Talk:Dissociative identity disorder

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Archives (These Archives are still very relevant but the page was so long it was getting hard to open!)--Zeraeph 14:29, 3 February 2006 (UTC)
Archive 2004 Archive 2005 Archive 2006-1 Archive 2006-2 /Archive Feb 2006 - Oct 2007

Contents 1 Terrible article 2 Relegate "controversy" elsewhere and let's keep this page on the facts 3 Explanation of Changes 4 Possible source 5 Careful examination of subject matter experts 6 Pathophysiology Revisited 7 Archive, treatment 8 Causes/etiology 9 Sources 10 Request for DreamGuy 11 Smegging hell 12 Diagnosis 13 History 14 References 15 Accepting MPs, rather than trying to eliminate them? 16 question about MPD/DID epidemic section 17 Court Cases 18 Drug patients 19 Agree less about controversy, more helpful information 20 Wholesale Changes 21 merckdoc ref 22 MPD controversy 23 reverting vandalism 24 recent revert of OR 25 recent reversion of unreliable source 26 deleting OR from the cultural references section 27 revert unsourced edits by anon IP 28 Is there such thing as willful MPD?

[edit] Terrible article

I was hoping for an article on DID. What I got was an endless nonsense about nomenclature -- and unconvincing nonsense, at that. Take the iatrogenic theory. If all DID is iatrogenic, then (a) the existence of a single case of DID that manifests itself before any kind of treatment will falsify the theory, and (b) every case of DID is an indicator of an act of malpractice on the part of someone, and thus should be investigated.

The scientific outlook of practitioners would be a lot more convincing if they took a good hard stab at (a), and their professionalism and concern for the patients would be a lot more convincing if they took a vigorous go at (b). But nooo, it all seems to be a debating society.

That some diagnoses are fashionable and some are not, and that these fashions change over time, is incontestable. The real question is what relationship this has, if any, to the patients' problems.

It is my understanding that people who are diagnosed with DID have similar problems that respond in similar ways to treatment. The challenges faced by family, friends, and loved ones of people diagnosed with DID are also similar. This means that a DID diagnosis has utility for the patients and those around them, independent of any theoretical niceties of the diagnosis itself.

So please, let's stick a sock in it. Take all the controversy blather and put it in its own article, and make the DID article about DID and, in particular, what resources people with this diagnosis and their loved ones might be able to turn to. What words you wrap around the symptoms is irrelevant pedagogy that is of little interest to those whose main concern is the patient, not the practitioner. No one really understands DID, so all the definitions are wrong anyway. —Preceding unsigned comment added by RobertPlamondon (talk • contribs) 22:09, 11 November 2007 (UTC)

• It's impossible for me to agree more with you. This is totally unacceptable crap. I think this article needs to be completely rewritten by somebody who is an EXPERT on the matter, not an expert skeptic. If this diagnosis is so "controversial", why in the hell has it been in the DSM for 27 years? Let's get this crap cleaned up.
• Daniel Santos 05:26, 15 November 2007 (UTC)

Well, I think it's the experts who say that it should be removed as a diagnosis... and lots of things in the DSM have been controversial and were eventually removed. I also think you should go read the WP:NPOV article so you understand that your personal beliefs on the matter are not as important as an objective look at what experts on all sides have to say about the matter. DreamGuy 15:51, 15 November 2007 (UTC)

• The the point is not whether the category is debatable. Categories are always debatable until you can do a diagnosis with a blood test or something equally hard-edged. Problems like DID are discovered long before their causes, treatment, and diagnosis are perfected. Anyway, there are always "experts" to contest anything, which is why the debating society should be in a different article. Heck, there are even people who believe that shell shock/battle fatigue/PTSD was never real, and the millions of sufferers were all fakers. The real point is that a lot of people who know someone diagnosed with DID are going to turn to this article for information and come up empty. When I met a person with DID, I looked all over the place for information, and I eventually found it -- but not in Wikipedia. RobertPlamondon (talk) 15:12, 19 November 2007 (UTC)

I don't know what you mean by category, but the diagnosis *IS* disputed, and by people experts in the field. This isn't a fringe belief, this is in the field and undeniable. Our WP:NPOV and WP:RS policies demand then that we cover the topic without bias, which includes having real professionals who criticize the diagnosis mentioned, especially as the diagnosis has been controversial for decades. The accurate info about DID is here... it may not be what you want to read if all you want to know is one view -- the view that coincides with yours -- but that's not what Wikipedia is for. DreamGuy (talk) 16:26, 19 November 2007 (UTC)

Don't worry RobertPlamondon, all of this crap will be over with soon enough. What DreamGuy and others fail to understand, is that exceedingly few, if any, mental health experts who dispute DID actually work with survivors of severe childhood trauma on any regular basis. It's like a pompus attorney who is a 25 year family law veteran speaking out against an intricate detail on intellectual property law -- he isn't qualified, but he can't seem to get that in his head. (Clarification: This reference is compared to the afore mentioned mental health experts, not any Wikipedia users. --Daniel Santos (talk) 06:14, 6 December 2007 (UTC) ) In my experiences with DreamGuy, he has been quick to undo edits, often without examining any of the evidence, prone towards sly insults, and generally shows poor Wikipedia:Wiki_spirit. And DreamGuy, while you may have contributed significantly to removing vandalism, junk claims, etc., I have to wonder what the net gain or loss of your total contributions are after taking into account the hash, flippant, suppression-oriented manner of editing and postings I have seen from you. I sincerely hope that you will consider this criticism.

As to the sorry debating you referred to, RobertPlamondon, I am proposing that we deal with this issue once and for all by examining said "experts". It's going to take a lot of work, and I might compile a bunch of crap in Excel and export it to wiki format later, but it should make it clear enough. If DreamGuy, et. al. do not concede at this point, the dispute resolution course, will straighten things out. Daniel Santos (talk) 23:52, 4 December 2007 (UTC)

[edit] Relegate "controversy" elsewhere and let's keep this page on the facts

This is the first time I've come across this article and I admit I was quite taken aback. I'm a pretty hardcore "objectivist" and when discussing the topic of Dissociative Identity Disorder, let's discuss Dissociative Identity Disorder. We should let readers know about this controversy and link them to it, but we don't need to infiltrate every paragraph with disclaimers about what the "other camp" thinks. There is a solid basis of clinical studies and information such that the American Psychiatric Association has recognized it since 1980. Tell me one other diagnosis that either the APA or AMA have had documented and declared for 27 years that is being questioned? Let's stick to the facts here guys. Daniel Santos 06:45, 15 November 2007 (UTC)

The APA frequently has been questioned as time moves on and more information comes in. They used to declare homosexuality a mental illness for decades, and they stopped doing that.

Yes, we need to stick to the facts, but the facts are that this diagnosis is not considered as reliable by many within the psychiatric community. It is also a fact that many diagnoses of mental conditions get questioned later on, like the fugue state, Oedipus complex and many, many other examples. And the AMA and other medical bodies also have diagnoses that get changed over the years, as they used to believe that masturbation caused mental illness, that a woman's uterus could wander around her body, and so forth.

And, by the way, if you label yourself an "objectivist" I think you are using the term quite incorrectly. Objectivists look at facts and remain objective, while you have just assumed that anything the APA came up with years back must be real, despite that fact that it has since been under fire from scientists. Might want to either rethink your stance on this issue or find a different term to refer to your beliefs as. DreamGuy 15:48, 15 November 2007 (UTC)

Yes, homosexuality is a good example, point taken. There are some quite remarkable stories about early psychiatrists who were gay when it was still considered an illness. On the point of objectivity however, I'm not biased, I've simply researched it for over 15 years and I know better. Daniel Santos 04:41, 16 November 2007 (UTC)

[edit] Explanation of Changes

I have renamed the section "Defining the Controversy" to "Controversy" as the original is too verbose and fails to encompass the subject covered in the section. Additionally, I have moved the section down, which is the reason I'm writing this post. I have moved it down to what seems appropriate for it's importance. The main concerns of this article should be on the facts and science of the condition and not on the controversy. Rather the "anti-DID" positions are seen as accurate or inaccurate, it's relevance is low in comparison to the facts (etiology, diagnostic criteria, treatment, etc) of the disorder. Please post descending opinions. Thanks. Daniel Santos 08:50, 15 November 2007 (UTC)

Your belief about its importance (lack of importance) is at odds with what was discussed here previously. You simply cannot have a full article pretending that this is a real, accepted condition and then at the end mention that some people think it's not real and expect readers to follow that. You can't at all talk about the "facts and science of the condition" while downplaying the fact that these alleged facts are in dispute and science has many people saying the condition doesn't exist at all.

Also, your wording changes created a number of new spelling and grammar problems and did not improve the article. IFor examples on this page, on your comment above you talk about "explaination" and "descending opinions", which should be "explanation" and "dissenting opinions". If you learned English as a second language and are not a native speaker this cold explain such errors, but you should understand then that you probably need to double check your wording before making edits to an English language encyclopedia.DreamGuy 15:41, 15 November 2007 (UTC)

Well, when you include "IFor" and that not being a native speaker "cold" explain these errors, it's a bit silly correcting my own errors don't you think?. None the less, it's not the article, it's a discussion.

So the real issue is the lack of understanding of the reality of this "alleged condition." The problem with this assertion is the lack of credible science behind it. Just because a "consensus" of people on a web site get fired up about opposing the facts of this issue, doesn't create a plausible reason to discard the overwhelming evidence and science. Honestly, this not a debate I thought I would experience on Wikipedia! I don't think it's presumptuous to "pretend" that a well-accepted condition that has been in the DSM for 27 years, is indeed real.

I think that there are many more studies that can be done to verity the facts of Dissociative Identity Disorder, they are just illegal. Carefully structured studies involving children being repeatedly tortured and raped by their parents, or another trusted caregiver, should be able to solidly confirm the existence of DID, as well as help us learn more about what happens during it's formation and what the major components are that determine if the child creates multiple personalities or copes in some other fashion. Such studies could also help us understand a lot about the development of the human mind when under duress. In lieu of this, the clinical science is a lot slower, but it has the added benefit of producing information about how to actually treat the condition as well.

