MRH Chemistry

Extensive and unusual loss of memory pertaining to personal information another feature of DID

Differential diagnosis generally involves ruling out the effects of chemical substances and medical (as opposed to psychological) conditions. When evaluating children, it is also important to ensure that symptoms are distinguishable from imaginary play (American Psychiatric Association, 2000).

In clinical populations, the estimated prevalence of DID ranges from 0.5 to 1.0% (Maldonado, Butler, & Spiegel, 2002). In the general population, estimates of prevalence are somewhat higher, ranging from 1-5% (Rubin & Zorumski, 2005). Females are more likely to receive a diagnosis of DID, at a ratio of 9:1 (Lewis-Hall, 2002

High percentages of individuals with DID have comorbid diagnoses of Post-Traumatic Stress Disorder or Borderline Personality Disorde

DID commonly have a previous diagnosis of Schizophrenia. However, this most likely represents a misdiagnosis rather than comorbidity, du

Other possible comorbid disorders involve substance abuse, eating disorders, somatoform disorders, problems of anxiety and mood, personality disorders, psychotic disorders, and organic mental disorders (ISSD, 2005), OCD, or some combination of conversion and somatoform disorder

Other factors influencing a poor prognosis include remaining in abusive situations, involvement with criminal activity, substance abuse, eating disorders, or antisocial personality features

the average age of diagnosis is thirt

One study found that the risk of developing a dissociative disorder (DD) increased seven times with a child’s exposure to trauma.

Dissociative Identity Disorder is linked to childhood abuse in 95-98% of the cases

Studies on genetic factors contributing to DID present mixed findings. However, one study involving dyzogotic and monozygotic twins found that considerable variance in experiences of pathological dissociation could be attributed to both shared and non-shared environmental experiences, but heritability appeared to have no effect (Waller & Ross, 1997).

Treatment most commonly follows a framework of “1) safety, stabilization and symptom reduction, 2) working directly and in depth with traumatic memories, and 3) identity integration and rehabilitation” (p. 89).

A study involving 280 outpatient participants (98% DID diagnosis) from five different races (Caucasian, African American, Hispanic, Asian, and Other) demonstrated the effectiveness of a similar five-phase model in reducing symptoms of dissociation.

the white insulating coat of myelin

on the axons that carry signals between nerve cells continues to accumulate,

a process not completed until the early 20s

Among the last connections to be fully established are the links between the prefrontal cortex

seat of

judgment and problem-solving, and the emotional centers in the limbic system, especially the amygdala.

The adolescent brain pours out adrenal stress hormones, sex hormones,

and growth hormone, which in turn influence brain development.

Sex hormones act in the limbic system and in the raphe nucleus, source of the

neurotransmitter serotonin

things can go wrong in many ways,

Stress can retard the growth of the hippocampus, which consolidates

memories.

They also may have trouble organizing their thoughts and expressing themselves

speech and behavior can be so disorganized that they may seem frightening to others

most misunderstood mental illnesses

Jekyll-and-Hyde" type of split personality

Schizophrenia literally means "a split mind," and this may be where the misconception of split personality took root.

difficulty functioning in society, at work, and in school

But the symptoms of schizophrenia vary widely from one person to another. In some people, the dissociated feelings caused by the illness are a constant part of life. In others, the symptoms will come and go. People with schizophrenia do not always act abnormally. They may appear perfectly responsible and in control, even when experiencing hallucinations or delusions.

Schizophrenia cannot be cured

considered to be multifactorially inherited

Multifactorial inheritance means that "many factors"

where a combination of genes from both parents, in addition to unknown environmental factors, produce the trait or condition

factors are usually both genetic and environmental

Often, one gender (either males or females) is affected more frequently than the other in multifactorial traits

means that one gender is more likely to show the problem

Slightly more males develop schizophrenia in childhood, however, by adolescence schizophrenia affects males and females equally.

