Treatment of Did and Ddnos Patients in a Regional

European Psychiatry, 1999

Dissociative Identity Disorder (DID) is a controversial diagnosis and empirical data on the efficacy of treatment modalities are scanty. The objective of this study was to explore the frequency of the diagnosis, the types and efficacy of prevailing treatment practices, and to examine demographic data on patients in the Netherlands.

2013

Severe dissociative disorders (DD) are associated with high levels of impairment, treatment utilization, and treatment costs, yet relatively little systematic research has focused on treatment for these challenging patients. The goal of this naturalistic observational 30-month follow-up study of an international sample of patients with dissociative disorders was to determine if treatment provided by community providers was associated with improvements in symptoms and adaptive functioning. The patients were diagnosed with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS). The patients and their therapists completed surveys at study entry and at 6-, 18-, and 30-month follow-up. At the 30-month follow-up, 119 of the original 226 patients completed the surveys. According to patients' reports, they showed decreased levels of dissociation, posttraumatic stress disorder symptoms, general distress, drug use, physical pain, and depression over the course of treatment. As treatment progressed, patients reported increased socializing, attending school or volunteering, and feeling good. According to therapists' reports, patients engaged in less self-injurious behavior and had fewer hospitalizations as well as increased global assessment of functioning scores (American Psychiatric Association, 2000) and adaptive capacities over time. These results suggest that treatment provided by therapists who have training in treating DID/DDNOS appears to be beneficial across a number of clinical domains. Additional research into the treatment of DD is warranted.

This essay answers the question "To what extent could Hypnosis be a Potentially Harmful Therapy (PHT) for Dissociative Identity Disorder (DID)?". In the beginning, the essay explains how therapies are created through experimentation and analysis of a mental disorder. Where theories and models of disorders are interpreted to form the basic methods of approach. Then detailed explanation of a specific mental disorder, which is Dissociative Identity Disorder, shall be stated. The paper explains as well the causes of the disorder based on the observation of the subjects that have experienced it.

1997

In the Netherlands, the diagnosis of dissociative identity disorder (DID) is widely accepted, although skeptics also have made their opinions known. Dutch clinicians treating DID patients generally follow the common three phase model for treatment of post-traumatic stress. Given the fact that they usually deal with complicated cases and enmeshed patients (cf. Horevitz & Loewenstein, 1994), most often treatment is restricted to Phase 1: stabilization and symptom reduction. Treatment of higher functioning patients, on the other hand, usually aims at processing of traumatic memories and complete personality integration as well. In this article, two Dutch cases are described in detail, with a special emphasis on the clinical deliberations which, in the first case, led to the decision to proceed to trauma treatment, and which led in the second case to the decision to refrain from it. The current standard of care with regard to the treatment of trauma-induced disorders, including posttrau...

American Journal of Psychiatry, 1991

conducted a study using a Dutch version of the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D) with additional questions on childhood trauma and symptoms of borderline and histrionic personality disorders. Method: All interviews were audiotaped or videotaped and rated by two investigators separately. Forty-four patients (42 women and two men) participated in the study. Most of the patients had been referred f or evaluation of dissociative symptoms; five had participated in a nationwide survey on incest. None ofthe patients had ever received a diagnosis ofa dissociative disorder, and none had evidence of organic brain syndrome or mental retardation. All patients were in active treatment: 23 were being treated in an outpatient psychiatric service, 13 in an inpatient psychiatric service, and eight in private practice. Thirty-two patients had been psychiatric inpatients at least once. Results: Four diagnostic groups ofpatients were identified: two with dissociative disorders (1 2 patients with multiple personality disorder and 1 1 with dissociative disorder not otherwise specified), one with DSM-III-R personality disorders (1 1 patients), and one without dissociative or personality disorders (1 0 patients). Conclusions: Dissociative disorders are clearly not only an American phenomenon. The diagnosis can be made outside of the United States if the symptoms are sought. The SCID-D proved to be a promising instrument.

