User:Jaclyn Burch/sandbox

Dissociative Identity Disorder (DID) is a mental disease succumbed within the category: Dissociative Disorders, of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and notwithstanding its induction, it was previously and incorrectly referred to as "multiple personality disorder," implying multiplicity is possible, but this idea has been discounted by ƒunctional magnetic resonance imaging (ƒMRI) and positron emission tomography (PET). Trauma-Related Stressor and Dissociative Disorders are trauma-caused and lack all genetic origin, which differentiates them from all other mental disease. Today all models have been incorporated into Structural Dissociation, which is inclusive of posttraumatic stress disorder (PTSD), other specified dissociative disorder (OSDD), dissociative amnesia (DA), and DID, and children are not available for study, but PET scans and ƒMRI evidence existence. Distinct personality states (DPS) in PTSD, DA, and OSDD are without value, but in DID they are rigid and unyielding. Polyvagal responses of fight and flight are non-existent in both DID and PTSD in childhood, but at the same time PTSD is determined during childhood while DID is a reaction to infancy reacting in either DID or death. Because of the depth of brain damage inflicted during early childhood early intervention is primarily non-existent, and therapy is ineffective until after full-maturity has been reached which is fifty years of age in females and approximately 58 in males, however in OSDD children demonstrate fluent alterations in what appear to be lesser damaged DPS and are easily identified throughout their lives. DID is diagnosed with DPS are distinct, separate, and the afflicted demonstrate both an ability to see normally and are also completely blind, deaf or mute because that is the only way that anyone with DID presents. "Existing data show DID as a complex, valid and uncommon disorder associated with developmental and cultural variables, which are amenable to psychotherapeutic intervention."

Story portrayal is historically always based on OSDD and not DID, and even though the world does not realize it, they are spreading misinformation in a way that is harmful to the therapeutic relationship between a person with DID and their environment, because until this is realized the people that really have DID will be chastised, threatened, made fun of and ridiculed, and all because the world is misinformed.

Structural Dissociation
Reference to the most identified model of trauma-caused disorders today is Structural Dissociation; identified by both DPS and lesser distinct personality states (L-DPS). Positron emission tomography (PET) supports functional magnetic resonance imaging (ƒMRI), single-photon emission computed tomography (SPECT), event-related potential (E.R.P.) and electroencephalography reveal both DPS and L-DPS leading to neuroimaging identification; DID, PTSD, OSDD, but DA is inclusive of all three.

Symptoms
Determinates of symptoms are dependent upon DPS, L-DPS actions, reaction and display of afflicted parts of the brain in which itemized memory of an individual's life is kept from them in order to maintain a part of themselves that is able to function in a daily life capacity, because these persons are highly damaged and without calm in their life they will cease to function.

Misconceptions
Borderline Personality Disorder (BPD) is a genetic disease, like all another mental disease with the exception of those in the DSM-5 Dissociative Disorder and Trauma-Stressor Disorders. Neither trauma-caused DSM-5 categories consist of any mental disease that is genetically passed from a biological parent to their offspring, but at the same time it is neurologically impossible for any human to have a trauma-caused disorder and any other disorder in the DSM-5.

Diagnosis
The DSM reports the minimum criteria needed to diagnose any mental disorder, and in the case of DID only two criteria are needed: separation of DPS from amnesia and lack of L-DPS from amnesia.

Psychophysiology
The only mental disorder where psychophysiology is present is DID, with the following physiopsycho analysis, often performed as a means of research to identify DID from OSDD showing how different DPS in DID alternate as they switch; measurement includes: vision, hearing, blood pressure, pulse, spinal reaction to visual acuity within the boundaries of blindness, deafness, and terror, action of polyvagal response limited to vision, but not to hearing as it is associated with limited frames of time that are not realized by the subject, but are apparent to the researcher because it is a test within the confines of a laboratory. In addition, there are five more responses that are testable including vagal responses tested in animal studies that while cannot be functional in humans are sought out by limited bodily reaction to pulmonary response, and they include respiration, transpiration, sexual response to touch, feelings, and the past, and a transpiratory limited action of texture and laxivity. Physiological alterations are not only common in DID, but brain functioning determines DPS switching by the following measurement: blindness, deafness, mutism, and other oddities that science has struggled to understand, but it is simply basic polyvagal responses limited to, but notwithstanding complication of the Dissociative Disorder DID.

