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PubMed1989

Effects of hypnosis on the features of multiple personality disorder.

The authors compared 57 patients with multiple personality disorder (MPD) who had been hypnotized both before and after diagnosis to 38 patients who had not been hypnotized during assessment or treatment. The two groups did not differ on the diagnostic criteria for MPD or in number of personalities. Hypnosis therefore does not have a gross distorting effect on the features of the disorder. Hypnosis may, however, affect the recall of sexual and physical abuse and the manifestation of certain types of alter personality. These include child personalities, personalities of different age, sex, or race, and protectors. The authors hypothesize that the hypnotized group may require hypnosis for access of more traumatic memories held by child personalities.

Adult↗
PubMed1995

Insanity and adultery: forensic implications of a divorce case.

Legal responsibility for acts presumes that a person's behavior is rationally intentional and under voluntary control. Automatism, a type of insanity defense, contends that the person's conscious, voluntary control of behavior has been impaired by a mental disorder. In a recent case in South Carolina, automatism was offered as a defense to adultery, an at-fault grounds to divorce. On appeal, the State Supreme Court recognized the novel application of mental impairment defenses in domestic litigation and remanded the case for rehearing. Implications of the ruling for clinical and forensic practice in family court are discussed.

Adult↗
PubMed1982

The multiple personality epidemic. Additional cases and inferences regarding diagnosis, etiology, dynamics, and treatment.

The past decade has witnessed a marked increase in the reported incidence of multiple personality patients. This review examines 16 papers published between 1970 and early 1981 that reported 29 cases of multiple personality other than the 50 cases reported earlier by George Greaves. These 29 case reports confirm that psychic and physical abuse, sexual trauma, and restrictive environments during childhood and consequent conflicts, especially regarding anger and sex, are likely to have etiological significance for this disorder. All but one of these patients were females, which might reflect sex differences in modes of conflict resolution. Psychic and physical abuse, sexual trauma, restrictive environments, and suicide attempts appear to have diagnostic implications. Prognosis appears favorable when integrative procedures are employed. This review and that by Greaves provide a comprehensive compilation of recent reports of multiple personality patients.

Adult↗
PubMed1997

Assessing the criminal responsibility of individuals with multiple personality disorder: legal cases, legal theory.

This article discusses the criminal responsibility of individuals diagnosed with multiple personality disorder (MPD). First, it reviews how courts understand and assess criminal responsibility. Second, it gives an overview of how courts have applied the doctrine of criminal responsibility to individuals with MPD. Third, it explains what legal theorists say about this question. Finally, it uses a case example to illustrate how various theorists would assess the responsibility of a criminal defendant with MPD.

Criminal Law↗
PubMed1993

Multiple personality disorders: treatment coordination in a partial hospital setting.

Many patients with multiple personality disorder (MPD) can be effectively treated in a partial hospital setting. Partial hospital treatment teams and their patients develop and manage a safe transitional environment that contains the therapy and begins the process of independent functioning in the community. Not all patients with MPD can be treated in partial hospital settings. The author provides guidelines for appropriate placement of these patients.

Ambulatory Care↗
PubMed1991

Historical reliability: a key to differentiating populations among patients presenting signs of multiple personality disorder.

The clinical value of inconsistencies in the historical data of patients presenting with signs of multiple personality disorder was assessed. Three major inconsistencies in historical data were identified in 23 patients who were admitted to a Dissociative Disorders Program with a diagnosis of Multiple Personality Disorder. This group showed psychological disturbance that was quite different from 23 patients with a similar discharge diagnosis but who did not exhibit inconsistencies in history. The former group reported less psychological disturbance and fewer dissociative experiences. Patients who are less credible by virtue of inconsistencies in their historical reports may belong to a different diagnostic group. The findings point to the need to chart history carefully in authenticating genuine cases.

Adult↗
PubMed1991

Bandaging a "broken heart": hypnoplay therapy in the treatment of multiple personality disorder.

Hypnoplay therapy is beneficial in two stages of the treatment of multiple personality disorder, as illustrated in two cases. First, when applied to child alters, this method provides an alternative route to the disclosure of secrets, the nonverbal expression of thoughts and feelings, and the safe abreaction of powerful emotion. Second, during postfusion, hypnoplay therapy can help the patient to establish a reliable self-object and to complete developmental periods that were absent or severely curtailed.

Adult↗
PubMed1984

Multiple personality disorder in a hospital setting.

Multiple personality disorder (MPD) should be considered in cases where there have been multiple diagnoses, failure of conventional treatments, a mixture of psychiatric and somatic symptoms, and/or extremely rapid shifts in symptoms and level of function. Proper diagnosis and treatment often leads to a significant amelioration in symptoms and increase in level of function for a patient previously refractory to treatment.

Adult↗
PubMed1986

High-functioning multiple personality patients. Three cases.

This article describes the circumstances of the diagnosis of three of a group of 12 high-functioning multiple personality disorder patients. All had performed major social and professional activities with consistent competence, and all appeared to be neurotic patients suitable for classical psychoanalysis. All 12 had been misdiagnosed on at least three occasions before the correct diagnosis was made. Aspects of the difficulties encountered in assessing these patients are discussed and guidelines for the preservation of their high level of function during the treatment process are offered.

Achievement↗
PubMed1991

Crime and multiple personality disorder: a case history and discussion.

