Cited by 225Psychosomatic Disorders and Their TreatmentsPsychoanalysis and Psychopathology ResearchIdentity, Memory, and Therapy

Dissociative identity disorder: An empirical overview

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Dorahy, Martin J, Brand, Bethany L, Şar, Vedat, Krüger, Christa, Stavropoulos, Pam, Martínez-Taboas, Alfonso, Lewis-Fernández, Roberto, Middleton, Warwick·2014·Australian & New Zealand Journal of Psychiatry

Abstract

Objective: Despite its long and auspicious place in the history of psychiatry, dissociative identity disorder (DID) has been associated with controversy. This paper aims to examine the empirical data related to DID and outline the contextual challenges to its scientific investigation. Methods: The overview is limited to DID-specific research in which one or more of the following conditions are met: (i) a sample of participants with DID was systematically investigated, (ii) psychometrically-sound measures were utilised, (iii) comparisons were made with other samples, (iv) DID was differentiated from other disorders, including other dissociative disorders, (v) extraneous variables were controlled or (vi) DID diagnosis was confirmed. Following an examination of challenges to research, data are organised around the validity and phenomenology of DID, its aetiology and epidemiology, the neurobiological and cognitive correlates of the disorder, and finally its treatment. Results: DID was found to be a complex yet valid disorder across a range of markers. It can be accurately discriminated from other disorders, especially when structured diagnostic interviews assess identity alterations and amnesia. DID is aetiologically associated with a complex combination of developmental and cultural factors, including severe childhood relational trauma. The prevalence of DID appears highest in emergency psychiatric settings and affects approximately 1% of the general population. Psychobiological studies are beginning to identify clear correlates of DID associated with diverse brain areas and cognitive functions. They are also providing an understanding of the potential metacognitive origins of amnesia. Phase-oriented empirically-guided treatments are emerging for DID. Conclusions: The empirical literature on DID is accumulating, although some areas remain under-investigated. Existing data show DID as a complex, valid and not uncommon disorder, associated with developmental and cultural variables, that is amenable to psychotherapeutic intervention.

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Crossref · 10.1177/0004867414527523

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  • DID has an onset during early childhood.

    “With an onset during early childhood, DID occurs in the context of maltreatment perpetrated most often by caregivers [2,9,18], and it is delineated by the subjective experience of identity alteration [1].”

    From Treatment of dissociative identity disorder: leveraging neurobiology to optimize success (2024) · cites this paper as [2]

    The Aetiological Pathways section (page not supplied) describes DID as developing in childhood and links it to childhood trauma and disrupted integration of self-states. It does not establish the more specific claim that DID begins in early childhood; its reference to earlier onset concerns abuse, not DID. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • A large body of systematic empirical research has found individuals with DID consistently report severe histories of childhood neglect and abuse.

    “A large body of systematic empirical research has found individuals with DID consistently report severe histories of childhood neglect and abuse [2].”

    From Treatment of dissociative identity disorder: leveraging neurobiology to optimize success (2024) · cites this paper as [2]

    In “Aetiological Pathways and Influences in Development of DID: Cultural and Relational Context” (page unavailable), the review says systematic studies consistently find severe childhood trauma in the histories of almost all individuals with DID and describes evidence of severe childhood abuse. The passages do not specifically establish the claimed history of childhood neglect. (LLM, conf=0.86)

    Experimental — accuracy not yet measured
  • DID affects approximately 1% of adults in the general population.

    “Dissociative identity disorder (DID) is a treatable mental health condition affecting approximately 1% of adults in the general population [1–4].”

    From Treatment of dissociative identity disorder: leveraging neurobiology to optimize success (2024) · cites this paper as [2]

    Experimental — accuracy not yet measured
  • DID occurs in the context of maltreatment perpetrated most often by caregivers.

    “With an onset during early childhood, DID occurs in the context of maltreatment perpetrated most often by caregivers [2,9,18], and it is delineated by the subjective experience of identity alteration [1].”
  • Dissociative identity disorder (DID) is a treatable mental health condition.

    “Dissociative identity disorder (DID) is a treatable mental health condition that is associated with a range of psychobiological manifestations.”

