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PubMedDate not supplied

Development, reliability, and validity of a child dissociation scale.

Dissociation is a complex psychophysiological process that ranges along a continuum from minor, normal dissociation to Axis I psychopathology. High levels of dissociation are associated with increased self-destructive behaviors and other symptoms. Although several validated measures of dissociation exist for adults, no measures are available for children. The Child Dissociative Checklist (CDC) was developed to meet this need and is a reliable and valid observer report measure of dissociation in children. The CDC had a 1-year test-retest reliability coefficient of rho = .69 (N = 73, p = .0001) in a sample of normal and sexually abused girls. The CDC had high discriminant validity among four test samples including: normal control girls, sexually abused girls, boys and girls with dissociative disorder NOS and boys and girls with multiple personality disorder. The CDC is intended as a clinical screening instrument and as a research measure. The CDC is not designed to be used as a diagnostic instrument.

Adolescent↗
PubMed2002

Is low self-esteem an inevitable consequence of stigma? An example from women with chronic mental health problems.

It is often assumed that membership in a stigmatized group has negative consequences for the self-concept. However, this relationship is neither straightforward nor inevitable, and there is evidence suggesting that negative consequences may not necessarily occur (Psychol. Rev. 96(4) (1989) 608). This paper argues that the relationship has not been sufficiently theorized, and that a more detailed analysis is called for in order to understand the relationship between stigma and the self. The paper presents a critical examination of modified labeling theory (Am. Sociol. Rev. 52 (1987) 96), with examples from a study examining perceptions of stigma and their relationship to self-evaluation in women with chronic mental health problems. Open-ended interviews and qualitative analyses were used in preference to global measures of self-esteem. It was found that although the women were aware of society's unfavorable representations of mental illness, and the effects this had on their lives, they did not accept these representations as valid and therefore rejected them as applicable to the self. The participants did not deny their mental health problems, but their acceptance of labels was critical and pragmatic. Labels were rejected when they were perceived as carrying an unrealistic and negative stereotype, or when the women felt that their symptoms did not fit with the diagnostic criteria. The research illustrates the importance of considering people's subjective understandings of stigmatized conditions and societal reactions in order to understand the relation between stigma and the self.

Adult↗
PubMed1975

Multiple personality. A single case study with a 15 year follow-up.

A review of the literature relating to multiple personality is presented together with a study of a single case of hysterical aetiology that demonstrates the development of multiple personality from a fugue amnesic state. A re-examination of this case after 15 years without significant psychotherapeutic intervention demonstrates a tendency towards remission. The view that multiple personality is a form of fugue, not necessarily hysterical, in which an alternative personality is adopted and that this behaviour is reinforced by the attention that it receives, is discussed.

Adolescent↗
PubMed2002

The role of psychophysiology in clinical assessment: ERPs in the evaluation of memory.

Psychophysiological measures hold great potential for informing clinical assessments. The challenge, before such measures can be widely used, is to develop test procedures and analysis strategies that allow for statistically reliable and valid decisions to be made for any particular examinee, despite large individual differences in psychophysiological responding. Focusing on the evaluation of memory in clinical, criminal, and experimental contexts, this paper reviews the rationale for and development of ERP-based memory assessment procedures, with a focus on methods that allow for statistically supported decisions to be made in the case of a single examinee. The application of one such procedure to the study of amnesia in Dissociative Identity Disorder is highlighted. To facilitate the development of other psychophysiological assessment tools, psychophysiological researchers are encouraged to report the sensitivity and specificity of their measures where possible.

Amnesia↗
PubMed1991

Disintegrated experience: the dissociative disorders revisited.

We present proposed changes to the dissociative disorders section of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders and review the concept of pathological and nonpathological dissociation, including empirical findings on the relations between trauma and dissociative phenomenology and between dissociation and hypnosis. The most important proposals include the creation of two new diagnostic entities, brief reactive dissociative disorder and transient dissociative disturbance, and the readoption of the criterion of amnesia for a multiple personality disorder diagnosis. We conclude that further work on dissociative processes will provide an important link between clinical and experimental approaches to human cognition, emotion, and personality.

Depersonalization↗
PubMed2004

How many selves in emotion experience? Reply to Dalgleish and Power (2004).

T. Dalgleish and M. J. Power (see record 2004-15929-012) suggest that J. A. Lambie and A. J. Marcel's (2002) article implicitly presents a unitary view of self in emotion experience and propose that certain clinical phenomena require multiple selves. This reply summarizes Lambie and Marcel's usages of the term self and examines both Dalgleish and Power's gloss of these and their own usages. This indicates that their own central usage of the term misrepresents Lambie and Marcel and is itself an improper usage. More important, examination of the phenomena claimed to require multiple selves suggests that they do not and that Dalgleish and Power may have misread the relevant clinical literature. Finally, Lambie and Marcel's own conception of dissociative phenomena and multiple selves are outlined, and alternative approaches are sketched. In discussing the usages of the term self and interpretation of cognitive and affective disorders, this reply attempts to clarify certain confusions.

Awareness↗
PubMed1990

Dissociation and displacement: where goes the "ouch?".

Hypnosis is widely used to relieve pain. Current theory emphasizes its dissociative features. Multiple personality patients can eliminate pain in the primary personality by displacing it into underlying alters. The Hilgards demonstrated that normal hypnotized subjects can similarly dissociate pain into a covert cognitive structural system which they called the "hidden observer." The Watkins discovered that "hidden observers" appeared to be the same phenomenon as "ego states." "Ego-state theory" assumes that human personality develops through integration and differentiation. At one end of the continuum, "differentiation" is adaptive. Ego states possess relatively permeable boundaries as in normal moods. At the other end ego-state boundaries become less permeable. Normal "differentiation" becomes maladaptive "dissociation" and multiple personalities may be created. In the intermediate range of the differentiation/dissociation continuum, "covert" ego states can be found in many normal subjects who volunteer for hypnotic laboratory experiments. Normal individuals, like multiple personalities and "hidden observer" subjects, can displace (dissociate) pain into "covert" ego states. The pain is not eliminated. This suggests that when we remove pain by hypnosis we may not be getting away "scot-free."

