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 journal 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 outstanding research by the French psychiatristProfessionals who are medically trained doctors with specialist training in psychiatry. They can prescribe medication, diagnose and conduct research. Besides psychiatric medication treatments include ECT and psychotherapy. <ref name=AboutPsychiatry/>, Pierre Marie Félix Janet (1859-1947) have fortuitously helped to take the world for a ride down the wrong path for far too long. This road was filled with potholes created by groups and individuals with ulterior motives, who lacked proper education and/or misinterpreted evidence gleamed directly from the afflicted. This is how research often goes, but the year 2014 marks an important milestone where modern day technology regularly uses fMRI scans and other contemporary tools to discern certain aspects of the Trauma and Stressor and Dissociative Disorders. We welcome you to this project where we attempt to present, and keep updated, the most accurate information possible. The site name www.dissociative-identity-disorder.net was chosen due to it's reference of the most complex of all disorders that are not innate, but are instead caused by human action and inaction.

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 DissociationStructural dissociation (SD) is one of the three accepted etiological ideas for the etiology of dissociative identity disorder. <ref name=HauntedSelf/> <ref name=Dell2009/>{{Rp|158-165}} It also explains other specified dissociative disorder, dissociative forms of borderline personality disorder, and dissociative posttraumatic stress disorder {{See also| Structural dissociation}}Structural dissociation of the personality is a theory that describes the effect of trauma on the personality. It applies to PTSD, complex PTSD, other specified dissociative disorder and dissociative identity disorder. of the PersonalityEvery individual has a personality that is composed of many diverse, fragmentary and generally illusory images of [[Personality|self]]. (see multiples) <ref name=Noricks2011/>The DSM-IV uses the term identity in its definition of dissociation. (see identity) <ref name=Dell2009/>{{Rp|127}}

Structural dissociation follows a predetermined course of action when adequate servicing of a young child's basic needs are not met, resulting in a build-up of of trauma and its associated memories. While the child is "stressed," the mind is afflicted with an inability to communicate proper signals to the hippocampus of the brain, and as a result the trauma memories remain in the mind, buried and unable to complete the cycle of memory processing. The ganglia of neurons, referred to as the personality, creates a barrier that contains, separates and attempts to isolate the trauma memories. The barrier is semipermeable so try as it might, it still does leak to the part of the personality that is attempting to attend to daily life.

Posttraumatic stress disorder and a complex version of posttraumatic stress disorder are Trauma Stressor-Related Disorders that fall within the boundaries of Structural Dissociation. The complex Dissociative Disorders: other specified dissociative disorder and dissociative identity disorder do as well, and all of these disorders are caused by Structural Dissociation. Borderline personality disorder (BPD) is a Personality Disorder and is not caused by Structural Dissociation, however after borderline personality disorder has established itself, the individual can have unprocessed trauma memories that accumulate and eventually overwhelm the person causing Structural Dissociation and the associated dissociative symptoms.

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

FMRI scans capture distinct states switching with one another in DID. DID is the only disorder where 2 or more distinct states have ever been observed switching. The smaller lit up areas on the images are seen in all the Dissociative and Trauma Disorders. These are "less than distinct states," or as the DSM calls them, "discontinuities in sense of self and agency." In OSDD images show 1 distinct state only, and it switches with the less than distinct states at random times without ever needing a trigger. All states in OSDD can literally be lit up on a scan at one time. When a trigger does occur then the affected states comes forward, and either takes over for the distinct state or it influences it. In PTSD there is 1 less than distinct state and 1 distinct state, and both stay lit until a trigger causes the less than distinct state to respond (flashback or other reaction to unprocessed memories) and then the distinct state disappears from the image and the less than distinct state takes over. In the complex version of PTSD there is always 2 less than distinct states, which stay together in the scans, but otherwise act the same as in PTSD. BPD involves 1 distinct state that is always visible until the individual is in distress, and then 2 less than distinct states show up together, but don't take over as is seen in PTSD, and so there are no flashbacks or other symptoms reacting from the unprocessed trauma memories, but there are other dissociative symptoms. See the links for references

Differences between DID and OSDD

The DSM criteria for other specified dissociative disorder (OSDD) differs from the now defunct description of "dissociative disorder not otherwise specified" (DDNOS), which was a category the DSM-IV. The DSM-5, published late in 2013, offers criteria that simplify the diagnosis of other specified dissociative disorder as well as dissociative identity disorder, but to understand how clear the new criteria make diagnosis, an understanding of distinct states and less than distinct states ("discontinuities in sense of self and agency") is necessary.

Dissociative identity disorder is the only disorder with two or more distinct states, so obviously it's the only disorder where two distinct states can switch. Other specified dissociative disorder switches with states that are fairly elaborate, but there is only one distinct state in this disorder, with the rest being less than distinct states, or as the DSM calls them: "discontinuities in sense of self and agency." Dissociative identity disorder and other specified dissociative disorder could be described as follows: the person with dissociative identity disorder is so fearful of the past that each "state" of their being "refuses to remember it," while the person with other specified dissociative disorder is so manipulated and influenced by their past, they can never get relief from it. It's also important to note that the individual with dissociative identity disorder, and those around them, will rarely recognize anything is wrong, while the individual with other specified dissociative disorder cannot help but have their problems noticed.

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

DSM differences between PTSD and C-PTSD

Posttraumatic stress disorder has one less than distinct state, while complex-posttraumatic stress disorder has two less than distinct states. Both disorders also have one distinct state and their less than distinct states lack elaboration and individuality.

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}}

All Dissociative Disorders have dissociative boundaries associated with the states, and those boundaries direct how states act and react. Boundaries associated with distinct states vary in complexity, and in dissociative identity disorder they reach their ultimate resistance. Their chemical, neurological and the physical makeup work function as "desperate" attempts to keep trauma memories from affecting the part of the personality that must function in daily life. The states in this disorder contain, replicate, and isolate most effects including trauma memory. They are unyielding in their phobia of each other, until a great deal of work has been done to bring the trauma memories to focus and then process them. This also occurs, but to a lesser extent in other disorders that result from Structural Dissociation.

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

Integration

Overtime many individuals with Trauma Stressor-Related Disorders and Dissociative Disorders process their trauma memories through mindful work. The individual has bring the problem to the minds attention or the trauma memories will remain buried and the resulting symptoms will continue. Once the trauma memories are recognized through a maze of deflection and semi-permeable boundaries, the mind and brain can finally communicate adequately and continue the process they are designed to do, which is to process trauma memories in the hippocampus (of the brain).

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

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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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