾患" data-language-autonym="中文" data-language-local-name="Chinese" 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searchaux" style="display:none">Mental illness with multiple personality states</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">"DID" and "Split personality" redirect here. For other uses, see <a href="/wiki/DID_(disambiguation)" class="mw-disambig" title="DID (disambiguation)">DID (disambiguation)</a> and <a href="/wiki/Split_Personality_(disambiguation)" class="mw-redirect mw-disambig" title="Split Personality (disambiguation)">Split Personality</a>. For the psychological experience, see <a href="/wiki/Dissociation_(psychology)" title="Dissociation (psychology)">Dissociation (psychology)</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Dissociative identity disorder</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Multiple personality disorder Split personality disorder </td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Psychiatry" title="Psychiatry">Psychiatry</a>, <a href="/wiki/Clinical_psychology" title="Clinical psychology">clinical psychology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">At least two distinct and relatively enduring <a href="/wiki/Personality" title="Personality">personality states</a>,<a href="#cite_note-DSM5-1">[1]</a> recurrent episodes of <a href="/wiki/Dissociative_amnesia" title="Dissociative amnesia">dissociative amnesia</a>,<a href="#cite_note-DSM5-1">[1]</a> inexplicable intrusions into consciousness (e.g., voices, intrusive thoughts, impulses, trauma-related beliefs),<a href="#cite_note-DSM5-1">[1]</a><a href="#cite_note-2">[2]</a> alterations in sense of self,<a href="#cite_note-DSM5-1">[1]</a> <a href="/wiki/Depersonalization" title="Depersonalization">depersonalization</a> and <a href="/wiki/Derealization" title="Derealization">derealization</a>,<a href="#cite_note-DSM5-1">[1]</a> intermittent functional neurological symptoms.<a href="#cite_note-DSM5-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data">Trauma and shame-based beliefs, <a href="/wiki/Fugue_state" class="mw-redirect" title="Fugue state">dissociative fugue</a>, <a href="/wiki/Eating_disorders" class="mw-redirect" title="Eating disorders">eating disorders</a>, <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a>, <a href="/wiki/Sleep_disturbances" class="mw-redirect" title="Sleep disturbances">sleep disturbances</a> (eg. <a href="/wiki/Sleep_terrors" class="mw-redirect" title="Sleep terrors">sleep terrors</a>, nightmares, sleepwalking, insomnia, <a href="/wiki/Hypersomnia" title="Hypersomnia">hypersomnia</a>), <a href="/wiki/Suicide" title="Suicide">suicidality</a>, <a href="/wiki/Self-harm" title="Self-harm">self-harm</a></td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">Long-term<a href="#cite_note-Mer2019Pro-3">[3]</a></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data">Disputed</td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Patient_education" title="Patient education">Patient education</a>,<a href="#cite_note-Mitra_Jain_DID_StatPearls-4">[4]</a> <a href="/wiki/Peer_support" title="Peer support">peer support</a>,<a href="#cite_note-Mitra_Jain_DID_StatPearls-4">[4]</a> Safety planning,<a href="#cite_note-Mitra_Jain_DID_StatPearls-4">[4]</a> grounding techniques,<a href="#cite_note-Mitra_Jain_DID_StatPearls-4">[4]</a> <a href="/wiki/Supportive_care" class="mw-redirect" title="Supportive care">supportive care</a>, <a href="/wiki/Psychotherapy" title="Psychotherapy">psychotherapy</a><a href="#cite_note-Mer2019Pro-3">[3]</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">1.1–1.5% lifetime prevalence in the general population<a href="#cite_note-DSM5-1">[1]</a><a href="#cite_note-Guidelines2011-5">[5]</a></td></tr></tbody></table> Dissociative identity disorder (DID), previously known as multiple personality disorder (MPD), is characterized by the presence of at least two distinct and relatively enduring <a href="/wiki/Personality" title="Personality">personality states</a>. It has a history of extreme controversy.<a href="#cite_note-6">[6]</a><a href="#cite_note-pmid15503730-7">[7]</a><a href="#cite_note-pmid15560314-8">[8]</a> The disorder is accompanied by <a href="/wiki/Dissociative_amnesia" title="Dissociative amnesia">memory gaps</a> more severe than could be explained by ordinary forgetfulness.<a href="#cite_note-DSM5-1">[1]</a><a href="#cite_note-Hersen2014-9">[9]</a> According to the DSM-5-TR, early childhood trauma, typically starting before 5–6 years of age, places someone at risk of developing dissociative identity disorder.<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a><a href="#cite_note-11">[11]</a>(p334) Across diverse geographic regions, 90% of people diagnosed with dissociative identity disorder report experiencing multiple forms of <a href="/wiki/Child_abuse" title="Child abuse">childhood abuse</a>, such as rape, violence, neglect, or severe bullying.<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p334) Other traumatic childhood experiences that have been reported include painful medical and surgical procedures,<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p334)<a href="#cite_note-Dissociative-Identity-Disorder-12">[12]</a> war,<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p334) terrorism,<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p334) <a href="/wiki/Attachment_disorder" title="Attachment disorder">attachment disturbance</a>,<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p334) natural disaster, <a href="/wiki/Cult" title="Cult">cult</a> and <a href="/wiki/Occult" title="Occult">occult</a> abuse,<a href="#cite_note-sciencedirect.com-13">[13]</a> loss of a loved one or loved ones,<a href="#cite_note-Dissociative-Identity-Disorder-12">[12]</a> <a href="/wiki/Human_trafficking" title="Human trafficking">human trafficking</a>,<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p334)<a href="#cite_note-sciencedirect.com-13">[13]</a> and dysfunctional family dynamics.<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p334)<a href="#cite_note-Vedat-14">[14]</a> There is no medication to treat DID directly, but <a href="/wiki/Psychiatric_medication" title="Psychiatric medication">medications</a> can be used for <a href="/wiki/Comorbidity" title="Comorbidity">comorbid</a> disorders or targeted symptom relief—for example, <a href="/wiki/Antidepressant" title="Antidepressant">antidepressants</a> for anxiety and depression or sedative-hypnotics to improve sleep.<a href="#cite_note-Guidelines2011-5">[5]</a><a href="#cite_note-MacDonald-15">[15]</a> Treatment generally involves <a href="/wiki/Supportive_care" class="mw-redirect" title="Supportive care">supportive care</a> and <a href="/wiki/Psychotherapy" title="Psychotherapy">psychotherapy</a>.<a href="#cite_note-Mer2019Pro-3">[3]</a> The condition generally does not remit without treatment, and many patients have a lifelong course.<a href="#cite_note-Mer2019Pro-3">[3]</a><a href="#cite_note-Brand2014-16">[16]</a> Lifetime prevalence was found to be 1.1–1.5% of the general population (based on multiple epidemiological studies) and 3.9% of those admitted to psychiatric hospitals in Europe and North America.<a href="#cite_note-DSM5-1">[1]</a><a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p334)<a href="#cite_note-Guidelines2011-5">[5]</a> DID is diagnosed 6–9 times more often in women than in men.<a href="#cite_note-Hersen2014-9">[9]</a> The number of recorded cases increased significantly in the latter half of the 20th century, along with the number of identities reported by those affected, but it is unclear whether increased rates of diagnosis are due to better recognition or to sociocultural factors such as <a href="/wiki/Mass_media" title="Mass media">mass media</a> portrayals.<a href="#cite_note-Hersen2014-9">[9]</a> The typical presenting symptoms in different regions of the world may also vary depending on culture, such as alter identities taking the form of possessing spirits, deities, ghosts, or mythical creatures in cultures where possession states are normative.<a href="#cite_note-DSM5-1">[1]</a><a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p335) <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Definitions">Definitions</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=1" title="Edit section: Definitions">edit</a>]</div> Critics argue that <a href="/wiki/Dissociation_(psychology)" title="Dissociation (psychology)">dissociation</a>, the term that underlies <a href="/wiki/Dissociative_disorder" title="Dissociative disorder">dissociative disorders</a>, lacks a precise, empirical, and generally agreed upon definition.<a href="#cite_note-Hersen2012-17">[17]</a><a href="#cite_note-Nijenhuis-2011-18">[18]</a><a href="#cite_note-Wiley-2008-19">[19]</a>(p9) Many diverse experiences have been termed dissociative, ranging from normal failures in attention to the breakdowns in memory processes characterized by the dissociative disorders.<a href="#cite_note-Nijenhuis-2011-18">[18]</a><a href="#cite_note-Wiley-2008-19">[19]</a>(pp19–21) It is therefore unknown whether there is a commonality among all dissociative experiences, or whether the range of mild to severe symptoms is a result of different etiologies and biological structures.<a href="#cite_note-Hersen2012-17">[17]</a> Other terms used in the literature, including <a href="/wiki/Personality" title="Personality">personality</a>, personality state, <a href="/wiki/Identity_(social_science)" title="Identity (social science)">identity</a>, ego state, and <a href="/wiki/Amnesia" title="Amnesia">amnesia</a>, also lack agreed upon definitions.<a href="#cite_note-Kihlstrom-20">[20]</a><a href="#cite_note-pmid15560314-8">[8]</a> Multiple competing models exist that incorporate some non-dissociative symptoms while excluding dissociative ones.<a href="#cite_note-Kihlstrom-20">[20]</a> Due to the lack of consensus about terminology in the study of DID, several terms have been proposed. One is <a href="/wiki/Alter_ego" title="Alter ego">ego state</a> (behaviors and experiences possessing permeable boundaries with other such states but united by a common sense of self). Another is <a href="/wiki/Alter_ego" title="Alter ego">alters</a> (each of which may have a separate <a href="/wiki/Autobiographical_memory" title="Autobiographical memory">autobiographical memory</a>, independent initiative and a sense of ownership over individual behavior).<a href="#cite_note-Gillig-21">[21]</a><a href="#cite_note-Rieger-22">[22]</a> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=2" title="Edit section: Signs and symptoms">edit</a>]</div> The full presentation of dissociative identity disorder can onset at any age,<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a> although symptoms typically begin by ages 5–10.<a href="#cite_note-Gillig-21">[21]</a> DID is generally a childhood-onset disorder. According to the fifth edition [text revision] of the <a href="/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders" title="Diagnostic and Statistical Manual of Mental Disorders">Diagnostic and Statistical Manual of Mental Disorders</a> (DSM-5-TR), symptoms of DID include "the presence of two or more distinct personality states" accompanied by the inability to recall personal information beyond what is expected through normal memory issues. Other DSM-5 symptoms include a loss of identity as related to individual distinct personality states, loss of one's subjective experience of the passage of time, and degradation of a sense of self and consciousness.<a href="#cite_note-dsm-23">[23]</a> In each individual, the clinical presentation varies and the level of functioning can change from severe impairment to minimal impairment.<a href="#cite_note-Cardena-24">[24]</a><a href="#cite_note-Mer2019Pro-3">[3]</a> The symptoms of <a href="/wiki/Dissociative_amnesia" title="Dissociative amnesia">dissociative amnesia</a> are subsumed under a DID diagnosis, and thus should not be diagnosed separately if DID criteria are met.<a href="#cite_note-DSM5-1">[1]</a> Individuals with DID may experience distress from both the symptoms of DID (hearing voices, intrusive thoughts/emotions/impulses) and the consequences of the accompanying symptoms (inability to remember specific information or periods of time).<a href="#cite_note-Spiegel-25">[25]</a> The large majority of patients with DID report repeated childhood <a href="/wiki/Sexual_abuse" title="Sexual abuse">sexual</a> and/or <a href="/wiki/Physical_abuse" title="Physical abuse">physical abuse</a>, usually by caregivers as well as organized abuse.<a href="#cite_note-APA2008-26">[26]</a><a href="#cite_note-27">[27]</a> Amnesia between identities may be asymmetrical; identities may or may not be aware of what is known by another.<a href="#cite_note-Mer2019Pro-3">[3]</a> Individuals with DID may be reluctant to discuss symptoms due to associations with abuse, shame, and fear.<a href="#cite_note-APA2008-26">[26]</a> Around half of people with DID have fewer than 10 identities and most have fewer than 100; although as many as 4,500 have been reported by Richard Kluft in 1988.<a href="#cite_note-Hersen2012-17">[17]</a>(p 503) The average number of identities has increased over the past few decades, from two or three to now an average of approximately 16. However, it is unclear whether this is due to an actual increase in identities, or simply that the psychiatric community has become more accepting of a high number of compartmentalized memory components.<a href="#cite_note-Hersen2012-17">[17]</a>[<a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">failed verification</a>] <div class="mw-heading mw-heading3"><h3 id="Comorbid_disorders">Comorbid disorders</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=3" title="Edit section: Comorbid disorders">edit</a>]</div> The <a href="/wiki/Psychiatric_history" title="Psychiatric history">psychiatric history</a> frequently contains multiple previous diagnoses of various disorders and <a href="/wiki/Therapy" title="Therapy">treatment</a> failures.<a href="#cite_note-webmd-28">[28]</a> The most common presenting complaint of DID is <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a> (90%) that is often treatment-resistant, with <a href="/wiki/Headache" title="Headache">headaches</a> and non-epileptic seizures being common neurologic symptoms. Comorbid disorders include <a href="/wiki/Post-traumatic_stress_disorder" title="Post-traumatic stress disorder">post-traumatic stress disorder</a> (PTSD), <a href="/wiki/Substance_use_disorder" title="Substance use disorder">substance use disorders</a>, <a href="/wiki/Eating_disorder" title="Eating disorder">eating disorders</a>, <a href="/wiki/Anxiety_disorder" title="Anxiety disorder">anxiety disorders</a>, <a href="/wiki/Personality_disorders" class="mw-redirect" title="Personality disorders">personality disorders</a>, and <a href="/wiki/Autism_spectrum" class="mw-redirect" title="Autism spectrum">autism spectrum disorder</a>.<a href="#cite_note-Dorahy2014-29">[29]</a><a href="#cite_note-30">[30]</a><a href="#cite_note-31">[31]</a><a href="#cite_note-32">[32]</a> 30-70% of those diagnosed with DID have history of <a href="/wiki/Borderline_personality_disorder" title="Borderline personality disorder">borderline personality disorder</a>.<a href="#cite_note-Shadows-33">[33]</a> Presentations of dissociation in people with <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a> differ from those with DID as not being rooted in trauma, and this distinction can be effectively tested, although both conditions share a high rate of auditory hallucinations in the form of voices.<a href="#cite_note-34">[34]</a><a href="#cite_note-pmid18652789-35">[35]</a> Other disorders that have been found to be comorbid with DID are somatization disorders, <a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">major depressive disorder</a>, as well as history of a past suicide attempt, in comparison to those without a DID diagnosis.<a href="#cite_note-36">[36]</a> 70-75% of DID patients attempt suicide, and multiple attempts are common. Disturbed and altered <a href="/wiki/Sleep" title="Sleep">sleep</a> has also been suggested as having a role in dissociative disorders in general and specifically in DID, alterations in environments also largely affecting the DID patient.<a href="#cite_note-Kloet2012-37">[37]</a> Individuals diagnosed with DID demonstrate the highest <a href="/wiki/Hypnosis" title="Hypnosis">hypnotizability</a> of any clinical population.<a href="#cite_note-Spiegel-25">[25]</a> Although DID has high comorbidity and its development is related to trauma, abundant empirical evidence suggests that DID is a separate condition from other disorders like PTSD.<a href="#cite_note-38">[38]</a> <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=4" title="Edit section: Causes">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="General">General</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=5" title="Edit section: General">edit</a>]</div> There are two competing theories on what causes dissociative identity disorder to develop. The trauma-related model suggests that complex trauma or severe adversity in childhood, also known as developmental trauma, increases the risk of someone developing dissociative identity disorder.<a href="#cite_note-Blihar-39">[39]</a><a href="#cite_note-Dalenberg-2012-40">[40]</a><a href="#cite_note-Vissia-2016-41">[41]</a> The non-trauma related model, also referred to as the sociogenic or fantasy model, suggests that dissociative identity disorder is developed through high fantasy-proneness or suggestibility, roleplaying, or sociocultural influences.<a href="#cite_note-Blihar-39">[39]</a><a href="#cite_note-Dalenberg-2012-40">[40]</a><a href="#cite_note-Vissia-2016-41">[41]</a> The DSM-5-TR states that "early life trauma (e.g., neglect and physical, sexual, and emotional abuse, usually before ages 5-6 years) represents a major risk factor for dissociative identity disorder."<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p333) Other risk factors reported include painful medical procedures, war, terrorism, or being trafficked in childhood.<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p333) Dissociative disorders frequently occur after trauma, and the DSM-5-TR places them after the chapter on trauma- and stressor-related disorders to reflect this close relationship between complex trauma and dissociation.<a href="#cite_note-American-Psychiatric-Association-2022-10">[10]</a>(p329) <div class="mw-heading mw-heading3"><h3 id="Traumagenic_model">Traumagenic model</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=6" title="Edit section: Traumagenic model">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Trauma_model_of_mental_disorders" title="Trauma model of mental disorders">Trauma model of mental disorders</a></div> Dissociative identity disorder is often conceptualized as "the most severe form of a childhood-onset post-traumatic stress disorder."