Dissociative Disorders

by

Steven Jay Lynn, Reed Maxwell, Anne Malaktaris, Colleen Cleere, Peter Lemons, Jessica Baltman, Liam Condon

• LAST REVIEWED: 30 March 2015
• LAST MODIFIED: 30 March 2015
• DOI: 10.1093/obo/9780199828340-0164

Introduction

From the seminal writing of Pierre Janet (b. 1859–d. 1947) to the present, dissociative disorders have fascinated, puzzled, and provoked controversy among scientists and clinicians, while providing fodder for sensationalized accounts in the public domain. This article will steer readers toward the best sources of information about dissociative disorders at both introductory and advanced levels, with readings often representing divergent perspectives regarding dissociation and dissociative psychopathology. The dissociative disorders have stirred much attention and contentiousness in the scientific community because their presentation is often perplexing, dramatic, and variable across and within individuals. Readers will be able to use the bibliography to understand the historical underpinnings of current conceptualizations of dissociation; the symptoms and characteristics of major dissociative disorders, including depersonalization/derealization disorder, dissociative amnesia, and dissociative identity disorder (DID, formerly called multiple personality disorder); the prevalence of dissociative disorders in clinical and nonclinical populations; the major theoretical divides that splinter the contemporary study of dissociation and encompass competing notions (the idea that the genesis of dissociation is closely linked with a history of trauma versus the idea that serious dissociative disorders can be accounted for in terms of social and cultural variables, such as the influence of the media and suggestive approaches in psychotherapy in shaping symptoms); and the assessment and treatment of dissociative disorders. References will be provided that touch on potential biological etiologies of dissociative disorders, the role of sleep in dissociation, and topics including memory in dissociative disorders.

Introductory Works

Dissociative disorders are characterized by a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior (American Psychiatric Association 2013). The introductions to different facets of dissociative disorders cited in this section provide an overview of the dissociative disorders (Lynn and Rhue 1994), beginning with historical traditions described by Ellenberger 2008, Hacking 1998, and van der Hart and Dorahy 2009 and extending to (a) the diagnosis of the dissociative disorders presented in DSM-5, American Psychiatric Association 2013; (b) the validity of the diagnosis of DID, discussed in Gleaves, et al. 2001; and (c) the description of dissociative conditions ranging from the more mundane and relatively common, presented by Kihlstrom 2005 (cited under Dissociative Amnesia) and Simeon and Abugel 2006, to severe pathology as described in Lynn, et al. 2012 and Spanos 1996 (cited under Research and Applied Reference Works). Finally, Elzinga, et al. 1998 discusses controversies in the field of dissociation that are very much alive today.

• American Psychiatric Association. 2013. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Arlington, VA: American Psychiatric Publishing.

  Diagnostic manual provides criteria for major dissociative disorders (i.e., depersonalization/derealization disorder, dissociative amnesia, dissociative identity disorder, residual categories of other specified dissociative disorder, and unspecified dissociative disorder).

• Ellenberger, Henri F. 2008. The discovery of the unconscious: The history and evolution of dynamic psychiatry. New York: Basic Books.

  This book addresses the origins and conceptualizations of hypnosis and automatism and explains how these concepts are related to the psychodynamic approach of scholars like Freud.

• Elzinga, Bernet M., Richard van Dyck, and Philip Spinhoven. 1998. Three controversies about dissociative identity disorder. Clinical Psychology & Psychotherapy 5:13–23.

  DOI: 10.1002/(SICI)1099-0879(199803)5:1<13::AID-CPP148>3.0.CO;2-J

  Influential article delineates prominent controversies centering on potential treatment-induced (i.e., iatrogenic) influences, amnesia and pseudomemories (false or inaccurate memories), and possible overdiagnosis.

• Gleaves, David H., Mary C. May, and Etzel Cardeña. 2001. An examination of the diagnostic validity of dissociative identity disorder. Clinical Psychology Review 21:577–608.

  DOI: 10.1016/S0272-7358(99)00073-2

  Review concludes there is considerable evidence for the validity of DID as a diagnostic category that merits inclusion in the diagnostic manual (DSM); see Paris 2012 (cited under Controversy) for an alternate, critical perspective on the inclusion of DID in the DSM.

• Hacking, I. 1998. Rewriting the soul. Princeton, NJ: Princeton Univ. Press.

  DOI: 10.1515/9781400821686

  This book provides an in-depth analysis of 19th-century texts on dissociation and explains how the French tradition has its echoes in contemporary texts on dissociation.

• Kihlstrom, John F., Martha L. Glisky, and Michael J. Angiulo. 1994. Dissociative tendencies and dissociative disorders. Journal of Abnormal Psychology 103:117–124.

  DOI: 10.1037/0021-843X.103.1.117

  Classic article reviews dissociative disorders and experiences ranging from everyday dissociative phenomena like absorption, fantasy proneness, and openness to experience to severe dissociative psychopathology.

• Lynn, Steven J., Joanna Berg, Scott O. Lilienfeld, et al. 2012. Dissociative disorders. In Adult psychopathology and diagnosis. Edited by Michel Hersen and Deborah C. Beidel, 497–538. Hoboken, NJ: John Wiley.

  General overview of dissociative disorders, including description of major disorders, etiology, assessment, treatment, and controversies.

• Lynn, Steven, and Judith W. Rhue, eds. 1994. Dissociation: Clinical and theoretical perspectives. New York: Guilford.

  Experts who represent different perspectives review theory and research, diagnosis, assessment, treatment, and issues and controversies.

• Simeon, Daphne, and Jeffrey Abugel. 2006. Feeling unreal: Depersonalization disorder and the loss of the self. New York: Oxford Univ. Press.

  Introduction to the subjective experience and symptoms of depersonalization and depersonalization disorder; provides a history of investigation of the disorder, a discussion of research and theory, and case studies of depersonalization.

• van der Hart, Onno, and Martin J. Dorahy. 2009. History of the concept of dissociation. In Dissociation and the dissociative disorders: DSM-V and beyond. Edited by Paul Dell and John A. O’Neil, 3–26. New York: Routledge.

  Provides a brief history of the concept of dissociation; argues that terms such as dissociation, personality, alter, and dissociative parts of the personality need to be better defined.