The empirical evidence is overwhelming to anyone who actually understands the issues. While there are also a large number of mental health professionals who disagree, let's be restrict accepted opinions to actual mental health professionals and go from there. So, I challenge you to come up with a list of mental health professionals who specialize in treating trauma survivors, that believe that the existence of DID is false. One can be a psychologist who specializes in marriage and family counseling or a psychiatrist who specializes in treating bipolar disorder and that does not make them an expert on trauma and dissociative disorders.

I feel like I'm trying to convince somebody that the world is round here. Daniel Santos 17:20, 15 November 2007 (UTC)

Well, your opinion that this is a "the world is round" issue is certainly at odds with the experts with professional backgrounds who equate the idea of multiple personalities as being a throwback to the superstitions that were widespread when people thought the world was flat. The claim that "The empirical evidence is overwhelming to anyone who actually understands the issues." is absolutely false, as you just dismiss anyone who disagrees with you as ot understanding, which is not a reasonable argument. The fact of the matter is that many experts with academic credentials dispute the concept of DID, and by Wikipedia policies this article has to reflect that fact. If you disagree with them, that's you're right, but if you want to write something to argue against it you should write your own book or blog or something and not try to enforce that opinion upon what's supposed to be an encyclopedia. DreamGuy 20:44, 15 November 2007 (UTC)

You are quite obviously talented in justifying your false positions in such a manner as to cause others to feel that your opponents assertions have been debased, when indeed they haven't been. Fortunately for those suffering from the effects of sever trauma and DID, you're current opponent isn't that easy, although I appreciate your art form. These phrases you use, assuming an authoritative stance, surely cause a lot of people to think you are correct, when you are not. Example:

The fact of the matter is that many experts with academic credentials dispute the concept of DID,...

True!

...and by Wikipedia policies this article has to reflect that fact.

False! Indeed, many "experts with academic credentials" also believe that:

• Sex with children is appropriate, as the highly credentialed Ralph Underwager told Paidika^[1][2]. Underwager was co-founder of the False Memory Syndrome Foundation and is credited with coining the very term "False Memory Syndrome"^[3].
• Elvis is still alive

Sounds outlandish? No, I've met "experts", in one field or another, with "academic credentials", such as a high school diploma, GED, etc., that will make this assertion. Thus, your statement that the condition of "many experts with academic credentials disput[ing] the concept of DID" creates a mandates, via Wikipedia policy, that their opinions be reflected in this article is false, else, the opinions of many expert cocaine producers with a middle school diploma who assert that cocaine is not addictive should also have their views equally weighed in the article on Cocaine_dependence. The same is true of your statements about "experts with professional backgrounds".

Now lets narrow the scope from "anybody who is an expert at anything and possesses some form of academic credentials", to "anybody who is a mental health expert with academic credentials, specifically in mental health", should a large number of these experts with a dissenting opinion on the existence of DID be reflected in the article? Well what specifically is such a person anyway? In America, you can become a Certified Drug and Alcohol Counselor with 155 hours of classroom training (not semester hours) and would qualify as an "academically credentialed mental health expert", but would you be qualified to dispute the existence of DID? Hell no. "Highly credentialed mental health experts" (Masters and higher)? We're getting much closer now, but still no cigar.

Although academic experience is important, it is inconsequential compared to real experience. Would you want a surgeon fresh out of school doing your open heart surgery unsupervised? As I said earlier, show me the list of mental health professionals who actually treat survivors of trauma and have a dissenting opinion on the existence of Dissociative Identity Disorder. I would get started if I were you, because your little reign on this article is coming to an end. Wikimedia exists to provide free information to the people, not propaganda and misinformation. You and those like you are not serving the people. The consensus that you claim to be present is not and this will be made clear. I'll be on vacation for the next week and a half, so I'll have to pick this up after the holiday. See you then. Daniel Santos 04:19, 16 November 2007 (UTC)

Also, you ignored the fact that most of the Causes/etiology section is copyrighted material of Merck (http://www.merck.com/mmpe/sec15/ch197/ch197e.html?qt=dissociative%20identiy%20disorder&alt=sh#sec15-ch197-ch197e-177), the primary reason I rewrote most of it. Daniel Santos 17:22, 15 November 2007 (UTC)

So we'll have to work on that section then. I apologize, when I have a chance I'll go back and look at that one part again. DreamGuy 20:44, 15 November 2007 (UTC)

It looks like somebody pointed this out last year, but it got missed Talk:Dissociative_identity_disorder#Question re: "potential causes" section. Perhaps correcting my grammar errors will be less work than another rewrite, but I can't help with it this week. Daniel Santos 04:33, 16 November 2007 (UTC)

[edit] Possible source

It's relatively recent, and it's a review.

Kihlstrom JF (2005). "Dissociative disorders". Annual review of clinical psychology 1: 227–53. doi:10.1146/annurev.clinpsy.1.102803.143925. PMID 17716088. 

WLU (talk) 19:24, 20 November 2007 (UTC)

w00t! full text! Daniel Santos (talk) 07:11, 6 December 2007 (UTC)

Here's another one:

Pope HG, Barry S, Bodkin A, Hudson JI (2006). "Tracking scientific interest in the dissociative disorders: a study of scientific publication output 1984-2003". Psychotherapy and psychosomatics 75 (1): 19–24. doi:10.1159/000089223. PMID 16361871.  WLU (talk) 19:28, 20 November 2007 (UTC)

Whenever I see "recovered memory therapy," as in the abstract of this study, I'm always suspicious of the author's intentions going into the study. There is no formal methodology called "recovered memory therapy" as there is for cognitive therapy, hypnotherapy, EMDR, etc., rather, this appears to be a term invented by the "recovery backlash" movements such as the FMSF and VOCAL in attempt to discredit survivors of abuse and their therapists. Here is an interesting experiment that demonstrates this:

• "recovered memory therapy" - 24.6k googles
• "recovered memory therapy" -malpractice -fraud -"false memories" -"false memory syndrome" 1.2k googles

A difference of 1950%, as opposed to

• "cognitive therapy" - 1.31M googles
• "cognitive therapy" -malpractice -fraud -"false memories" -"false memory syndrome" - 1.28M googles

A difference of 2.3%, or

• "music therapy" - 1.6M googles
• "music therapy" -malpractice -fraud -"false memories" -"false memory syndrome" - 1.56M googles

A difference of 2.6%. But the major reason that I lost my initial excitement when reading the abstract is that it doesn't examine the credentials or specialties of the publishers of the publications they examined. I might try to get the library this weekend and get the full text of some of these studies. Daniel Santos (talk) 06:55, 6 December 2007 (UTC)

[edit] Careful examination of subject matter experts

I am beginning an exhaustive examination of mental health professionals who have published works on DID, with both dissenting and supporting stances. I'm still a bit of a newbie here, but I'm thinking it should have it's own page. Can an arbitrary page be created under "Talk" like the archives? Example Talk:Dissociative_identity_disorder/Examination of Subject Matter Experts? I would appreciate the contributions of all those who have been active on this article, especially the editors. This is not an opinion page. I would like to keep this page limited strictly to the lists of authors, their publications (articles, books, etc.), their stance on DID, if it can be summarized as "dissenting" or "supporting", and an examination of their credentials. Would somebody with more Wikipedia experience kindly comment on the proposed location for this document? Thanks, Daniel Santos 19:50, 1 December 2007 (UTC)

[edit] Pathophysiology Revisited

DreamGuy, if you undo edits without reviewing the evidence, your behavior may appear biased POV, and you wouldn't want to be seen that way would you?

User:WLU made some changes, some of which were pleasant refinements, others that weren't. At issue with the EEG studies, changing "showed distinct differences" to "showed mixed results" destroys the main point of this fact: that distinct differences in brain wave activity have been observed on more subject with DID when switching between personality states. The fact that such results were not found with other subjects is secondary. Also, the 1984 study was worded in such a way that I'm not really sure that it was attempting to measure the differences between personality states. If I can get more info on this study, and they indeed weren't attempting to measure that, I will just remove the reference all together or move it somewhere that it's findings are relevant. The point is that section exists to examine physiological characteristics of subjects with DID (the pathology).

As to the studies on blood flow, note that blood flow is an artifact of perfusion. I originally added this to the verbiage due to this nit-picking, but decided that it's just superfluous. The specific finding of the study in question revealed hyperperfusion (needs it's own article some day), which is also a reaction to brain trauma, indicating a higher significance. In no way was this a "mixed evidence" or "failed to find results" study. However, I would expect that if multiple studies were done, many subjects would be found to have normal cerebral blood flow (and perfusion) between different personality states. While there have been many discoveries correlating various psychological observances with physiological, there is still a vast amount that is unknown. But again, the point is the significant findings, not the lack of them existing in every study. --Daniel Santos 18:08, 4 December 2007 (UTC)

WLU, it looks good to me. However, I added a new study earlier today that deals with overall physiology differences between DID and non-DID that looks pretty nice from the abstract (21 subjects, and 9 in a control group). This is nice info, so I would hate to remove it, but it's not related to differences between alters. Maybe we can create a new section for pathophysiology and move it there, as a few other points (shrinking hippocampus, etc.) were related to pathophysiology as well?

And I don't know if it's relevant, or even worth mentioning, but a shrinking hippocampus has been solidly associated with depression and, thus, findings that DID patients exhibit a shrunken hippocampus may be an artifact of depression, which is exceedingly prevalent amongst DID patients. (Studies also found that SSRI anti-depressants markedly reduce or entirely prevent the phenomena. I hope I'm not babbling here. :) Daniel Santos (talk) 22:30, 4 December 2007 (UTC)

Daniel, just to say that you are doing a great job here. I've found that many of the media-driven "controversies" manufactured by the False Memory Syndrome Foundation in the 1990s are being reproduced here on Wikipedia as though they represent the current state of play, when they have long been bedded down in the academic and professional literature.