<a href="#cite_note-Blihar-39">[39]</a> According to many researchers, the etiology of dissociative identity is multifactorial, involving a complex interaction between developmental trauma, sociocultural influences, and biological factors.<a href="#cite_note-Dorahy-42">[42]</a><a href="#cite_note-Blihar-39">[39]</a><a href="#cite_note-Vedat-14">[14]</a> People diagnosed with dissociative identity disorder often report that they have experienced <a href="/wiki/Physical_abuse" title="Physical abuse">physical</a> or <a href="/wiki/Sexual_abuse" title="Sexual abuse">sexual abuse</a> during childhood<a href="#cite_note-Mer2019Pro-3">[3]</a> (although the accuracy of these reports has been disputed<a href="#cite_note-dsm-23">[23]</a>); others report overwhelming stress, serious medical illness, or other traumatic events during childhood.<a href="#cite_note-Mer2019Pro-3">[3]</a> They also report more historical psychological trauma than those diagnosed with any other mental illness.<a href="#cite_note-Sar2011-43">[43]</a><a href="#cite_note-44">[a]</a> Severe sexual, physical, or psychological trauma in childhood has been proposed as an explanation for its development; awareness, memories, and emotions of harmful actions or events caused by the trauma are sequestered away from consciousness, and alternate parts form with differing memories, emotions, beliefs, temperament and behavior.<a href="#cite_note-45">[44]</a> Dissociative identity disorder is also attributed to extremes of <a href="/wiki/Stress_(psychological)" class="mw-redirect" title="Stress (psychological)">stress</a> and disturbances of <a href="/wiki/Attachment_theory" title="Attachment theory">attachment</a> to caregivers in early life. What may result in complex post-traumatic stress disorder (PTSD) in adults may become dissociative identity disorder when occurring in children, possibly due to their greater use of <a href="/wiki/Imagination" title="Imagination">imagination</a> as a form of <a href="/wiki/Coping_(psychology)" class="mw-redirect" title="Coping (psychology)">coping</a> as well as lack of developmental integration in childhood.<a href="#cite_note-Spiegel-25">[25]</a> Possibly due to developmental changes and a more coherent sense of self past age 6-9 years, the experience of extreme trauma may result in different, though also complex, dissociative symptoms, identity disturbances and trauma-related disorders.<a href="#cite_note-Spiegel-25">[25]</a> Relationships between childhood abuse, <a href="/wiki/Disorganized_attachment" class="mw-redirect" title="Disorganized attachment">disorganized attachment</a>, and lack of social support are thought to be common risk factors leading to dissociative identity disorder.<a href="#cite_note-Gillig-21">[21]</a> Although the role of a child's biological capacity to dissociate remains unclear, some evidence indicates a neurobiological impact of developmental stress. Moreover, children are universally born un-integrated.<a href="#cite_note-Vedat-14">[14]</a> Delinking early trauma from the <a href="/wiki/Etiology" title="Etiology">etiology</a> of dissociation has been explicitly rejected by those supporting the early trauma model. However, a 2012 review article supports the hypothesis that current or recent trauma may affect an individual's assessment of the more distant past, changing the experience of the past and resulting in dissociative states.<a href="#cite_note-pmid22423434-46">[45]</a> Giesbrecht et al. have suggested there is no actual <a href="/wiki/Empirical_research" title="Empirical research">empirical evidence</a> linking early trauma to dissociation, and instead suggest that problems with <a href="/wiki/Neuropsychology" title="Neuropsychology">neuropsychological functioning</a>, such as increased distractibility in response to certain emotions and contexts, account for dissociative features.<a href="#cite_note-pmid18729565-47">[46]</a> A middle position hypothesizes that trauma, in some situations, alters neuronal mechanisms related to memory. Evidence is increasing that dissociative disorders are related both to a trauma history and to "specific neural mechanisms".<a href="#cite_note-Spiegel-25">[25]</a> It has also been suggested that there may be a genuine but more modest link between trauma and dissociative identity disorder, with early trauma causing increased <a href="/wiki/Fantasy_(psychology)" title="Fantasy (psychology)">fantasy</a>-proneness, which may in turn render individuals more vulnerable to socio-cognitive influences surrounding the development of dissociative identity disorder.<a href="#cite_note-Lynn2012-48">[47]</a> Another suggestion made by Hart indicates that there are triggers in the brain that can be the catalyst for different self-states, and that victims of trauma are more susceptible to these triggers than non-victims of trauma; these triggers are said to be related to dissociative identity disorder.<a href="#cite_note-49">[48]</a> Paris states that the trauma model of dissociative identity disorder increased the appeal of the diagnosis among health care providers, patients and the public as it validated the idea that child abuse had lifelong, serious effects. Paris asserts that there is very little experimental evidence supporting the trauma-dissociation hypothesis, and no research showing that dissociation consistently links to long-term memory disruption.<a href="#cite_note-Paris2012-50">[49]</a> Neuroimaging studies have reported a consistently smaller volume of the <a href="/wiki/Hippocampus" title="Hippocampus">hippocampus</a> in DID patients, supporting the trauma model.<a href="#cite_note-Shadows-33">[33]</a><a href="#cite_note-Blihar-39">[39]</a> <div class="mw-heading mw-heading3"><h3 id="Sociogenic_model">Sociogenic model</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=7" title="Edit section: Sociogenic model">edit</a>]</div> Symptoms of dissociative identity disorder may be created by therapists using <a href="/wiki/Recovered-memory_therapy" title="Recovered-memory therapy">techniques to "recover" memories</a> (such as the use of <a href="/wiki/Hypnosis" title="Hypnosis">hypnosis</a> to "access" alter identities, facilitate <a href="/wiki/Age_regression_in_therapy" title="Age regression in therapy">age regression</a> or retrieve memories) on suggestible individuals.<a href="#cite_note-pmid15503730-7">[7]</a><a href="#cite_note-pmid15560314-8">[8]</a><a href="#cite_note-Cardena-24">[24]</a><a href="#cite_note-Boysen-51">[50]</a><a href="#cite_note-Blackwell-52">[51]</a> Referred to as the non-trauma-related model, or the sociocognitive model or fantasy model, it proposes that dissociative identity disorder is due to a person consciously or unconsciously behaving in certain ways promoted by cultural stereotypes,<a href="#cite_note-Boysen-51">[50]</a> with unwitting therapists providing cues through improper therapeutic techniques. This model posits that behavior is enhanced by media portrayals of dissociative identity disorder.<a href="#cite_note-Lynn2012-48">[47]</a> Proponents of the non-trauma-related model note that the dissociative symptoms are rarely present before intensive therapy by specialists in the treatment of dissociative identity disorder who, through the process of eliciting, conversing with, and identifying alters, shape or possibly create the diagnosis.<a href="#cite_note-53">[52]</a> While proponents note that dissociative identity disorder is accompanied by genuine suffering and the distressing symptoms, and can be diagnosed reliably using the DSM criteria, they are skeptical of the trauma-related etiology suggested by proponents of the trauma-related model.<a href="#cite_note-McNally2005-54">[53]</a> Proponents of non-trauma-related dissociative identity disorder are concerned about the possibility of hypnotizability, suggestibility, frequent fantasization and mental absorption predisposing individuals to dissociation.<a href="#cite_note-MacDonald-15">[15]</a> They note that a small subset of doctors are responsible for diagnosing the majority of individuals with dissociative identity disorder.<a href="#cite_note-Blackwell_neurology-55">[54]</a><a href="#cite_note-pmid15560314-8">[8]</a><a href="#cite_note-Paris2012-50">[49]</a> Psychologist <a href="/wiki/Nicholas_Spanos" title="Nicholas Spanos">Nicholas Spanos</a> and others have suggested that in addition to therapy-caused cases, dissociative identity disorder may be the result of <a href="/wiki/Role-playing" title="Role-playing">role-playing</a>, though others disagree, pointing to a lack of incentive to manufacture or maintain separate identities and point to the claimed histories of abuse.<a href="#cite_note-56">[55]</a> Other arguments that therapy can cause dissociative identity disorder include the lack of children diagnosed with DID, the sudden spike in <a href="/wiki/Incidence_(epidemiology)" title="Incidence (epidemiology)">rates of diagnosis</a> after 1980 (although dissociative identity disorder was not a diagnosis until DSM-IV, published in 1994), the absence of evidence of increased rates of child abuse, the appearance of the disorder almost exclusively in individuals undergoing psychotherapy, particularly involving <a href="/wiki/Hypnosis" title="Hypnosis">hypnosis</a>, the presences of bizarre alternate identities (such as those claiming to be animals or mythological creatures) and an increase in the number of alternate identities over time<a href="#cite_note-Lynn2012-48">[47]</a><a href="#cite_note-pmid15560314-8">[8]</a> (as well as an initial increase in their number as psychotherapy begins in DID-oriented therapy<a href="#cite_note-Lynn2012-48">[47]</a>). These various cultural and therapeutic causes occur within a context of pre-existing psychopathology, notably <a href="/wiki/Borderline_personality_disorder" title="Borderline personality disorder">borderline personality disorder</a>, which is commonly comorbid with dissociative identity disorder.<a href="#cite_note-Lynn2012-48">[47]</a> In addition, presentations can vary across cultures, such as <a href="/wiki/India" title="India">Indian</a> patients who only switch alters after a period of sleep – which is commonly how dissociative identity disorder is presented by the media within that country.<a href="#cite_note-Lynn2012-48">[47]</a> Proponents of non-trauma-related dissociative identity disorder state that the disorder is strongly linked to (possibly suggestive) psychotherapy, often involving <a href="/wiki/Repressed_memory" title="Repressed memory">recovered memories</a> (memories that the person previously had amnesia for) or <a href="/wiki/False_memory" title="False memory">false memories</a>, and that such therapy could cause additional identities. Such memories could be used to make an allegation of <a href="/wiki/Child_sexual_abuse" title="Child sexual abuse">child sexual abuse</a>. There is little agreement between those who see therapy as a cause and trauma as a cause.<a href="#cite_note-Rein2008-57">[56]</a> Supporters of therapy as a cause of dissociative identity disorder suggest that a small number of clinicians diagnosing a disproportionate number of cases would provide evidence for their position<a href="#cite_note-Boysen-51">[50]</a> though it has also been claimed that higher rates of diagnosis in specific countries like the United States may be due to greater awareness of DID. Lower rates in other countries may be due to artificially low recognition of the diagnosis.<a href="#cite_note-Cardena-24">[24]</a> However, false memory syndrome per se is not regarded by mental health experts as a valid diagnosis,<a href="#cite_note-58">[57]</a> and has been described as "a non-psychological term originated by a private foundation whose stated purpose is to support accused parents,"<a href="#cite_note-Carstensen1993-59">[58]</a> and critics argue that the concept has no empirical support, and further describe the <a href="/wiki/False_Memory_Syndrome_Foundation" title="False Memory Syndrome Foundation">False Memory Syndrome Foundation</a> as an advocacy group that has distorted and misrepresented memory research.<a href="#cite_note-Dallam-60">[59]</a><a href="#cite_note-olio-61">[60]</a> <div class="mw-heading mw-heading3"><h3 id="Children">Children</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=8" title="Edit section: Children">edit</a>]</div> The rarity of DID diagnoses in children is cited as a reason to doubt the validity of the disorder,<a href="#cite_note-pmid15560314-8">[8]</a><a href="#cite_note-Boysen-51">[50]</a> and proponents of both etiologies believe that the discovery of dissociative identity disorder in a child who had never undergone treatment would critically undermine the non-trauma related model. Conversely, if children are found to develop dissociative identity disorder only after undergoing treatment it would challenge the trauma-related model.<a href="#cite_note-Boysen-51">[50]</a> As of 2011<a class="external text" href="https://en.wikipedia.org/w/index.php?title=Dissociative_identity_disorder&action=edit">[update]</a>, approximately 250 cases of dissociative identity disorder in children have been identified, though the data does not offer unequivocal support for either theory. While children have been diagnosed with dissociative identity disorder before therapy, several were presented to clinicians by parents who were themselves diagnosed with dissociative identity disorder; others were influenced by the appearance of dissociative identity disorder in popular culture or due to a diagnosis of psychosis due to hearing voices – a symptom also found in dissociative identity disorder. No studies have looked for children with dissociative identity disorder in the general population, and the single study that attempted to look for children with dissociative identity disorder not already in therapy did so by examining siblings of those already in therapy for dissociative identity disorder. An analysis of diagnosis of children reported in scientific publications, 44 case studies of single patients were found to be evenly distributed (i.e., each case study was reported by a different author) but in articles regarding groups of patients, four researchers were responsible for the majority of the reports.<a href="#cite_note-Boysen-51">[50]</a> The initial theoretical description of dissociative identity disorder was that dissociative symptoms were a means of <a href="/wiki/Coping_(psychology)" class="mw-redirect" title="Coping (psychology)">coping</a> with extreme stress (particularly childhood sexual and physical abuse), but this belief has been challenged by the data of multiple research studies.<a href="#cite_note-Lynn2012-48">[47]</a> Proponents of the trauma-related model claim the high <a href="/wiki/Correlation_and_dependence" class="mw-redirect" title="Correlation and dependence">correlation</a> of child sexual and physical abuse reported by adults with dissociative identity disorder corroborates the link between trauma and dissociative identity disorder.<a href="#cite_note-Hersen2012-17">[17]</a><a href="#cite_note-Lynn2012-48">[47]</a> However, the link between dissociative identity disorder and maltreatment has been questioned for several reasons. The studies reporting the links often rely on self-report rather than independent corroborations, and these results may be worsened by <a href="/wiki/Selection_bias" title="Selection bias">selection</a> and referral bias.<a href="#cite_note-Hersen2012-17">[17]</a><a href="#cite_note-Lynn2012-48">[47]</a> Most studies of trauma and dissociation are <a href="/wiki/Cross-sectional_study" title="Cross-sectional study">cross-sectional</a> rather than <a href="/wiki/Longitudinal_study" title="Longitudinal study">longitudinal</a>, which means researchers can not attribute <a href="/wiki/Correlation_does_not_imply_causation" title="Correlation does not imply causation">causation</a>, and studies avoiding <a href="/wiki/Recall_bias" title="Recall bias">recall bias</a> have failed to corroborate such a causal link.<a href="#cite_note-Hersen2012-17">[17]</a><a href="#cite_note-Lynn2012-48">[47]</a> In addition, studies rarely <a href="/wiki/Scientific_control" title="Scientific control">control for</a> the many <a href="#Comorbid_disorders">disorders comorbid with dissociative identity disorder</a>, or <a href="/wiki/Dysfunctional_family" title="Dysfunctional family">family maladjustment</a> (which is itself highly correlated with dissociative identity disorder).<a href="#cite_note-Hersen2012-17">[17]</a><a href="#cite_note-Lynn2012-48">[47]</a> The popular association of dissociative identity disorder with childhood abuse is relatively recent, occurring only after the publication of <a href="/wiki/Sybil_(Schreiber_book)" title="Sybil (Schreiber book)">Sybil</a> in 1973. Most previous examples of "multiples" such as <a href="/wiki/Chris_Costner_Sizemore" title="Chris Costner Sizemore">Chris Costner Sizemore</a>, whose life was depicted in the book and film <a href="/wiki/The_Three_Faces_of_Eve" title="The Three Faces of Eve">The Three Faces of Eve</a>, reported no memory of childhood trauma.<a href="#cite_note-McNally2005-54">[53]</a> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=9" title="Edit section: Pathophysiology">edit</a>]</div> Despite research on DID including structural and functional <a href="/wiki/Magnetic_resonance_imaging" title="Magnetic resonance imaging">magnetic resonance imaging</a>, <a href="/wiki/Positron_emission_tomography" title="Positron emission tomography">positron emission tomography</a>, <a href="/wiki/Single-photon_emission_computed_tomography" title="Single-photon emission computed tomography">single-photon emission computed tomography</a>, <a href="/wiki/Event-related_potential" title="Event-related potential">event-related potentials</a>, and <a href="/wiki/Electroencephalography" title="Electroencephalography">electroencephalography</a>, no convergent <a href="/wiki/Neuroimaging" title="Neuroimaging">neuroimaging</a> findings have been identified regarding DID, with the exception of smaller hippocampal volume in DID patients. In addition, many of the studies that do exist were performed from an explicitly trauma-based position. There is no research to date regarding the neuroimaging and introduction of false memories in DID patients,<a href="#cite_note-Rein2008-57">[56]</a> though there is evidence of changes in visual parameters<a href="#cite_note-pmid8888853-62">[61]</a> and support for amnesia between alters.