Dissociative identity disorder to PTSD: The Trauma and Dissociative Disorders

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It's time accuracy took precedence through a debris littered history, partly founded by a clucking of child abusers, cults, religions, de facto pseudosciences, pop-culture media presentations, poor court findings and inaccurate science news and articles written by journalists who reside within the thought process of the groups listed, or unwittingly turned to those people for information for their articles. In addition, educators and researchers with good intentions, who have not fully surmised the enormity of neurological evidence, have fortuitously helped to take the world for a ride down the wrong path. A pothole filled road was manufactured by entities with ulterior motives, those who lacked proper education and/or misinterpreted evidence gleamed directly from the afflicted. The year 2014 marks an important milestone where modern day technology regularly uses fMRIA type of neuroimaging. Neuroimaging is an approach that allows researchers to view areas of the brain that become active during behavioral events such as emotion, perception and cognition. It is part of the science of in psychophysiology.<ref name=Andreassi2010/> scans and other contemporary tools to discern certain aspects of the Trauma and Stressor and Dissociative Disorders and put an end to supposition and unwavering inaccuracies. We welcome you to this project where we present research that lies on the very cutting edge of science. The site name: www.dissociative-identity-disorder.net infers that information on dissociative identity disorder and all less complex "trauma caused disorders" are incorporated into this site.

  • Most popular pages:
  • Dissociative identity disorder DID (multiple personality disorderPrior to the DSM-IV, <ref name=DSMIV/> <ref name=DSM5Deskref/> dissociative identity disorder was known as multiple personality disorder, which was from 1980-1994. The International Classification of Diseases,(ICD) still uses this label, <ref name=ICD10/> even though the ICD-11 is expected to change it. The term is misleading. No one can have more than one personality, nor is the disorder a personality disorder. {{See also| Multiple Personality Disorder}})
  • Other specified dissociative disorder OSDD (Used in the DSMPublished by the American Psychiatric Association as the standard classification of mental disorders used by US mental health professionals. It consists of diagnostic classification, the diagnostic criteria sets, and descriptive text. The DSM-II listed multiple personality disorder as a symptom of hysterical neurosis, dissociative type. The DSM-III (1980) moved Multiple Personality Disorder from a symptom to its own disorder. The DSM-IV changed the name to dissociative identity disorder (1994) and the DSM-5 (May 2013) updated the listing to current standards. <ref name=DSMIV/> <ref name=DSM5/> <ref name=Dell2009/>{{Rp|384}}-5, replacing DDNOS from the DSM-IV)
  • Posttraumatic stress disorder (PTSD) and complex-posttraumatic stress disorder (C-PTSD)
  • Integration and unification
  • Memory and unprocessed trauma events
  • Amnesia, true amnesia and dissociative amnesia
  • Attachment style and reactive attachment disorder (RADOriginally the only attachment disorder listed in the [[DSM]]. A stressor-related disorder, disinhibited social engagement disorder was originally a subtype of RAD.)
  • Structural dissociation of the personality
  • Distinct state and Less than distinct state
  • Inner world of the subconscious mind

Dissociative Disorders

The Dissociative Disorders (DD) in the DSM-5 include 300.14 dissociative identity disorder (DID), 300.12 dissociative amnesia (DA), 300.6 depersonalization - derealization disorder, 300.15 other specified dissociative disorder (OSDD), 300.15 and unspecified dissociative disorder.

Trauma and Stressor-Related Disorders

The Trauma and Stressor-Related Disorders in the DSM-5 includes 313.89 reactive attachment disorder (RAD), 313.89 disinhibited social engagement disorder, 309.81 posttraumatic stress disorder (PTSD), 308.3 and acute stress disorder (ASD). The adjustment disorders consist of 309.89 other specified trauma and stressor-related disorder and 309.9 unspecified trauma and stressor-related disorder.

Structural dissociation of the personality

Structural dissociation follows a predetermined "course of action" in response to "exiguous servicing" of a child's innate needs. Inadequate responsiveness, mirroring, nutrition, cleanliness, kindness and safety all affect the neurological development of a child. Combine the lack of rudiment developmental requirements that any human child needs with psychological trauma and it sets the stage for a disruption of ganglia that comprise the personality. Through the accumulating effects of caregiver neglect, essential elements of the brain fail to fully development, affecting the minds ability to relay and interpret neurological impulse to and from the brain, leaving accumulated trauma floundering in the mind, replaying endlessly, until it's plucked by the hippocampus of the brain in an effort to process it to actual memory. If trauma accumulates in the mind, it eventually causes structural dissociation of the personality, where the personality, creates an imperfect barrier separating and isolating trauma from the ganglia that abhors it and its affects. Posttraumatic stress disorder and a "complex version of posttraumatic stress disorder" are Trauma Stressor-Related Disorders that fall within the boundaries of structural dissociation, and the complex Dissociative Disorders: other specified dissociative disorder and dissociative identity disorder do as well. These disorders are caused by structural dissociation, but borderline personality disorder (Personality Disorder rather than a Trauma Stressor-Related or Dissociative Disorder) is not, however, after borderline personality disorder has established itself, an individual with unprocessed trauma can eventually succumb to structural dissociation and will then suffer dissociative symptoms.