Children Scientific evidence shows terrifying abuse throughout early childhood leads to identification of mental illness within the time-frame that is thought to establish normal integration of memory, ideas, personality states, and critical thinking, without thought of cause, suffering or mental anguish, because not all the Dissociative Disorders are caused by purposeful abuse. Within the category of Dissociative Disorders, DA is a consistent value, and while OSDD and DID are not, they resume the ability to define themselves completely separate from one another because while one is fraught with terror starting in infancy, the other does not have to carry this same etiology, and while DID is the most complex of any mental health disease, Structural Dissociation determines their distinct differences.

Etiology
DID has an etiology based in polyvagal responses dependent upon early human ancestry of starvation, threat, and inhumane living conditions, and because humans were fraught with distinct living conditions in pre-Neanderthal days, it is rare that any infant and toddler will meet such extremes, but it does happen, and when it does, then a child either survives exaggerated polyvagal responses in infancy or they die in childhood.

Lack of inheritability
Innate genetics are lacking in trauma-caused disorders, but all other mental illness has been proven to be caused by hereditary means, and interestingly when genetic mental disease is present a trauma-caused disorder cannot develop.

Pathophysiology
Response to overwhelming distress initiates cranial nerve response in adults, whereas children would respond in such a way that they were unable to remember what had occurred when switching of DPS takes place, but in OSDD it is an alternation of L-DPS that cause the overwhelming response of incapable brain response to stimuli, and so those afflicted with OSDD, as well as DA are only capable of increased memory saturation, while those with DID suffer decreased memory saturation in both the frontal, spinal and occipital portions of the brain.

Psychobiological
Biology frames DID as a non-genetic, but congenital disease because it stems from a natural reaction to the environment an infant grows up in, and as such, genetics do not manipulate boundaries, but they do participate in finding new memory to establish among the afflicted population.

Physiology alterations
Subjects with DID will have deficiencies in tests of conscious control which show signs of compartmentalization in non-verbal communication, but verbal skills will be inconsistent with memory because the brain is not able to associate memory with motor skills until full-integration which will never happen in anyone with DID until after the age of 50; full maturity must be obtained before the brain can develop enough to compensate for the damage caused in infancy.

Comorbidity
Co-morbid disorders are limited to substance abuse and eating disorders.

Sociocultural (iatrogenic) ideals
"SCM theorists acknowledge that iatrogenic and sociocultural influences typically operate on a backdrop of preexisting psychopathology, and exert their impact primarily on individuals who are seeking a causal explanation for their instability, identity seemingly inexplisive behaviors."

"DID does not have a sociocultural (e.g., iatrogenic) origin."

Treatment
"The model, Structural Dissociation is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity."

There was a general lack of consensus in the diagnosis and treatment of multiplicity prior to the formation of the International Society for the Study of Trauma and Dissociation (ISSTD) and European Society for Trauma and Dissociation (ESTD) which provided training. This ISSTD/ESTD supported treatment guide divides therapy into three overlapping phases focusing on symptoms of relief while ensuring safety for patients, which is followed by trauma processing and integration of memory, mind, brain, and function. Co-morbid disorders are limited to substance abuse and eating disorders, which are addressed in the first phase of treatment. •	Phase I: standard talk therapy meant to ease the subject into trauma processing. •	Phase II: stepwise exposure to traumatic past occurrence and prevention of self-harm during the trauma processing journey. •	Phase III: reconsolidation of DPS, L-DPS, and trauma occurrence.