<a href="#cite_note-Rein2008-57">[56]</a>[<a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">failed verification</a>]<a href="#cite_note-Kihlstrom-20">[20]</a>[<a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">failed verification</a>] DID patients also appear to show deficiencies in tests of conscious control of attention and memorization (which also showed signs of compartmentalization for <a href="/wiki/Implicit_memory" title="Implicit memory">implicit memory</a> between alters but no such compartmentalization for <a href="/wiki/Verbal_memory" title="Verbal memory">verbal memory</a>) and increased and persistent vigilance and <a href="/wiki/Startle_response" title="Startle response">startle responses</a> to sound. DID patients may also demonstrate altered <a href="/wiki/Neuroanatomy" title="Neuroanatomy">neuroanatomy</a>.<a href="#cite_note-Gillig-21">[21]</a> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=10" title="Edit section: Diagnosis">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="General_2">General</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=11" title="Edit section: General">edit</a>]</div> The fifth, revised edition of the <a href="/wiki/American_Psychiatric_Association" title="American Psychiatric Association">American Psychiatric Association</a>'s <a href="/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders" title="Diagnostic and Statistical Manual of Mental Disorders">Diagnostic and Statistical Manual of Mental Disorders</a> (DSM-5-TR) diagnoses DID according to the diagnostic criteria found under <a href="/wiki/DSM-5_codes#Dissociative_disorders" class="mw-redirect" title="DSM-5 codes">code 300.14 (dissociative disorders)</a>. DID is often initially misdiagnosed because clinicians receive little training about <a href="/wiki/Dissociative_disorders" class="mw-redirect" title="Dissociative disorders">dissociative disorders</a> or DID, and often use standard diagnostic interviews that do not include questions about trauma, dissociation, or post-traumatic symptoms.<a href="#cite_note-Guidelines2011-5">[5]</a>(p 118) This contributes to difficulties diagnosing the disorder, and to clinician bias.<a href="#cite_note-Guidelines2011-5">[5]</a> DID is rarely diagnosed in children.<a href="#cite_note-pmid15560314-8">[8]</a> The criteria require that an individual be recurrently controlled by two or more discrete <a href="/wiki/Identity_(social_science)" title="Identity (social science)">identities</a> or <a href="/wiki/Personality_psychology" title="Personality psychology">personality</a> states, accompanied by <a href="/wiki/Amnesia" title="Amnesia">memory lapses</a> for important information that is not caused by alcohol, drugs or medications and other medical conditions such as <a href="/wiki/Complex_partial_seizure" class="mw-redirect" title="Complex partial seizure">complex partial seizures</a>.<a href="#cite_note-DSM5-1">[1]</a> In children, the symptoms must not be better explained by "imaginary playmates or other fantasy play".<a href="#cite_note-DSM5-1">[1]</a> Diagnosis is normally performed by a clinically trained mental health professional such as a <a href="/wiki/Psychiatrist" title="Psychiatrist">psychiatrist</a> or <a href="/wiki/Psychologist" title="Psychologist">psychologist</a> through clinical evaluation, interviews with family and friends, and consideration of other ancillary material. Specially designed interviews (such as the <a href="/wiki/SCID-D" class="mw-redirect" title="SCID-D">SCID-D</a>) and personality assessment tools may be used in the evaluation as well.<a href="#cite_note-webmd-28">[28]</a> Since most of the symptoms depend on self-report and are not concrete and observable, there is a degree of subjectivity in making the diagnosis.<a href="#cite_note-Kihlstrom-20">[20]</a> People are often disinclined to seek treatment, especially since their symptoms may not be taken seriously; thus dissociative disorders have been referred to as "diseases of hiddenness".<a href="#cite_note-MacDonald-15">[15]</a><a href="#cite_note-Recognizing_Traumatic_Dissociation-63">[62]</a> The diagnosis has been criticized by supporters of therapy as a cause or the sociocognitive hypothesis as they believe it is a <a href="/wiki/Culture-bound_syndrome" title="Culture-bound syndrome">culture-bound</a> and often health care induced condition.<a href="#cite_note-Hersen2012-17">[17]</a><a href="#cite_note-pmid15560314-8">[8]</a><a href="#cite_note-pmid15503730-7">[7]</a> The social cues involved in diagnosis may be instrumental in shaping patient behavior or attribution, such that symptoms within one context may be linked to DID, while in another time or place the diagnosis could have been something other than DID.<a href="#cite_note-Paris2012-50">[49]</a> Other researchers disagree and argue that the existence of the condition and its inclusion in the DSM is supported by multiple lines of reliable evidence, with diagnostic criteria allowing it to be clearly discriminated from conditions it is often mistaken for (schizophrenia, borderline personality disorder, and seizure disorder).<a href="#cite_note-Cardena-24">[24]</a> That a large proportion of cases are diagnosed by specific health care providers, and that symptoms have been created in nonclinical research subjects given appropriate cueing has been suggested as evidence that a small number of clinicians who specialize in DID are responsible for the creation of alters through therapy.<a href="#cite_note-Hersen2012-17">[17]</a> <div class="mw-heading mw-heading3"><h3 id="Differential_diagnoses">Differential diagnoses</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=12" title="Edit section: Differential diagnoses">edit</a>]</div> Patients with DID are diagnosed with 5-7 comorbid disorders on average – higher than other mental conditions. Misdiagnoses (e.g. schizophrenia, bipolar disorder) are very common among patients with DID.<a href="#cite_note-Gillig-21">[21]</a> Due to overlapping symptoms, the differential diagnosis includes <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a>, normal and rapid-cycling <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disorder</a>, <a href="/wiki/Epilepsy" title="Epilepsy">epilepsy</a>, <a href="/wiki/Borderline_personality_disorder" title="Borderline personality disorder">borderline personality disorder</a>, and <a href="/wiki/Autism_spectrum_disorder" class="mw-redirect" title="Autism spectrum disorder">autism spectrum disorder</a>.<a href="#cite_note-Shibayama-64">[63]</a> Delusions or auditory hallucinations can be mistaken for speech by other personalities.<a href="#cite_note-Spiegel-25">[25]</a> Persistence and consistency of identities and behavior, amnesia, measures of dissociation or hypnotizability and reports from family members or other associates indicating a history of such changes can help distinguish DID from other conditions. A diagnosis of DID takes precedence over any other dissociative disorders. Distinguishing DID from <a href="/wiki/Malingering" title="Malingering">malingering</a> is a concern when financial or legal gains are an issue, and <a href="/wiki/Factitious_disorder" title="Factitious disorder">factitious disorder</a> may also be considered if the person has a history of help or attention-seeking. Individuals who state that their symptoms are due to external spirits or entities entering their bodies are generally diagnosed with <a href="/wiki/Dissociative_disorder_not_otherwise_specified" title="Dissociative disorder not otherwise specified">dissociative disorder not otherwise specified</a> rather than DID due to the lack of identities or personality states.<a href="#cite_note-dsm-23">[23]</a> Most individuals who enter an <a href="/wiki/Emergency_department" title="Emergency department">emergency department</a> and are unaware of their names are generally in a psychotic state. Although auditory hallucinations are common in DID, complex visual hallucinations may also occur.<a href="#cite_note-Gillig-21">[21]</a> Those with DID generally have adequate reality testing. People with DID may have more positive and less negative Schneiderian symptoms of schizophrenia.<a href="#cite_note-Cardena2-65">[64]</a> The DID persona perceives any voices heard as coming from inside their heads whereas the schizophrenia persona perceives voices as external).<a href="#cite_note-Hersen2012-17">[17]</a> In addition, individuals with psychosis are much less susceptible to hypnosis than those with DID.<a href="#cite_note-Spiegel-25">[25]</a> Difficulties in differential diagnosis are increased in children.<a href="#cite_note-Boysen-51">[50]</a> DID must be distinguished from, or determined if comorbid with, a variety of disorders including <a href="/wiki/Mood_disorder" title="Mood disorder">mood disorders</a>, <a href="/wiki/Psychosis" title="Psychosis">psychosis</a>, <a href="/wiki/Anxiety_disorder" title="Anxiety disorder">anxiety disorders</a>, PTSD, <a href="/wiki/Personality_disorders" class="mw-redirect" title="Personality disorders">personality disorders</a>, <a href="/wiki/Cognitive_disorder" title="Cognitive disorder">cognitive disorders</a>, <a href="/wiki/Neurological_disorder" title="Neurological disorder">neurological disorders</a>, <a href="/wiki/Epilepsy" title="Epilepsy">epilepsy</a>, <a href="/wiki/Somatoform_disorder" class="mw-redirect" title="Somatoform disorder">somatoform disorder</a>, <a href="/wiki/Factitious_disorder" title="Factitious disorder">factitious disorder</a>, <a href="/wiki/Malingering" title="Malingering">malingering</a>, other dissociative disorders, and <a href="/wiki/Trance" title="Trance">trance</a> states.<a href="#cite_note-Sad2007-66">[65]</a> An additional aspect of the controversy of diagnosis is that there are many forms of dissociation and memory lapses, which can be common in both stressful and nonstressful situations and can be attributed to much less controversial diagnoses.<a href="#cite_note-Paris2012-50">[49]</a> A relationship between DID and borderline personality disorder has been posited, with various clinicians noting overlap between symptoms and behaviors and it has been suggested that some cases of DID may arise "from a substrate of borderline traits". Reviews of DID patients and their <a href="/wiki/Medical_record" title="Medical record">medical records</a> concluded that 30-70% of those diagnosed with DID have comorbid <a href="/wiki/Borderline_personality_disorder" title="Borderline personality disorder">borderline personality disorder</a>.<a href="#cite_note-Gillig-21">[21]</a> The DSM-5 elaborates on cultural background as an influence for some presentations of DID.<a href="#cite_note-DSM5-1">[1]</a>(p 295) <style data-mw-deduplicate="TemplateStyles:r1244412712">.mw-parser-output .templatequote{overflow:hidden;margin:1em 0;padding:0 32px}.mw-parser-output .templatequotecite{line-height:1.5em;text-align:left;margin-top:0}@media(min-width:500px){.mw-parser-output .templatequotecite{padding-left:1.6em}}</style><blockquote class="templatequote">Many features of dissociative identity disorder can be influenced by the individual's cultural background. Individuals with this disorder may present with prominent medically unexplained neurological symptoms, such as non-epileptic seizures, paralyses, or sensory loss, in cultural settings where such symptoms are common. Similarly, in settings where normative possession is common (e.g., rural areas in the developing world, among certain religious groups in the United States and Europe), the fragmented identities may take the form of possessing spirits, deities, demons, animals, or mythical figures. Acculturation or prolonged intercultural contact may shape the characteristics of other identities (e.g., identities in India may speak English exclusively and wear Western clothes). Possession-form dissociative identity disorder can be distinguished from culturally accepted possession states in that the former is involuntary, distressing, uncontrollable, and often recurrent or persistent; involves conflict between the individual and his or her surrounding family, social, or work milieu; and is manifested at times and in places that violate the norms of the culture or religion.</blockquote> <div class="mw-heading mw-heading2"><h2 id="Controversy_and_criticism_of_validity">Controversy and criticism of validity</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=13" title="Edit section: Controversy and criticism of validity">edit</a>]</div> DID is among the most controversial of the dissociative disorders and among the most controversial disorders found in the DSM-5-TR.<a href="#cite_note-Stern-67">[66]</a><a href="#cite_note-Hersen2012-17">[17]</a><a href="#cite_note-Blihar-39">[39]</a> The primary dispute is between those who believe DID is caused by traumatic stresses that split the mind into <a href="/wiki/Multiplicity_(psychology)" class="mw-redirect" title="Multiplicity (psychology)">multiple identities</a>, each with a separate set of memories,<a href="#cite_note-Howell-68">[67]</a><a href="#cite_note-Kihlstrom-20">[20]</a> and those who believe that the symptoms of DID are produced <a href="/wiki/Iatrogenesis#Psychology" title="Iatrogenesis">artificially</a> by certain psychotherapeutic practices or patients playing a role they believe appropriate for a person with DID.<a href="#cite_note-Blackwell-52">[51]</a><a href="#cite_note-pmid15503730-7">[7]</a><a href="#cite_note-MacDonald-15">[15]</a><a href="#cite_note-Weiten-69">[68]</a><a href="#cite_note-Cardena2-65">[64]</a> The debate between the two positions is characterized by intense disagreement.<a href="#cite_note-Rein2008-57">[56]</a><a href="#cite_note-Blackwell-52">[51]</a><a href="#cite_note-pmid15560314-8">[8]</a><a href="#cite_note-pmid15503730-7">[7]</a><a href="#cite_note-Weiten-69">[68]</a><a href="#cite_note-Cardena2-65">[64]</a> Research has been characterized by poor <a href="/wiki/Scientific_method" title="Scientific method">methodology</a>.<a href="#cite_note-Howell-68">[67]</a> Psychiatrist Joel Paris notes that the idea that a personality is capable of splitting into independent alters is an unproven assertion at odds with research in <a href="/wiki/Cognitive_psychology" title="Cognitive psychology">cognitive psychology</a>.<a href="#cite_note-Paris2012-50">[49]</a> Some people, such as Russell A. Powell and Travis L. Gee, believe that DID is caused by health care, i.e. symptoms of DID are created by therapists themselves via hypnosis. This implies that those with DID are especially susceptible to manipulation by hypnosis and suggestion.<a href="#cite_note-70">[69]</a> The iatrogenic model also sometimes states that treatment for DID is harmful. According to Brand, Loewenstein, and Spiegel, "claims that DID treatment is harmful are based on anecdotal cases, opinion pieces, reports of damage that are not substantiated in the scientific literature, misrepresentations of the data, and misunderstandings about DID treatment and the phenomenology of DID". Their claim is evidenced by the fact that only 5%–10% of people receiving treatment initially worsen in their symptoms.<a href="#cite_note-Brand2014-16">[16]</a> Psychiatrists August Piper and Harold Merskey have challenged the trauma hypothesis, arguing that <a href="/wiki/Correlation_does_not_imply_causation" title="Correlation does not imply causation">correlation does not imply causation</a>—that people with DID report childhood trauma does not mean trauma causes DID—and point to the rarity of the diagnosis before 1980 as well as a failure to find DID as an outcome in <a href="/wiki/Longitudinal_study" title="Longitudinal study">longitudinal studies</a> of traumatized children. They assert that DID cannot be accurately diagnosed because of vague and unclear diagnostic criteria in the DSM and undefined concepts such as "personality state" and "identities", and question the evidence for childhood abuse beyond self-reports, the lack of a defined threshold of abuse sufficient to induce DID, and the extremely small number of cases of children diagnosed with DID despite an average age of appearance of the first alter of three years.<a href="#cite_note-pmid15560314-8">[8]</a> Psychiatrist Colin Ross disagrees with Piper and Merskey's conclusion that DID cannot be accurately diagnosed, pointing to internal consistency between different structured dissociative disorder interviews (including the <a href="/wiki/Dissociative_Experiences_Scale" title="Dissociative Experiences Scale">Dissociative Experiences Scale</a>, Dissociative Disorders Interview Schedule, and Structured Clinical Interview for Dissociative Disorders)<a href="#cite_note-Kihlstrom-20">[20]</a> in the internal validity range of widely accepted mental illnesses such as schizophrenia and <a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">major depressive disorder</a>. In his opinion, Piper and Merskey set the standard of proof higher than it is for other diagnoses. He also asserts that Piper and Merskey have <a href="/wiki/Cherry_picking_(fallacy)" class="mw-redirect" title="Cherry picking (fallacy)">cherry-picked</a> data and not incorporated all relevant scientific literature, such as independent corroborating evidence of trauma.<a href="#cite_note-Ross2009-71">[70]</a> A paper published in 2022 in the journal <a href="/wiki/Comprehensive_Psychiatry" title="Comprehensive Psychiatry">Comprehensive Psychiatry</a> described how prolonged social media use, especially on video-sharing platforms including <a href="/wiki/TikTok" title="TikTok">TikTok</a>, has exposed young people, largely adolescent females, a core user group of TikTok, to a growing number of content creators making videos about their self-diagnosed disorders. "An increasing number of reports from the US, UK, Germany, Canada, and Australia have noted an increase in functional tic-like behaviors prior to and during the <a href="/wiki/COVID-19_pandemic" title="COVID-19 pandemic">COVID-19 pandemic</a>, coinciding with an increase in social media content related to[…]dissociative identity disorder." The paper concluded that there "is an urgent need for focused empirical research investigation into this concerning phenomenon that is related to the broader research and discourse examining social media influences on mental health".<a href="#cite_note-72">[71]</a><a href="#cite_note-73">[72]</a><a href="#cite_note-74">[73]</a><a href="#cite_note-pmid37271332-75">[74]</a> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=14" title="Edit section: Treatment">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="Treatment_under_the_sociogenic_model">Treatment under the sociogenic model</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=15" title="Edit section: Treatment under the sociogenic model">edit</a>]</div> Proponents of the sociogenic model dispute that dissociative identity disorder is an organic response to trauma, but believe it is a socially constructed behavior and psychic contagion.