A review of the dissociative disorders: from multiple personality disorder to the posttraumatic stress

Authors

DOI: https://doi.org/10.6018/analesps.32.2.218301
Keywords: Dissociative disorders, multiple personality disorder, posttraumatic stress disorder, dissociative phenomena, hypnosis, suicide ideation.

Supporting Agencies

  • Servicio de Neuropsicología y Rehabilitación
  • Huelva
  • Departamento de Psicología Clínica
  • Experimental y Social de la Universidad de Huelva

Abstract

In this paper we review the idea of dissociation, dissociative disorders and their relationship with the processes of consciousness. We will deal specifically with multiple personality disorder and posttraumatic stress disorder. Both polarize the discussion of diagnostic categories with dissociative symptoms. This review compares the initial ideas (one century old) with the current scenario and emerging trends in research, which are relating cognitive processes and dissociative phenomena and disorders from a neuroscientific approach. We discuss the ideas on dissociation, hypnosis and suicide associated with these disorders. There seems to be a lack of consensus as to the nature of dissociation with theoretical, empirical and clinical implications.

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Author Biography

Modesto J. Romero-López, Dto. Psicología Clínica, Experimental y Social. Universidad de Huelva

Prof. Asociado LOU en el Dto. de Psicología Clínica, Experimental y Social de la Uhu.

Neuropsicólogo Clinico del Servicio de Neuropsicología y Rehabilitación (SEREN) de Huelva.

References

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Text revised. Arlington (VA): American Psychiatric Association.

Asociación Americana de Psiquiatría. (2014). Manual diagnóstico y estadístico de los trastornos mentales (DSM-5), 5ª Ed. Arlington (VA): Asociación Americana de Psiquiatría.

Atchison , M., & McFarlane, A. C. (1994). A review of dissociation and dissociative disorders. Australian and New Zealand Journal of Psychiatry, 28, 591-599. doi: 10.3109/00048679409080782

Auxéméry, Y. (2012). Posttraumatic stress disorder (PTSD) as a consequence of the interaction between an individual genetic susceptibility, a traumatogenic event and a social context. Encephale, 5, 373-380. doi: 10.1016/j.encep.2011.12.003

Brand, B. L., Classen, C. C., McNary, S. W., & Zaveri, P. (2009). A review of dissociative disorders treatment studies. Journal of Nervous and Mental Disease, 197, 646-654. doi: 10.1097/NMD.0b013e3181b3afaa

Brown, R. J., Cardeña, E., Nijenhuis, E. Sar, V., & van der Hart, O. (2007). Should conversion disorder be reclassified as a dissociative disorder in DSM V? Psychosomatics, 48, 369-378. doi: 10.1176/appi.psy.48.5.369

Bru, M., Santamaría, M., Coronas, R. y Cobo, J. V. (2009). Trastorno disociativo y acontecimientos traumáticos. Un estudio en población española. Actas Españolas de Psiquiatría, 37, 200-204. Recuperado de http://actaspsiquiatria.es/repositorio/10/58/ESP/14143+4.+1174+esp.pdf

Bruce, A. S., Ray, W. J., Bruce, J. M. Arnett, P. A., & Carlson, R. A. (2007) The relationship between executive functioning and dissociation. Journal of Clinical and Experimental Neuropsychology, 29, 626-633.

Bryant, R. A., & Harvey, A. G. (1997). Acute stress disorder: a critical review of diagnostic issues. Clinical Psychology Review, 17, 757-773. doi: 10.1016/S0272-7358(97)00052-4

Cardeña, E., Maldonado, J., Galdón, M. J. y Spiegel, D. (1999). La hipnosis y los trastornos postraumáticos. Anales de Psicología, 15, 147-155. Recuperado de http://www.um.es/analesps/v15/v15_1pdf/13h10carde.pdf

Cima, M., Merckelbach, H., Klein, B., Schellbach-Matties, R., & Kremer, K. (2001). Frontal lobe dysfunctions, dissociation, and trauma self-reports in forensic psychiatric patients. Journal of Nervous and Mental Disease, 189, 188-190. doi: 10.1097/00005053-200103000-00008