Individual treatment ideals include an eclectic mix of psychotherapy including cognitive behavioral therapy (CBT), insight-oriented therapies, dialectical behavioral therapy (DBT), hypnotherapy and eye movement desensitization and reprocessing (EMDR).

Medication
Medication is counterproductive in those afflicted with DID, but has been used for co-morbid disorders: depression, eating problems and self-harm that can occur during trauma processing in all trauma-caused disorders.

Sleep
Sleep is essential to processing trauma occurrence, and letting the brain, mind and neurons relax in a way that they enter a full cycle of both REM and non-REM sleep is essential to repair damage to the brain, cord, and stem, and without adequate sleep the brain not only slows its pace, but it also is open to cross contamination from trauma processing, both with and without substance, because when sleep is interrupted enough it is not functioning in a way that is important to sustain human life, and as such death can ensue.

Epidemiology
"Existing data show DID as a complex, valid and uncommon disorder associated with developmental and cultural variables that are amenable to psychotherapeutic intervention." Reported rates vary from 1% to 3% for all Dissociative Disorders in the U. S. with higher quotients among psychiatric patients, but DID measures are unattainable because of the nature of the disease, but it is thought to be essentially a rare disease in this day and age of adequate nutrition, care, and lifestyle.

Prognosis
DID have a grim prognosis with maturity of self-being the indicator of growth, because prior to age 50 in females and 58 in males there is no accumulation of process because the mature brain is only capable of integration.

History of désagrégation psychologique
Désagrégation psychologique (dissociation) is best described by using Structural Dissociation, and inhibitory cases of it are marked throughout history. In the early 1700's hypnotists reported what was thought to be second personalities emerging during hypnosis. An intense interest in spiritualism, parapsychology, and hypnosis continued throughout the 19th and early 20th centuries, running in parallel with John Locke's views that there was an association of ideas requiring the coexistence of feelings with awareness of the feelings. In the 19th century, the still undetermined and unnamed occurrence of what is today called OSDD was frequently described as a state of sleepwalking, with scholars hypothesizing that the patients were switching between a normal consciousness and a somnambulistic state of wake alternating with REM sleep and non-REM sleep. There was a general acceptance that traumatic experience could cause long-term disorders displaying a variety of symptoms, but some individuals experienced a profound effect of emotional instability. For example, Louis Vivet encountered a viper at the age of 13, and his symptoms were attributed to that encounter, and so Vivet was the subject of countless medical papers and became the most studied case of OSDD in the 19th century. Later, Jean-Martin Charcot introduced ideas referred to as nervous shock, which led to an uproar among Americans for a more concise manual for mental disorders and the DSM-I was born, and then later after the work of Pierre Marie Felix Janet, the DSM-II was established with a small mention of dissociation under the avenue of hysteria. Christine Beauchamp became well known when she volunteered to receive shock therapy in order to fix her dementia, which was later thought to be a Dissociative Disorder, but not DID. Morton Prince, studied her between 1898 and 1906, describing her as associated with dissociation and results that beget medication and he prescribed laudanum for her.

Within the confines of multiplicity, there have been over 600 cases of what was thought to be DID that became famous, but not one of them actually was, but all of them do fall into the category of complex-Dissociative Disorders.

Screening and DSM
Marlene Steinberg created the mini-SCID-d, which is used to identify subjects who appear to suffer dissociation, but the Dissociative Disorders Interview Schedule (IDDIS) took its place, and other questionnaires came into focus: Dissociative Experiences Scale (DES), and Perceptual Alterations Scale (PAS).
 * 1) DSM-II used the term hysterical neurosis dissociative type to describe occurrence of alterations in DPS, and L-DPS, including symptoms of amnesia.
 * 2) DSM-III grouped four Dissociative Disorders together with like-identification and coined the misleading term - multiple personality disorder.
 * 3) DSM-IV changed reference to DID slightly, by noting that amnesia was a confusion of childhood thoughts rather that efforts to suppress memory concerns, and renamed it DID. The change emphasizes the problem is not multiple personalities, but rather a lack of a single, unified identity, and appearance of memory concerns.
 * 4) DSM-IV-TR criteria only made one slight change to the criteria that did not reduce or add to its effectiveness but did change the name of the topic at hand, from multiple personality disorder to dissociative identity disorder.