<a href="#cite_note-76">[75]</a> McHugh says that the disorder is "sustained in large part by the attention that doctors tend to pay to it. This means that it is not a mental condition that derives from nature, such as panic anxiety or major depression. It exists in the world as an artificial product of human devising".<a href="#cite_note-FOOTNOTEMcHugh200860-77">[76]</a> According to McHugh, at <a href="/wiki/Johns_Hopkins_Hospital" title="Johns Hopkins Hospital">Johns Hopkins Hospital</a> doctors should ignore the displays from "alters", and instead focus on treatment for other psychiatric problems patients present with. This method of treatment is reportedly successful:<a href="#cite_note-FOOTNOTEMcHugh2008134-78">[77]</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1244412712"><blockquote class="templatequote">What surprises many people is that multiple personalities tend to fall away quickly when ignored. Usually on our anorexia nervosa floor, patients who entered with MPD [multiple personality disorder] cease discussing their alters within a few days and often report that after a week or two of recovering their body weight and attending group therapy tied to their eating disorder, the ideas and preoccupations with their “alters” gradually vanished from their thinking.</blockquote> McHugh believes that proponents of Dissociative Identity Disorder inadvertently worsen patient condition by validating the behavior and providing attention.<a href="#cite_note-FOOTNOTEMcHugh200884-79">[78]</a> <div class="mw-heading mw-heading3"><h3 id="Treatments_under_the_trauma_model">Treatments under the trauma model</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=16" title="Edit section: Treatments under the trauma model">edit</a>]</div> The <a href="/wiki/International_Society_for_the_Study_of_Trauma_and_Dissociation" title="International Society for the Study of Trauma and Dissociation">International Society for the Study of Trauma and Dissociation</a>, proponents of the trauma model, have published guidelines for phase-oriented treatment in adults as well as children and adolescents that are widely used successfully in the field of DID treatment.<a href="#cite_note-Dorahy2014-29">[29]</a><a href="#cite_note-Guidelines2011-5">[5]</a> The guidelines state that "a desirable treatment outcome is a workable form of integration or harmony among alternate identities". Some experts in treating people with DID use the techniques recommended in the 2011 treatment guidelines.<a href="#cite_note-Dorahy2014-29">[29]</a> The <a href="/wiki/Empirical_research" title="Empirical research">empirical research</a> includes the longitudinal TOP DD treatment study, which found that patients showed "statistically significant reductions in dissociation, PTSD, distress, depression, hospitalisations, suicide attempts, self-harm, dangerous behaviours, drug use, and physical pain" and improved overall functioning.<a href="#cite_note-Dorahy2014-29">[29]</a> Treatment effects have been studied for over thirty years, with some studies having a follow-up of ten years.<a href="#cite_note-Dorahy2014-29">[29]</a> Adult and child treatment guidelines exist that suggest a three-phased approach.<a href="#cite_note-Guidelines2011-5">[5]</a> Common treatment methods include an eclectic mix of <a href="/wiki/Psychotherapy" title="Psychotherapy">psychotherapy</a> techniques, including <a href="/wiki/Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">cognitive behavioral therapy</a> (CBT),<a href="#cite_note-Guidelines2011-5">[5]</a><a href="#cite_note-Gillig-21">[21]</a> <a href="/wiki/Insight-oriented_therapy" class="mw-redirect" title="Insight-oriented therapy">insight-oriented therapy</a>,<a href="#cite_note-Kihlstrom-20">[20]</a> <a href="/wiki/Dialectical_behavioral_therapy" class="mw-redirect" title="Dialectical behavioral therapy">dialectical behavioral therapy</a> (DBT), <a href="/wiki/Hypnotherapy" title="Hypnotherapy">hypnotherapy</a>, and <a href="/wiki/Eye_movement_desensitization_and_reprocessing" title="Eye movement desensitization and reprocessing">eye movement desensitization and reprocessing</a> (EMDR).<a href="#cite_note-80">[79]</a> Hypnosis should be carefully considered when choosing both treatment and provider practitioners because of its dangers. For example, hypnosis can sometimes lead to false memories and false accusations of abuse by family, loved ones, friends, providers, and community members. Those who suffer from dissociative identity disorder have commonly been subject to actual abuse (sexual, physical, emotional, financial) by therapists, family, friends, loved ones, and community members.<a href="#cite_note-81">[80]</a> Brief treatment due to <a href="/wiki/Managed_care" title="Managed care">managed care</a> may be difficult, as individuals diagnosed with DID may have unusual difficulties in trusting a therapist and take a prolonged period to form a comfortable <a href="/wiki/Therapeutic_alliance" title="Therapeutic alliance">therapeutic alliance</a>.<a href="#cite_note-Guidelines2011-5">[5]</a> Regular contact (at least weekly) is recommended, and treatment generally lasts years – not weeks or months.<a href="#cite_note-Gillig-21">[21]</a> <a href="/wiki/Sleep_hygiene" title="Sleep hygiene">Sleep hygiene</a> has been suggested as a treatment option, but has not been tested. In general there are very few <a href="/wiki/Clinical_trial" title="Clinical trial">clinical trials</a> on the treatment of DID, none of which were <a href="/wiki/Randomized_controlled_trial" title="Randomized controlled trial">randomized controlled trials</a>.<a href="#cite_note-Lynn2012-48">[47]</a> Therapy for DID is generally phase oriented.<a href="#cite_note-Dorahy2014-29">[29]</a> Different alters may appear based on their greater ability to deal with specific situational stresses or threats. While some patients may initially present with a large number of alters, this number may reduce during treatment – though it is considered important for the therapist to become familiar with at least the more prominent personality states as the "host" personality may not be the "true" identity of the patient. Specific alters may react negatively to therapy, fearing the therapist's goal is to eliminate the alter (particularly those associated with illegal or violent activities). A more realistic and appropriate goal of treatment is to integrate adaptive responses to abuse, injury, or other threats into the overall personality structure.<a href="#cite_note-Gillig-21">[21]</a> The first phase of therapy focuses on symptoms and relieving the distressing aspects of the condition, ensuring the safety of the individual, improving the patient's capacity to form and maintain healthy relationships, and improving general daily life functioning. Comorbid disorders such as <a href="/wiki/Substance_use_disorder" title="Substance use disorder">substance use disorder</a> and <a href="/wiki/Eating_disorders" class="mw-redirect" title="Eating disorders">eating disorders</a> are addressed in this phase of treatment.<a href="#cite_note-Guidelines2011-5">[5]</a> The second phase focuses on stepwise exposure to traumatic memories and prevention of re-dissociation. The final phase focuses on reconnecting the identities of disparate alters into a single functioning identity with all its memories and experiences intact.<a href="#cite_note-Guidelines2011-5">[5]</a> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=17" title="Edit section: Prognosis">edit</a>]</div> Little is known about prognosis of untreated DID.<a href="#cite_note-Sad2007-66">[65]</a> Symptoms commonly wax and wane over time.<a href="#cite_note-Mer2019Pro-3">[3]</a> Patients with mainly dissociative and post-traumatic symptoms face a better prognosis than those with comorbid disorders or those still in contact with abusers, and the latter groups often face a lengthier and more difficult treatment course. <a href="/wiki/Suicidal_ideation" title="Suicidal ideation">Suicidal ideation</a>, <a href="/wiki/Suicide_attempt" title="Suicide attempt">suicide attempts</a>, and <a href="/wiki/Self-harm" title="Self-harm">self-harm</a> are common in the DID population.<a href="#cite_note-Mer2019Pro-3">[3]</a> Duration of treatment can vary depending on patient goals, which can range from merely improving inter-alter communication and cooperation, to reducing inter-alter amnesia, to integration and fusion of all alters, but this last goal generally takes years, with trained and experienced psychotherapists.<a href="#cite_note-Mer2019Pro-3">[3]</a> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=18" title="Edit section: Epidemiology">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="General_3">General</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=19" title="Edit section: General">edit</a>]</div> According to the American Psychiatric Association, the 12-month prevalence of DID among adults in the US is 1.5%, with similar prevalence between women and men.<a href="#cite_note-Reategui-2019-82">[81]</a> Population prevalence estimates have been described to widely vary, with some estimates of DID in inpatient settings suggesting 1-9.6%."<a href="#cite_note-Hersen2012-17">[17]</a> Reported rates in the community vary from 1% to 3% with higher rates among psychiatric patients.<a href="#cite_note-Guidelines2011-5">[5]</a><a href="#cite_note-Cardena-24">[24]</a> As of 2017, evidence suggested a prevalence of DID of 2–5% among psychiatric inpatients, 2–3% among outpatients, and 1% in the general population,<a href="#cite_note-Vedat-14">[14]</a><a href="#cite_note-Sar-2014-83">[82]</a> with rates reported as high as 16.4% for teenagers in psychiatric outpatient services.<a href="#cite_note-Reategui-2019-82">[81]</a> As of 2012, DID was diagnosed 5 to 9 times more common in women than men during young adulthood, although this may have been due to selection bias as men meeting DID diagnostic criteria were suspected to end up in the criminal justice system rather than hospitals.<a href="#cite_note-Hersen2012-17">[17]</a> DID diagnoses are extremely rare in children; much of the research on childhood DID occurred in the 1980s and 1990s and does not address ongoing controversies surrounding the diagnosis.<a href="#cite_note-Boysen-51">[50]</a> DID occurs more commonly in young adults<a href="#cite_note-Sadockconcise-84">[83]</a> and declines in prevalence with age.<a href="#cite_note-85">[84]</a> There is a poor awareness of DID in the clinical settings and the general public. Poor clinical education (or lack thereof) for DID and other dissociative disorders has been described in literature: "most clinicians have been taught (or assume) that DID is a rare disorder with a florid, dramatic presentation."<a href="#cite_note-Guidelines2011-5">[5]</a><a href="#cite_note-Stern-67">[66]</a> Symptoms in patients are often not easily visible, which complicates diagnosis.<a href="#cite_note-Guidelines2011-5">[5]</a> DID has a high correlation with, and has been described as a form of, <a href="/wiki/Complex_post-traumatic_stress_disorder" title="Complex post-traumatic stress disorder">complex post-traumatic stress disorder</a>.<a href="#cite_note-86">[85]</a> There is a significant overlap of symptoms between <a href="/wiki/Borderline_personality_disorder" title="Borderline personality disorder">borderline personality disorder</a> and DID.<a href="#cite_note-87">[86]</a> <div class="mw-heading mw-heading3"><h3 id="Historical_prevalence">Historical prevalence</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=20" title="Edit section: Historical prevalence">edit</a>]</div> Rates of diagnosed DID were increasing in the late 20th century, reaching a peak of diagnoses at approximately 40,000 cases by the end of the 20th century, up from less than 200 diagnoses before 1970.<a href="#cite_note-APA2008-26">[26]</a><a href="#cite_note-Hersen2012-17">[17]</a> Initially DID along with the rest of the <a href="/wiki/Dissociative_disorders" class="mw-redirect" title="Dissociative disorders">dissociative disorders</a> were considered the rarest of psychological conditions, diagnosed in less than 100 by 1944, with only one further case reported in the next two decades.<a href="#cite_note-Kihlstrom-20">[20]</a> In the late 1970s and '80s, the number of diagnoses rose sharply.<a href="#cite_note-Kihlstrom-20">[20]</a> An estimate from the 1980s placed the incidence at 0.01%.<a href="#cite_note-APA2008-26">[26]</a> Accompanying this rise was an increase in the number of alters, rising from only the primary and one alter personality in most cases, to an average of 13 in the mid-1980s (the increase in both number of cases and number of alters within each case are both factors in professional skepticism regarding the diagnosis).<a href="#cite_note-Kihlstrom-20">[20]</a> Others explain the increase as being due to the use of inappropriate therapeutic techniques in highly suggestible individuals, though this is itself controversial<a href="#cite_note-Blackwell-52">[51]</a><a href="#cite_note-Weiten-69">[68]</a> while proponents of DID claim the increase in incidence is due to increased recognition of and ability to recognize the disorder.<a href="#cite_note-Hersen2012-17">[17]</a> A 1996 essay suggested three possible causes for the sudden increase of DID diagnoses, among which the author suspects the first being most likely:<a href="#cite_note-Paris_J_1996-88">[87]</a> <ol><li>The result of therapist suggestions to suggestible people, much as <a href="/wiki/Jean-Martin_Charcot" title="Jean-Martin Charcot">Charcot</a>'s hysterics acted in accordance with his expectations.</li> <li>Psychiatrists' past failure to recognize dissociation being redressed by new training and knowledge.</li> <li>Dissociative phenomena are actually increasing, but this increase only represents a new form of an old and protean entity: "hysteria".</li></ol> Dissociative disorders were excluded from the <a href="/wiki/Psychiatric_epidemiology#Example:_The_Epidemiological_Catchment_Area_Project" title="Psychiatric epidemiology">Epidemiological Catchment Area Project</a>.<a href="#cite_note-89">[88]</a> <div class="mw-heading mw-heading3"><h3 id="North_America">North America</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=21" title="Edit section: North America">edit</a>]</div> DID continues to be considered a controversial diagnosis; it was once regarded as a phenomenon confined to North America, though studies have since been published from DID populations across 6 continents.<a href="#cite_note-pmid15503730-7">[7]</a><a href="#cite_note-pmid7794202-90">[89]</a> Although research has appeared discussing the appearance of DID in other countries and cultures<a href="#cite_note-91">[90]</a> and the condition has been described in non-English speaking nations and non-Western cultures, these reports all occur in English-language journals authored by international researchers who cite Western scientific literature.<a href="#cite_note-Boysen-51">[50]</a> <div class="mw-heading mw-heading2"><h2 id="History">History</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=22" title="Edit section: History">edit</a>]</div> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:Viv%C3%A9.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/12/Viv%C3%A9.jpg/220px-Viv%C3%A9.jpg" decoding="async" width="220" height="316" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/12/Viv%C3%A9.jpg/330px-Viv%C3%A9.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/12/Viv%C3%A9.jpg/440px-Viv%C3%A9.jpg 2x" data-file-width="480" data-file-height="689" /></a><figcaption>One of ten photogravure portraits of <a href="/wiki/Louis_Vivet" title="Louis Vivet">Louis Vivet</a> published in Variations de la personnalité by <a href="/w/index.php?title=Henri_Bourru&action=edit&redlink=1" class="new" title="Henri Bourru (page does not exist)">Henri Bourru</a> and <a href="/w/index.php?title=Prosper_Ferdinand_Burot&action=edit&redlink=1" class="new" title="Prosper Ferdinand Burot (page does not exist)">Prosper Ferdinand Burot</a></figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Early_references">Early references</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=23" title="Edit section: Early references">edit</a>]</div> In the 19th century, "dédoublement", or "double consciousness", the historical precursor to DID, was frequently described as a state of <a href="/wiki/Sleepwalking" title="Sleepwalking">sleepwalking</a>, with scholars hypothesizing that the patients were switching between a normal consciousness and a "somnambulistic state".<a href="#cite_note-Kloet2012-37">[37]</a> An intense interest in <a href="/wiki/Spiritualism_(beliefs)" title="Spiritualism (beliefs)">spiritualism</a>, <a href="/wiki/Parapsychology" title="Parapsychology">parapsychology</a> and <a href="/wiki/Hypnosis" title="Hypnosis">hypnosis</a> continued throughout the 19th and early 20th centuries,<a href="#cite_note-pmid7794202-90">[89]</a> running in parallel with <a href="/wiki/John_Locke" title="John Locke">John Locke</a>'s views that there was an <a href="/wiki/Association_of_ideas" title="Association of ideas">association of ideas</a> requiring the coexistence of feelings with awareness of the feelings.<a href="#cite_note-pmid12094818-92">[91]</a> <a href="/wiki/Hypnosis" title="Hypnosis">Hypnosis</a>, which was pioneered in the late 18th century by <a href="/wiki/Franz_Mesmer" title="Franz Mesmer">Franz Mesmer</a> and <a href="/wiki/Armand-Marie-Jacques_de_Chastenet,_Marques_of_Puys%C3%A9gur" class="mw-redirect" title="Armand-Marie-Jacques de Chastenet, Marques of Puységur">Armand-Marie Jacques de Chastenet, Marques de Puységur</a>, challenged Locke's association of ideas. Hypnotists reported what they thought were second personalities emerging during hypnosis and wondered how two minds could coexist.<a href="#cite_note-pmid7794202-90">[89]</a> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Plaque_Pierre_Janet,_54_rue_de_Varenne,_Paris_7.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/51/Plaque_Pierre_Janet%2C_54_rue_de_Varenne%2C_Paris_7.jpg/220px-Plaque_Pierre_Janet%2C_54_rue_de_Varenne%2C_Paris_7.jpg" decoding="async" width="220" height="155" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/51/Plaque_Pierre_Janet%2C_54_rue_de_Varenne%2C_Paris_7.jpg/330px-Plaque_Pierre_Janet%2C_54_rue_de_Varenne%2C_Paris_7.