The application of the concept of multiple personality disorder (MPD) is one of the most complex and controversial issues facing forensic psychiatrists. The case presented is one in which a diagnosis of multiple personality disorder is not only well documented, but was so diagnosed at least 10 years before the ultimate homicide. Nonetheless, consideration of the legal issues was difficult. Other cases, particularly the Bianchi case, reflect the clinical difficulties in diagnosis. Subsequent cases have reflected a judicial review of the issues and a trend to disallow the concept of MPD as a defense; the author suggests that forensic psychiatrists incorporate these opinions in their future judgments.

Dissociative Identity Disorder↗
PubMed1987

Mary Reynolds: a post-traumatic reinterpretation of a classic case of multiple personality disorder.

In 1811 Mary Reynolds, a somber Pennsylvania spinster, awoke from a prolonged sleep as a new personality. Family memoirs describing her 18 years of shifts between two personalities shaped nineteenth century thinking about multiple personality disorder. As in other early case histories, no mention was made of childhood trauma, a factor found in 97% of contemporary cases. This discussion reviews genealogical and historical documents which suggest that Mary Reynolds did experience early trauma as a victim of religious persecution, which finally forced her family to leave Birmingham, England, when Mary was eight. Review of her illness indicates it may have functioned to eradicate memories of traumatic early experiences.

Adult↗
PubMed1993

Family treatment of spouses and children of patients with multiple personality disorder.

Although there is a large body of literature on the individual treatment of patients with multiple personality disorder (MPD), there are few accounts of the treatment of the spouses and children of these patients. After reviewing some of the existing literature, the authors present case examples of family work with patients, spouses, and children on two inpatient units and in the partial hospitalization program at Menninger. Techniques for the beginning, middle, and later phases of family treatment are illustrated.

Adult↗
PubMed1988

The postunification treatment of multiple personality disorder: first findings.

The treatment issues encountered in the unified multiple personality disorder (MPD) patient have received little attention in the literature to date. This study reviews the therapy records of 91 such patients and identifies seven recurrent areas of concern: (1) coping with the psychophysiologic changes associated with unification, (2) coping with the psychologic changes associated with unification, (3) working through, (4) abandoning autohypnotic evasions, (5) modifying adaptive and coping mechanisms, (6) interpersonal adjustments, (7) and major life changes. Some therapeutic approaches are indicated.

Adaptation, Psychological↗
PubMed1990

Expressive therapy in conjunction with psychotherapy in the treatment of persons with multiple personality disorder.

This article examines the prevalence and complexity of multiple personality disorder as well as the contributions that psychiatry and occupational therapy make in its treatment. The value of activity is that it serves as a nonverbal mediator of communication. Activities are also useful in helping the therapist to obtain a patient's history, which is necessary for abreaction (i.e., the patient's reliving and recalling of the original abuse). Abreaction is a precursor to the integration of the abusive memories into the patient's current life.

Dissociative Identity Disorder↗
PubMed1990

Adolescent multiple personality disorder: a preliminary study of eleven cases.

The diagnostic features and treatment histories of 11 adolescents with multiple personality disorder (MPD) are presented. Clinical evaluation revealed that the majority of these adolescents manifested extremely variable school performance, disruptive behavior, trances, amnesias, mood swings, sharp changes in personality, apparent lying, voices heard in the head, and depression. All had a history of childhood trauma: Sexual abuse (73%), physical abuse (73%), and emotional abuse (82%). Seventy-three percent had a parent with a diagnosable dissociative disorder; 36% of the mothers had MPD. These adolescents had a mean number of 24.1 alter personalities and appear to have become multiple at a mean age of 3 years, 1 month. All patients had angry protector alters, depressed alters, scared alters, and child alters. Fifty-four percent of these cases have integrated during treatment or are progressing toward integration. The remaining cases dropped out of therapy.

Adolescent↗
PubMed1989

Post-traumatic aspects of the treatment of victims of sexual abuse and incest.

This study assesses the frequency of childhood abuse and adult traumatization and the presence of symptomatology of post-traumatic stress and dissociation across different DSM-III diagnostic categories including affective disorder, schizophrenia, eating disorders, PTSD, borderline personality disorder, and multiple personality disorder. Findings revealed high levels of child abuse among patients with dissociative disorder and borderline personality disorder. The patients with dissociative disorders were found to have an increased incidence of rape and wife battery in adulthood. Patients with dissociative and post-traumatic stress disorders were found to experience similar symptomatology. The findings from this study highlight the need to assess all psychiatric patients for a history of physical and sexual trauma. Major treatment issues in patients who suffer from either type of trauma include the development of trust and the abreaction and working through of traumatic memories. Conjoint sessions with concerned others may be beneficial.

Adolescent↗
PubMed1984

Spontaneous self-hypnosis in multiple personality disorder.

The authors posits that the central mechanisms in cases of multiple personality appears to be spontaneous self-hypnosis. As the syndrome is a product of hypnosis and as excellent hypnotic subjects are potentially able to induce a variety of psychiatric symptoms, these patients report many symptoms referable to other major syndromes. This accounts for the many diagnoses attributable to them. The study of multiple personalities offers insights into the capabilities of hypnosis, the genesis of an unconscious, and the mechanism of repression.

Adolescent↗
PubMed1988

Subpersonalities with dreaming functions in a patient with multiple personalities.

A case report of the hypnotherapy and unusual dream work of a patient with multiple personality disorder is described. Two of his 13 personalities claimed a dream production function. These personalities claimed the ability to organize and create dreams in order to communicate with the host personality. In the course of therapy, clinical data are described that tend to support this claim. The data of this case are then briefly applied to some current models of dream function. Some dream theories with an information-processing and reprogramming emphasis are particularly supported by this case material.

Adult↗