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PubMed2002

[The fragility of the self].

This presentation raises the hypothesis that the "self" is a construction of the brain and extremely fragile. In order to support this statement, Prof. Rubia provides three different reasonings: firstly, we are not borne with the "self", but rather it is the result of development during childhood; secondly, the self is subject to cultural influences, so that the perception of this "self" or of the own personality varies according to different cultures. And thirdly, the self is not indivisible, as shown by epileptic patients with a "split-brain" operation, or the psychiatric cases of double personality or the multiple personality disorder.

Brain↗
PubMed1992

Carbamazepine-induced increases in total serum cholesterol: clinical and theoretical implications.

To assess the effect of carbamazepine (CBZ) upon total serum cholesterol, we examined 38 inpatients with affective illness and one with multiple personality disorder who received a course of CBZ monotherapy. CBZ therapy yielded significant increases in total serum cholesterol that became evident during the second week of therapy, persisted throughout therapy, and reversed in the first few weeks after discontinuation of therapy. CBZ-induced increases in total cholesterol appeared independent of initial mood state, diagnostic subtype, baseline cholesterol or thyroid indices; CBZ levels, doses, and level-to-dose ratios; and the degree of change in mood and thyroid indices. CBZ induction of enzymes mediating cholesterol synthesis is a possible mechanism of the increase in total cholesterol observed with CBZ therapy. Although preclinical studies suggest possible influence of cholesterol on neurotransmitter regulation and behavior, clinical studies have yielded conflicting data. There are insufficient data to support a role for cholesterol in the anticonvulsant and psychotropic mechanisms of CBZ. The increase in total serum cholesterol seen with CBZ therapy is likely due to an increase in the high density lipoprotein fraction and is thus not likely to be clinically problematic in relationship to atherosclerosis.

Adult↗
PubMedDate not supplied

History of childhood sexual abuse and general psychopathology.

Reported history of childhood sexual abuse (CSA) was correlated with general measures of psychopathology on the SCL-90-R in a sample that included inpatients with borderline personality disorder (BPD), inpatients with major depression, and a nonpatient control group. When subjects who reported abuse were compared with those who did not, scores for the Global Severity Index (GSI) and all subscales of the SCL-90-R, except for the obsessive-compulsive and somatization subscales, were significantly-higher. When only those subjects who reported CSA were studied and when specific measures of CSA were the independent variables and SCL-90-R subscales were the dependent variables, scores on the hostility, interpersonal sensitivity, and paranoia subscales of the SCL-90-R were significantly higher. Because a large proportion of the sample consisted of borderline patients, and because both the specific measures of CSA and the borderline diagnosis could predict similar SCL-90-R subscale results, a series of stepwise regressions were performed. In the first regression, diagnosis, gender, and specific measures of CSA were the predictor variables and SCL-90-R subscale scores were the dependent variables; in the second regression, SCL-90-R subscales and specific measures of CSA were the predictor variables and diagnosis was the dependent variable. Interpersonal sensitivity was the only significant predictor of the borderline diagnosis. We suggest that, at least in some cases, interpersonal sensitivity may be the constitutional/environmental substrate on which traumatic experiences interact to arrive at the borderline diagnosis.

Adult↗
PubMed1999

The multiple self: working with dissociation and trauma.

This paper describes a patient who appears to have a chronic dissociative personality disorder. Renewed clinical interest in dissociative disorders had arisen in North America in the 1980s, in part due to the influence of the Women's Movement which had highlighted the incidence of child sexual abuse. The early psychological observations of Janet, Freud and Jung on hysterical patients who displayed dissociative phenomena were similar to those displayed by the patient. consideration is given to theoretical understanding of the condition, taking into account the views of the earlier theorists and object-relations theory. The possibility of trauma, in particular childhood sexual abuse, as a causative factor in dissociative disorders is discussed.

Adult↗
PubMed1988

Cognitive analysis of multiple personality disorder.

Multiple personality disorder is not rare, and it can be treated using the principles of cognitive therapy. Noncognitive techniques are also required. The purpose of this paper is to define the basic cognitive map of multiple personality disorder, one which recurs in the majority of cases. Multiple personality patients commonly make the classical cognitive errors such as selective abstraction and dichotomization, but they also have a set of schemata and cognitions derived from their abusive childhoods that are specific for the disorder.

Adaptation, Psychological↗
PubMed1991

Multiple personality disorder: a risk indicator, diagnostic marker and psychiatric outcome for severe child abuse.

Recent studies suggest that multiple personality disorder (MPD) is not as rare as previously believed. Indeed, it may represent a relatively common (as many as 25% of cases) outcome of severe physical and sexual abuse of children. Because diagnosis and treatment offer the best prognosis, it is important for the pediatric clinician to become familiar with both the at risk situations (such as cult practices and multigenerational sexual abuse) as well as the more unusual behavioral presentations of this disorder.

Adolescent↗
PubMed1984

Multiple personality and child abuse. An overview.

Childhood abuses take various forms including emotional and physical neglect, psychologic and physical brutalization, and sexual violation. This cogent overview outlines these abuses and demonstrates their genesis into multiple personality disorder.

Child↗
PubMed1990

Structured interview data on 102 cases of multiple personality disorder from four centers.

Patients with multiple personality disorder (N = 102) at four different centers were interviewed with the Dissociative Disorders Interview Schedule. The presenting characteristics of the patients at all four centers were very similar. The clinical profile that emerged included a history of childhood physical and/or sexual abuse in 97 (95.1%) of the cases. The subjects reported an average of 15.2 somatic symptoms, 6.4 Schneiderian symptoms, 10.2 secondary features of the disorder, 5.2 borderline personality disorder criteria, and 5.6 extrasensory experiences; their average score on the Dissociative Experiences Scale was 41.4. The results indicate that multiple personality disorder has a stable, consistent set of features.

Borderline Personality Disorder↗
PubMed1994

Multiple personality disorder.

Five aspects of the diagnosis and treatment of multiple personality disorder (MPD) were examined. The following five conclusions were made: the contemporary diagnostic criteria are vague and overinclusive; the recent alleged increase in prevalence of the disorder is almost certainly artefactual; legal proceedings involving MPD patients raise disturbing questions about personal responsibility; there is little literature support for the theory that MPD results from childhood trauma; and many of the techniques used to diagnose and treat the condition reinforce its symptoms. A careful revision of diagnostic criteria for the disorder is recommended.

Adult↗