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/51/Plaque_Pierre_Janet%2C_54_rue_de_Varenne%2C_Paris_7.jpg/440px-Plaque_Pierre_Janet%2C_54_rue_de_Varenne%2C_Paris_7.jpg 2x" data-file-width="1987" data-file-height="1403" /></a><figcaption>The plaque on the former house of <a href="/wiki/Pierre_Janet" title="Pierre Janet">Pierre Marie Félix Janet</a> (1859–1947), the philosopher and psychologist who first alleged a connection between events in the subject's past and present mental health, also coining the words "dissociation" and "subconscious"</figcaption></figure> In the 19th century, there were a number of reported cases of multiple personalities which Rieber<a href="#cite_note-pmid12094818-92">[91]</a> estimated would be close to 100. <a href="/wiki/Epilepsy" title="Epilepsy">Epilepsy</a> was seen as a factor in some cases,<a href="#cite_note-pmid12094818-92">[91]</a> and discussion of this connection continues into the present era.<a href="#cite_note-pmid6427406-93">[92]</a><a href="#cite_note-pmid2725878-94">[93]</a> By the late 19th century, there was a general acceptance that emotionally traumatic experiences could cause long-term disorders which might display a variety of symptoms.<a href="#cite_note-Borch-Jacobsen_M_2000-95">[94]</a> These <a href="/wiki/Conversion_disorder" title="Conversion disorder">conversion disorders</a> were found to occur in even the most resilient individuals, but with profound effect in someone with emotional instability like <a href="/wiki/Louis_Vivet" title="Louis Vivet">Louis Vivet</a> (1863–?), who had a traumatic experience as a 17-year-old when he encountered a viper. Vivet was the subject of countless medical papers and became the most studied case of dissociation in the 19th century. Between 1880 and 1920, various international medical conferences devoted time to sessions on dissociation.<a href="#cite_note-putnam-96">[95]</a> It was in this climate that <a href="/wiki/Jean-Martin_Charcot" title="Jean-Martin Charcot">Jean-Martin Charcot</a> introduced his ideas of the impact of nervous shocks as a cause for a variety of neurological conditions. One of Charcot's students, <a href="/wiki/Pierre_Janet" title="Pierre Janet">Pierre Janet</a>, took these ideas and went on to develop his own theories of dissociation.<a href="#cite_note-pmid2686473-97">[96]</a> One of the first individuals diagnosed with multiple personalities to be scientifically studied was Clara Norton Fowler, under the <a href="/wiki/Pseudonym" title="Pseudonym">pseudonym</a> <a href="/wiki/Christine_Beauchamp_(pseudonym)" title="Christine Beauchamp (pseudonym)">Christine Beauchamp</a>; American <a href="/wiki/Neurology" title="Neurology">neurologist</a> <a href="/wiki/Morton_Prince" title="Morton Prince">Morton Prince</a> studied Fowler between 1898 and 1904, describing her <a href="/wiki/Case_study" title="Case study">case study</a> in his 1906 <a href="/wiki/Monograph" title="Monograph">monograph</a>, Dissociation of a Personality.<a href="#cite_note-pmid2686473-97">[96]</a><a href="#cite_note-98">[97]</a> <div class="mw-heading mw-heading3"><h3 id="20th_century">20th century</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=24" title="Edit section: 20th century">edit</a>]</div> In the early 20th century, interest in dissociation and multiple personalities waned for several reasons. After Charcot's death in 1893, many of his so-called hysterical patients were exposed as frauds, and Janet's association with Charcot tarnished his theories of dissociation.<a href="#cite_note-pmid7794202-90">[89]</a> <a href="/wiki/Sigmund_Freud" title="Sigmund Freud">Sigmund Freud</a> recanted his earlier emphasis on dissociation and childhood trauma.<a href="#cite_note-pmid7794202-90">[89]</a> In 1908, <a href="/wiki/Eugen_Bleuler" title="Eugen Bleuler">Eugen Bleuler</a> introduced the term "schizophrenia" to represent a revised disease concept for Emil Kraepelin's <a href="/wiki/Dementia_praecox" title="Dementia praecox">dementia praecox</a>.<a href="#cite_note-Noll_2011-99">[98]</a> Whereas Kraepelin's natural disease entity was anchored in the metaphor of progressive deterioration and mental weakness and defect, Bleuler offered a reinterpretation based on dissociation or "splitting" (Spaltung) and widely broadened the inclusion criteria for the diagnosis. A review of the <a href="/wiki/Index_medicus" class="mw-redirect" title="Index medicus">Index medicus</a> from 1903 through 1978 showed a dramatic decline in the number of reports of multiple personality after the diagnosis of schizophrenia became popular, especially in the United States.<a href="#cite_note-pmid7004385-100">[99]</a> The rise of the broad diagnostic category of dementia praecox has also been posited in the disappearance of "hysteria" (the usual diagnostic designation for cases of multiple personalities) by 1910.<a href="#cite_note-101">[100]</a> A number of factors helped create a large climate of skepticism and disbelief; paralleling the increased suspicion of DID was the decline of interest in dissociation as a laboratory and clinical phenomenon.<a href="#cite_note-putnam-96">[95]</a> Starting in about 1927, there was a large increase in the number of reported cases of schizophrenia, which was matched by an equally large decrease in the number of multiple personality reports.<a href="#cite_note-putnam-96">[95]</a> With the rise of a uniquely American reframing of dementia praecox/schizophrenia as a functional disorder or "reaction" to psychobiological stressors – a theory first put forth by <a href="/wiki/Adolf_Meyer_(psychiatrist)" title="Adolf Meyer (psychiatrist)">Adolf Meyer</a> in 1906—many trauma-induced conditions associated with dissociation, including "shell shock" or "war neuroses" during World War I, were subsumed under these diagnoses.<a href="#cite_note-Noll_2011-99">[98]</a> It was argued in the 1980s that DID patients were often misdiagnosed with schizophrenia.<a href="#cite_note-putnam-96">[95]</a> The public, however, was exposed to psychological ideas which took their interest. <a href="/wiki/Mary_Shelley" title="Mary Shelley">Mary Shelley</a>'s <a href="/wiki/Frankenstein" title="Frankenstein">Frankenstein</a>, <a href="/wiki/Robert_Louis_Stevenson" title="Robert Louis Stevenson">Robert Louis Stevenson</a>'s <a href="/wiki/Strange_Case_of_Dr_Jekyll_and_Mr_Hyde" title="Strange Case of Dr Jekyll and Mr Hyde">Strange Case of Dr Jekyll and Mr Hyde</a>, and many <a href="/wiki/Short_story" title="Short story">short stories</a> by <a href="/wiki/Edgar_Allan_Poe" title="Edgar Allan Poe">Edgar Allan Poe</a> had a formidable impact.<a href="#cite_note-pmid12094818-92">[91]</a> <div class="mw-heading mw-heading4"><h4 id="The_Three_Faces_of_Eve">The Three Faces of Eve</h4>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=25" title="Edit section: The Three Faces of Eve">edit</a>]</div> In 1957, with the publication of the bestselling book The Three Faces of Eve by psychiatrists <a href="/wiki/Corbett_H._Thigpen" title="Corbett H. Thigpen">Corbett H. Thigpen</a> and <a href="/wiki/Hervey_M._Cleckley" title="Hervey M. Cleckley">Hervey M. Cleckley</a>, based on a <a href="/wiki/Case_study" title="Case study">case study</a> of their patient <a href="/wiki/Chris_Costner_Sizemore" title="Chris Costner Sizemore">Chris Costner Sizemore</a>, and the subsequent popular <a href="/wiki/The_Three_Faces_of_Eve" title="The Three Faces of Eve">movie of the same name</a>, the American public's interest in multiple personality was revived. More cases of dissociative identity disorder were diagnosed in the following years.<a href="#cite_note-Schacter,_D._L._2011-102">[101]</a> The cause of the sudden increase of cases is indefinite, but it may be attributed to the increased awareness, which revealed previously undiagnosed cases or new cases may have been induced by the influence of the media on the behavior of individuals and the judgement of therapists.<a href="#cite_note-Schacter,_D._L._2011-102">[101]</a> During the 1970s an initially small number of clinicians campaigned to have it considered a legitimate diagnosis.<a href="#cite_note-putnam-96">[95]</a> <div class="mw-heading mw-heading3"><h3 id="History_in_the_DSM">History in the DSM</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=26" title="Edit section: History in the DSM">edit</a>]</div> The DSM-II used the term hysterical neurosis, dissociative type. It described the possible occurrence of alterations in the patient's state of consciousness or identity, and included the symptoms of "amnesia, somnambulism, fugue, and multiple personality".<a href="#cite_note-dsmii-103">[102]</a> The DSM-III grouped the diagnosis with the other four major <a href="/wiki/Dissociative_disorders" class="mw-redirect" title="Dissociative disorders">dissociative disorders</a> using the term "multiple personality disorder". The <a href="/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders" title="Diagnostic and Statistical Manual of Mental Disorders">DSM-IV</a> made more changes to DID than any other dissociative disorder,<a href="#cite_note-Cardena-24">[24]</a> and renamed it DID.<a href="#cite_note-dsm-23">[23]</a> The name was changed for two reasons: First, the change emphasizes the main problem is not a multitude of personalities, but rather a lack of a single, unified identity<a href="#cite_note-Cardena-24">[24]</a> and an emphasis on "the identities as centers of information processing".<a href="#cite_note-Spiegel-25">[25]</a> Second, the term "personality" is used to refer to "characteristic patterns of thoughts, feelings, moods, and behaviors of the whole individual", while for a patient with DID, the switches between identities and behavior patterns is the personality.<a href="#cite_note-Cardena-24">[24]</a> It is, for this reason, the DSM-IV-TR referred to "distinct identities or personality states" instead of personalities. The diagnostic criteria also changed to indicate that while the patient may name and personalize alters, they lack independent, objective existence.<a href="#cite_note-Cardena-24">[24]</a> The changes also included the addition of amnesia as a symptom, which was not included in the DSM-III-R because despite being a core symptom of the condition, patients may experience "amnesia for the amnesia" and fail to report it.<a href="#cite_note-Spiegel-25">[25]</a> Amnesia was replaced when it became clear that the risk of <a href="/wiki/Type_II_error" class="mw-redirect" title="Type II error">false negative</a> diagnoses was low because amnesia was central to DID.<a href="#cite_note-Cardena-24">[24]</a> The <a href="/wiki/ICD-10" title="ICD-10">ICD-10</a> places the diagnosis in the category of "dissociative disorders", within the subcategory of "other dissociative (conversion) disorders", but continues to list the condition as multiple personality disorder.<a href="#cite_note-ICD10-104">[103]</a> The DSM-IV-TR criteria for DID have been criticized for failing to capture the clinical complexity of DID, lacking usefulness in diagnosing individuals with DID (for instance, by focusing on the two least frequent and most subtle symptoms of DID) producing a high rate of <a href="/wiki/Type_II_error" class="mw-redirect" title="Type II error">false negatives</a> and an excessive number of DDNOS diagnoses, for excluding <a href="/wiki/Spirit_possession" title="Spirit possession">possession</a> (seen as a cross-cultural form of DID), and for including only two "core" symptoms of DID (amnesia and self-alteration) while failing to discuss hallucinations, trance-like states, <a href="/wiki/Somatoform_disorder" class="mw-redirect" title="Somatoform disorder">somatoform</a>, <a href="/wiki/Depersonalization" title="Depersonalization">depersonalization</a>, and <a href="/wiki/Derealization" title="Derealization">derealization</a> symptoms. Arguments have been made for allowing diagnosis through the presence of some, but not all of the characteristics of DID rather than the current exclusive focus on the two least common and noticeable features.<a href="#cite_note-Spiegel-25">[25]</a> The DSM-IV-TR criteria have also been criticized<a href="#cite_note-105">[104]</a> for being <a href="/wiki/Tautology_(logic)" title="Tautology (logic)">tautological</a>, using imprecise and undefined language and for the use of instruments that give a false sense of validity and empirical certainty to the diagnosis. The <a href="/wiki/DSM-5" title="DSM-5">DSM-5</a> updated the definition of DID in 2013, summarizing the changes as:<a href="#cite_note-highlights-106">[105]</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1244412712"><blockquote class="templatequote">Several changes to the criteria for dissociative identity disorder have been made in DSM-5. First, Criterion A has been expanded to include certain possession-form phenomena and functional neurological symptoms to account for more diverse presentations of the disorder. Second, Criterion A now specifically states that transitions in identity may be observable by others or self-reported. Third, according to Criterion B, individuals with dissociative identity disorder may have recurrent gaps in recall for everyday events, not just for traumatic experiences. Other text modifications clarify the nature and course of identity disruptions.</blockquote> Between 1968 and 1980, the term that was used for dissociative identity disorder was "Hysterical neurosis, dissociative type". The APA wrote in the second edition of the DSM: "In the dissociative type, alterations may occur in the patient's state of consciousness or in his identity, to produce such symptoms as amnesia, somnambulism, fugue, and multiple personality."<a href="#cite_note-dsmii-103">[102]</a> The number of cases sharply increased in the late 1970s and throughout the 80s, and the first scholarly <a href="/wiki/Monograph" title="Monograph">monographs</a> on the topic appeared in 1986.<a href="#cite_note-Kihlstrom-20">[20]</a> <div class="mw-heading mw-heading4"><h4 id="Book_and_film_Sybil">Book and film Sybil</h4>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=27" title="Edit section: Book and film Sybil">edit</a>]</div> In 1974, the highly influential book <a href="/wiki/Sybil_(Schreiber_book)" title="Sybil (Schreiber book)">Sybil</a> was published, and later made into a <a href="/wiki/Miniseries" title="Miniseries">miniseries</a> in <a href="/wiki/Sybil_(1976_film)" title="Sybil (1976 film)">1976</a> and <a href="/wiki/Sybil_(2007_film)" title="Sybil (2007 film)">again in 2007</a>. Describing what Robert Rieber called "the third most famous of multiple personality cases,"<a href="#cite_note-Rieber-107">[106]</a> it presented a detailed discussion of the problems of treatment of "Sybil Isabel Dorsett", a <a href="/wiki/Pseudonym" title="Pseudonym">pseudonym</a> for <a href="/wiki/Shirley_Ardell_Mason" title="Shirley Ardell Mason">Shirley Ardell Mason</a>. Though the book and subsequent films helped popularize the diagnosis and trigger an epidemic of the diagnosis,<a href="#cite_note-Paris2012-50">[49]</a> later analysis of the case suggested different interpretations, ranging from Mason's problems having been caused by the therapeutic methods and <a href="/wiki/Sodium_thiopental" title="Sodium thiopental">sodium pentathol</a> injections used by her psychiatrist, <a href="/wiki/Cornelia_B._Wilbur" title="Cornelia B. Wilbur">C. B. Wilbur</a>, or an inadvertent hoax due in part to the lucrative publishing rights,<a href="#cite_note-Rieber-107">[106]</a><a href="#cite_note-108">[107]</a> though this conclusion has itself been challenged.<a href="#cite_note-109">[108]</a> David Spiegel, a Stanford psychiatrist whose father treated Shirley Ardell Mason on occasion, says that his father described Mason as "a brilliant hysteric. He felt that Wilbur tended to pressure her to exaggerate on the dissociation she already had."<a href="#cite_note-110">[109]</a> [<a href="/wiki/Wikipedia:NOTRS" class="mw-redirect" title="Wikipedia:NOTRS">better source needed</a>] As media attention on DID increased, so too did the controversy surrounding the diagnosis.<a href="#cite_note-Farrell-111">[110]</a> <div class="mw-heading mw-heading4"><h4 id="Re-classifications">Re-classifications</h4>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=28" title="Edit section: Re-classifications">edit</a>]</div> The DSM-III intentionally omitted the terms "hysteria" and "neurosis", naming those as Dissociative Disorders, which included Multiple Personality Disorder,<a href="#cite_note-112">[111]</a> and also added Post-traumatic Stress Disorder in Anxiety Disorders section. In the opinion of <a href="/wiki/McGill_University" title="McGill University">McGill University</a> psychiatrist Joel Paris, this inadvertently legitimized them by forcing textbooks, which mimicked the structure of the DSM, to include a separate chapter on them and resulted in an increase in diagnosis of dissociative conditions. Once a rarely occurring spontaneous phenomenon (research in 1944 showed only 76 cases),<a href="#cite_note-113">[112]</a> the diagnosis became "an artifact of bad (or naïve) psychotherapy" as patients capable of dissociating were accidentally encouraged to express their symptoms by "overly fascinated" therapists.<a href="#cite_note-Paris2008-114">[113]</a> In a 1986 book chapter (later reprinted in another volume), philosopher of science <a href="/wiki/Ian_Hacking" title="Ian Hacking">Ian Hacking</a> focused on multiple personality disorder as an example of "making up people" through the untoward effects on individuals of the "dynamic nominalism" in medicine and psychiatry. With the invention of new terms, entire new categories of "natural kinds" of people are assumed to be created, and those thus diagnosed respond by re-creating their identity in light of the new cultural, medical, scientific, political and moral expectations. Hacking argued that the process of "making up people" is historically contingent, hence it is not surprising to find the rise, fall, and resurrection of such categories over time.<a href="#cite_note-115">[114]</a> Hacking revisited his concept of "making up people" in a 2006.<a href="#cite_note-116">[115]</a> "Interpersonality amnesia" was removed as a diagnostic feature from the DSM III in 1987, which may have contributed to the increasing frequency of the diagnosis.<a href="#cite_note-Kihlstrom-20">[20]</a> There were 200 reported cases of DID as of 1980, and 20,000 from 1980 to 1990.<a href="#cite_note-pmid7788115-117">[116]</a> <a href="/wiki/Joan_Acocella" title="Joan Acocella">Joan Acocella</a> reports that 40,000 cases were diagnosed from 1985 to 1995.<a href="#cite_note-Accocella-118">[117]</a> Scientific publications regarding DID peaked in the mid-1990s then rapidly declined.