Dissociative Disorders↗
PubMed1992

Enhancing the hospital treatment of dissociative disorder patients by developing nursing expertise in the application of hypnotic techniques without formal trance induction.

Many symptoms suffered by dissociative disorder patients are unresponsive or incompletely responsive to medications. This poses a unique challenge to the staff of specialized dissociative disorder units, in which many such patients who require hospital care suffer serious distress that may not respond predictably to the pharmacological interventions that are available. However, the majority of their symptoms are dissociative in nature, and dissociative disorder patients generally are quite hypnotizable. Anticipating the need for nonpsychopharmacological interventions that we could use in the absence of the treating psychiatrist, we taught the unit's nursing and social work staff to rely on the inherent trance-proneness of these patients to utilize hypnotic techniques without the formal induction of hypnosis. Their implementation facilitated crisis resolution, led to a greater sense of safety on the part of the patients, enhanced the staff's sense of mastery, and minimized the need for emergency sedation and restraints.

Dissociative Disorders↗
PubMed1992

The interface between multiple personality, spirit mediumship, and hypnosis.

In this paper I draw parallels between multiple personality, spirit mediumship, and hypnosis from historical, anthropological, and clinical perspectives. I emphasize Milton H. Erickson's view of multiple personalities as not necessarily pathological but as potential resources. He employed hypnosis to gain access to personalities and to transform their behavior from involuntary to voluntary actions. I discuss similarities between this view and the use of spirits as a resource with mediums. Natural trance therapies in other cultures offer a new perspective for viewing the normalcy or pathology of "other selves."

Dissociative Disorders↗
PubMed1993

Ego-state therapy: an overview.

Ego-state therapy is a psychodynamic approach in which techniques of group and family therapy are employed to resolve conflicts between the various "ego states" that constitute a "family of self" within a single individual. Although covert ego states do not normally become overt except in true multiple personality, they are hypnotically activated and made accessible for contact and communication with the therapist. Any of the behavioral, cognitive, analytic, or humanistic techniques may then be employed in a kind of internal diplomacy. Some 20 years experience with this approach has demonstrated that complex psychodynamic problems can often be resolved in a relatively short time compared to more traditional analytic therapies.

Dissociative Disorders↗
PubMed1993

Ego-state therapy for self-injurious behavior.

The authors describe the use of ego-state therapy for the treatment of self-injurious behavior (SIB). We propose that for some patients, SIB results from conflict among dissociated ego states. We review the historical and theoretical basis for this position and delineate a specific treatment technique. Our strategy consists of identifying an ego state in which SIB occurs, activating the patient's ego strengths using inner-adviser techniques and facilitating the integration of these resources within the ego state responsible for the behavior. We have used this strategy with favorable results for patients with dissociative symptoms, primarily those suffering from borderline personality disorder, posttraumatic stress disorder, or dissociative disorders.

Adult↗
PubMed1994

Interacting within metaphors.

Creating metaphorical settings in which a patient may therapeutically interact while hypnotized would appear to have many of the advantages of more traditional uses of metaphors and to possess advantages of its own. Although this type of guided imagery may be widely used in practice, it is underrepresented in the literature compared to other uses of metaphor. I describe the use of a castle setting as one example of this type of metaphorical setting that may be useful in working with trauma patients. I also describe some features useful for this interventions, using three case examples.

Adaptation, Psychological↗
PubMed2001

Generalized dissociative amnesia: episodic, semantic and procedural memories lost and found.

OBJECTIVE: This review tests Ribot's classic twofold categorization of generalized amnesia (GA) into Type I, total loss of episodic memory, and Type II, additional more or less extensive loss of semantic and/or procedural memory. It also explores his law of regression, according to which, cast in modern terms, recovery of lost procedural and semantic memories precedes recovery of episodic memory, as well as reported aetiological factors. METHOD: Clinically and formally assessed cases of GA, published since 1845, were surveyed and further analysed. RESULTS: Over and above authentic episodic memory loss, cases differed widely in the extent of impairment of semantic and procedural memory. Recovery of semantic and procedural memory often preceded recovery of episodic memory. This particularly applied to authenticated trauma memories. To an extent, lost memories affected current functioning, and in some cases were associated with alternating dissociative personalities. Severe memory distortions upon memory recovery were not reported. Most cases were trauma or stress related, while in some cases the aetiology remained unknown. CONCLUSIONS: Contrary to the view expressed in DSM-IV, which states that dissociative amnesia pertains to an inability to recall personal information, GA may also involve loss and recovery of semantic and procedural memories. Since the loss of various memory types in GA is dimensional rather than categorical, Ribot's typological distinction does not hold. Some of the reviewed cases suggest a trauma-related aetiology. Generalized amnesia of varying degrees of severity can involve delayed retrieval of trauma memories, as well as the loss and delayed retrieval of the premorbid personality.

Amnesia↗
PubMed1994

A review of dissociation and dissociative disorders.

There has been an explosion of activity concerning dissociation and dissociative disorders overseas, but little interest is apparent in Australian psychiatric publications. This article aims to critically examine the current conceptualisation of dissociation and its proposed relevance to the understanding of psychopathology, in order to create discussion about these issues in Australian psychiatry. Multiple personality disorder and post-traumatic stress disorder are critically examined.

Arousal↗