I've also had some big problems with Dreamguy, but that's another story. --Biaothanatoi (talk) 00:37, 5 December 2007 (UTC)

Thanks for your support! :) But DreamGuy has a tiny bit of policy to stand on, being that the discussion here on Wikipedia has been clouded with "junk science" that hasn't been discernible by Wikipedia admins/editors during past attempts at dispute resolution. So we wont be able to seriously turn this around until we spell all of this out by the book. Until then, I'm at least clearing up some details that don't step on the "DID might not be real" issue, and between WLU and I, we're getting rid of some copyrighted material. Nobody wants to be in the cross-hairs of an attorney! Daniel Santos (talk) 01:02, 5 December 2007 (UTC)

Actually, the field itself is full of junk science -- and in fact many experts would call DID/MPD to be a huge example of it. Simply saying that people here aren't as smart as you and aren;t capable of telling junk science when it happens is a hugely biased opinion and tries to ignore the experts who say you are wrong. You can;t edit out of bias, and it seems like you aren't even trying to follow our policies here on this issue. Personal attacks and assumptions of superior knowledge aren't a justification for these actions. DreamGuy (talk) 14:35, 5 December 2007 (UTC)

Dreamguy, you are drawing on debates about DID/MPD from a decade ago or more, much of which was not driven by 'experts' but rather by social researchers and experimental psychologists aligned with anti-psychotherapy activist groups like the False Memory Syndrome Foundation. On this page and elsewhere, you seem deeply influenced by their populist literature, although their arguments have often been made irrelevant by new research findings and new forms of clinical and professional practice.

Daniel has pointed out that this article is very poorly drafted and cited by Wikipedia standards, and it does not reflect the current state of knowledge on DID. None of your dodgy online sources, outdated populist literature, or the few voices in the wilderness still prosecuting a decade-old culture war on child abuse, change that. This page should be a resource for people with DID and the professionals who treat them, not a place where people who know nothing about the subject matter uncritically reproduce anti-psychotherapy propaganda. --Biaothanatoi (talk) 00:05, 6 December 2007 (UTC)

Thank you, Biaothanatoi. DreamGuy, is knowingly publishing copyrighted material following Wikipedia policies? That is what you have just done by rolling back the changes. I re-wrote it last month, explaining that it was copyrighted material and you rolled it back. I called it to your attention and you apologized and said you would take care of it. Now, 2 weeks later, it's still not done. So I put it back in, fixed it up some and you roll it back again? I tear your illogical arguments and misrepresentations down and you keep coming up with new ones. Example:

Simply saying that people here aren't as smart as you...

You speak of personal attacks while firing off your own. Where did I say that I was smarter than anybody else? This shows that you have a talent for manipulation and that you like to undermine your opponent's character as a means to win your debates. Read Wikipedia:Civility lately? I noticed this when you initially attempted to insult me by pointing out my spelling and grammar errors on the talk page. That's great in politics, but it doesn't belong on Wikipedia.

You speak of "editor consensus", but I only see and you and CloudSurfer doing this. I have attempted, in good faith, to work with you and your behavior continues to fall short of the Wikipedia policies (including NPOV) and spirit. I examined the Causes/etiology section and the only place where I appear to have altered POV (which is another issue entirely) is not carrying over the opening sentence fragment "Although many experts dispute the existence of this controversial diagnosis,...". I urge you to behave more responsibly. Add the missing sentence fragment, do not carelessly roll back hours of my work! Daniel Santos (talk) 02:13, 6 December 2007 (UTC)

The comment "has been clouded with "junk science" that hasn't been discernible by Wikipedia admins/editors during past attempts at dispute resolution." most definitely assumes that the people who disagree with you on this issue is because they follow junk science and are not as smart as you in being able to sort through it. That's nonsense. I am certainly far more knowledgable than that, and in fact I go against junk science all the time, and I would argue -- along with lots of professionals in psychology -- that DID is the junk science, not the other way around. You have extensively altered POV because you went around changing all the references in research to claiming that they all side with you and only getting sources from one side of the debate. That's cooking the results. My actions here have been to uphold Wikipedia policies and the spirit. You cannot claim good faith becaus you have not tried to hammer out any differences, you've just barrelled ahead making any changes you want without considering other editor's concerns. Simply put, you can't complain about people undoing your "hours of work" when your changes are undoing *years* of work on this page to get it to conform to policies and to represent the issue neutrally. You cannot lecture me on responsibility ad what I should do when you don't seem to be trying to follow any of those rules yourself and I am just enforcing the rules. DreamGuy (talk) 15:07, 6 December 2007 (UTC)

Daniel, please continue - I'd really like to see an informative and useful article on DID here. If Dreamguy keeps blocking any changes that contradict his POV (e.g. any empirical research finding on DID published in the last 10 years) and you need to take it to mediation, you have my support. --Biaothanatoi (talk) 04:21, 6 December 2007 (UTC)

Thank you. I've never engaged in the dispute resolution process before, but I'm trying to "play by the book", so I put in a request for editor assistance for advice on how to best deal with the problem. But from reading Wikipedia:Dispute_resolution, it seems like I've done everything else right thus far. My thought was to give him one more chance before going further, but depending upon the feedback I get from the editor's assistance, I may move forward anyway. Daniel Santos (talk) 05:22, 6 December 2007 (UTC)

No offense, but you've not followed pretty much anything in Wikipedia:Dispute_resolution. You have completely skipped over ALL Of steps 1 through 5 and gone straight to complaining. You certainly have not focussed on the issues, instead attacking me personally and portraying anyone who disagrees with you as not knowing what they are talking about. You have not considered whether this is urgent or not -- there is no need for you to rush and make sweeping changes to the article when you can (and should) discuss them here first and work out a version acceptable to all parties. You certainly have not stayed cool, as even pointed out by other editors on this page. And you have not done any real discussion here -- just insisted you were right, assumed bad faith on my part, accused my reverts of "suppressing" information and targetting you personally and so forth and so on. And there's certainly no truce, as yo are actively engaged it edit warring, accusations, and so forth. If you are serious about following Wikipedia policies you will start working together. If you don't, well, don't be surprised if you don't get what you want. DreamGuy (talk) 15:13, 6 December 2007 (UTC)

[edit] Archive, treatment

Archived talk page, I tried to capture everything that was a dead discussion 'cause the page was huge. If you've anything that I cut that you think should be brought back, copy from the archive please. Also, the treatment section was a direct copy and paste from Web MD, I reworded what I could. Most of the treatments were psychotherapies, so rather than rhyming them off, I just said psychotherapy and culled the ones that didn't have more to offer (and didn't have references). WLU 20:36, 4 December 2007 (UTC)

Cool, it loads so fast now! :) Daniel Santos (talk) 22:17, 4 December 2007 (UTC)

[edit] Causes/etiology

I put back in my original re-write of the Causes/etiology section from last month and started fixing it, the previous was Merck's copyrighted material. Most of this information is from memory or personal experiences with DID, but I don't remember every study I've read. Hopefully, I can find some of these quickly. If making any major reversals to the section, please do post here. Aside from a few more areas where wording is weak, here is my summary on the needed references.

• likelihood of developing DID compared to age at onset of trauma
• mitigating factors to severity of DID. IMO, each of these items should have a reference.
• all data referencing the Merck Online Manual in the last paragraph -- we need their sources and references added for those (or replace existing?)

--Daniel Santos (talk) 01:10, 5 December 2007 (UTC)

The original rewrite? Meaning, the POV-pushing version you came up with earlier that was removed as a violation of WP:NPOV policy? You completely took out pretty much any part that was neutral and factual and switched things so that they only supported the views of those people who believe in the diagnosis, presented results and conclusions from one source as if they were the only word on the matter, and so forth and so on. Based upon these edits and the comments yo have left above about how the article should outright take the side of view that you yourself have it's clear you need to go read some of our policies, or agree to follow them. Some of the other edits are unobjectionable, but you can't build them on top of a version that has a clear view that it's promoting. You should take things step by step and get agreement here before rushing along to make big changes. DreamGuy (talk) 14:31, 5 December 2007 (UTC)

So you don't know how to rollback changes on a single section? Sounds like suppression-oriented editing to me. Daniel Santos (talk) 00:02, 6 December 2007 (UTC)

You're making a wide variety of changes all at once, mixed together but slpit up over several edits. Individually rolling back each one would be prohibitively time-consuming if possible, but because they are mixed it would not even work, as I'd have to go through and do everything by hand. That should not be necessary, however, because if you had discussed the issues here and gotten a consensus that the edits you want to make are accurate and follow policy BEFORE making your changes then we'd all save a lot of time. You don't just get to ignore what everyone else says. Whether you agree with me or not, you have to work with me, and just edit warring to some new version against the concerns of other editors is not the way to do it. DreamGuy (talk) 15:00, 6 December 2007 (UTC)

Dreamguy, you clearly want this article to revolve around the question as to whether DID is "true" or "false". As Daniel's sources demonstrate, such debates have been resolved by research findings that have affirmed the construct validity of DID numerous times over the last twenty years, in both clinical and experimental settings. There is now a substantial body of research into the physiology and aetiology of DID and it should have a place here.

Please try to engage constructively in the development of this article for the reader - that means actually reading and considering changes in good faith, rather then rejecting them outright because you don't like what those sources have to say. --Biaothanatoi (talk) 00:23, 6 December 2007 (UTC)

What I want is for this article to follow the policy of WP:NPOV, which is a fundamental building block of how things are done here. The claim that the debate has been resolved and all the research findings say what you claim is simply false. Experts are divided on the diagnosis, up to and including the present day. In fact, trying to switch to a version claiming there is no controversy would set the knowledge about this issue back several decades. Your opinion and Daniel Santos' opinion that this is real and indisputable are not the only view there is -- and I would argue not even one with a strong basis anymore -- and you can't totally rewrite an article to indicate your opinion as truth. Period. That part of Wikipedia will not change. DreamGuy (talk) 14:56, 6 December 2007 (UTC)

Dreamguy, you point to NPOV whenever the thrust of an article runs against your own POV. It's your standard technique - rather then actually reflect on the various sources according to their merits, you just claim some kind of universal Wikipedia mandate to reverse/block/delete any change that challenges your own beliefs.

The article should be a reflection of the current literature, rather then rotate around whatever question you (or anyone esle) personally thinks is most pertinent. Personally, I do not simply believe that DID is "real and indisputable" - I am a social researcher and I think that some psychiatric categories are too individualistic and discrete to properly capture the phenomenon they seek to describe. However, the fact that I believe these things (and there is literature that reflects on these issues) does not mean that I should insist that it is stamped upon the article itself.

