User talk:Jaclyn Burch/sandbox

Dissociative Identity Disorder (DID) is a mental disease under the main category: Dissociative Disorders. 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 discounted by ƒunctional magnetic resonance imaging (ƒMRI) and positron emission tomography scans (PET). DID is trauma-caused, as are the other Dissociative Disorders and the Trauma-Related Stressor Disorders, and they have no genetic origin, which differentiates them from all other mental disease. There have been a variety of theories, models, and ideas of frame etiology, function, and treatment, but today there is only one design that stands above all others; it incorporates posttraumatic stress disorder (PTSD),other specified dissociative disorder (OSDD), dissociative amnesia (DA), and DID. Etiology is grounded in childhood, but studies lack bearing; abused children are not readily available for study due to the nature of childhood. PET scans and ƒMRI determine the DPS in PTSD, DA, and OSDD are without value. The polyvagal responses of fight and flight are non-existent in both DID and PTSD in childhood, but at the same time PTSD derives in a way that bears difficulty on childhood, while DID is a reaction to childhood reacting in either DID or death. DID is symptomless to the afflicted until a time in life in which they have obtained safety, calm and a desire to look inwardly, but until then they will not ever know they have this complex mental disease, and the people in their life will not either. This is in stark contrast to OSDD, which is overwhelmingly obtuse, and the subject, friends, family, co-workers, and therapists will rapidly identify these mental disorders because it is distinctly obvious as lesser-distinct personality states alternate between themselves in a way that is fraught with emotion and distraction to observers. This is the disease that has been portrayed in every story the media has ever produced, and it is what almost all people who have been diagnosed with DID suffer from. DID is diagnosed when two or more DPS are determined, and upon examination of all DID subjects there will be either deafness, blindness, mutism within at least one of the daily present DPS. Etiology is based on survival of polyvagal responses in infancy and early childhood. "Existing data show DID as a complex, valid and uncommon disorder associated with developmental and cultural variables, which are amenable to psychotherapeutic intervention." Many journal articles start out with words like: DID is controversial, but it is because researchers are explaining why it is not controversial, and still some forms of media use those words to misconstrue the idea of DID and the other Dissociative Disorders. The history of DID is limited to scientific collection and it was not until the DSM-III was published that this disorder even had a name, and until the DSM-5 was printed the information in the manual was incorrect and it mixed up the various Dissociative Disorders, as well as other trauma-caused disorders.

Reference to the most identified model of trauma-caused disorders today is Structural Dissociation; identified by both distinct personality states and lesser distinct personality states (L-DPS). Structural Dissociation supports functional magnetic resonance imaging (ƒMRI), positron emission tomography (PET), single-photon emission computed tomography (SPECT), event-related potential (E.R.P.) and electroencephalography reveal both DPS and L-DPS leading to neuroimaging identification identifying DID, transit operations and single photon emission transparency with regard to level and adequate knowledge of all mental illness that results from the formation of DPS and L-DPS.

Symptoms
Within the period of measures of symptomology the Dissociative Disorders gain attention as a method of switching of DPS, but in reality that is a reaction to the symptoms and not a symptom itself. Symptoms include fatigue due to polyvagal stressors that react and interact with the cranial nervous system of the human brain, and at the same time the measures feign, freeze, faint, fright, fight. These five polyvagal responses determined all trauma-caused disorders including PTSD, AD, OSDD and DID, but each disorder is unique unto itself in a way that is understood through the study of psychophysiology, psychobiology, psychoanatomy, neurology concerning DPS, L-DPS, memory, personality, innate genetic disease which is lacking in the Dissociative Disorders, while at the same time genetics plays a role in parentage, because it is likely that a child who has PTSD is raised by a parent with it, and a child with OSDD is raised by a parent with it, and while DID is a disorder caused by the most extreme measures, it is not a function of inherited behavior that is copied by a child. However, a child with DID will take on the behavior displayed by a parent, but not a caregiver, because a parent is a mocking symbol for the child, while a caregiver is not, and yet in the past researchers could not understand that introjected behavior is not a disease, but a parroting of behavior, much like a gaggle of ducks imprints upon their mother because it is innate to their behavioral anatomy, but it is not a mental disease.

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 heath 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.

Pathophysiology
Response to overwhelming distress initiates a way of finding harmony among the cranial nerve responses and the spine, which are casual upon normalcy, but in DID the cord is over reactive and within the limitations of design of the disease.

Psychobiological
Biology frames DID as a non-genetic, but congenital disease because it stems from a natural reaction to the environment an infant grow up in, and as such, genetics do not play a role, but caretaking does.

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."

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 at least 50-years of age, because the subject must reach full maturity before the brain can develop enough to compensate for the brain damage caused by their infancy.

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 other organization that provided training. This ISSTD supported treatment guide divides therapy into three overlapping phases of therapy focusing on symptoms of relief while ensuring safety for the subject, improving the patient capacity to maintain relationships, improving functioning on all levels. Co-morbid disorders: substance abuse and eating disorders are addressed in this 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 with DID, but has been used for co-morbid disorders: depression, eating disorders and self-harm that can decidedly occur during trauma processing in AD, OSDD, and although it does not happen in DID, caution is taken.

Sleep
Sleep is essential to processing trauma occurrence, and letting the brain, mind and neurons relax in order that they may approach trauma processing in a way that is beneficial to the self, and community as a whole, because without deep sleep; the REM cycle, in particular, then trauma cannot be brought to bear, naturalized or remedied.