Although schizophrenia affects men and women equally, symptoms in men generally begin earlier than in women

schizophrenia first appears in men during their late teens or early 20s

women, schizophrenia often first appears during their 20s or early 30s.

schizophrenia affects 2.7 million Americans

child born into a family with one or more schizophrenic family member has a greater chance of developing schizophrenia than a child born into a family with no history of schizophrenia.

chance for a sibling to also be diagnosed with schizophrenia is 7 to 8 percen

If a parent has schizophrenia, the chance for a child to have the disorder is 10 to 15 percen

Risks increase with multiple affected family members.

Distorted perception of reality (i.e., difficulty telling dreams from reality) Confused thinking (i.e., confusing television with reality) Detailed and bizarre thoughts and ideas Suspiciousness and/or paranoia (fearfulness that someone, or something, is going to harm them) Hallucinations (seeing, hearing, or feeling things that are not real such as hearing voices telling them to do something) Delusions (ideas that seem real but are not based in reality) Extreme moodiness Severe anxiety and/or fearfulness Flat affect (lack of emotional expression when speaking) or inability to manage emotions Difficulty in performing functions at work and/or school Exaggerated self-worth and/or unrealistic sense of superiority of one's self Social withdrawal (severe problems in making and keeping friends ) Disorganized or catatonic behavior (suddenly becoming agitated and confused, or sitting and staring, as if immobilized) Odd behaviors

The symptoms of schizophrenia are often classified as positive (symptoms including delusions, hallucinations, and bizarre behavior), negative (symptoms including flat affect, withdrawal, and emotional unresponsiveness), disorganized speech (including speech that is incomprehensible), and disorganized or catatonic behavior (including marked mood swings, sudden aggressive, or confusion, followed by sudden motionlessness and staring).

diagnosed by a psychiatrist

Specific treatment for schizophrenia will be determined by your physician based on: Your age, overall health, and medical history Extent of the disease Your tolerance for specific medications, procedures, or therapies Expectations for the course of the disease Your opinion or preference

Types of treatment that may be helpful to an individual with schizophrenia may include: Medications (also called psychopharmacological management; to reduce the symptoms of schizophrenia), including the following: Neuroleptics--a specialized class of medications used to treat schizophrenia. Neuroleptics are used primarily to treat the pervasive, intrusive, and disturbing thoughts of a person with schizophrenia. They are designed to help minimize the severity of delusions and hallucinations the individual is experiencing. Antipsychotic medications--medications that act against the symptoms of psychotic illness, but do not cure the illness. However, these medications can reduce symptoms or reduce the severity of symptoms; a specialized class of medications used to treat schizophrenia. Individual and family psychotherapy (including cognitive and behavioral therapy) Specialized educational and/or structured activity programs (i.e., social skills training, vocational training, speech and language therapy) Self-help and support groups

Preventive measures to reduce the incidence of schizophrenia are not known at this time

McNally, a professor in the Department of Psychology

In addition to raising the public profile of the disorder, the book also marked the first suggestion that alternate personalities were created as a way to wall off traumatic memories of physical or sexual abuse, and that those memories could be recovered with the help of a therapist.

The idea at the time was that the mind locks these memories away, but with the help of a therapist, and through hypnosis or the use of drugs like Sodium Pentothal, these memories could become accessible,

Called a “concealed information task,” the test’s goal is ostensibly simple: identify words as they flash on a computer screen. If one of a small set of randomly selected “target” words appears, press yes. For all other words, press no. The catch, McNally said, is that while many of the words hold no meaning for the patients, a small subset of the non-target words are taken from two autobiographical questionnaires patients fill out at the start of the test — one while inhabiting one personality, the second in another.

When one of those personally relevant words — such as a best friend’s name, favorite food, or favorite sport — appears on screen, McNally said, most patients’ first impulse is to press the yes button. Within moments, however, they realize the word doesn’t appear on the target list, and they eventually give the “correct” answer by pressing no.

All participants showed a nearly identical lag for words that were relevant to their alternate personalities, McNally said, suggesting that the information wasn’t locked away in a separate identity.

This study clarifies the mechanism and function of memory in various dissociative states and helps explain why trauma might result in the development of alters.