And neither should you. It is clear that you know very little about DID, beyond what you have read in decades-old populist "skeptical" literature. Please stop blocking Daniel from adding peer-reviewed and recent scietific research findings, simply because you can't bear to countenance the possibility that your beliefs aboud DID are wrong. --Biaothanatoi (talk) 22:29, 9 December 2007 (UTC)

I don't mean to intrude... okay that's a lie, but for a topic like this if one really wants to argue that DID is indeed some sort of psychology scam, shouldn't they just pull up and attach the appropriate refrences? With that said, I really don't see why under Causes at the moment the start of it is arguing against DID being a factual disorder. Most other articles put the less popular, less refrenced opinions below the... you know... scientifically sound and properly represented and refrenced ones. —Preceding unsigned comment added by 75.17.201.207 (talk) 10:20, 6 December 2007 (UTC)

I think you are right. Regardless of the dispute that still exists amongst the scientific and psychiatric communities, we don't need it proliferating every aspect of this article with it, especially since there is an entire article on this controversy already. Daniel Santos (talk) 18:00, 6 December 2007 (UTC)

What? There's an entire page dedicated to it? Well then it really doesn't need to be here. It seems to needlessly detract from the topic this page should be about. —Preceding unsigned comment added by 75.17.201.207 (talk) 01:10, 13 December 2007 (UTC)

[edit] Sources

OK, the page seems to be in a state of dispute. I'm having a go at reading through section by section and seeing what's sourced, what it's saying, if the source is reliable, and various sundry. Expect me to forget to remove large numbers of reflist templates between now and my final version. If I only get partway through and can't finish I'll try to note it, so if there's a greater than 2 hour gap in the edit history, remove the {{underconstruction}} and edit as normal. A page like this, on a medical diagnosis, there should be tons of pubmed and peer-reviewed articles on the subject so no excuse for not having a top-drawer page. A reminder that if you're adding text to the page, please use a reference and not just background knowledge. Content is built through reliable sources, not what I read somewhere. If it can't be sourced, it shouldn't be on the page. WLU (talk) 15:45, 5 December 2007 (UTC)

OK, I'm momentarily sidetracked by the terrible (yet easily repaired, if time-consuming) mess that is psychogenic amnesia. I should be able to get to this page today though. WLU (talk) 16:22, 5 December 2007 (UTC)

Totally underestimated how productive I'd be. Got very little done. Is now ordered in line with WP:MEDMOS, so please keep things within the present order and sections. Will try to do more tomorrow. WLU (talk) 21:09, 5 December 2007 (UTC)

Do you think there is any reason to separate studies aimed at detected physiological differences between alters? You're pretty good with this article flow thing, it might help to remove studies from pathophysiology that do not specifically address physiological evidence of pathology, although, one may argue that the phenomena of there being physiological changes between alter states does indeed demonstrate pathology. If we did separated it, maybe a section under pathophysiology? Daniel Santos (talk) 03:13, 6 December 2007 (UTC)

[edit] Request for DreamGuy

Please edit, do not revert. Unless you have a better body of text to stick into Causes, please make some positive contributions and do not revert back to copyrighted material. Daniel Santos (talk) 02:44, 6 December 2007 (UTC)

Please do not use ALL CAPS and BOLD in posts and edit summaries as it looks like you are SHOUTING, which makes it hard to remain civil. You aren't even shouting at me and it's getting my back up. Please, let us all be reasonable and discuss rather than reverting. Remember to comment on the content, not the contributor and assume there's a reason for everyone's edit. Thanks. WLU (talk) 03:03, 6 December 2007 (UTC)

Sorry, I was very irritated. I edited the original post to cooler language. Daniel Santos (talk) 03:17, 6 December 2007 (UTC)

Any request to not revert coming from someone making sweeping changes to the article that he knows are controversial and who routinely reverts from the longstanding wording of this article to his preferred version simply is not one that is done in good faith. If you think reverting is bad, don't do it. If you want to have the article reflect your changes, you're going to have to get cnsensus to do so. That absolutely will not happen if you ignore WP:NPOV policy and try to rewrite the article with a specific view in mind. We all play by the same rules here, and you do not get to do all the things you say you don't want me to do (and in the process go against longstanding consensus and ignore the very important issues discussed for years on this talk page) and go off running making a complaint like I am someone a bad person. Every time you edit a page you get a notice that you agree that others can further edit your changes and that changes that do not follow policy will not be accepted. You agree to those conditions when you edit. DreamGuy (talk) 14:53, 6 December 2007 (UTC)

You pay so little attention, that you missed all of the "real discussion" here. You also failed to notice that it wasn't even myself who removed most of the text on the "controversy." Anyway, you will continue to misconstrue and false invent accusations. Daniel Santos (talk) 15:19, 6 December 2007 (UTC)

OMG! He's even posted his arguments on the page where I requested editor advice! . Daniel Santos (talk) 15:41, 6 December 2007 (UTC)

[edit] Smegging hell

All the back and forth on the page is pretty irritating, and I'm basically staying out of it. When the page has settled, I may have a crack at editing it again. I only ask that the editors remember a couple things.

1. This is a medical article, meaning:
   1. There's lots of medical sources and per WP:MEDRS, they should be used. Only after the medical sources are exhausted, or in sections where it's not a medical discussion, should less reliable sources be used.
   2. WP:MEDMOS applies. Please keep the order and sections in line with these guidelines.
2. Rather than accuse, be civil. It's hard for me to edit the page with all the reverting and acrimony. In a well-researched area like this, disputes should be minimal as there should be both skeptical and believing sources at www.pubmed.org, your primary search engine for pages like this. We are always limited by our sources on a medical page, so speculation should not be necessary. Negotiate your wording. WLU (talk) 18:15, 6 December 2007 (UTC)

I've culled almost all sources barring PUBMED, the DSM, the Merck manual and webMD (in descending order of reliability). There's a couple stray websites and other stuff. Please do not revert, add information gradually and make sure it's well-sourced. I may have a crack at the history section, but I doubt I'll have time today. Again, discuss the page, evidence and sources (content), not contributors. Again, it's a medical article, so try to stick to the best sources available. The history section will probably be the hardest to write given the controversy, but the rest should be almost pure pubmed citations. I wouldn't mind replacing Merck and webMD with pubmeds, but I can only access abstracts, not full text in most cases. WLU (talk) 19:46, 7 December 2007 (UTC)

Dang! You go! :) Yea, the history is a huge mess, I haven't even looked at it in depth. I would sure like to see a lot more info in here, but I'm on board with what you are doing here. Daniel Santos (talk) 00:42, 8 December 2007 (UTC)

[edit] Diagnosis

Just a few notes on my changes to Diagnosis. I have added the exact text of the DSM diagnostic criteria. I have removed the following paragraph:

If symptoms seem to be present, the patient should first be evaluated by performing a complete medical history and physical examination. Diagnostic tests, such as X-rays and blood tests, may be used to rule out physical illness or medication side effects as the cause of the symptoms. Certain conditions, including brain diseases, head injuries, drug and alcohol intoxication, and sleep deprivation, can lead to symptoms similar to those of dissociative disorders, including dissociative amnesia.

I removed this because, most importantly, it wasn't sourced. But what particularly struck me was the statement that about first having all of these other examinations including blood tests, x-rays, etc., it's complete and total bullshit. Either way, it's pretty much stripped down to the bare bones, so we can build on it later. Please post any other comments. Daniel Santos (talk) 02:00, 8 December 2007 (UTC)

I disagree, it's quite common for the DSM and other diagnostic criteria to present exclusionary criteria (i.e. not due to alcohol, drugs, physical injury, etc), though it is better with a source and I'm not sure enough to insist. My preference would be replacing the information and adding a {{fact}} tag. It's not absolutely necessary to remove every unsourced statement, sometimes it's better to leave the information in. I think this is one of those sometimes. But if you feel strongly, I'll try to come up with a source when I remember.

Also, with this edit, Springer is a respectable publishing house based on my knowledge, and books are perfectly acceptable sources. Though on-line sources are easier to access, paper sources are perfectly acceptable, and as you can see from the lead, Springer publishes mainly academic books and journals. I don't see any reason to remove the paragraph; without any reason to remove it other than 'it's a book' (not a good reason in my mind), best practice is to assume good faith and leave the note in. A pubmed article would be nice, but it's not necessary all the time. I'd prefer the sentence replaced; often books are useful for broad characterizations because they, by their nature, cover a much broader scope than individual articles. WLU (talk) 02:29, 8 December 2007 (UTC)

It's nice to have real discourse for a change. First off, the paragraph I removed from the Diagnosis section gives medical/psychiatric advice that is bad. I have never heard of a physical examination being indicated when DID is suspected. To the contrary, most survivors of severe sexual abuse are highly resistant to the idea of physical examinations of any kind and will go to great lengths to avoid them, sometimes leading to dreadful consequences. I've known women with DID who skipped her pap smears for years on end. The sentence was either constructed by somebody who is very ignorant on the subject matter or hoped to deter people who suspect they have DID from seeking treatment or diagnosis. Likewise for x-rays and, for the most part, blood tests. Psychiatrists will sometimes order a thyroid panel if they have reason to suspect depression symptoms are due thyroid rather than actual depression where they will usually prescribe DHEA instead of an SSRI and I'm sure there also are a number of other reasons why a psychiatrist might order blood tests. However, but this is exceedingly rare for outpatient treatment, unless the patient is on a medicine such as Depakote where levels have to be monitored. Inpatient psychiatric treatment is a different story and blood tests (of many sorts) are mandatory in the US. But I digress, the point is that it's inaccurate. The last sentence I don't object to very much, although I don't think it's all that helpful since the diagnostic criteria covers this, just with less examples.

