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Cited by 179Psychosomatic Disorders and Their TreatmentsPsychopathy, Forensic Psychiatry, Sexual OffendingChild Abuse and Trauma

Objective Documentation of Child Abuse and Dissociation in 12 Murderers With Dissociative Identity Disorder

Lewis, Dorothy Otnow, Yeager, Catherine A., Swica, Yael, Pincus, Jonathan H., Lewis, Melvin·1997·American Journal of Psychiatry
DOI 10.1176/ajp.154.12.1703
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Abstract

OBJECTIVE: The skepticism regarding the existence of dissociative identity disorder as well as the abuse that engenders it persists for lack of objective documentation. This is doubly so for the disorder in murderers because of issues of suspected malingering. This article presents objective verification of both dissociative symptoms and severe abuse during childhood in a series of adult murderers with dissociative identity disorder. METHOD: This study consisted of a review of the clinical records of 11 men and one woman with DSM-IV-defined dissociative identity disorder who had committed murder. Data were gathered from medical, psychiatric, social service, school, military, and prison records and from records of interviews with subjects' family members and others. Handwriting samples were also examined. Data were analyzed qualitatively. RESULTS: Signs and symptoms of dissociative identity disorder in childhood and adulthood were corroborated independently and from several sources in all 12 cases; objective evidence of severe abuse was obtained in 11 cases. The subjects had amnesia for most of the abuse and underreported it. Marked changes in writing style and/or signatures were documented in 10 cases. CONCLUSIONS: This study establishes, once and for all, the linkage between early severe abuse and dissociative identity disorder. Further, the data demonstrate that the disorder can be distinguished from malingering and from other disorders. The study shows that it is possible, with great effort, to obtain objective evidence of both the symptoms of dissociative identity disorder and the abuse that engenders it.

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  • DID is associated with atypical information processing and altered reality perception, though much evidence relies on self-report.

    “Cognitively, DID is associated with atypical information processing and altered reality perception, though much evidence relies on self -report, raising validity concerns given trauma survivors ' tendencies toward mistrust and low self -con fi dence (Dorahy et al. 2016; Lewis et al. 1997).”

    From Examining the linguistic and behavioural patterns of gender identity in women with dissociative identity disorder (2025) · cites this paper as Lewis et al. 1997

  • The strengthening of feelings subtheme captured emotionally charged expressions, aligning with evidence of emotion regulation difficulties in trauma-affected populations.

    “The strengthening of feelings subtheme captured emotionally charged expressions, aligning with evidence of emotion regulation dif fi culties in trauma-affected populations (Dorahy et al. 2016; Lewis et al. 1997).”

    From Examining the linguistic and behavioural patterns of gender identity in women with dissociative identity disorder (2025) · cites this paper as Lewis et al. 1997

  • In the context of DID, intensifiers appear to serve as emphatic tools - amplifying speech to convey urgency, conviction, or unresolved trauma.

    “In the context of DID, intensi fi ers appear to serve as emphatic tools -amplifying speech to convey urgency, conviction, or unresolved trauma (Dorahy et al. 2016; Lewis et al. 1997).”

    From Examining the linguistic and behavioural patterns of gender identity in women with dissociative identity disorder (2025) · cites this paper as Lewis et al. 1997

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Authors
Lewis, D. O., Yeager, C. A., Swica, Y., Pincus, J. H., & Lewis, M.
Affiliations
NYU Langone Health (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
1997-12-01
Volume
154
Issue
12
Pages
1703-1710
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/ajp.154.12.1703
OpenAlex
W2012699209
Cited by
179
References
23
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 11 · 2022: 2 · 2021: 1 · 2020: 7 · 2019: 8 · 2018: 7 · 2017: 6 · 2016: 6 · 2015: 8 · 2014: 9 · 2013: 6 · 2012: 5
FWCI
5.48
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion, public-domain)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
dissociative identity disorder, child abuse, murder, malingering, handwriting analysis, amnesia, dissociation, forensic psychiatry
MeSH terms
Adult, Child, Child Abuse, Child Abuse, Sexual, Diagnosis, Differential, Dissociative Disorders, Female, Forensic Psychiatry, Handwriting, Homicide, Humans, Male, Malingering, Dissociative Identity Disorder, Prisoners, Comorbidity

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