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Cites

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Research works printed but not linked: 15

  1. Alvi T and Assad F (2011) Presentation of psychiatric co-morbidity in patients presenting with dissociative disorders. Journal of Pakistani Psychiatric Society 8(1): 18-21.
  2. Cocker KI, Edwards GA, Anderson JW and Meares RA (1994) Electrophysiological changes under hypnosis in multiple personality disorder: A two-case exploratory study. Australian Journal of Clinical and Experimental Hypnosis 22(2): 165-76.
  3. Dorahy MJ (2001a) Culture, cognition and dissociative identity disorder. In Schumaker JF and Ward T (eds) Culture, Cognition and Psychopathology. Westport, Conn: Praeger, pp.157-169.
  4. Hornstein, G. (2013) Whose account matters? Feminism and Psychology, 23(1), 29-40.
  5. Lloyd M (2011) How investing in therapeutic services provides a clinical cost saving in the long term. Health Service Journal (online): http://tinyurl.com/74sefbz. Accessed 11/2012.
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  8. Peters ML, Uyterlinde SA, Consemulder J et al. (1998) Apparent amnesia on experimental memory tests in dissociative identity disorder. Consciousness and Cognition 7(1): 27-41.
  9. Prince M, and Peterson F (1909) Experiments in psychogalvanic reactions from co- conscious ideal in a case of multiple personality. Journal of Abnormal Psychology 3: 114-131.
  10. Şar V and Öztürk E (2009) Psychotic presentations of dissociative identity disorder. In: Dell PF and O"Neil JA (eds) Dissociation and Dissociative Disorders:DSM-V and Beyond. New York: Routledge, pp.535-545.
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  12. Steinberg M (1994b) Structured Clinical Interview for DSM-IV Dissociative Disorders - Revised (SCID-D-R) (2 nd Ed.). Washington, DC: American Psychiatric Press.
  13. Steinberg M, Cicchetti D, Buchanan J et al. (1994) Distinguishing between multiple personality disorder (dissociative identity disorder) and schizophrenia using the structured clinical interview for DSM-IV dissociative disorders. Journal of Nervous and Mental Disease 182(9): 495-502.
  14. Stringer AY and Cooley EL (1994) Divided attention performance in multiple personality disorder. Neuropsychiatry, Neuropsychology, & Behavioral Neurology 7(1): 51-56
  15. Tutkun H, Yargiç LI and Şar V (1995). Dissociative identity disorder: A clinical investigation of 20 cases in Turkey. Dissociation 8(1): 3-9.

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Authors
Dorahy, M. J., Brand, B. L., Şar, V., Krüger, C., Stavropoulos, P., Martínez-Taboas, A., Lewis-Fernández, R., & Middleton, W.
Affiliations
  • University of Canterbury (NZ)
  • Towson University (US)
  • Istanbul University (TR)
  • University of Pretoria (ZA)
  • Adults Surviving Child Abuse, Sydney, Australia
  • Department of Psychology, Carlos Albizu University, San Juan, Puerto Rico
  • Department of Psychiatry, Columbia University, New York, USA
  • The University of Queensland (AU)
Venue
Australian & New Zealand Journal of Psychiatry
Published
2014-05
Volume
48
Issue
5
Pages
402-417
ISSN
  • 0004-8674 (ISSN-L)
  • 1440-1614
OpenAlex
W2118227624
Cited by
225
References
186
Citations by year
2026: 21 · 2025: 26 · 2024: 30 · 2023: 31 · 2022: 18 · 2021: 13 · 2020: 15 · 2019: 9 · 2018: 17 · 2017: 14 · 2016: 13 · 2015: 12 · 2014: 6
FWCI
2.06
Type
journal article
Language
en
Open access
Locations
  • Australian & New Zealand Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • UpSpace Institutional Repository (University of Pretoria) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Psychology › Developmental and Educational Psychology › Identity, Memory, and Therapy
Keywords
dissociative identity disorder, dissociative disorders, diagnostic validity, childhood trauma, amnesia, neurobiology, cognitive correlates, metacognition, psychotherapy
MeSH terms
Brain, Cognition Disorders, Humans, Dissociative Identity Disorder, Psychiatric Status Rating Scales, Psychotherapy, Reproducibility of Results, Neuroimaging

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