The main problems that I have with the sentence I removed from the Treatment section is that it has anti-DID rhetoric that cannot be verified without reading an entire book, as pages were not given. The fact that some clinicians, DBT or otherwise, subscribe to the belief that DID is caused by bad therapy rather than childhood trauma is now covered in Epidemiology that I modified earlier. Of course, I believe that that theory is a load of fertilizer, but it's part of the facts of this topic. As far as responding to only a single identity, I believe that the greatest progress in DID therapy occurs when the therapist puts the onus on the host personality for internal communication and personal responsibility for their actions, even when it was "another personality" who took that action, because no matter how many ways you slice it, they are still a single human. That said, refusing to ever deal with alternate personalities (in somebody with actual DID) will significantly impede therapy. Some survivors of trauma will split their minds, but not develop full personalities, what we would call DID. Some refer to this as "fragmenting" and it's typically diagnosed as Dissociative Disorder NOS (300.15) and usually on an axis II or III. I don't think it's appropriate to "try to talk to the alters" of people who don't have DID, so there is real reason for caution and care in this area. But my personal observation of DID patients who worked with a therapist who didn't believe in DID was that it was either minimally helpful, not helpful at all (the usual case), or actually harmful. These are my observations and opinions of course, but we should have treatment information in this article that has solid science (clinical results) behind it and doesn't require reading an entire book to verify. Daniel Santos (talk) 07:56, 8 December 2007 (UTC)

Biaothanatoi, do you have any opinion? Daniel Santos (talk) 07:59, 8 December 2007 (UTC)

The fact that the information is difficult to find within the book is irrelevant in my mind, the point is that the information is sourced, and to a very reliable source at that. You seem to be challenging the source because it can't be easily verified; that's not the point of reliable sources, the point is that it can be verified. A newspaper article from 1985 can't be easily verified either, but it's still a reliable source. WP:V says In general, the most reliable sources are peer-reviewed journals...and books published by respected publishing houses... This book fits that criteria, and the information fits my background knowledge of how a behaviour therapist would react. You could bring it up on Wikipedia:Reliable sources/Noticeboard for an opinion, or if you don't want to, I will. I do think that this is a valid point and should be included. Books are good sources if they're published with oversight as this one is.

Regards the exclusionary diagnosis, the final bullet in diagnosis states that the disturbances should not be caused by toxins or medical conditions. The original statement was a blatant copy and paste from webmd, but webmd is reliable I think and the information could be included in a prose summary. It's essentially an expansion of that final bullet to say 'not due to physical cause'. I think the types of tests used could be included.

*The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). In children, the symptoms are not attributable to imaginary playmates or other fantasy play.[1] A patient history and tests such as X-rays and blood tests can be used to eliminate symptoms being due to brain injury, medication, sleep depriviation or intoxicants, all of which can mimic symptoms of DID.(webmd)

Also note that it's not a matter of good or bad advice (note that the disclaimer at the bottom of the page covers this, but more importantly, WP:NOT#HOWTO), it's a matter of sourced or unsourced information. Sourced information should stay, unsourced should not. The expanded diagnosis section is useful in my mind, because it points out that part of the process of arriving at DID as a diagnosis is eliminating other possible sources of symptoms.

As an aside, I'm pissed that some moron blatantly pasted an enormous volume of text from webmd. Copyright violations can get pages deleted, this isn't something small. WLU (talk) 18:26, 8 December 2007 (UTC)

I fully support the wording you posted for diagnosis above! I don't have much time today, but I agree on the copyright violations. Although I didn't realize it at first, nearly half of the article from a month ago was copyrighted information of Merck and WebMD.

On the topic of the Treatment section, the problem I have with not supplying the page numbers in a source is that it makes it easy to spew out garbage. If I claim that stegosaurus used to feed on Skittles and beer and used a reference to a 1200 page book on dinosaurs, it might be hard to debase that if you didn't know that neither Skittles and beer had existed at that time. OK, that's a bad example, but I hope you get my meaning. I would very much like to see the source about that sentence to see if there is information being misconstrued, like I've seen in a number of other places here. That said, what is your opinion about the following wording?

Some behavior therapists respond with behavioral treatments such only responding to a single identity, and using more traditional therapy once a consistent response is established.^[4]

In a way, this skips info that's already in Epidemiology (because it's more than just some behavioral therapists that believe it's iatrogenically induced) while reducing language that would give a survivor the message that they are "making it up" (i.e., behavior therapists believing that therapy causes DID, rather than trauma). I especially find importance in this because in DID patients, the memories of the trauma are almost always relegated to personalities other than the host. This is how so many recovery opponents are able to argue that the therapist creates them, because prior to the survivor with DID receiving competent therapy, the memories rarely surface unaided. One last note on the source is that it's 16 years old, even though there are some very good books on DID that are 16+ years old, most notably Putnam's. That said, there is a lot of validity to establishing a relationship to the "primary identity" or "host" and using traditional therapy techniques (including DBT).

But if you still don't agree, then just please rollback my change because I would rather not consume too much of your time and my time with this when there's other things that are far worse broken (e.g., the history section). None the less, this has been a great discussion! :)

Also, I haven't gotten a chance to read all of the links you posted yet. My brain seems to be in low power mode today. Daniel Santos (talk) 20:36, 8 December 2007 (UTC)

<undent>Done on both counts. Please note however, that I still think your interpretation of the use of the source is in error and pretty much a contradiction of WP:AGF. Without good reason, if information is sourced to a reliable book, there's no real policy basis for objecting by my knowledge of the policies. As a final point, personal knowledge is of limited use on wikipedia, and a reliable source always takes precedence over opinion. 16 years old or not, a reliable source is a reliable source. WLU (talk) 20:33, 9 December 2007 (UTC)

Your critique is taken to heart and appreciated. It's good to have an objective, outside opinion. I guess the <blockquote> tag is what we're supposed to use instead of indenting and italicizing then? I did kind-of wonder what the best approach is for discussing and editing a section of text prior to changing it the article was. It would be nice if we could edit the body of text in the talk page because you can see the diffs, but then it makes it harder to see what somebody's original idea was. Bah, I still have so much to learn here :) Daniel Santos (talk) 02:34, 10 December 2007 (UTC)

Objective? Ha! No-one's objective, hence my reliance on reliable sources. bq isn't really a preference (I've never seen anything official), but it's easy to encapsulate something with it and there's a wikimarkup tag that does it automatically. Usually it's not a big deal, it's just better to be slow and careful when people disagree. WLU (talk) 02:44, 10 December 2007 (UTC)

[edit] History

There's a nice section on the history of dissociative disorders in Coping with Trauma: A Guide to Self-Understanding By Jon G. Allen starting on page 200. Unfortunately, this section isn't "available for preview" on google books. It traces the 1st case back to 1791. However, he's drawing most of this on a review by psychologist George Greaves. I'll have to post more info on this later. Daniel Santos (talk) 21:00, 8 December 2007 (UTC)

[edit] References

---

Why is there a references section on the talk page? WLU (talk) 12:45, 12 December 2007 (UTC)

[edit] Accepting MPs, rather than trying to eliminate them?

An online friend of mine recently told me he has multiple personalities. I was puzzled, looked for info and found a site, Astraea's Web, that has a different approach: accepting it as a trait, not a disease; finding a balance in the "multiple system", rather than trying to integrate or eliminate the alts. That sounds reasonable... I chatted with my friend's two alts, and neither seemed to be hostile or dangerous in any way. I think this point of view should be mentioned in the article as well. --- 201.9.74.157 (talk) 20:11, 21 December 2007 (UTC) (posting without signing in for privacy reasons)

That's not a reliable source, and for an article like this, under WP:MEDMOS and more importantly WP:MEDRS, the only sources that are really acceptable are peer-reviewed journals and university-press textbooks. If you can source it to a proper source, that info could be added but not from a random website. WLU (talk) 21:43, 21 December 2007 (UTC)

Well, true... but here's a suggestion, could someone try to find proper medical literature with that approach? -- 201.9.74.157 (talk) 17:37, 22 December 2007 (UTC)

Sure, feel free. Here's the pubmed search engine. [www.pubmed.org] Pretty much anything it spits out is a reliable source. WLU (talk) 19:02, 22 December 2007 (UTC)

hehe, good answer WLU :) Also, I agree with what WLU said in regards to this article and Wikipedia. The fact is that DID is caused by severe, early childhood trauma, so it is not a normal condition. If anybody was trying to "eliminate" their personalities, they are going to have a tough time, because a multiple's "personalities" are only aspects of themselves. There is never more than one "person" inside of a single body as this site states. No matter how many ways you slice it, there is still only one person, one soul, one body.

Having said that, most therapists that work with DID learned long ago that super-glue is not a solution (well, it is a solution :) as the patient will just split again when faced with a stressful situation. The cure is resolving the issues, focusing on internal communication and healthy functioning (as you mentioned) and allowing the far superior subconscious mind to worry about which psychic compartments should or shouldn't be connected to each other. Many times, this does involve the "host" reducing dissociative barriers between their personalities to resolve these emotional conflicts. Many DID patients are reluctant to do this because it means they will inevitably be faced with the feelings and memories of trauma that are, needless to say, unpleasant. Presuming the patient is actually safe from abuse in the present, it is only in confronting the past in the context of a healthy life situation that the cognitive distortions can be undone and the "self" reclaimed one piece at a time. If the patient refuses to do this, they are left in denial of what happened (because they don't remember), while the part(s) that it happened to are left:

• in the past, often without context of the current year or even decade,
• not knowing that their body has grown and that they are now safe,
• feeling abandon, unloved and unwanted,
• believing that the abuse is evidence of their own defectiveness (i.e., clinical depression),
• and not knowing that what happened was indeed abuse and not just something they deserved.

This type of "recovery from DID" topic can be covered in the article if it's well enough sourced (which I don't have yet).

On the "disease" topic, I actually agree with you somewhat. The creative ability to split one's mind and create personalities is just the coping mechanism to deal with the real disease which, IMO, is abuse. I don't know how much of this particular discussion belongs in an encyclopedia or can be properly sourced outside of an oped at this point. Daniel Santos (talk) 19:57, 22 December 2007 (UTC)

[edit] question about MPD/DID epidemic section

I read this section and saw that only one source was used to verify the data in this section. Has the entire section been verified according to this source?