Cooper L. M., & London, P. (1971). The development of hypnotic susceptibility: A longitudinal (convergence) study. Child Development, 42, 487-503. doi: 10.2307/1127482

Crawford, H. J., Knebel, T., Vendemia J. M. C., Horton, J. E. y Lamas, J. R. (1999). La naturaleza de la analgesia hipnótica: Bases y evidencias neurofisiológicas. Anales de Psicología, 15, 133-146. Recuperado de http://www.um.es/analesps/v15/v15_1pdf/12h05Craw.pdf

Damsa, C., Lazignac, C., Pirrotta, R., & Andreoli, A. (2006). Dissociative disorders: clinical, neurobiological and therapeutical approaches. Revue Médicale Suisse, 8, 400-405.

de Ruiter, M. B., Elzinga, B. M., & Phaf, R. H. (2006). Dissociation: cognitive capacity or dysfunction?. Journal of Trauma and Dissociation, 7, 115-134. doi 10.1300/J229v07n04_07

Deeley, Q., Oakley, D. A., Walsh, E., Bell, V., Mehta, M. A., & Halligan, P. W. (2014). Modelling psychiatric and cultural possession phenomena with suggestion and fMRI. Cortex, 53, 107-119. doi: 10.1016/j.cortex.2014.01.004

Devillé, C., Moeglin, C., & Sentissi, O. (2014). Dissociative Disorders: Between Neurosis and Psychosis. Case Report in Psychiatry, doi: 10.1155/2014/425892

Dienes, Z., Brown, E., Hutton, S., Kirsch, I., Mazzoni, G., & Wright, D. B. (2009) Hypnotic suggestibility, cognitive inhibition, and dissociation. Consciousness and Cognition, 18, 837-847. doi: 10.1016/j.concog.2009.07.009

Doan, B. D., & Bryson S. E. (1994). Etiological and maintaining factor in multiple personality disorder: a critical review. En R. M. Klein y B. K. Doane (Eds.), Psychological Concepts and Dissociative Disorders (pp. 51-84). New Jersey: Lawrence Erlbaum Associates Inc.

Elvevag, B., & Goldberg, T. E. (2000). Cognitive impairment in schizophrenia is the core of the disorder. Critical Reviews in Neurobiology, 14, 1-21. doi: 10.1615/CritRevNeurobiol.v14.i1.10

Espirito-Santo, H., & Pio-Abreu, J. L. (2009) Psychiatric symptoms and dissociation in conversion, somatization and dissociative disorders. Australian and New Zealand Journal of Psychiatry, 43, 270-276. doi: 10.1080/00048670802653307

Flor-Henry, P. (1994). Cerebral Aspect of hysteria and Multiple Personality. En R. M. Klein & B. K. Doane (Eds.), Psychological Concepts and Dissociative Disorders (pp. 237-258). New Jersey: Lawrence Erlbaum Associates Inc.

Flor-Henry, P., Fromm-Auch, D., Tapper, M. & Schopflocher, D. (1981). A neuropsychological study of the stable syndrome of hysteria. Biological Psychiatry, 16, 601-616.

Flor-Henry, P., Tomer, R., Kumpula, I., Koles, Z. J., & Yeudall, L. T. (1990). Neurophysiological and neuropsychological study of two cases of multiple personality syndrome and comparison with chronic hysteria. International Journal of Psychophysiology, 10, 151-161.

Foote, B., Smolin, Y., Kaplan, M., Legatt, M. E., & Lipschitz, D. (2006). Prevalence of dissociative disorders in psychiatric outpatients. American Journal of Psychiatry, 163, 623-629. doi: 10.1176/ajp.2006.163.4.623

García-Campayo, J., Fayed, N., Serrano-Blanco, A., & Roca, M. (2009). Brain dysfunction behind functional symptoms: neuroimaging and somatoform, conversive, and dissociative disorders. Current Opinion in Psychiatry, 22, 224-231. doi: 10.1097/YCO.0b013e3283252d43