The Journal of nervous and mental disease, 2013

Psychiatric Clinics of North America, 2006

2022

The combination of inadequate training in recognizing traumatic dissociation, limited exposure tocorrect scientific information about IPD, symptom similarities with other disorders (such asschizophrenia, bipolar disorder, and borderline personality disorder), and discussion of etiologyhas led to reluctance to consider the diagnosis of DID, leading to an incomplete and misdiagnosisof the disorder. hindered effective treatment. Reference Reinders , Marquand , Schlumpf , Chalavi correctly diagnosed, individuals on average have four other prediagnoses, inadequate pharmacological treatments, few hospitalizations, and ultimately extended periods in mental healthservices. they spend years. These years of misdirected treatment cause prolonged personalsuffering and high direct and indirect societal costs. Other causes are unfamiliarity with thespectrum of dissociative disorders, the presence of false DID , the reluctance of individuals withDID to present their dissociative symptoms , often because of feelings of shame, and a lack ofknowledge and appreciation of its epidemiology. (“Dissociative identity disorder: out of theshadows at last?”) Factors contributing to the underdiagnosis and misdiagnosis of dissociativeidentity disorder (DID). The lifetime prevalence of DID is estimated to be about 1.5%, Reference.Reinders , Marquand , Schlumpf , Chalavi , Vissia and Nijenhuis5 mean that at least one million people in the UK will suffer from DID in their lifetime . (“Dsm v dissociative identity disorder pdf”) It is therefore clinically extremely important to bring DID out of the shadows to ease earliercorrect diagnosis, avoid unnecessary suffering, and encourage research into faster and moretargeted interventions . of the DKB Evidence from brain biology supporting the trauma theoryAccording to criteria set out in DSM-5, dissociative identity disorder (DID) is characterized byfluctuating consciousness as well as two or more distinct identities or overlapping personalitystates

Psychological Trauma: Theory, Research, Practice, and Policy, 2013

Severe dissociative disorders (DD) are associated with high levels of impairment, treatment utilization, and treatment costs, yet relatively little systematic research has focused on treatment for these challenging patients. The goal of this naturalistic observational 30-month follow-up study of an international sample of patients with dissociative disorders was to determine if treatment provided by community providers was associated with improvements in symptoms and adaptive functioning. The patients were diagnosed with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS). The patients and their therapists completed surveys at study entry and at 6-, 18-, and 30-month follow-up. At the 30-month follow-up, 119 of the original 226 patients completed the surveys. According to patients' reports, they showed decreased levels of dissociation, posttraumatic stress disorder symptoms, general distress, drug use, physical pain, and depression over the course of treatment. As treatment progressed, patients reported increased socializing, attending school or volunteering, and feeling good. According to therapists' reports, patients engaged in less self-injurious behavior and had fewer hospitalizations as well as increased global assessment of functioning scores (American Psychiatric Association, 2000) and adaptive capacities over time. These results suggest that treatment provided by therapists who have training in treating DID/DDNOS appears to be beneficial across a number of clinical domains. Additional research into the treatment of DD is warranted.

Psychological Trauma: Theory, Research, Practice, and Policy, 2012

Little empirical evidence exists about the treatment of dissociative identity disorder and dissociative disorder not otherwise specified. Thus, we must rely on the clinical literature, which advocates a staged course of treatment. A survey of 36 international experts in the treatment of dissociative disorder (DD) was conducted to learn what treatment interventions they recommended at each stage of treatment. These highly experienced therapists recommended a carefully staged treatment consisting of three phases. In the initial phase, they advocated emphasizing skill building in development and maintenance of safety from dangerousness to self or others and other high-risk behaviors, as well as emotion regulation, impulse control, interpersonal effectiveness, grounding, and containment of intrusive material. In addition, they recommended specific trauma-focused cognitive therapy to address trauma-based cognitive distortions. They uniformly recommended identifying and working with dissociated self states beginning early in treatment. They advised the use of exposure or abreaction techniques-albeit modified to not overwhelm these complex dissociative patients-balanced with core, foundational interventions for the middle stage. The last stage of treatment is less clearly delineated and more individualized. Unification of self states appears to occur in only a minority of patients with DD. This study provides directions to pursue for future training and research on DD.