Epidemiology
"Existing data show DID as a complex, valid and uncommon disorder associated with developmental and cultural variables that is amenable to psychotherapeutic intervention."

Reported rates in the community vary from 1% to 3% for all Dissociative Disorders with higher rates 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
The disease is unresolved until self-identification has accumulated treatment schedules of self-worth, self-idealization, and time and patients still in contact with abusers face lengthier and more complex action of healing than not, and even though suicidal idealization is not established in DID patients, those who have been misdiagnosed will attempt to relive the pain of trauma processing.

History of désagrégation psychologique
The term dissociation désagrégation psychologique was reported by the founder of the current and most widely accepted method of determining the innate disease that capture the world's attention: Dissociative Disorders, and while his name was buried along with him, it was ungraved by Onno van der Hart, who is given credit as the most prolific scientist of the 20th century because not only did he solve the dilemma of what was referred to as multiplicity, but he also determined that PTSD, and the other trauma-caused disorders were all part of the same threshold called Structural Dissociation.

Hypnotists, who are not physicians, psychiatrists or psychologists had little credibility, but in the early 1700's reported what they thought were 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 other specified dissociative disorder was frequently described as a state of sleepwalking, with scholars hypothesizing that the patients were switching between a normal consciousness and a "somnambulistic state". There was a general acceptance that emotionally traumatic experiences could cause long-term disorders which might display a variety of symptoms, but some individuals displayed 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, but as we know today his illness was set long before that age. Vivet was the subject of countless medical papers and became the most studied case of dissociation in the 19th century.

Jean-Martin Charcot introduced his ideas of the impact of nervous shock as a cause for a variety of neurological conditions, and meanwhile is prime student Pierre Janet developed his own theories of dissociation. The first individual reportedly diagnosed with multiplicity (other specified dissociative disorder) was Clara Norton Fowler (Christine Beauchamp). The study was made public by American neurologist Morton Prince who studied Fowler between 1898 and 1904, and describing her in the 1906 monograph titled Dissociation of a Personality. Misled physicians created a climate of skepticism and disbelief due to lack of education, interest, and the fact that popular media had infiltrated the field of medicine calling physicians quacks. Charcot died in 1893, and many of his diagnosed hysterical patients were called frauds by Sigmund Freud, but the famous psychiatrist was shamed into doing so because he had ascertained a logical agreement with Charcot, but upon the the death of his confidant, Freud was left without anyone to backup the claims, and he was unwilling to do so on his own.

Changing prevalence
Reported multiplicity numbered less than 100 throughout history to 1944, with only one further case added in the next two decades. The Medicus reports from 1903 to 1978, and maybe beyond, showed dramatic decline in multiple personality cases as reported in the insane asylums. It was considered the rarest of psychological conditions in the early 1980's, with an estimate of multiplicity in insane asylums at 0.01%. Rates of it were increasing, reaching a peak of approximately 40,000 cases by the end of the 20th century. Early in the 1980's, Kraepelin's natural disease entity anchored the metaphor progressive deterioration, and as a result mental disease became more broadly accepted within the U.S, but not the world in general, while Spaltung widened acceptance for the lesser known continents of the world. The 19th century saw a number of reported cases of multiplicity, which Rieber estimated would be close to 100. The late 1920's revealed a large increase in the number of reported cases of schizophrenia, what is now known as PTSD, borderline personality disorder, and hysteria, as well as what was referred to as multiple personality, but is now known as other specified dissociative disorder. It was argued in the 1980s that these patients were actually had schizophrenia because it was the more socially accepted mental disease. Between 1968 and 1980, the term hysterical neurosis, dissociative type was introduced into the DSM-II as "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." The number of cases sharply increased in the late 1970's and throughout the 1980's, and the first scholarly monographs on the topic appeared in 1986.

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 evidence of etiology, design and spread.

Screening and DSM
Marlene Steinberg created the mini-SCID-d used to identify subjects with DID, but the Dissociative Disorders Interview Schedule (IDDIS) took its place. Other questionnaires include the Dissociative Experiences Scale (DES), Perceptual Alterations Scale (PAS). All are strongly intercorrelated and except the Mini-SCIDD, all incorporate absorption, which is a normal part of behavior involving narrowing or broadening of attention. The DES is a simple, quick, and validated questionnaire that was widely used to screen for dissociative symptoms of the Dissociative Disorders, providing a quick screening of subjects. The reliability of the DES in non-clinical samples was been questioned and for the most part screening has not been used since 2000.

DSM-II used the term hysterical neurosis dissociative type to describe occurrence of alterations in a subjects DPS, and L-DPS, including symptoms of amnesia, fugue, and dissociation. The DSM-III grouped four Dissociative Disorders together with like identification. The DSM-IV changed reference to DID slightly, 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. DSM-IV-TR criteria only made one slight change to the criteria that did not reduce or add to its effectiveness. The therapy-caused cases of DID, it is argued, are strongly linked to false memory syndrome, a concept and term coined by members of the False Memory Syndrome Foundation in reaction to memories of abuse they allege were recovered by a range of controversial therapies whose effectiveness is unproven. Such a memory could be used to make a false allegation of child sexual abuse. However, false memory syndrome per se is not regarded by mental health experts as a valid diagnosis, and has been described as "a non-psychological term originated by a private foundation whose stated purpose is to support accused parents", and critics argue that the concept has no empirical support, and furthermore describe the False Memory Syndrome Foundation as an advocacy group that has distorted and misrepresented research into memory.