Gentile, J. P., Snyder, M., & Gillig, P. (2014). Stress and Trauma: Psychotherapy and Pharmacotherapy for Depersonalization/Derealization Disorder. Innovation in Clinical Neuroscience, 11, 37-41. Recuperado de http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204471/

Giesbrecht, T., & Merckelbach, H. (2005). The causal relation between dissociation and trauma. A critical overview. Der Nervenarzt, 76, 20-27. Recuperado de http://arnop.unimaas.nl/show.cgi?fid=2405

Giesbrecht, T., Lynn, S. J., Lilienfeld, S. O., & Merckelbach, H. (2008). Cognitive processes in dissociation: an analysis of core theoretical assumptions. Psychological Bulletin, 134, 617-647. doi: 10.1037/0033-2909.134.5.617

Giesbrecht, T., Merckelbach, H., Geraerts, E., & Smeets, E. (2004). Dissociation in undergraduate students: Disruptions in executive functioning. The Journal of Nervous and Mental Disease, 192, 567-569. doi: 10.1097/01.nmd.0000135572.45899.f2

González-Ordi, H. y Miguel-Tobal, J. J. (1999). Características de la sugestionabilidad y su relación con otras variables psicológicas. Anales de Psicología, 15, 57-75. Recuperado de http://www.um.es/analesps/v15/v15_1pdf/07h01hect.pdf

Gruzelier, J. (1999). La hipnosis desde una perspectiva neurobiológica: Una revisión de la evidencia y aplicaciones a la mejora de la función inmune. Anales de Psicología, 15, 111-132. Recuperado de http://revistas.um.es/analesps/article/view/31191

Hagenaars, M. A., van Minnen, A., & Hoogduin, K. A. L. (2010). The impact of dissociation and depression on the efficacy of prolonged exposure treatment for PTSD. Behaviour Research and Therapy, 48, 19-27. doi:10.1016/j.brat.2009.09.001

Hilgard, E. R. (1977). Divided consciousness: Multiple controls in human thought and action. New York: Wiley.

Holland, J. C. (1989). Fears and Abnormal reactions to cancer in physically healthy individuals. En J.C. Holland, & J.H. Rowland (Eds.), Handbook of Psychooncology (pp. 13-21). New York: Oxford University Press.

Holmes, E. A., Brown, R. J., Mansell, W., Fearon, R. P., Hunter, E. C. M., Frasquilho, F., & Oakley, D. A. (2005). Are there two qualitatively distinct forms of dissociation? A review and some clinical implications. Clinical Psychology Review, 25, 1-23. doi: 10.1016/j.cpr.2004.08.006

Hunter, E. C., Sierra, M., & David, A. S. (2004). The epidemiology of depersonalisation and derealisation. A systematic review. Social Psychiatry and Psychiatric Epidemiology, 39, 9-18.

Irpati, A. S., Avasthi, A., & Sharan, P. (2006). Study of stress and vulnerability in patients with somatoform and dissociative disorders in a psychiatric clinic in North India. Psychiatry and Clinical Neurosciences, 60, 570-574. doi: 10.1111/j.1440-1819.2006.01560.x

Janet, P. (1889). L’automatisme psychologique. Paris: Felix Alcan.

Janet, P. (1907). The mayor symptoms of hysteria. New York: MacMillan.

Kihlstrom, J. E., & Hoyt, I. P. (1990). Repression, dissociation, and hypnosis. En J. L. Singer (Ed.), Repression and dissociation (pp. 181-208). Chicago: University of Chicago Press.

Kihlstrom, J. F., Glisky, M. L., & Angiulo, M. J. (1994). Dissociative tendencies and dissociative disorders. Journal of Abnormal Psychology, 102, 117-124. doi: 10.1037/0021-843X.103.1.117

Kirsch, I., & Lynn, S. J. (1998). Dissociation theories of Hypnosis. Psychological Bulletin, 123, 100-115. doi: 10.1037//0033-2909.123.1.100

Kluft, R. P. (1984).Aspects of treatment of multiple personality disorder. Psychistric Annals, 14, 51-55. doi: 10.3928/0048-5713-19840101-09

Kluft, R. P. (1987). An update on multiple personality disorder. Hospital and Community Psychiatry, 38, 363-373. doi: 10.1176/ps.38.4.363

Kluft, R. P. (1991). Hospital treatment of multiple personality disorder: An Overview. Psychiatric Clinics of North America, 14, 695-719.