The MPD/DID epidemic in North America

Paris [62] in a review offered three possible causes for the sudden increase in people diagnosed with MPD/DID:

The result of therapist suggestions to suggestible people, much as Charcot's hysterics acted in accordance with his expectations. Psychiatrists' past failure to recognise dissociation being redressed by new training and knowledge. Dissociative phenomena are actually increasing, but this increase only represents a new form of an old and protean entity: "hysteria." Paris opines that the first possible cause is the most likely.

The debate over the validity of this condition, whether as a clinical diagnosis, a symptomatic presentation, a subjective misrepresentation on the part of the patient, or a case of unconscious collusion on the part of the patient and the professional is considerable (see Multiple personality controversy). Unlike other diagnostic categorizations, there is very little in the way of objective, quantifiable evidence for describing the disorder. This makes the disorder itself subjective, as well as its diagnosis.

The main points of disagreement are these:

Whether MPD/DID is a real disorder or just a fad. If it is real, is the appearance of multiple personalities real or delusional? If it is real, whether it should it be defined in psychoanalytic terms. Whether it can, or should, be cured. Who should primarily define the experience—therapists, or those who believe that they have multiple personalities.

^ Paris J (1996). "Review-Essay : Dissociative Symptoms, Dissociative Disorders, and Cultural Psychiatry". Transcult Psychiatry 33 (1): 55-68. doi:10.1177/136346159603300104.Dataman5 (talk) 23:42, 29 December 2007 (UTC)

I don't know, but I wouldn't doubt it. WLU came a few weeks ago and cleaned house on the article, but he didn't get to the History section, so there is still a lot of garbage in there. You can delete the entire section as far as I'm concerned. Primarily, the questions about it being a real disorder are exceedingly out of date with the current science. If you want to keep the section, we might try to find a study that's more recent than 1996 to examine the rates of diagnosis. Personally, I think that it's still under-diagnosed, but mostly because of the lack of wide-spread knowledge and expertise amongst treating professionals. I also wouldn't put anything in Wikipedia just based on my personal opinions.

One of the major problems is that undergrad psych texts are filled with crap, as the ISSTD has noticed. It would seem to be a similar phenomena that high school history text books suffer as described in Lies My Teacher Told Me by James W. Loewen, where gross misinformation appears in lower education texts, when the correct information exists in higher education texts and is agreed upon by professionals in the field. On the topic of US and World History as taught in the US, the "age of reason", if you will, appears to be freshmen college History. With DID, the "age of reason" appears to be masters level psych. If somebody has done a study on this, I think it would be quite worth examining in this article (i.e., the phenomena of undergrad psych literature treating DID differently than post-grad).

But back to your question, while I haven't examined studies on this personally, I would certainly hope that a newly discovered diagnosis will be used more often once it's recognized and documented. Before a disorder is understood or recognized, how are you going to diagnose it? I personally haven't met anybody who was diagnosed DID that didn't seem to fit the bill, although I know vast numbers who appear DID or DD-NOS (i.e., clearly fragmented) and are undiagnosed. So most of this ado about the "epidemic" in DID diagnosis would seem to be pure hype. Some of the reason for the alledged drop in diagnosis may be simply backlash -- fear by professionals of being sued for doing their job and diagnosing, what they believe to be DID. But again, I haven't personally studied this aspect of DID. --Daniel Santos (talk) 00:48, 30 December 2007 (UTC)

I was so sure I had replied to this, I don't know wht happened. The whole history section isn't great, and the subsection you pointed out is probably a very problematic one. It doesn't look like a particularly reliable peer-reviewed journal, and irrespective it needs to be trimmed down. For a single reference, there's a lot of text, and it looks like undue weight to a not particularly reliable source. WLU (talk) 04:22, 30 December 2007 (UTC)

I have reviewed the article by Paris. It appears that Paris at times presents an extreme minority view. He makes statements like:

"It would not be surprising if fragmenting social forces can produce fragmentation in individuals, i.e., dissociative phenomena. In this view, the recent interest of dissociative disorders is itself a reflection of cultural pathology. Multiple personality disorder reflects a problem. However, the construct of dissociative disorders is not the solution."

Some of the statements he makes appear to be based on opinion, rather than data or fact.

The section in the wiki article presently presents only "three possible causes for the sudden increase in people diagnosed with MPD/DID." Paris' article had four. The last section in the wiki article section appears not to have come from the Paris article and appears to be OR. After reading Paris' article, I agree with WLU above. "For a single reference, there's a lot of text, and it looks like undue weight to a not particularly reliable source."

Based on the reasoning above, I will be deleting the section from the page and adding it on as an EL for reference.Dataman5 (talk) 02:30, 7 January 2008 (UTC)

[edit] Court Cases

Are there any court cases involving DID?(as a defense maybe?) If so, please add to article. Thanx. F34RthePHISH (talk) 01:18, 21 January 2008 (UTC)

[edit] Drug patients

The following text was added, I think it deserves a slightly more nuanced presentation and would like to discuss it before it goes back on the page. What do others think? WLU (talk) 22:09, 21 January 2008 (UTC)

Some believe that Dissociative Identity Disorder is a rather common mental disorder."Dissociative Identity Disorder Amnesia and Related Disorders Merck Manual Home Edition".  It is found in 3 to 4% of people in hospitals for other mental health disorders and "in a sizable minority of people in drug abuse treatment facilities."(Merck2)

I agree that it should be in the article. Please suggest a "more nuanced presentation."

Also I believe that "Reports by people with Dissociative Identity Disorder of their past physical and sexual abuse are often confirmed by objective evidence.^[1]" should be included in the article, since it comes from the DSM and is about DID.Dataman5 (talk) 03:49, 22 January 2008 (UTC)

I don't really like the statement that 'abuse is often confirmed by objective evidence' as is - it implies that without this confirmation, there is a reason to doubt that the abuse has acutally happened. If there is a reason (is DID contested enough that if someone is diagnosed, others automatically doubt abuse, a la false memory syndrome?) then this 'confirmation' statement should accompany that block of text. Otherwise it looks odd to my eye. I'm not against statements of doubt about the reality of abuse, just that right now this 'confirmation' bit looks like it's begging a question.

Also note that the Merck reference is already included in the page as reference [9]; to re-use the reference, append the tag <ref name = merckpat/> to the text and it will automagically appear as a [9]. Regards the use of the Merck to justify the statement, the statement itself comes out of left field and isn't particularly useful or informative. What is a 'sizeable minority'? I'd rather have the source that Merck worked from, but since we don't, forward we go. I think the best place for this information might be the Epidemiology section. Also note that, assuming the Merck is based on North American (probably U.S.) figures, it's possibly contradicted by the 2006 citation in the table in this section - Foote et al cite 6-10% in psychiatric populations. A careful reading of Merck suggests that the 3-4% figure might be a comorbidity one (It can be found in 3 to 4% of people hospitalized for other mental health disorders), or a figure for inpatients only, or something else I'm note sure about. I'd rather leave the 3-4% figure out given these concerns and the more reliable sources found in the tables, but the drug abuse is still possibly valuable. How about at the end of the Epidemiology section,

A significant number of individuals in drug treatment facilities appear to have DID.<ref name = merckpat/>

As a final point, I noticed you removed the Skepdic external link. It's a nice link to have because it provides background, positive and negative commentary, in a very broad, understandable tone, from a reliable source (PhD in philosophy with a published popular book) and often includes further reading. Skepdic usually has a good enough pedigree that it is frequently used as an EL, but I've also seen it argued that it's better suited as a reference. So I've converted it to a reference instead and added it to the new sentence I slotted into causes section on the possibly iatrogenic nature of DID. WLU (talk) 16:01, 22 January 2008 (UTC)

I agree with your comment on the Merck reference. Please feel free to place the drug part in the Epidemiology section. I agree with your statement about : "Reports by people with Dissociative Identity Disorder of their past physical and sexual abuse are often confirmed by objective evidence."^[1] But I think it is important to fit it in somewhere, since the DSM-IV TR is a highly reliable source and some already believe otherwise.

I will be adding a counter to the iatrogenic reference in the causes section. Please feel free to suggest ways it can fit better into the article, if needed.Dataman5 (talk) 03:55, 23 January 2008 (UTC)

I have added back two quotes. I have followed your suggestion on the Merckpat drug reference quote. I have used the DSM quote on objective evidence to follow the claims of the iatrogenisists. It appears to fit in well there. I have also added data from the Merckpat on the 95% of children and the 85% of adults' documentation to follow the Merckpat data on the incident rate of abuse being 97-98%. This also occurs in the actual Merckpat article.Dataman5 (talk) 21:37, 25 January 2008 (UTC)

I've removed the two - the 95/85 figure is redundant to the first sentence, the confirmed thing looks weird as a standing sentence and still looks like it implies there is reason to doubt claims of abuse. This is fine if there is diagnosed controversy over the truth of allegations, but since there is none, it just looks weird and out of place. WLU (talk) 21:52, 27 January 2008 (UTC)

I've replaced the 'confirmed' bit, by vaguing up the wording and slotting it in with the incidence of actual abuse. Note that even though it is mentioned in a very reliable source, it's we don't need to or have to put all the information into the page; it's a matter of what it adds, how well it's integrated, does it make sense in context. This is the best I could do, I really don't think it needs more than this, unless it's accompanied by a greater block of text that makes it explicit why it is important to confirm that the abuse was real. Otherwise it looks apologist. WLU (talk) 22:00, 27 January 2008 (UTC)

I will change the wording slightly. I believe that "documenting" is more accurate to the source than "confirmimg." I do believe that this sentence "Researchers have also found that reports of the past physical and sexual abuse of people with DID are often confirmed by objective evidence" is important to add back to the text. It answers with data the iatrogenisists claims about DID not being trauma-based. Please feel free to suggest a compromise for this issue.Dataman5 (talk) 03:25, 28 January 2008 (UTC)

<undent>I wish you had mentioned that sooner, that's a pretty good reason : ) I'll have a look and see what I can think of - I think the sentence is better placed in juxtaposition with the 'iatrogenic' statement for the reason you supplied above. Lacking any further knowledge, I'd be curious to see an expert's opinion of this - the abuse isn't made up, but does the treatment for the abuse generates DID? It seems like there's a fine distinction that needs to be made but I don't have the sources to make it. WLU (talk) 16:16, 28 January 2008 (UTC)