<a href="#cite_note-Pope-119">[118]</a> There were several contributing factors to the rapid decline of reports of multiple personality disorder/dissociative identity disorder. One was the discontinuation in December 1997 of Dissociation: Progress in the Dissociative Disorders, the journal of The International Society for the Study of Multiple Personality and Dissociation.<a href="#cite_note-120">[119]</a> The society and its journal were perceived as uncritical sources of legitimacy for the extraordinary claims of the existence of intergenerational satanic cults responsible for a "hidden holocaust"<a href="#cite_note-121">[120]</a> of <a href="/wiki/Satanic_ritual_abuse" class="mw-redirect" title="Satanic ritual abuse">Satanic ritual abuse</a> that was linked to the rise of MPD reports. In an effort to distance itself from the increasing skepticism regarding the clinical validity of MPD, the organization dropped "multiple personality" from its official name in 1993, and then in 1997 changed its name again to the <a href="/wiki/International_Society_for_the_Study_of_Trauma_and_Dissociation" title="International Society for the Study of Trauma and Dissociation">International Society for the Study of Trauma and Dissociation</a>.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] In 1994, the fourth edition of the DSM replaced the criteria again and changed the name of the condition from "multiple personality disorder" to the current "dissociative identity disorder" to emphasize the importance of changes to consciousness and identity rather than personality. The inclusion of interpersonality amnesia helped to distinguish DID from <a href="/wiki/Dissociative_disorder_not_otherwise_specified" title="Dissociative disorder not otherwise specified">dissociative disorder not otherwise specified</a> (DDNOS), but the condition retains an inherent subjectivity due to difficulty in defining terms such as personality, identity, ego-state, and even <a href="/wiki/Amnesia" title="Amnesia">amnesia</a>.<a href="#cite_note-Kihlstrom-20">[20]</a> The <a href="/wiki/ICD-10" title="ICD-10">ICD-10</a> classified DID as a "Dissociative [conversion] disorder" and used the name "multiple personality disorder" with the classification number of F44.81.<a href="#cite_note-ICD10-104">[103]</a> In the <a href="/wiki/ICD-11" title="ICD-11">ICD-11</a>, the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> have classified DID under the name "dissociative identity disorder" (code 6B64), and most cases formerly diagnosed as DDNOS are classified as "partial dissociative identity disorder" (code 6B65).<a href="#cite_note-122">[121]</a> <div class="mw-heading mw-heading3"><h3 id="21st_century">21st century</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=29" title="Edit section: 21st century">edit</a>]</div> A 2006 study compared scholarly research and publications on DID and <a href="/wiki/Dissociative_amnesia" title="Dissociative amnesia">dissociative amnesia</a> to other mental health conditions, such as <a href="/wiki/Anorexia_nervosa" title="Anorexia nervosa">anorexia nervosa</a>, <a href="/wiki/Alcohol_use_disorder" class="mw-redirect" title="Alcohol use disorder">alcohol use disorder</a>, and <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a> from 1984 to 2003. The results were found to be unusually distributed, with a very low level of publications in the 1980s followed by a significant rise that peaked in the mid-1990s and subsequently rapidly declined in the decade following. Compared to 25 other diagnosis, the mid-1990s "bubble" of publications regarding DID was unique. In the opinion of the authors of the review, the publication results suggest a period of "fashion" that waned, and that the two diagnoses "[did] not command widespread scientific acceptance."<a href="#cite_note-Pope-119">[118]</a> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=30" title="Edit section: Society and culture">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="In_popular_culture">In popular culture</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=31" title="Edit section: In popular culture">edit</a>]</div> The public's long fascination with DID has led to a number of different books and films,<a href="#cite_note-Guidelines2011-5">[5]</a>(p 169) with many representations described as increasing stigma by perpetuating the myth that people with mental illness are usually dangerous.<a href="#cite_note-Cinema-123">[122]</a> Movies about DID have been also criticized for poor representation of both DID and its treatment, including "greatly overrepresenting" the role of hypnosis in therapy,<a href="#cite_note-Gabbard-124">[123]</a> showing a significantly smaller number of personalities than many people with DID have,<a href="#cite_note-DoalMedia-125">[124]</a><a href="#cite_note-Gabbard-124">[123]</a><a href="#cite_note-seattleobituary-126">[125]</a> and misrepresenting people with DID as having theatrical and blatant switches between very conspicuous and different alters.<a href="#cite_note-Hunterbook-127">[126]</a> Some movies are parodies and ridicule DID, for instance, <a href="/wiki/Me,_Myself_%26_Irene" title="Me, Myself & Irene">Me, Myself & Irene</a>, which also incorrectly states that DID is <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a>.<a href="#cite_note-ButlerDidIt-128">[127]</a> In some stories, DID is used as a plot device, e.g. in <a href="/wiki/Fight_Club" title="Fight Club">Fight Club</a>, and in <a href="/wiki/Whodunnit" class="mw-redirect" title="Whodunnit">whodunnit</a> stories like <a href="/wiki/Secret_Window" title="Secret Window">Secret Window</a>.<a href="#cite_note-WeddingMovies-129">[128]</a><a href="#cite_note-ButlerDidIt-128">[127]</a> <a href="/wiki/United_States_of_Tara" title="United States of Tara">United States of Tara</a> was reported to be the first US television series with DID as its focus, and a professional commentary on each episode was published by the <a href="/wiki/International_Society_for_the_Study_of_Trauma_and_Dissociation" title="International Society for the Study of Trauma and Dissociation">International Society for the Study of Trauma and Dissociation</a>.<a href="#cite_note-isstd-Tara-130">[129]</a><a href="#cite_note-Halter2017-131">[130]</a> A number of people with DID have publicly spoken about their experiences, including comedian and talk show host <a href="/wiki/Roseanne_Barr" title="Roseanne Barr">Roseanne Barr</a>, who interviewed <a href="/wiki/Truddi_Chase" title="Truddi Chase">Truddi Chase</a>, author of When Rabbit Howls; <a href="/wiki/Chris_Costner_Sizemore" title="Chris Costner Sizemore">Chris Costner Sizemore</a>, the subject of <a href="/wiki/The_Three_Faces_of_Eve" title="The Three Faces of Eve">The Three Faces of Eve</a>, Cameron West, author of <a href="/wiki/First_Person_Plural" title="First Person Plural">First Person Plural: My life as a multiple</a>, and <a href="/wiki/National_Football_League" title="National Football League">NFL</a> player <a href="/wiki/Herschel_Walker" title="Herschel Walker">Herschel Walker</a>, author of Breaking Free: My life with dissociative identity disorder.<a href="#cite_note-DoalMedia-125">[124]</a><a href="#cite_note-132">[131]</a> In The Three Faces of Eve (1957) hypnosis is used to identify a childhood trauma which then allows her to fuse from three identities into just one.<a href="#cite_note-Gabbard-124">[123]</a> However, Sizemore's own books I'm Eve and A Mind of My Own revealed that this did not last; she later attempted suicide, sought further treatment, and actually had twenty-two personalities rather than three.<a href="#cite_note-Gabbard-124">[123]</a><a href="#cite_note-seattleobituary-126">[125]</a> Sizemore re-entered therapy and by 1974 had achieved a lasting recovery.<a href="#cite_note-Gabbard-124">[123]</a> <a href="/wiki/Voices_Within:_The_Lives_of_Truddi_Chase" title="Voices Within: The Lives of Truddi Chase">Voices Within: The Lives of Truddi Chase</a> portrays many of the 92 personalities Chase described in her book When Rabbit Howls, and is unusual in breaking away from the typical ending of integrating into one.<a href="#cite_note-Hunterbook-127">[126]</a><a href="#cite_note-ButlerDidIt-128">[127]</a> <a href="/wiki/Frankie_%26_Alice" title="Frankie & Alice">Frankie & Alice</a> (2010), starring <a href="/wiki/Halle_Berry" title="Halle Berry">Halle Berry</a> was based on a real person with DID.<a href="#cite_note-WeddingMovies-129">[128]</a> In popular culture dissociative identity disorder is often confused with <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a>,<a href="#cite_note-EncyclopediaTrauma-133">[132]</a> as was true of the 1958 episode "The Case of the Deadly Double" of the <a href="/wiki/Perry_Mason_(1957_TV_series)" title="Perry Mason (1957 TV series)">Perry Mason</a> TV series, where a woman shown as having two very distinct personas is described as being schizophrenic <a href="#cite_note-134">[133]</a> On the other hand, some movies advertised as representing dissociative identity disorder may be more representative of <a href="/wiki/Psychosis" title="Psychosis">psychosis</a> or <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a>, for example <a href="/wiki/Psycho_(1960_film)" title="Psycho (1960 film)">Psycho</a> (1960).<a href="#cite_note-Cinema-123">[122]</a><a href="#cite_note-WeddingMovies-129">[128]</a> In his book The C.I.A. Doctors: Human Rights Violations by American Psychiatrists, psychiatrist <a href="/wiki/Colin_A._Ross" title="Colin A. Ross">Colin A. Ross</a> states that based on documents obtained through <a href="/wiki/Freedom_of_information_legislation" class="mw-redirect" title="Freedom of information legislation">freedom of information legislation</a>, a psychiatrist linked to <a href="/wiki/Project_MKULTRA" class="mw-redirect" title="Project MKULTRA">Project MKULTRA</a> reported being able to deliberately induce dissociative identity disorder using a variety of highly aversive and abusive techniques, creating a <a href="/wiki/The_Manchurian_Candidate" title="The Manchurian Candidate">Manchurian Candidate</a> for military purposes.<a href="#cite_note-Vogt2019-135">[134]</a><a href="#cite_note-Ross2006-136">[135]</a> In the <a href="/wiki/USA_Network" title="USA Network">USA Network</a> television production <a href="/wiki/Mr._Robot" title="Mr. Robot">Mr. Robot</a>, the protagonist <a href="/wiki/Elliot_Alderson" class="mw-redirect" title="Elliot Alderson">Elliot Alderson</a> was created using anecdotal experiences of DID of the show's creator's friends. <a href="/wiki/Sam_Esmail" title="Sam Esmail">Sam Esmail</a> said he consulted with a psychologist who "concretized" the character's mental health conditions, especially his plurality.<a href="#cite_note-137">[136]</a> In <a href="/wiki/M._Night_Shyamalan" title="M. Night Shyamalan">M. Night Shyamalan</a>'s <a href="/wiki/Unbreakable_(film_series)" title="Unbreakable (film series)">Unbreakable</a> superhero film series (specifically, the films <a href="/wiki/Split_(2016_American_film)" title="Split (2016 American film)">Split</a> and <a href="/wiki/Glass_(2019_film)" title="Glass (2019 film)">Glass</a>), <a href="/wiki/Kevin_Wendell_Crumb" class="mw-redirect" title="Kevin Wendell Crumb">Kevin Wendell Crumb</a> is diagnosed with DID, and that some of the personalities have super-human powers. Experts and advocates say the films are a negative portrayal of DID and the films promote the stigmatization of the disorder.<a href="#cite_note-138">[137]</a> In the 1997 Japanese role-playing game <a href="/wiki/Final_Fantasy_VII" title="Final Fantasy VII">Final Fantasy VII</a>, the protagonist <a href="/wiki/Cloud_Strife" title="Cloud Strife">Cloud Strife</a> is shown to have an identity disorder involving <a href="/wiki/False_memory" title="False memory">false memories</a> as a result of <a href="/wiki/Post-traumatic_stress_disorder" title="Post-traumatic stress disorder">post-traumatic stress disorder</a> (PTSD). Sharon Packer has identified Cloud as having DID.<a href="#cite_note-139">[138]</a> In <a href="/wiki/Marvel_Comics" title="Marvel Comics">Marvel Comics</a>, the character of <a href="/wiki/Moon_Knight" title="Moon Knight">Moon Knight</a> is shown to have DID. In the TV series <a href="/wiki/Moon_Knight_(miniseries)" title="Moon Knight (miniseries)">Moon Knight</a> based on the comic book character, protagonist <a href="/wiki/Marc_Spector_(Marvel_Cinematic_Universe)" title="Marc Spector (Marvel Cinematic Universe)">Marc Spector</a> is depicted with DID; the website for the <a href="/wiki/National_Alliance_on_Mental_Illness" title="National Alliance on Mental Illness">National Alliance on Mental Illness</a> appears in the series' end credits.<a href="#cite_note-140">[139]</a> Another Marvel character, <a href="/wiki/Legion_(Marvel_Comics)" title="Legion (Marvel Comics)">Legion</a>, has DID in the comics, although he has schizophrenia in the <a href="/wiki/Legion_(TV_series)" title="Legion (TV series)">TV show version</a>, highlighting the general public's confusion between the two distinct and separate disorders.<a href="#cite_note-141">[140]</a> <div class="mw-heading mw-heading3"><h3 id="Legal_issues">Legal issues</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=32" title="Edit section: Legal issues">edit</a>]</div> People with dissociative identity disorder may be involved in legal cases as a witness, defendant, or as the victim/injured party. Claims of DID have been used only rarely to argue <a href="/wiki/Insanity_defense" title="Insanity defense">criminal insanity</a> in court.<a href="#cite_note-Farrell-111">[110]</a><a href="#cite_note-Farrell2011-142">[141]</a> In the United States dissociative identity disorder has previously been found to meet the <a href="/wiki/Frye_standard" title="Frye standard">Frye test</a> as a generally accepted medical condition, and the newer <a href="/wiki/Daubert_standard" title="Daubert standard">Daubert standard</a>.<a href="#cite_note-FrankelCrime-143">[142]</a><a href="#cite_note-Crego2020-144">[143]</a> Within legal circles, DID has been described as one of the most disputed psychiatric diagnoses and <a href="/wiki/Forensic_psychology" title="Forensic psychology">forensic assessments</a> are needed.<a href="#cite_note-Rein2008-57">[56]</a> For defendants whose defense states they have a diagnosis of DID, courts must distinguish between those who genuinely have DID and those who are <a href="/wiki/Malingering" title="Malingering">malingering</a> to avoid responsibility.<a href="#cite_note-FrankelCrime-143">[142]</a><a href="#cite_note-Rein2008-57">[56]</a> Expert witnesses are typically used to assess defendants in such cases,<a href="#cite_note-Farrell-111">[110]</a> although some of the standard assessments like the <a href="/wiki/Minnesota_Multiphasic_Personality_Inventory" title="Minnesota Multiphasic Personality Inventory">MMPI-2</a> were not developed for people with a trauma history and the validity scales may incorrectly suggest malingering.<a href="#cite_note-BrownDetect-145">[144]</a> The <a href="/wiki/Multiscale_Dissociation_Inventory" title="Multiscale Dissociation Inventory">Multiscale Dissociation Inventory</a> (Briere, 2002) is well suited to assessing malingering and dissociative disorders, unlike the self-report Dissociative Experiences Scale.<a href="#cite_note-BrownDetect-145">[144]</a> In DID, evidence about the altered states of consciousness, actions of alter identities and episodes of amnesia may be excluded from a court if they are not considered relevant, although different countries and regions have different laws.<a href="#cite_note-Farrell-111">[110]</a> A diagnosis of DID may be used to claim a defense of <a href="/wiki/Not_guilty_by_reason_of_insanity" class="mw-redirect" title="Not guilty by reason of insanity">not guilty by reason of insanity</a>, but this very rarely succeeds, or of diminished capacity, which may reduce the length of a sentence.<a href="#cite_note-Farrell2011-142">[141]</a><a href="#cite_note-Crego2020-144">[143]</a> DID may also affect competency to stand trial.<a href="#cite_note-146">[145]</a> A not guilty by reason of insanity plea was first used successfully in an American court in 1978, in the <a href="/wiki/Billy_Milligan" title="Billy Milligan">State of Ohio v. Milligan</a> case.<a href="#cite_note-Farrell2011-142">[141]</a> However, a DID diagnosis is not automatically considered a justification for an insanity verdict, and since Milligan the few cases claiming insanity have largely been unsuccessful.<a href="#cite_note-Farrell2011-142">[141]</a> <a href="/wiki/Bennett_Braun" title="Bennett Braun">Bennett G. Braun</a> was an American psychiatrist known for his promotion of the concept of multiple personality disorder (now called "dissociative identity disorder") and involvement in promoting the "<a href="/wiki/Satanic_Panic" class="mw-redirect" title="Satanic Panic">Satanic Panic</a>", a <a href="/wiki/Moral_panic" title="Moral panic">moral panic</a> around a discredited <a href="/wiki/Conspiracy_theory" title="Conspiracy theory">conspiracy theory</a> that led to thousands of people being wrongfully medically treated or investigated for nonexistent crimes.<a href="#cite_note-Risen-2024-147">[146]</a><a href="#cite_note-Hanson-1998-148">[147]</a> <div class="mw-heading mw-heading3"><h3 id="Online_subculture">Online subculture</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=33" title="Edit section: Online subculture">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Multiplicity_(subculture)" title="Multiplicity (subculture)">Multiplicity (subculture)</a></div> A DID community exists on <a href="/wiki/Social_media" title="Social media">social media</a>, including <a href="/wiki/YouTube" title="YouTube">YouTube</a>, <a href="/wiki/Reddit" title="Reddit">Reddit</a>, <a href="/wiki/Discord" title="Discord">Discord</a>, and <a href="/wiki/TikTok" title="TikTok">TikTok</a>. In those contexts, the experience of dissociative identities has been called multiplicity.<a href="#cite_note-Lucas-2021-149">[148]</a><a href="#cite_note-150">[149]</a> High-profile members of this community have been criticized for faking their condition for views, or for portraying the disorder lightheartedly.<a href="#cite_note-Lucas-2021-149">[148]</a> Psychologist Naomi Torres-Mackie, head of research at The Mental Health Coalition, has stated "All of a sudden, all of my adolescent patients think that they have this, and they don't ... Folks start attaching clinical meaning and feeling like, 'I should be diagnosed with this. I need medication for this', when actually a lot of these experiences are normative and don't need to be pathologized or treated."<a href="#cite_note-Teen-Vogue-2022-151">[150]</a> However, online communities for DID can be beneficial. Aubrey Bakker, a neuropsychologist, says, "Dissociative Identity Disorder can be extremely isolating... and [p]articipating in TikTok’s DID community can remedy some of that isolation."