Kluft, R. P. (2001). The difficult to treat patient with dissociative disorders. En M. J. Dewan, & R.W. Pies (Eds.), The difficult-to-treat psychiatric patient (pp. 209-242). Washington D.C.: American Psychiatric Publishing Inc.

Kluft, R. P. (2003). Current issues in dissociative identity disorder. Bridging Eastern and Western Psychiatry, 1, 71-87. doi: 10.1097/00131746-199901000-00001

Kreidler, M. C., Zupancic, M. K., Bell, C., & Longo, M. B. (2000). Trauma and dissociation: Treatment perspectives. Perspectives in Psychiatric Care, 36, 77-85. doi: 10.1111/j.1744-6163.2000.tb00697.x

Lanius, R. A., Brand, B., Vermetten, E., Frewen, P. A., & Spiegel, D. (2012). The dissociative subtype of posttraumatic stress disorder: rationale, clinical and neurobiological evidence, and implications. Depression and Anxiety, 29, 701-708. doi: 10.1002/da.21889

Luwdig, A. M. (1990). The Psychobiological functions of dissociation. American Journal of Clinical Hypnotherapy, 26, 93-99. doi: 10.1080/00029157.1983.10404149

Maia, L. A. C. R., & Costa-Oliveira, J. M. (2010). Bases neurobiológicas del estrés post-traumático. Anales de Psicología, 26, 1-10. doi: 10.6018/91891

McHugh, P. R., & Treisman G. (2007). PTSD: a problematic diagnostic category. Journal of Anxiety Disorders, 21, 211-222. doi: 10.1016/j.janxdis.2006.09.003

Middleton, W., & Butler, J. (1998). Dissociative identity disorder: An Australian series. Australian and New Zealand Journal of Psychiatr, 32, 794-804. doi: 10.3109/00048679809073868

Nijenhuis, E. R. S., Vanderlinden, J., & Spinhoven P. (1998). Animal defensive reactions as model for trauma-induced dissociative reactions. Journal of Traumatic Stress, 11, 243-260. doi: 10.1023/A:1024447003022

Nijenhuis, E. R., Spinhoven, P., van Dyck, R., van der Hart, O., & Vanderlinden, J. (1998). Degree of somatoform and psychological dissociation in dissociative disorder is correlated with reported trauma. Journal of Traumatic Stress, 11, 711-730. doi: 10.1023/A:1024493332751

Orbach, I. (1994). Dissociation, physical pain, and suicide: A hypothesis. Suicide and life-threatening behavior, 24, 68-79. doi: 10.1111/j.1943-278X.1994.tb00664.x

Oztürk, E., & Sar., V. (2008). Somatization as a predictor of suicidal ideation in dissociative disorders. Psychiatry and Clinical Neurosciences, 62, 662-668. doi: 10.1111/j.1440-1819.2008.01865.x

Pope, H. G., Oliva, P. S., Hudson, J. I., Bodkin, J. A., & Bruber, A. J. (1999). Attitudes toward DSM-IV dissociative disorders diagnoses among board-certified American psychiatrists. American Journal of Psychiatry, 156, 321-323. Recuperado de http://psychiatryonline.org/doi/full/10.1176/ajp.156.2.321

Putnam, F. W. (1986). The scientific investigation of multiple personality disorder. En J. M. Quen (Ed.). Split Mind Split Brain (pp.109-126). New York: New York University Press.