I've tried a re-write with this in mind. WLU (talk) 16:26, 28 January 2008 (UTC)

I reverted the second change you made. I read it several times and it didn't make sense to me. Somehow I think the DSM phrase has to come after the MerckPat/Skepdic phrase, to make it clear that some sources believe that the abuse is confirmed by objective evidence.Dataman5 (talk) 06:07, 29 January 2008 (UTC)

I still dislike this placement; juxtaposed with the previous sentence, it looks like it is somehow trying to rebut the idea that the condition is iatrogenic, We could go for a WP:3O on the sentence itself, the 3O-er might have a better idea of where to put it as well. By my reading, that the abuse is documented is ably demonstrated by the second sentence in the first paragraph - "Prolonged childhood abuse is frequently a factor, with a very high proportion of patients reporting documented abuse." Referenced to the DSM, the exact same source used in the final sentence. I'd say using the same source, to say the same thing, twice, places undue weight on the idea. WLU (talk) 00:06, 30 January 2008 (UTC)

I agree about undue weight. I have deleted the second sentence, added a phrase to the first sentence and moved the references to their appropriate spots.Dataman5 (talk) 04:50, 30 January 2008 (UTC)

Sure, that works, good edit. Note that when doing so, you deleted a space between a reference tag and the beginning of a new sentence [1] (between "merckdoc" and "Prolonged"). Watch for stuff like that if you can, I think I've seen it happen before on the page. Not that I can criticise, the number of spelling errors I make is not something to brag about. I tweaked the first sentence of the last paragraph in Causes to try to make it tighter. WLU (talk) 17:57, 31 January 2008 (UTC)

[edit] Agree less about controversy, more helpful information

I agree with Biaothanatoi that the controversy about DID dates more to the 1990s. It's my impression that the diagnosis is quietly becoming more accepted--fairly universally among professionals who work with trauma, dissociative disorders and/or PTSD and child abuse, if the literature I've read is anything to go by. It's my impression that this article overstates the prevalence of the controversy. (I seem to recall references to DID in the 2002 Sci Am article about Martin Teicher's work. Sci Am is a pretty conservative and aggressively-edited publication. I can't imagine them leaving those in if it was a raging controversy.)

You may find more about this in the literature on PTSD, which is rapidly expanding now that PTSD has finally acquired solid "legitimacy" as a diagnosis, thanks to its effects on soldiers. (For a long time that was pretty controversial too.)

If it's necessary to discuss the controversy--and for fair reportage it probably is--I agree that that should be a specific, separate section of the article. It's not necessary to introduce the question repeatedly and indeed gives the impression that someone perhaps has a personal agenda, which undermines the credibility of the article. Also, if the controversy is going to be discussed extensively, it might be more accurate to discuss it within its historical context. For a long time PTSD was thought to be "all in the mind." (See Trauma and Recovery by Judith Herman.) Child abuse and its effects have only relatively recently (past 3 decades or so) been discussed as valid concerns in the psychiatric literature (recall Freud's infamous, well, recall). There is some question as to whether the controversy is the result of people simply being unwilling to face the truth of the pervasiveness of child abuse in our culture. See the FMS and its history. All of this should be included for a balanced discussion of the controversy.

I agree that the rest of the article should contain information useful for people seeking to understand the diagnosis and its implications. (It's doing a much better job of that now than the version a couple of years ago did, by the way, and thanks for that.)

If it's not acceptable to include within the body of the piece helpful information for sufferers and the people who care about them, it might be good to add an external links to Sidran and the International Society for the Study of Trauma and Dissociation at the bottom (www.sidran.org and http://www.isst-d.org)

Hope this helps. Thanks for all your hard work. —Preceding unsigned comment added by Prhiannon (talk • contribs) 04:12, 16 February 2008 (UTC)

I agree. I have added both links to the page. The links appear to qualify as being ELs.

"Is it accessible to the reader?

Is it proper in the context of the article (useful, tasteful, informative, factual, etc.)?

Is it a functional link, and likely to continue being a functional link?" Dataman5 (talk) 01:44, 19 February 2008 (UTC)

--- I actually found this to be intresting and useful, however not unlike an encyclopedia. But I guess this is the point seeing as the internet is more convient but I think that we should post more intresting facts on more dull topics like this one, but please lets make them real. —Preceding unsigned comment added by 216.23.69.250 (talk) 19:36, 19 February 2008 (UTC)

The point is to inform, not entertain. The ISSTD is Ok as a scholarly society dedicated towards studying the disorder, but the sidran site appears to be an advocacy site, and wikipedia is not a soapbox and WP:EL calls for no web forum - though it's not a web forum it's not a scholarly source. I've removed it. WLU (talk) 02:19, 20 February 2008 (UTC)

There seems to be a very pro DID push going on here. Perhaps you guys should look at the epidemiology. If a disorder can vary from a prevalence of 0.015%-14% depending on the country and the clinician then there is something significant going on. DID is still regarded as very controversial and is not often diagnosed in most countries of the world except the US. A country with 300 million people does not determine world views, no matter how vocal it is about it. The article needs to balance the world view, not represent the majority view of one country. Besides, there is still significant, and perhaps growing, controversy in the US on the subject. Throughout history there have been many epidemics of fashionable disorders which have not stood the test of time. DID may well be one of these. --CloudSurfer (talk) 18:15, 4 March 2008 (UTC)

Yes, there was an EXTREME amount of pro-DID POV-pushing going on. The problem with Wikipedia is that, without eternal vigilance, some outside group with an agenda can hijack whole articles to push their own opinions instead of trying to cover the topic per Wikipedia rules on balance and scholarly sources. DreamGuy (talk) 01:12, 16 March 2008 (UTC)

IMO, the good thing about wikipedia is that different POVs from reliable sources can be balanced on the same page. Bringing in more neutral editors could help give all editors a better perspective on the topic and page. ResearchEditor (talk) 19:13, 16 March 2008 (UTC)

[edit] Wholesale Changes

I was comparing the two versions, the long-lived, consensus-edited, based on a long history of edits version, and DreamGuy's revamp. When I came across this line - "Although many experts dispute the existence of this controversial diagnosis" - I knew it needed to be reverted. That in the same phrase in a single sentence we refer to it twice as disputed/controversial is over-the-top. The original article noted in the lead that it was controversial. Can the article be improved? Yes, of course. Is a wholesale, unilateral revamp the way to go? No. The article now reads, to a large extent, like an article on the controversy rather than on the condition. There's another page for that.

Let's discuss the major changes here first. A lot of the additional information could and should be added, but not in the singular manner in which it was the first time. • VigilancePrime • • • 21:30 (UTC) 14 Mar '08

Some specific issues - WP:MEDMOS has things to say about the order of sections. Controversy shouldn't be first I'd say, and a section that long should be in the lead. DreamGuy's edits did seem to preserve the references (at minimum, the number of references remained the same). The external links section seemed unduly biased towards skepticism and rejection; I might accept most of the links, but I think there was merit to the previous links. A section-by-section editing by DreamGuy might be better, so the changes can be tracked more easily. Since this is a medical condition, at minimum it should be easy to establish parity of sources - mostly medical journals, per WP:MEDRS. A bold change isn't necessarily a bad thing, but it's difficult to compare version to version rather than section to section. For what it's worth, I re-vamped section-by-section a while ago for more minor changes (but left history alone for the most part). One thing I did like about DG's edit was moving much of the controversy out of the lead. Current lead is very heavy and long, with much detail I consider excessive. WLU (talk) 21:49, 14 March 2008 (UTC)

I agree with both WLU and VigilancePrime above. I have added one line to the controversy section from the DSM to balance it. ResearchEditor (talk) 18:44, 15 March 2008 (UTC) (formerly AT)

I've edited the section again, to more closely represent the relevant DSM section, which juxtaposes the different sides of the controversy much more closely. WLU (talk) 19:40, 15 March 2008 (UTC)

Vigilance Prime claims above: "I was comparing the two versions, the long-lived, consensus-edited, based on a long history of edits version, and DreamGuy's revamp." This is nonsense. The version I changed it to WAS the long-lived, consensus-edited, based upon a long history of edits version. I simply reverted the article back to an earlier state, before a handful of people with very obvious agenda of extreme POV-pushing wholesale changed the entire article. most notably to remove all mention of the diagnosis being controversial. If the claim here is that we should respect consensus, history of a large number of people working on the article, etc. then the version I had was the more proper one of the two.

And it's also clear from recent edits that a clear consensus does support the need to give solid information on why the diagnosis is controversial before a huge, long list of sections have already discussed it like it was 100% real and undeniable. I'm all for compromise and consensus, which is how the article was created over years of hard work. The version I edited was only a few months old and just plain insanely bad. DreamGuy (talk) 01:09, 16 March 2008 (UTC)

It's POV-pushing to overstate the controversy (per WP:UNDUE) and it's POV-pushing to eliminate any mentions of the controversy. Yes, DID is a controversial condition, but that shouldn't be the focus of the article. --clpo13_(talk) 01:25, 16 March 2008 (UTC)

Perhaps I overstated a bit or was hyper-dramatic. No offense was intended, Dream. The changes did push this article away from the condition, though, and too heavily toward the controversy. With that on its own page, a brief mention and {{main}} link is all that's needed. Yes, we need to mention it, but we do not wish to make it the overstated, spoonfed, cram-it-down-our-throat focus of the article. I stand by my statement of When I came across this line - "Although many experts dispute the existence of this controversial diagnosis" - I knew it needed to be reverted. That's like saying "The controversial diagnosis is very controversial as experty dispute its controversial application, which has sparked controversy over the controversial condition's highly controversial existence." A little over-the-top.

As for your statement about "most notably to remove all mention of the diagnosis being controversial", the lead clearly identified that it was controversial, so this borders on a straw man or red herring argument (or is simply false). Also, "need to give solid information on why the diagnosis is controversial before a huge, long list of sections have already discussed it like it was 100% real and undeniable" was already the case, as the controversial nature (and link to the controversy article) was, as already pointed out, in the lead... which is before all sections. Again, I don't understand why or how you make these arguments that are simply incorrect. If anything, we're pushing toward the controversy aspect rather than away from it by having an entire controversy paragraph in the lead!