<a href="#cite_note-Teen-Vogue-2022-151">[150]</a> <div class="mw-heading mw-heading3"><h3 id="Advocacy">Advocacy</h3>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=34" title="Edit section: Advocacy">edit</a>]</div> Some advocates consider DID to be a form of <a href="/wiki/Neurodiversity" title="Neurodiversity">neurodiversity</a>, leading to advocacy in recognizing 'positive plurality' and the use of plural pronouns such as "we" and "our".<a href="#cite_note-DoalMedia-125">[124]</a><a href="#cite_note-152">[151]</a> Advocates also challenge the necessity of integration.<a href="#cite_note-153">[152]</a><a href="#cite_note-154">[153]</a> Timothy Baynes argues that forcing people to undergo it as a therapeutic treatment is "seriously immoral".<a href="#cite_note-155">[154]</a> In 2011, author Lance Lippert wrote that most people with DID downplayed or minimized their symptoms rather than seeking fame, often due to shame or fear of the effects of stigma.<a href="#cite_note-Guidelines2011-5">[5]</a><a href="#cite_note-156">[155]</a> Therapists may discourage people with DID from media work due to concerns that they may feel exploited or traumatized, for example as a result of demonstrating switching between personality states to entertain others.<a href="#cite_note-Guidelines2011-5">[5]</a>(p 169) A DID Awareness Day takes place on March 5 annually, and a multicolored awareness ribbon is used, based on the idea of a "crazy quilt".<a href="#cite_note-McHugh2019-157">[156]</a><a href="#cite_note-158">[157]</a> <div class="mw-heading mw-heading2"><h2 id="References">References</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=35" title="Edit section: References">edit</a>]</div> Informational notes <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-lower-alpha"> <div class="mw-references-wrap"><ol class="references"> <li id="cite_note-44"><a href="#cite_ref-44">^</a> Most of the published clinical case series are focused on chronic and complex forms of dissociative disorders. Data collected in diverse geographic locations such as North America [2], Puerto Rico [3], Western Europe [4], Turkey [5], and Australia [6] underline the consistency in clinical symptoms of dissociative disorders. These clinical case series have also documented that dissociative patients report highest frequencies of childhood psychological trauma among all psychiatric disorders. Childhood sexual (57.1%–90.2%), emotional (57.1%), and physical (62.9%–82.4%) abuse and neglect (62.9%) are among them (2–6). — Sar (2011)<a href="#cite_note-Sar2011-43">[43]</a>: §1, Introduction, p. 1  </li> </ol></div></div> Citations <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239543626"><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-DSM5-1">^ <a href="#cite_ref-DSM5_1-0">a</a> <a href="#cite_ref-DSM5_1-1">b</a> <a href="#cite_ref-DSM5_1-2">c</a> <a href="#cite_ref-DSM5_1-3">d</a> <a href="#cite_ref-DSM5_1-4">e</a> <a href="#cite_ref-DSM5_1-5">f</a> <a href="#cite_ref-DSM5_1-6">g</a> <a href="#cite_ref-DSM5_1-7">h</a> <a href="#cite_ref-DSM5_1-8">i</a> <a href="#cite_ref-DSM5_1-9">j</a> <a href="#cite_ref-DSM5_1-10">k</a> <a href="#cite_ref-DSM5_1-11">l</a> <a href="#cite_ref-DSM5_1-12">m</a> <a href="#cite_ref-DSM5_1-13">n</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFAmerican_Psychiatric_Association2013" class="citation book cs1"><a href="/wiki/American_Psychiatric_Association" title="American Psychiatric Association">American Psychiatric Association</a> (2013). <a rel="nofollow" class="external text" href="https://archive.org/details/diagnosticstatis0005unse/page/291">Diagnostic and Statistical Manual of Mental Disorders</a> (5th ed.). 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Retrieved 9 May 2020.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Chicago+Tribune&rft.atitle=Truddi+Chase&rft.date=1987-08-30&rft.aulast=Cheryl&rft.aufirst=Lavin&rft_id=https%3A%2F%2Fwww.chicagotribune.com%2Fnews%2Fct-xpm-1987-08-30-8703050949-story.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADissociative+identity+disorder" class="Z3988"> </li> <li id="cite_note-155"><a href="#cite_ref-155">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBayne2002" class="citation journal cs1">Bayne TJ (1 February 2002). "Moral Status and the Treatment of Dissociative Identity Disorder". The Journal of Medicine and Philosophy. 27 (1): 87–105. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1076%2Fjmep.27.1.87.2973">10.1076/jmep.27.1.87.2973</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11961688">11961688</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Journal+of+Medicine+and+Philosophy&rft.atitle=Moral+Status+and+the+Treatment+of+Dissociative+Identity+Disorder&rft.volume=27&rft.issue=1&rft.pages=%3Cspan+class%3D%22nowrap%22%3E87-%3C%2Fspan%3E105&rft.date=2002-02-01&rft_id=info%3Adoi%2F10.1076%2Fjmep.27.1.87.2973&rft_id=info%3Apmid%2F11961688&rft.aulast=Bayne&rft.aufirst=Timothy+J.&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADissociative+identity+disorder" class="Z3988"> </li> <li id="cite_note-156"><a href="#cite_ref-156">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLippertHallMiller-OttDavis2019" class="citation book cs1">Lippert LR, Hall RD, Miller-Ott AE, Davis DC (2019-12-15). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=B9a8DwAAQBAJ">Communicating Mental Health: History, Contexts, and Perspectives</a>. Rowman & Littlefield. pp. 84–85. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4985-7802-8" title="Special:BookSources/978-1-4985-7802-8"><bdi>978-1-4985-7802-8</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Communicating+Mental+Health%3A+History%2C+Contexts%2C+and+Perspectives&rft.pages=%3Cspan+class%3D%22nowrap%22%3E84-%3C%2Fspan%3E85&rft.pub=Rowman+%26+Littlefield&rft.date=2019-12-15&rft.isbn=978-1-4985-7802-8&rft.aulast=Lippert&rft.aufirst=Lance+R.&rft.au=Hall%2C+Robert+D.&rft.au=Miller-Ott%2C+Aimee+E.&rft.au=Davis%2C+Daniel+Cochece&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DB9a8DwAAQBAJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADissociative+identity+disorder" class="Z3988"> </li> <li id="cite_note-McHugh2019-157"><a href="#cite_ref-McHugh2019_157-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMcMaugh2019" class="citation web cs1">McMaugh K (2019-03-08). <a rel="nofollow" class="external text" href="https://news.isst-d.org/dissociative-identities-awareness-day/">"Dissociative Identities Awareness Day – ISSTD News"</a>. isst-d.org. Retrieved 2020-07-24.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=isst-d.org&rft.atitle=Dissociative+Identities+Awareness+Day+%E2%80%93+ISSTD+News&rft.date=2019-03-08&rft.aulast=McMaugh&rft.aufirst=Kate&rft_id=https%3A%2F%2Fnews.isst-d.org%2Fdissociative-identities-awareness-day%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADissociative+identity+disorder" class="Z3988"> </li> <li id="cite_note-158"><a href="#cite_ref-158">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBroady2018" class="citation web cs1">Broady K (2018-03-06). <a rel="nofollow" class="external text" href="https://www.discussingdissociation.com/2018/03/dissociative-identity-disorder-awareness-day-march-5/">"Dissociative Identity Disorder (DID) Awareness Day - March 5"</a>. Discussing Dissociation. Retrieved 2020-07-24.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Discussing+Dissociation&rft.atitle=Dissociative+Identity+Disorder+%28DID%29+Awareness+Day+-+March+5&rft.date=2018-03-06&rft.aulast=Broady&rft.aufirst=Kathy&rft_id=https%3A%2F%2Fwww.discussingdissociation.com%2F2018%2F03%2Fdissociative-identity-disorder-awareness-day-march-5%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADissociative+identity+disorder" class="Z3988"> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2>[<a href="/w/index.php?title=Dissociative_identity_disorder&action=edit&section=36" title="Edit section: External links">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid 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ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-abovebelow"> Dissociative identity disorder at Wikipedia's <a href="/wiki/Wikipedia:Wikimedia_sister_projects" title="Wikipedia:Wikimedia sister projects">sister projects</a></div> <div class="side-box-flex"> <div class="side-box-text plainlist"><ul><li><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/0/06/Wiktionary-logo-v2.svg/27px-Wiktionary-logo-v2.svg.png" decoding="async" width="27" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/0/06/Wiktionary-logo-v2.svg/41px-Wiktionary-logo-v2.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/0/06/Wiktionary-logo-v2.svg/54px-Wiktionary-logo-v2.svg.png 2x" data-file-width="391" data-file-height="391" /><a href="https://en.wiktionary.org/wiki/dissociative_identity_disorder" class="extiw" title="wikt:dissociative identity disorder">Definitions</a> from Wiktionary</li><li><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/20px-Commons-logo.svg.png" decoding="async" width="20" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/40px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /><a href="https://commons.wikimedia.org/wiki/Category:Dissociative_identity_disorder" class="extiw" title="c:Category:Dissociative identity disorder">Media</a> from Commons</li><li><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/26px-Wikisource-logo.svg.png" decoding="async" width="26" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/39px-Wikisource-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/51px-Wikisource-logo.svg.png 2x" data-file-width="410" data-file-height="430" /><a href="https://en.wikisource.org/wiki/Special:Search/Dissociative_identity_disorder" class="extiw" title="s:Special:Search/Dissociative identity disorder">Texts</a> from Wikisource</li></ul></div></div> </div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.isst-d.org/">"International Society for the Study of Trauma and Dissociation"</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=International+Society+for+the+Study+of+Trauma+and+Dissociation&rft_id=http%3A%2F%2Fwww.isst-d.org%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADissociative+identity+disorder" class="Z3988"></li></ul> <div class="navbox-styles"><style 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· ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q18657" class="extiw" title="d:Q18657">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1829103493">6B64</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/F44.8">F44.8</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10-CM" title="ICD-10-CM">10-CM</a>: <a rel="nofollow" class="external text" href="https://icd10cmtool.cdc.gov/?fy=FY2024&query=F44.81">F44.81</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=300.14">300.14</a></li><li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D009105">D009105</a></li><li><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddbComorbid.htm">Comorbid</a></li><li><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a>: <a rel="nofollow" class="external text" href="http://snomed.info/id/31611000">31611000</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/916186-overview">article/916186</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link 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href="/wiki/Template_talk:Mental_disorders" title="Template talk:Mental disorders"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Mental_disorders" title="Special:EditPage/Template:Mental disorders"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Mental_disorders_(Classification)596" style="font-size:114%;margin:0 4em"><a href="/wiki/Mental_disorder" title="Mental disorder">Mental disorders</a> (<a href="/wiki/Classification_of_mental_disorders" title="Classification of mental disorders">Classification</a>)</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Adult_personality_and_behavior596" style="font-size:114%;margin:0 4em">Adult personality and behavior</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Sexual</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ego-dystonic_sexual_orientation" title="Ego-dystonic sexual orientation">Ego-dystonic sexual orientation</a></li> <li><a href="/wiki/Paraphilia" title="Paraphilia">Paraphilia</a> <ul><li><a href="/wiki/Sexual_fetishism" title="Sexual fetishism">Fetishism</a></li> <li><a href="/wiki/Voyeurism" title="Voyeurism">Voyeurism</a></li></ul></li> <li><a href="/wiki/Sexual_anhedonia" title="Sexual anhedonia">Sexual anhedonia</a></li> <li><a href="/wiki/Sexual_anorexia" title="Sexual anorexia">Sexual anorexia</a></li> <li><a href="/wiki/Sexual_maturation_disorder" title="Sexual maturation disorder">Sexual maturation disorder</a></li> <li><a href="/wiki/Sexual_relationship_disorder" title="Sexual relationship disorder">Sexual relationship disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Factitious_disorder" title="Factitious disorder">Factitious disorder</a> <ul><li><a href="/wiki/Factitious_disorder_imposed_on_self" title="Factitious disorder imposed on self">Munchausen syndrome</a></li></ul></li> <li><a href="/wiki/Fear_of_intimacy" title="Fear of intimacy">Fear of intimacy</a></li> <li><a href="/wiki/Gender_dysphoria" title="Gender dysphoria">Gender dysphoria</a></li> <li><a href="/wiki/Intermittent_explosive_disorder" title="Intermittent explosive disorder">Intermittent explosive disorder</a></li> <li><a href="/wiki/Excoriation_disorder" title="Excoriation disorder">Dermatillomania</a></li> <li><a href="/wiki/Kleptomania" title="Kleptomania">Kleptomania</a></li> <li><a href="/wiki/Pyromania" title="Pyromania">Pyromania</a></li> <li><a href="/wiki/Trichotillomania" title="Trichotillomania">Trichotillomania</a></li> <li><a href="/wiki/Personality_disorder" title="Personality disorder">Personality disorder</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Childhood_and_learning596" style="font-size:114%;margin:0 4em"><a href="/wiki/Mental_disorders_diagnosed_in_childhood" title="Mental disorders diagnosed in childhood">Childhood and learning</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Emotional_and_behavioral_disorders" title="Emotional and behavioral disorders">Emotional and behavioral</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Attention_deficit_hyperactivity_disorder" title="Attention deficit hyperactivity disorder">ADHD</a></li> <li><a href="/wiki/Conduct_disorder" title="Conduct disorder">Conduct disorder</a> <ul><li><a href="/wiki/Oppositional_defiant_disorder" title="Oppositional defiant disorder">ODD</a></li></ul></li> <li><a href="/wiki/Emotional_and_behavioral_disorders" title="Emotional and behavioral disorders">Emotional and behavioral disorders</a> <ul><li><a href="/wiki/Separation_anxiety_disorder" title="Separation anxiety disorder">Separation anxiety disorder</a></li></ul></li> <li><a href="/wiki/Movement_disorders" class="mw-redirect" title="Movement disorders">Movement disorders</a> <ul><li><a href="/wiki/Stereotypic_movement_disorder" title="Stereotypic movement disorder">Stereotypic</a></li></ul></li> <li>Social functioning <ul><li><a href="/wiki/Disinhibited_attachment_disorder" title="Disinhibited attachment disorder">DAD</a></li> <li><a href="/wiki/Reactive_attachment_disorder" title="Reactive attachment disorder">RAD</a></li> <li><a href="/wiki/Selective_mutism" title="Selective mutism">Selective mutism</a></li></ul></li> <li><a href="/wiki/Speech_disorder" title="Speech disorder">Speech</a> <ul><li><a href="/wiki/Cluttering" title="Cluttering">Cluttering</a></li> <li><a href="/wiki/Stuttering" title="Stuttering">Stuttering</a></li></ul></li> <li><a href="/wiki/Tic_disorder" title="Tic disorder">Tic disorder</a> <ul><li><a href="/wiki/Tourette_syndrome" title="Tourette syndrome">Tourette syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Intellectual_disability" title="Intellectual disability">Intellectual disability</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/X-linked_intellectual_disability" title="X-linked intellectual disability">X-linked intellectual disability</a> <ul><li><a href="/wiki/Lujan%E2%80%93Fryns_syndrome" title="Lujan–Fryns syndrome">Lujan–Fryns syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Psychological development (<a href="/wiki/Developmental_disability" title="Developmental disability">developmental disabilities</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pervasive_developmental_disorder" title="Pervasive developmental disorder">Pervasive</a></li> <li><a href="/wiki/Specific_developmental_disorder" title="Specific developmental disorder">Specific</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Mood_(affective)596" style="font-size:114%;margin:0 4em"><a href="/wiki/Mood_disorder" title="Mood disorder">Mood</a> (affective)</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bipolar_disorder" title="Bipolar disorder">Bipolar</a> <ul><li><a href="/wiki/Bipolar_I_disorder" title="Bipolar I disorder">Bipolar I</a></li> <li><a href="/wiki/Bipolar_II_disorder" title="Bipolar II disorder">Bipolar II</a></li> <li><a href="/wiki/Bipolar_disorder_not_otherwise_specified" title="Bipolar disorder not otherwise specified">Bipolar NOS</a></li> <li><a href="/wiki/Cyclothymia" title="Cyclothymia">Cyclothymia</a></li></ul></li> <li><a href="/wiki/Depression_(mood)" title="Depression (mood)">Depression</a> <ul><li><a href="/wiki/Atypical_depression" title="Atypical depression">Atypical depression</a></li> <li><a href="/wiki/Dysthymia" title="Dysthymia">Dysthymia</a></li> <li><a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">Major depressive disorder</a></li> <li><a href="/wiki/Melancholic_depression" class="mw-redirect" title="Melancholic depression">Melancholic depression</a></li> <li><a href="/wiki/Seasonal_affective_disorder" title="Seasonal affective disorder">Seasonal affective disorder</a></li></ul></li> <li><a href="/wiki/Mania" title="Mania">Mania</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Neurological_and_symptomatic596" style="font-size:114%;margin:0 4em">Neurological and symptomatic</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Autism_spectrum" class="mw-redirect" title="Autism spectrum">Autism spectrum</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Autism" title="Autism">Autism</a></li> <li><a href="/wiki/Asperger_syndrome" title="Asperger syndrome">Asperger syndrome</a></li> <li><a href="/wiki/High-functioning_autism" title="High-functioning autism">High-functioning autism</a></li> <li><a href="/wiki/Pervasive_developmental_disorder_not_otherwise_specified" title="Pervasive developmental disorder not otherwise specified">PDD-NOS</a></li> <li><a href="/wiki/Savant_syndrome" title="Savant