See the page on Structural Dissociation for referenced and more detailed information.

In "image B", this fMRI scan shows a distinct state switchingFull dissociation is when an alter switches with the alter currently in executive control, resulting in amnesia for that alter. (see executive control) <ref name=Howell2011/>{{Rp|4-6}} In full dissociation, there is complete amnesia between dissociated states, which is a <ref name=Dell2009/>{{Rp|228}} criteria for a diagnosis of dissociative identity disorder in the DSM-5. {{See also| Dissociation}} with an other distinct state, which is only possible in DID, because this is the only disorder with two or more distinct states. "Image A" shows three less than distinct states which are the parts that manage "unprocessed trauma," and react to it with vehement emotion. This is obviously an fMRI scan of DID since it shows there are two distinct states and three less than distinct states. In OSDD fMRI scans reveal only one distinct state is possible, and it switches with less than distinct states randomly, and the distinct state also switches in response to a "triggerA reactivating stimulus in trauma disorders. A stimulus in the present which is a reminder of a part of a traumatic [[memory]], which can cause the part of an individual that hold the trauma (EP) to feel as if it is reliving past trauma experience. <ref name=Boon2011/>{{Rp|166-186}} Also known as a trauma trigger.." In contrast to DID, every single state can literally be conscious (lit up) at one time, but in response to a trigger, all but one state will leave consciousness, which is again in contrast with DID. In PTSD there is only one less than distinct state and one distinct state, and both stay conscious until a trigger causes the less than distinct state to respond, (flashbackA flashback is a reactivated traumatic memory experienced as intrusive thoughts, feelings, or images associated with past trauma, but lacking a sense of being from the past. <ref name=Siegel2012/>{{Rp|30}} It is experienced by the state referred to as the EP. {{See also | Grounding techniques}}, fear, anxiety or other like symptom) and when it does the distinct state leaves consciousness. In the complex version of PTSD there are always two less than distinct states, and one distinct state. The less than distinct states are polarized, staying together, with both always conscious at the same time, but otherwise behave the same as simple PTSD. BPD involves one distinct state and it's always conscious until the individual is in distress, and then two less than distinct states show up together, but unlike C-PTSD these less than distinct states do not take over consciousness. The distinct state always remains with them. There are no flashbacks or other symptoms caused from unprocessed trauma events in BPD like there are in all the other disorders mentioned so far, but there are other dissociative symptoms. (Schlumpf et al. 2014), (Van der Hart et al. 2006)

Diagnosis of DID and OSDD

Diagnostic manuals (DSM, ICD) give the minimum criteria required to determine mental disorders, but are not meant to be referenced otherwise. The DSM-5 offers criteria to diagnose the complex Dissociative Disorders: other specified dissociative disorder and dissociative identity disorder, but an understanding of distinct states and less than distinct states ("discontinuities in sense of self and agency") is necessary. See distinct state and less than distinct state for more. Dissociative identity disorder is the only disorder with two or more distinct states, and so is the only disorder where two distinct states can switch. In addition, true amnesia exists only between distinct states, so dissociative identity disorder is the only disorder associated with true amnesia. In other specified dissociative disorder there are switches between states, but there is only one distinct state in this disorder, the bulk are less than distinct states, or as the DSM calls them: "discontinuities in sense of self and agency." Dissociative amnesia resides among all individuals with Dissociative Disorders. See amnesia for more. Complex Dissociative Disorders have elaborate and autonomous states, with the most elaborate, dissociated and distinct of any disorder belonging to dissociative identity disorder. Phobia between the states in dissociative identity disorder is far more impassioned than in any other "state disorder;" in fact, the states are so phobic of trauma, and their childhood that strong dissociative boundaries inhibit acceptance and therefore knowledge beyond their own moments of consciousness. This makes the distinct states of these individuals deny psychological injury, and appear strong and relatively fearless. In contrast, individuals with other specified dissociative disorder are so manipulated by their past, their pronounced fear overwhelms them, making them slaves to external triggers.

