Multiple Personality Disorder and the DSM-III

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3facesofeve1980 saw the revision of the DSM-II by the American Psychiatric Association. Several changes were made to the publication in the DSM-III concerning different disorders. One of the changes in the DSM-III was a separate category for the dissociative disorders. This gave considerable credence to the disorder. Of course it must be remembered that this was the time when Sybil was still fresh in people’s minds. Also around that time, Christine Sizemore, the “Eve” in “The Three Faces of Eve“, released a second publication about her experience with multiplicity. It had the unique perspective of being written in the first person by an integrated person who had suffered and been healed from the disorder.Sybil and The Minds of Billy Milligan soon followed, a “true” third person account, first as a text, then as a film, about a man who raped three women and used multiplicity as a legal defense during his trial.

In spite of multiple personality disorder’s inclusion in the DSM-III psychiatrists worldwide argued against its validity. At that time, MPD was almost completely an American phenomenon. It was very seldom reported by European physicians. It was and remains, an almost strictly a female phenomenon, with women being diagnosed as multiples approximately 8 times more often than men. Is that due to gender prejudice in the psychiatric system? Consider there is a listing in the DSM-5 for Hysteria, a disorder that defines women who display abnormal behaviour due to various stressors.

Since the publication of the Eve, Sybil and Milligan books, sybilalong with the inclusion of multiplicity in the DSM-III, there was a virtual explosion in the publication of psychiatric journals, books, biographical accounts, of accounts about patients with MPD. In 1980 there were a number of landmark publications about the disorder including E. L. Bliss’ study of fourteen patients, P. M. Coons systematic information about making a diagnosis, G. B. Greaves review article, B, G. Braun’s treatment recommendations and S. S. Marmer psychoanalytic study.  In 1989, Frank W. Putnam of the National Institutes of Mental Health published “Diagnosis and Treatment of Multiple Personality Disorder”. In 1989 Colin A. Ross, a researcher, published “Multiple Personality Disorder: Diagnosis, Clinical Features, and Treatment”.

In 1994 the DSM-IV renamed MPD as Dissociative Identity Disorder (DID) and the publication of Guidelines for Treating Dissociative Identity Disorder In Adults” by the International Society for the Study of Dissociation. Screening instruments, diagnostic instruments, and a mental status exam were developed. There is increasing information to the general public. Yet the debate involving the existence of Dissociative Identity Disorder and Multiple Personality Disorder continues.
Fmo4FCdU5umEFakK2vaySzk2c5s (1)The evolving theory of thought about DID, that the patient needs to be cured of his or her belief that s/he possesses varying mental fragments, makes little sense to me personally. I wonder where the patient developed the idea that s/he was more than one person. If this diagnosis was given by a clinician who believes in MPD, but another clinician who does not insists the patient suffers from DID, who is right?

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