Socio iatrogenic (SCM) from the 1980's in North America
The SCM model proposes that DID is due to a person consciously or unconsciously behaving in certain ways promoted by cultural stereotypes, with unwitting therapists providing cues through improper therapeutic techniques and that the behavior is enhanced by media portrayals of DID. The belief that the symptoms of DID are produced artificially by psychotherapy practices or patients playing a role they believe appropriate for DID, or that treatment for DID is harmful, is dated, but worth mentioning because there are still a small group of researchers, who are not considered experts in DID or Dissociative Disorders, but do still push their point of view, but according to Brand, Loewenstein and Spiegel: "The 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”. Proponents of the SCM claim "bizarre dissociative symptoms" are rarely present before intensive therapy by specialists in the treatment of DID who, through the process of eliciting, conversing with and identifying DPS and L-DPS shape, or possibly create the diagnosis. The characteristics of people diagnosed with DID (hypnotizability, suggestibility, frequent fantasization and mental absorption) contributed to these concerns and those regarding the validity of recovered trauma occurrence. Skeptics note that a small subset of doctors are responsible for diagnosing the majority of individuals with DID. Nicholas Spanos and others have suggested that in addition to perceived therapy caused cases, DID may be the result of role-playing rather than alternating of DPS and L-DPS. Other arguments that therapy can cause DID, include the lack of children diagnosed with DID, the sudden spike in incidence rates of diagnosis after 1980, the absence of evidence of increased rates of child abuse, the appearance of the disorder almost exclusively in individuals undergoing psychotherapy, particularly involving hypnosis, 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. Experimental tests of memory suggest that patients with DID may have improved memory for certain tasks, which has been used to criticize the hypothesis that DID is a means of forgetting or suppressing memory. Patients also show experimental evidence of being more fantasy-prone, which in turn is related to a tendency to over-report false memories of painful events. Psychiatrists August Piper and Harold Merskey argue that childhood trauma does not cause DID, and point to the rareness of the diagnosis before 1980, as well as a failure to find DID as an outcome in longitudinal studies 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 definition of what would indicate a threshold of abuse sufficient to induce DID, and the extremely small number of cases of children diagnosed with DID.

Later in 1996, Joel Paris led the world on another wild goose chase when he boasted he was the expert on "multiple personality," and while he is a researcher in the area of genetically caused mental disorders, the Dissociative Disorders are out of his realm and as such he is not an expert now or even back when he made his claim. Some people have thought the increase in diagnoses cases of multiplicity were due to inappropriate therapeutic techniques used on highly suggestible individuals, but today that has been disproven in essentially ever case the claim was brought against, but courts, due to their inadequate training and the design of the system find evidence to the contrary all the time, but that is court, and not a scientific study or controlled method of discovery, and so is discounted by any reputable scientist. Today, neurologists have used the hard evidence of ƒMRI and PET scans to obtain proof of etiology, design, and spread.

The False Memory Syndrome Foundation was created in order to establish a defense for adult men who were accused of abusing their own children, but while some legal establishment did occur, the foundation mainly held bearing for skeptics of anything that had to do with child abuse and as such it became marked in history for its contempt of both children, mothers and single agencies which fought to contend that some mental illness was caused by child abuse. There are many physicians, psychiatrists and even psychologists who still bear witness to this organization, but in the end there was good that came from it because it tightened up court hearings and through its actions social workers were taught how to not lead a witness and how to work with children who are part of the legal system because overall, that's what the whole idea of the FMSF is, an organization to tighten up legalize, and it is not one that has any bearing on research, education or past-times fraught with child abuse.