See the categories on Structural Dissociation, dissociative identity disorder, other specified dissociative disorder and the DSM for referenced and more detailed information.

Differences between PTSD and C-PTSD

Both types of posttraumatic stress disorder have one distinct state, but complex-posttraumatic stress disorder differs from the simpler version of this disorder in that it has two less than distinct states. When comparing elaboration, distinctness and autonomy, the states in both simple and complex-posttraumatic stress disorder are similar, but when there are three states to act and react, as is the case in the complex version, the result is symptoms that not only multiply, but also intensify. Both types of posttraumatic stress disorder succumb to dissociative amnesia.

See the categories on posttraumatic stress disorder, and the complex-posttraumatic stress disorder for referenced and more detailed information.

Dissociative boundariesA dissociative boundary separates dissociated states. <ref name=Spiegel2011/> <ref name=DSMIV/> <ref name=DSM5Deskref/> {{See also | Amnesia}} (trauma barriers)

All Trauma Stressor-Related and Dissociative Disorders have dissociative boundaries associated with affected states and the boundaries vary in complexity. In dissociative identity disorder they reach their ultimate complexity, with their chemical, neurological and the physical makeup efficient at resisting, containing, replicating, and isolating trauma. The depth of trauma suffered by individuals with this disorder would otherwise be overwhelming. Scans (fMRI) show that dissociative boundaries affect state behavior in the following ways. In dissociative identity disorder only one state is ever conscious at any given time, but the distinct state in other specified dissociative disorder is always present at the same time a less than distinct state is, and all states can be conscious at the same time. The dissociative boundaries in the two varieties of posttraumatic stress disorder are slight in comparison to the complex Dissociative Disorders; the distinct state is always present, and the less than distinct state(s) appear only when triggeredA reactivating stimulus in trauma disorders. A stimulus in the present which is a reminder of a part of a traumatic [[memory]], which can cause the part of an individual that hold the trauma (EP) to feel as if it is reliving past trauma experience. <ref name=Boon2011/>{{Rp|166-186}} Also known as a trauma trigger. to act. Borderline personality disorder is seen as having two less than distinct states and one distinct state, and either both less than distinct states are conscious together, or the distinct state is conscious alone. As you can see, each of these disorders and their associated dissociative boundaries are highly unique.

See the categories on Structural Dissociation, dissociative identity disorder, and other specified dissociative disorder for referenced and more detailed information.

IntegrationIntegration (state of unification) occurs in the minds of all individuals and is a process rather than an end product. "If integration is impaired, the result is chaos, rigidity, or both. Chaos and rigidity can then be seen as the red flags of blocked integration and impaired development of the mind." <ref name=Siegel2012/>{{Rp|9}} The natural process of the mind is to link differential parts (distinct modes of information processing) into a functional and unified self. No child has unified personality when born, in fact, they need years of sufficient nurturing for the parts of their personality to integrate. <ref name=Siegel2012/>{{Rp|394}} "Integration is more like making a fruit salad than like making a smoothie: It requires that elements retain their individual uniqueness while simultaneously linking to other components of the system. The key is balance of differentiation and linkage." <ref name=Siegel2012/>{{Rp|199}} Integration is the normal process that occurs in early childhood, but if interrupted by trauma, the child may not be able to integrate. <ref name=Howell2011/>{{Rp|143}}

Trauma processing is the movement of trauma from the mind to the hippocampus of the brain where it enters memory. Integration, on the other-hand, is the association of states, a process which can't complete without processing trauma, which occurs simultaneously with integration. Dissociative boundaries break down, and broken pathways are reconstructed in and around affected neurons. After the damage is repaired then the symptoms associated with damaged linkage fades away. Communication between the mind and the hippocampus of the brain is finally repaired so future trauma can be processed normally and moved to memory. The end result is a normal functioning mind and brain that is free from the disabling symptoms that resulted from the inability to process trauma.

See the categories on Structural Dissociation, dissociative identity disorder, and other specified dissociative disorder and integration for referenced and more detailed information.


DSM-5 Category: Dissociative Disorders

The DSM-5, was released May, 2013 and the DSM-5 committees have settled on the following categories:

DSM-5 Category: Trauma and Stressor-Related Disorders

The Trauma and Stressor-Related Disorders are:
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Child abuse and the Trauma and Dissociation Project

Child abusers can go to great length to hide emotional, physical and sexual abuse enacted upon the young and innocent, but the fact remains that child abuse is common, and is a hidden epidemic.

This page is an introduction, see the following pages for more information: Structural dissociation, other specified dissociative disorder, and dissociative identity disorder.

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