syndrome">Savant syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dementia" title="Dementia">Dementia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HIV-associated_neurocognitive_disorder" title="HIV-associated neurocognitive disorder">AIDS dementia complex</a></li> <li><a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's disease</a></li> <li><a href="/wiki/Creutzfeldt%E2%80%93Jakob_disease" title="Creutzfeldt–Jakob disease">Creutzfeldt–Jakob disease</a></li> <li><a href="/wiki/Frontotemporal_dementia" title="Frontotemporal dementia">Frontotemporal dementia</a></li> <li><a href="/wiki/Huntington%27s_disease" title="Huntington's disease">Huntington's disease</a></li> <li><a href="/wiki/Mild_cognitive_impairment" title="Mild cognitive impairment">Mild cognitive impairment</a></li> <li><a href="/wiki/Parkinson%27s_disease" title="Parkinson's disease">Parkinson's disease</a></li> <li><a href="/wiki/Pick%27s_disease" class="mw-redirect" title="Pick's disease">Pick's disease</a></li> <li><a href="/wiki/Sundowning" title="Sundowning">Sundowning</a></li> <li><a href="/wiki/Vascular_dementia" title="Vascular dementia">Vascular dementia</a></li> <li><a href="/wiki/Wandering_(dementia)" title="Wandering (dementia)">Wandering</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Delirium" title="Delirium">Delirium</a></li> <li><a href="/wiki/Organic_brain_syndrome" title="Organic brain syndrome">Organic brain syndrome</a></li> <li><a href="/wiki/Post-concussion_syndrome" title="Post-concussion syndrome">Post-concussion syndrome</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible uncollapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Neurotic,_stress-related_and_somatoform596" style="font-size:114%;margin:0 4em"><a href="/wiki/Neurosis" title="Neurosis">Neurotic</a>, <a href="/wiki/Stress_(biology)" title="Stress (biology)">stress</a>-related and <a href="/wiki/Somatic_symptom_disorder" title="Somatic symptom disorder">somatoform</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Adjustment_disorder" title="Adjustment disorder">Adjustment</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adjustment_disorder" title="Adjustment disorder">Adjustment disorder</a> with depressed mood</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anxiety_disorder" title="Anxiety disorder">Anxiety</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Phobia" title="Phobia">Phobia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Agoraphobia" title="Agoraphobia">Agoraphobia</a></li> <li><a href="/wiki/Childhood_phobia" title="Childhood phobia">Childhood phobia</a></li> <li><a href="/wiki/Social_anxiety" title="Social anxiety">Social anxiety</a></li> <li><a href="/wiki/Social_anxiety_disorder" title="Social anxiety disorder">Social phobia</a> <ul><li><a href="/wiki/Anthropophobia" class="mw-redirect" title="Anthropophobia">Anthropophobia</a></li> <li><a href="/wiki/Specific_social_phobia" title="Specific social phobia">Specific social phobia</a></li></ul></li> <li><a href="/wiki/Specific_phobia" title="Specific phobia">Specific phobia</a> <ul><li><a href="/wiki/Claustrophobia" title="Claustrophobia">Claustrophobia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Generalized_anxiety_disorder" title="Generalized anxiety disorder">Generalized anxiety disorder</a></li> <li><a href="/wiki/Obsessive%E2%80%93compulsive_disorder" title="Obsessive–compulsive disorder">OCD</a></li> <li><a href="/wiki/Panic_attack" title="Panic attack">Panic attack</a></li> <li><a href="/wiki/Panic_disorder" title="Panic disorder">Panic disorder</a></li> <li><a href="/wiki/Psychological_stress" title="Psychological stress">Stress</a> <ul><li><a href="/wiki/Acute_stress_reaction" title="Acute stress reaction">Acute stress reaction</a></li> <li><a href="/wiki/Post-traumatic_stress_disorder" title="Post-traumatic stress disorder">PTSD</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dissociative_disorder" title="Dissociative disorder">Dissociative</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Depersonalization-derealization_disorder" title="Depersonalization-derealization disorder">Depersonalization-derealization disorder</a></li> <li><a class="mw-selflink selflink">Dissociative identity disorder</a></li> <li><a href="/wiki/Dissociative_amnesia" title="Dissociative amnesia">Dissociative amnesia</a></li> <li><a href="/wiki/Dissociative_fugue" title="Dissociative fugue">Dissociative fugue</a></li> <li><a href="/wiki/Dissociative_disorder_not_otherwise_specified" title="Dissociative disorder not otherwise specified">Dissociative disorder not otherwise specified</a></li> <li><a href="/wiki/Other_specified_dissociative_disorder" title="Other specified dissociative disorder">Other specified dissociative disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Somatic_symptom_disorder" title="Somatic symptom disorder">Somatic symptom</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Body_dysmorphic_disorder" title="Body dysmorphic disorder">Body dysmorphic disorder</a></li> <li><a href="/wiki/Conversion_disorder" title="Conversion disorder">Conversion disorder</a> <ul><li><a href="/wiki/Ganser_syndrome" title="Ganser syndrome">Ganser syndrome</a></li> <li><a href="/wiki/Globus_pharyngis" title="Globus pharyngis">Globus pharyngis</a></li> <li><a href="/wiki/Psychogenic_non-epileptic_seizure" title="Psychogenic non-epileptic seizure">Psychogenic non-epileptic seizures</a></li></ul></li> <li><a href="/wiki/False_pregnancy" title="False pregnancy">False pregnancy</a></li> <li><a href="/wiki/Hypochondriasis" title="Hypochondriasis">Hypochondriasis</a></li> <li><a href="/wiki/Mass_psychogenic_illness" title="Mass psychogenic illness">Mass psychogenic illness</a></li> <li><a href="/wiki/Nosophobia" title="Nosophobia">Nosophobia</a></li> <li><a href="/wiki/Psychogenic_pain" title="Psychogenic pain">Psychogenic pain</a></li> <li><a href="/wiki/Somatization_disorder" class="mw-redirect" title="Somatization disorder">Somatization disorder</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Physiological_and_physical_behavior596" style="font-size:114%;margin:0 4em">Physiological and physical behavior</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Eating_disorder" title="Eating disorder">Eating</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anorexia_nervosa" title="Anorexia nervosa">Anorexia nervosa</a></li> <li><a href="/wiki/Bulimia_nervosa" title="Bulimia nervosa">Bulimia nervosa</a></li> <li><a href="/wiki/Rumination_syndrome" title="Rumination syndrome">Rumination syndrome</a></li> <li><a href="/wiki/Other_specified_feeding_or_eating_disorder" title="Other specified feeding or eating disorder">Other specified feeding or eating disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Nonorganic <a href="/wiki/Sleep_disorder" title="Sleep disorder">sleep</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypersomnia" title="Hypersomnia">Hypersomnia</a></li> <li><a href="/wiki/Insomnia" title="Insomnia">Insomnia</a></li> <li><a href="/wiki/Parasomnia" title="Parasomnia">Parasomnia</a> <ul><li><a href="/wiki/Night_terror" title="Night terror">Night terror</a></li> <li><a href="/wiki/Nightmare" title="Nightmare">Nightmare</a></li> <li><a href="/wiki/Rapid_eye_movement_sleep_behavior_disorder" title="Rapid eye movement sleep behavior disorder">REM sleep behavior disorder</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Psychiatric_disorders_of_childbirth" title="Psychiatric disorders of childbirth">Postnatal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Postpartum_depression" title="Postpartum depression">Postpartum depression</a></li> <li><a href="/wiki/Postpartum_psychosis" title="Postpartum psychosis">Postpartum psychosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sexual_dysfunction#Sexual_desire_disorders" title="Sexual dysfunction">Sexual desire</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypersexuality" title="Hypersexuality">Hypersexuality</a></li> <li><a href="/wiki/Hypoactive_sexual_desire_disorder" title="Hypoactive sexual desire disorder">Hypoactive sexual desire disorder</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div 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href="/wiki/Drug_withdrawal" title="Drug withdrawal">Withdrawal</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Schizophrenia,_schizotypal_and_delusional596" style="font-size:114%;margin:0 4em"><a href="/wiki/Schizophrenia" title="Schizophrenia">Schizophrenia</a>, <a href="/wiki/Schizotypal_personality_disorder" title="Schizotypal personality disorder">schizotypal</a> and <a href="/wiki/Delusional_disorder" title="Delusional disorder">delusional</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Delusional</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Delusional_disorder" title="Delusional disorder">Delusional disorder</a></li> <li><a href="/wiki/Folie_%C3%A0_deux" title="Folie à deux">Folie à deux</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Psychosis" title="Psychosis">Psychosis</a> and schizophrenia-like</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brief_reactive_psychosis" class="mw-redirect" title="Brief reactive psychosis">Brief reactive psychosis</a></li> <li><a href="/wiki/Schizoaffective_disorder" title="Schizoaffective disorder">Schizoaffective disorder</a></li> <li><a href="/wiki/Schizophreniform_disorder" title="Schizophreniform disorder">Schizophreniform disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Schizophrenia</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Childhood_schizophrenia" title="Childhood schizophrenia">Childhood schizophrenia</a></li> <li><a href="/wiki/Disorganized_schizophrenia" title="Disorganized schizophrenia">Disorganized (hebephrenic) schizophrenia</a></li> <li><a href="/wiki/Pseudoneurotic_schizophrenia" title="Pseudoneurotic schizophrenia">Pseudoneurotic schizophrenia</a></li> <li><a href="/wiki/Simple-type_schizophrenia" title="Simple-type schizophrenia">Simple-type schizophrenia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Catatonia" title="Catatonia">Catatonia</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Symptoms_and_uncategorized596" style="font-size:114%;margin:0 4em">Symptoms and uncategorized</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Impulse-control_disorder" title="Impulse-control disorder">Impulse-control disorder</a></li> <li><a href="/wiki/Kl%C3%BCver%E2%80%93Bucy_syndrome" title="Klüver–Bucy syndrome">Klüver–Bucy syndrome</a></li> <li><a href="/wiki/Psychomotor_agitation" title="Psychomotor agitation">Psychomotor agitation</a></li> <li><a href="/wiki/Stereotypy" title="Stereotypy">Stereotypy</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r886049405">.mw-parser-output .noitalic{font-style:normal}</style></div><div role="navigation" class="navbox" aria-labelledby="Satanic_panic136" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Satanic_ritual_abuse" title="Template:Satanic ritual abuse"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Satanic_ritual_abuse" title="Template talk:Satanic ritual abuse"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Satanic_ritual_abuse" title="Special:EditPage/Template:Satanic ritual abuse"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Satanic_panic136" style="font-size:114%;margin:0 4em"><a href="/wiki/Satanic_panic" title="Satanic panic">Satanic panic</a></div></th></tr><tr><td class="navbox-abovebelow" colspan="2"><div><a href="/wiki/List_of_satanic_ritual_abuse_allegations" title="List of satanic ritual abuse allegations">List of satanic ritual abuse allegations</a></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Cases and accused</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cleveland_child_abuse_scandal" title="Cleveland child abuse scandal">Cleveland child abuse scandal</a></li> <li><a href="/wiki/Country_Walk_case" title="Country Walk case">Country Walk case</a></li> <li><a href="/wiki/Faith_Chapel_Church_ritual_abuse_case" title="Faith Chapel Church ritual abuse case">Faith Chapel Church ritual abuse case</a></li> <li><a href="/wiki/Fells_Acres_day_care_sexual_abuse_trial" title="Fells Acres day care sexual abuse trial">Fells Acres day care sexual abuse trial</a></li> <li><a href="/wiki/Franklin_child_prostitution_ring_allegations" title="Franklin child prostitution ring allegations">Franklin child prostitution ring allegations</a></li> <li><a href="/wiki/Kern_County_child_abuse_cases" title="Kern County child abuse cases">Kern County child abuse cases</a></li> <li><a href="/wiki/Little_Rascals_day_care_sexual_abuse_trial" title="Little Rascals day care sexual abuse trial">Little Rascals day care sexual abuse trial</a></li> <li><a href="/wiki/Martensville_satanic_sex_scandal" title="Martensville satanic sex scandal">Martensville satanic sex scandal</a></li> <li><a href="/wiki/McMartin_preschool_trial" title="McMartin preschool trial">McMartin preschool trial</a></li> <li><a href="/wiki/Oak_Hill_satanic_ritual_abuse_trial" title="Oak Hill satanic ritual abuse trial">Oak Hill satanic ritual abuse trial</a></li> <li><a href="/wiki/Satanic_panic_(South_Africa)" title="Satanic panic (South Africa)">South African satanic panic</a></li> <li><a href="/wiki/South_Ronaldsay_child_abuse_scandal" class="mw-redirect" title="South Ronaldsay child abuse scandal">South Ronaldsay child abuse scandal</a></li> <li><a href="/wiki/The_Finders_(movement)" title="The Finders (movement)">The Finders</a></li> <li><a href="/wiki/Thurston_County_ritual_abuse_case" title="Thurston County ritual abuse case">Thurston County ritual abuse case</a></li> <li><a href="/wiki/Wee_Care_Nursery_School_abuse_trial" title="Wee Care Nursery School abuse trial">Wee Care Nursery School abuse trial</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other events</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fall_River_murders" title="Fall River murders">Fall River murders</a></li> <li><a href="/wiki/Ricky_Kasso" title="Ricky Kasso">Ricky Kasso</a></li> <li><a href="/wiki/Murders_of_Sally_McNelly_and_Shane_Stewart" title="Murders of Sally McNelly and Shane Stewart">Murders of Sally McNelly and Shane Stewart</a></li> <li><a href="/wiki/Death_of_Jeannette_DePalma" title="Death of Jeannette DePalma">Death of Jeannette DePalma</a></li> <li><a href="/wiki/West_Memphis_Three" title="West Memphis Three">West Memphis Three</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">People</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gerald_Amirault" title="Gerald Amirault">Gerald Amirault</a></li> <li><a href="/wiki/Anne_Johnson_Davis" title="Anne Johnson Davis">Anne Johnson Davis</a></li> <li><a href="/wiki/Mary_de_Young" title="Mary de Young">Mary de Young</a></li> <li><a href="/wiki/Paul_and_Shirley_Eberle" title="Paul and Shirley Eberle">Paul and Shirley Eberle</a></li> <li><a href="/wiki/Peter_Ellis_(childcare_worker)" title="Peter Ellis (childcare worker)">Peter Ellis</a></li> <li><a href="/wiki/Stephen_A._Kent" title="Stephen A. Kent">Stephen A. Kent</a></li> <li><a href="/wiki/Kee_MacFarlane" title="Kee MacFarlane">Kee MacFarlane</a></li> <li><a href="/wiki/Liz_Mullinar" title="Liz Mullinar">Liz Mullinar</a></li> <li><a href="/wiki/Diana_Napolis" title="Diana Napolis">Diana Napolis</a></li> <li><a href="/wiki/Debbie_Nathan" title="Debbie Nathan">Debbie Nathan</a></li> <li><a href="/wiki/Cathy_O%27Brien_(conspiracy_theorist)" title="Cathy O'Brien (conspiracy theorist)">Cathy O'Brien</a></li> <li><a href="/wiki/Richard_Ofshe" title="Richard Ofshe">Richard Ofshe</a></li> <li><a href="/wiki/Lawrence_Pazder" title="Lawrence Pazder">Lawrence Pazder</a></li> <li><a href="/wiki/Dorothy_Rabinowitz" title="Dorothy Rabinowitz">Dorothy Rabinowitz</a></li> <li><a href="/wiki/Valerie_Sinason" title="Valerie Sinason">Valerie Sinason</a></li> <li><a href="/wiki/Ralph_Underwager" title="Ralph Underwager">Ralph Underwager</a></li> <li><a href="/wiki/Mike_Warnke" title="Mike Warnke">Mike Warnke</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;line-height:1.2em;">Publications and media</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0;font-style:italic;"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Jay%27s_Journal" title="Jay's Journal">Jay's Journal</a></li> <li><a href="/wiki/Michelle_Remembers" title="Michelle Remembers">Michelle Remembers</a></li> <li><a href="/wiki/The_Courage_to_Heal" title="The Courage to Heal">The Courage to Heal</a></li> <li><a href="/wiki/Pace_memorandum" class="mw-redirect" title="Pace memorandum">Pace memorandum</a></li> <li><a href="/wiki/Indictment:_The_McMartin_Trial" title="Indictment: The McMartin Trial">Indictment: The McMartin Trial</a></li> <li><a href="/wiki/Treating_Survivors_of_Satanist_Abuse" title="Treating Survivors of Satanist Abuse">Treating Survivors of Satanist Abuse</a></li> <li><a href="/wiki/Cult_and_Ritual_Abuse" title="Cult and Ritual Abuse">Cult and Ritual Abuse</a></li> <li><a href="/wiki/Speak_of_the_Devil_(book)" title="Speak of the Devil (book)">Speak of the Devil</a></li> <li><a href="/wiki/No_Crueler_Tyrannies" class="mw-redirect" title="No Crueler Tyrannies">No Crueler Tyrannies</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Believe_the_Children" class="mw-redirect" title="Believe the Children">Believe the Children</a></li> <li><a href="/wiki/Blood_libel" title="Blood libel">Blood libel</a></li> <li><a href="/wiki/Children%27s_Institute_Inc." title="Children's Institute Inc.">Children's Institute Inc.</a></li> <li><a href="/wiki/Child_sexual_abuse_accommodation_syndrome" title="Child sexual abuse accommodation syndrome">Child sexual abuse accommodation syndrome</a></li> <li><a href="/wiki/Day-care_sex-abuse_hysteria" title="Day-care sex-abuse hysteria">Day-care sex-abuse hysteria</a></li> <li><a href="/wiki/Dungeons_%26_Dragons_controversies" title="Dungeons & Dragons controversies">Dungeons & Dragons controversies</a></li> <li><a href="/wiki/QAnon" title="QAnon">QAnon</a></li> <li><a class="mw-selflink selflink">Dissociative identity disorder</a></li> <li><a href="/wiki/False_memory_syndrome" title="False memory syndrome">False memory syndrome</a></li> <li><a href="/wiki/Moral_panic" title="Moral panic">Moral panic</a></li> <li><a href="/wiki/National_Center_for_Reason_and_Justice" title="National Center for Reason and Justice">National Center for Reason and Justice</a></li> <li><a href="/wiki/Maury_Terry" title="Maury Terry">Maury Terry</a></li></ul> </div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1130092004">.mw-parser-output .portal-bar{font-size:88%;font-weight:bold;display:flex;justify-content:center;align-items:baseline}.mw-parser-output .portal-bar-bordered{padding:0 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