Putnam, F. W. (1989). Pierre Janet and modern views of dissociation. Journal of Traumatic Stress, 2, 413-429. doi: 10.1007/BF00974599

Putnam, F. W. (2009). Take the measure of dissociation. Journal of trauma and dissociation (10), 233-236. doi: 10.1080/15299730902956564

Putnam, F. W., & Loewenstein, R. J. (1993). Treatment of multiple personality disorder: a survey of current practices. American Journal of Psychistry, 150 (7), 1048-1052. doi: 10.1176/ajp.150.7.1048

Quraishi, S., & Frangou, S. (2002). Neuropsychology of bipolar disorder: A review. Journal of Affective Disorders, 72, 209-226. doi: 10.1016/S0165-0327(02)00091-5

Rayner, K., & Pollatsek, A. (1989). The psychology of reading. Englewood Cliffs, NJ: Prentice-Hall.

Rogers, M. A., Kasai, K., Koji, M., Fukuda, R.,Iwanami, A., Nakagome, K., Fukuda, M., & Kato, N. (2004). Executive and prefrontal dysfunction in unipolar depression: A review of neuropsychological and imaging evidence. Neuroscience Research, 50, 1-11. doi: 10.1016/j.neures.2004.05.003

Ross, C. A. (1991) Epidemiology of multiple personality disorder and dissociation. Psychiatric Clinics of North America,14, 503-17.

Ross, C. A., Joshi, S., & Currie, R. (1991). Dissociative experiences in the general population. American Journal of Psychiatry, 147, 1547-1552.

Sharma, T., & Antonova, E. (2003). Cognition in schizophrenia: Deficits, functional consequences, and future treatments. Psychiatric Clinics of North America, 26, 25-40.

Spiegel, D., & Cardeña, E. (1991). Disintegrated experience: the dissociative disorders revisited. Journal of Abnormal Psychology, 100, 366-378. doi: 10.1037//0021-843X.100.3.366

Spiegel, D., Lewis-Fernández, R., Lanuis, R., Vermettern, E., Simeon, D., & Friedman, M. (2013). Dissociative disorders in DSM-5. Annual Review of Clinical Psychology, 9, 299-326. doi: 10.1146/annurev-clinpsy-050212-185531.

Spitzer, C., Barnow, S., Freyberger, H. J., & Grabe, H. J. (2006). Recent developments in the theory of dissociation. World Psychiatry, 5, 2-6. Recuperado de http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525127/pdf/wpa050082.pdf

Stein, D. J., Koenen, K. C., Friedman, M. J., Hill, E., McLaughlin, K. A., Petukhova, M., ... Kessler, R. C. (2013). Dissociation in Posttraumatic Stress Disorder: Evidence from the World Mental Health Surveys. Biological Psychiatry, 73(4), 302-312. doi: 10.1016/j.biopsych.2012.08.022

Stolovy, T., Lev-Wiesel, R., & Witztum, E. (2014). Dissociation: Adjustment or Distress? Dissociative Phenomena, Absorption and Quality of Life Among Israeli Women Who Practice Channeling Compared to Women with Similar Traumatic History. Journal of Religion and Health, 27. doi: 10.1007/s10943-014-9885-4

Twamley, E. W., Allard, C. B., Thorp, S. R., Norman, S. B., Cissell, S. H., Berardi, K. H., Grimes, E. M., & Stein, M . B. (2009). Cognitive impairment and functioning in PTSD related to intimate partner violence. Journal of the International Neuropsychological Society, 15, 879-887. doi: 10.1017/S135561770999049X

Weniger, G., Lange, C., Sachsse, U., & Irle E. (2008). Amygdala and hippocampal volumes and cognition in adult survivors of childhood abuse with dissociative disorders. Acta Psychiatrica Scandinavica, 118, 281-290. doi: 10.1111/j.1600-0447.2008.01246.x

Zlotnick, C., Mattia, J. I., & Zimmerman, M. (1999). Clinical correlates of self-mutilation in a sample of general psychiatric patients. Journal of Nervous and Mental Disease, 187, 296-301. doi: 10.1097/00005053-199905000-00005

Published
03-04-2016
How to Cite
Romero-López, M. J. (2016). A review of the dissociative disorders: from multiple personality disorder to the posttraumatic stress. Anales de Psicología / Annals of Psychology, 32(2), 448–456. https://doi.org/10.6018/analesps.32.2.218301
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Section
Clinical and Health Psychology