• VigilancePrime • • • 01:42 (UTC) 16 Mar '08

I have fixed the spelling and grammar of the reconstructed sentence in the controversy section, adding the DSM ref. Sorry about any perceived POV-pushing, it was not intended. I was trying to catch the DSM "debate" as accurately as possible. I have also added an EL on an extensive MPD bibliography. The brief quote was added to help readers. Please feel free to delete the quote if it is felt to be undue. I do believe that "The DSM notes the controversy over the condition..." is OR, since the DSM does not state there is a controversy over the condition. This could be inferred from the juxtaposition of ideas on page 527 of the Associated Features and Disorders section - first paragraph, but would like to hear other ideas about this. ResearchEditor (talk) 19:05, 16 March 2008 (UTC)

I have added a cat to the article and made the substitution I have noted above, IMO making the sentence more succinct and accurate. ResearchEditor (talk) 20:56, 23 March 2008 (UTC)

Undone - the category doesn't exist, if it did, the category it's already in - Category:Dissociative disorders - is nested within that heading anyway. In my opinion, the rephrasing removed the reason why the sentence was there - to emphasize that the DSM recognize the evidence for, and against the condition. It's controversial, the DSM, bible of psychology in North America, states that it's controversial, and notes both sides of the debate. That it explicitly notes the condition as controversial is noteworthy in my opinion, and should be kept. I had a hard time trying to craft a sentence that represented the source, which is pretty complex on the subject, accurately without the use of a quote. I've re-reworded, but that the DSM makes a point that the reporting of the abuse is controversial. That's worth noting I think. WLU (talk) 22:21, 23 March 2008 (UTC)

[edit] merckdoc ref

I have fixed the merck doc ref and added some info from it to the symptoms and diagnosis sections. ResearchEditor (talk) 02:22, 26 March 2008 (UTC)

That information was very close to a WP:COPYVIO, and unneeded - there was a series of vandalisms which replaced the section with nonsense. The nonsense was removed by well-meaning editors, but they failed to replace. I have reverted, but kept the addition about previous treatment, diagnoses, and doctor skepticism. WLU (talk) 19:08, 27 March 2008 (UTC)

The new version looks good. ResearchEditor (talk) 02:33, 28 March 2008 (UTC)

That's 'cos I rule.

Actually, it's a revert to an earlier version - treatment is pretty basic to a long page like this, checking for sophisticated or multiple rounds of vandalism is always a good idea when something like that is missing. WLU (talk) 20:56, 28 March 2008 (UTC)

[edit] MPD controversy

To bring people's attention to it, the multiple personality controversy is very, very bad. It's a badly organized POV fork of DID that doesn't really discuss the controversy. Attention is sorely needed. WLU (talk) 19:08, 27 March 2008 (UTC)

[edit] reverting vandalism

I have reverted vandalism on the page. Perhaps the page should be protected from anon IPs for now. ResearchEditor (talk) 03:37, 16 April 2008 (UTC)

[edit] recent revert of OR

I have reverted this due to its not having a reference. IMO, this would be good to add to the article if a source can be found. "The current name "Dissociative Identity Disorder" is generally viewed by those with the condition to be still in need of adjusting. Their argument being that putting DID in the same category as other mental illnesses, such as Schizophrenia, is not accurate and can lead to treatments that are more damaging than helpful. They view the condition as a highly advanced coping mechanism that was necessary to develop, in order to survive the extreme abuse and trauma they experienced on a regular basis over a long period of time, as small children." ResearchEditor (talk) 14:32, 18 April 2008 (UTC)

[edit] recent reversion of unreliable source

I have delete this phrase from the page. "However, critics who propose an iatrogenic etiology to the disorder have suggested that for individuals whose treatment is creating the disorder, prognosis improves once the patient's health insurance runs out, Religious Tolerance http://www.religioustolerance.org/mpd_did3.htm as they are no longer exposed to an environment where they are rewarded for producing alters." RT has been criticized as having made statements with no backing before.

This is the source for this statement from their page : "Observations by Hot Line volunteers: Many listeners at crisis centers/ suicide prevention lines in North America are well aware that MPD is an artificial phenomenon. All hot lines have repeat, regular callers, and the volunteer listeners frequently build up a close emotional bond with many of them. If a caller starts to go to a MPD clinic, they will typically start to present themselves as different alters, with different names. When they break contact with the clinic, often because their insurance runs out, the alters gradually disappear, and they become a single personality again -- calling the hot line once more under a single name. The disappearance of the alters may take only a few days, or may take years." No source is cited for this statement by RT. And IMO, Hot Line volunteers may not be a very good source for data on this subject, even if the data is accurate. ResearchEditor (talk) 03:04, 30 April 2008 (UTC)

Agreed that that's a good removal, but there is a similar statement sourced by a journal article I believe that the development of alters is purely based on behavioral reinforcement of different behaviors in different situations. Skepdic cites Spanos, but I'll have to do more research before I adjust. WLU (talk) 13:27, 9 May 2008 (UTC)

Spanos does have several studies where he backs his theory of the sociocognitive model. However this has been critiqued by several sources.

Gleaves, D. (July 1996). "The sociocognitive model of dissociative identity disorder: a reexamination of the evidence". Psychological Bulletin 120 (1): 42-59. “According to the sociocognitive model of dissociative identity disorder...DID is not a valid psychiatric disorder of posttraumatic origin; rather, it is a creation of psychotherapy and the media...In this article, the author reexamines the evidence for the model and concludes that it is based on numerous false assumptions about the psychopathology, assessment, and treatment of DID. Most recent research on the dissociative disorders does not support (and in fact disconfirms) the sociocognitive model, and many inferences drawn from previous research appear unwarranted. No reason exists to doubt the connection between DID and childhood trauma. Treatment recommendations that follow from the sociocognitive model may be harmful because they involve ignoring the posttraumatic symptomatology of persons with DID.” 

and

Brown, D; Frischholz E, Scheflin A. (1999). "Iatrogenic dissociative identity disorder - an evaluation of the scientific evidence". The Journal of Psychiatry and Law XXVII No. 3-4 (Fall-Winter 1999): 549 - 637. “Conclusions...At present the scientific evidence is insufficient and inadequate to support plaintiffs' complaints that suggestive influences allegedly operative in psychotherapy can create a major psychiatric disorder like MPD per se...there is virtually no support for the unique contribution of hypnosis to the alleged iatrogenic creation of MPD in appropriately controlled research.”  Further quotes: "The Spanos socio-cognitive model reduces MPD to socially constructed role enactments. In this model, the often severe psychopathology associated with clinical MPD is minimized. Very recent studies suggest a possible neurobiological basis to MPD in at least certain MPD patients....It is clear that Spanos et al.'s 1985 conclusion that MPD is a role enactment based on their observation of role-playing subjects is based on circular logic: You ask a subject to pretend that he has alters and he complies; then you conclude that having alters is the product of role playing....Spanos's conclusion of the iatrogenic nature of MPD also suffers from an additional logical error. Even if it were true that MPD could be created iatrogenically, that does not prove that every case for noniatrogenic MPD cases....Situationally bound enactment of predefined secondary-personality roles presumes sufficient executive control to do it. Genuine MPD is defined in DSM as the loss of executive control...Genuine DID was defined in DSM-IV as the loss of a unified identity...Presumably none of Spanos's laboratory subjects suffered from a fundamental loss of a unified identity as a result of the experimental instructions....Genuine MPD is characterized by enduring alter-personality states that are defined by a relatively stable set of personality characteristics over time....The secondary-personality states reported by Spanos's subjects in the laboratory were very temporary role enactments....Spanos has seriously overgeneralized from the data of his 1985, 1986 and 1991 laboratory experiments that multiple personalities can be created in the laboratory. The more conservative interpretation merited by these data is that certain individuals with certain personality characteristics in a particular social context report temporary role enactments of different identities that are limited to the context of the experiment....Overall the Spanos data offer no evidence that either stable alter personalities or the range of clinical features typically associated with MPD can be created in the laboratory, and the data certainly offer no support whatsoever that MPD per se can be created through suggestive influences. At best, these data support the view that certain individuals in a high-demand context, and/or under extreme interview conditions wherein misinformation is systematically supplied, report temporary secondary-personality states....Overall, these data offer little evidence that the disorder MPD per se can be created through suggestive influences." It would be interesting to see how both sides of the issue could play out in an article. ResearchEditor (talk) 14:46, 9 May 2008 (UTC)

Spanos was very old when he weighed into debates on MPD, and he died shortly after. His background was in experimental research into hypnosis and automative behaviour which, he posited, was the product of role-playing behaviour rather then a genuine altered state. He theorised a similar relationship between hypnosis role-playing and MPD, but he proffers no empirical data to support such a theory.

Spanos theories on MPD are now twenty years old and they should be treated as such. By the late 80s, a range of researchers, including Putnam and Ross, had established that hypnotic treatment did not vary the presentation of clients with DID. Over the last 15 year, the construct validity of MPD/DID has been supported by a number of empirical findings based on clinical samples and series as well as brain imaging.

Spanos is interesting from a historical point of view - not a psychiatric or diagnostic point of view. His theories set within a set of debates over hypnosis and brainwashing that are twenty years in the past. --Biaothanatoi (talk) 01:18, 12 May 2008 (UTC)

[edit] deleting OR from the cultural references section

I have deleted OR from this section as per WP:OR. ResearchEditor (talk) 04:57, 12 May 2008 (UTC)

[edit] revert unsourced edits by anon IP

I have reverted unsourced edits by anon IP which may have been vandalism. ResearchEditor (talk) 20:39, 18 May 2008 (UTC)

[edit] Is there such thing as willful MPD?

Whatever the reason may be is there such thing as multiple personality disorder where the so called sufferer has full control over what he's doing? 199.117.69.8 (talk) 23:32, 2 June 2008 (UTC)

Have not seen this in either the DSM-IV or in any peer reviewed journal article. ResearchEditor (talk) 03:10, 3 June 2008 (UTC)