Multiple personality disorder (MPD), now known as dissociative identity disorder (DID), is an officially recognized mental disorder and has been included in the international diagnostic manuals (DSM and ICD). The major features of DID include (1) the presence of at least two distinct identities or personality states that recurrently take control of the individual's behaviour (e.g., switching from one alternate personality states to another) and (2) psychological amnesia (e.g., memory gaps, inability to remember personal information or traumatic events). In some cultures, the symptoms of DID may be described as an experience of possession. Many persons who live with DID also suffer from other psychiatric symptoms, such as depression, auditory hallucinations and other posttraumatic symptoms (Ross, 1997). Some scholars believe that DID is a socially constructed phenomenon rather than a trauma disorder, while some other researchers provide evidence of DID’s validity and its relationship with trauma (Brand et al., 2016). Epidemiological studies suggest that about 1% of the general population may have DID; in psychiatric settings, DID is even more common (Şar, 2011). However, patients with DID usually have been in the health and social service systems and treated as having other conditions (e.g., depression, psychosis/schizophrenia) for many years before they are correctly diagnosed and appropriately treated. DID is highly associated with childhood trauma, such as physical abuse, emotional abuse, emotional neglect and family violence. DID is generally understood as the most severe form of posttraumatic psychopathology, and a cross-culturally occurring trauma disorder. Patients with DID usually respond well to specialized psychotherapy. In fact, DID is a creative and adaptive strategy for surviving complex trauma, allowing the victim to continue to manage daily life (e.g., learn in class, socially engage with friends) despite having overwhelming experiences.
Whitworth, M. (2006, 2006-03-13, January 01). Me, my selves and I... The Telegraph.
Robert Oxnam is a renowned China scholar as well as a past President of the Asia Society (1981-1992). He has been a traveling China lecturer for various famous people, including Bill Gates, Warren Buffett and President George H.W. Bush. Despite this success in his career, he also suffered from DID. He wrote a book A Fractured Mind: My Life with Multiple Personality Disorder to share his own experience of living with DID. This news article talks about the story of Robert Oxnam and highlights his personal thoughts. CITATION
陳怡妏. (2009, 2009-08-09, January 01). 多重人格畫家 擁12種畫風. 蘋果日報.
Munhwa Broadcasting Corporation, . (2015). Kill Me, Heal Me (킬미, 힐미). South Korea: Munhwa Broadcasting Corporation.
The main character in this non-fiction TV series from South Korea was a third-generation business heir with DID. He tried to regain control over other alters with the secret help of a female psychiatrist. He eventually discovered the roots of the problem and integrated the fragmented parts of in his mind. CITATION
Brand, B. L. & Loewenstein, R. J. (2010). Dissociative disorders: An overview of assessment, phenomenology, and treatment. Psychiatric Times, 27(10), 62–69.
This paper provides an overview of dissociative disorders, including the causes, comorbidities, prevalence, clinical features, differential diagnosis, treatment and costs of dissociative disorders. CITATION
Brand, B. L. et al. (2016). Separating fact from fiction: An empirical examination of six myths about dissociative identity disorder. Harvard Review of Psychiatry, 24(4), 257–270.
There are a number of debates about DID in the field. For example, some argue that DID is only a North American phenomenon, that DID is the same entity as borderline personality disorder (BPD), or that the treatment for DID is harmful. This study reviewed the empirical literature and examined six commonly held myths regarding DID. The authors also emphasized the high personal and economic costs of ignorance about DID. Practitioners should be aware of the empirical evidence regarding DID in order not to overlook these patients in clinical practice. CITATION
Dorahy, M. J. et al. (2014). Dissociative identity disorder: An empirical overview. Australian & New Zealand Journal of Psychiatry, 48(5), 402–417.
This study examined the empirical data related to DID in the literature in order to provide a scientific overview. According to the findings, DID is a valid disorder which can be discriminated from other mental disorders and DID is associated with a complex combination of developmental and cultural factors, including interpersonal trauma during childhood. It was also found that DID may be most prevalent in emergency psychiatric settings. In short, the existing empirical data show that DID is a valid disorder that is not rare. CITATION
Fung, H. W. et al. (2018). Psychometric properties of the pathological dissociation measures among Chinese research participants – A study using online methods. Journal of Evidence-Informed Social Work, 15(4), 371–384.
This paper reports the validity of three dissociation measures in the Chinese context. CITATION
Fung, H. W. et al. (in press). A preliminary investigation of depression in people with pathological dissociation. Journal of Trauma & Dissociation.
This paper shows that severe depression is common among people with pathological dissociation and that depressive symptoms are associated with more dissociative symptoms, post-traumatic stress disorder (PTSD) symptoms, borderline personality disorder (BPD) symptoms and poor symptom management; the level of depression is also associated with high-betrayal trauma but not with low-betrayal trauma. CITATION
Fung, H. W. et al. (in press). A web-based psychoeducation program for people with pathological dissociation: Development and pilot testing. Journal of Evidence-Based Social Work.
This paper reports the development of a web-based psychoeducation program for people with pathological dissociation and describes the initial findings of a pilot study. CITATION
International Society for the Study of Trauma and Dissociation, . (2011). Guidelines for treating dissociative identity disorder in adults, Third Revision. Journal of Trauma & Dissociation, 12(2), 115–187.
This comprehensive work reviews the assessment and treatment of DID and allied forms of dissociative disorder not otherwise specified (DDNOS) (now known as other specified dissociative disorder [OSDD]). As a practical guide to the management of adult patients with DID/OSDD, it represents a synthesis of current scientific findings. CITATION
Şar, V. & . (2011). Epidemiology of dissociative disorders: An overview. Epidemiology Research International, 2011, 1–8.
There are debates about the prevalence of dissociative disorders and DID, despite the fact that quite a number of screening studies using assessment tools for dissociative disorders have been conducted across different countries. This study reviewed the data from epidemiological studies on dissociative disorders in the literature. It was suggested that DID and other dissociative disorders were not rare in both clinical and nonclinical populations. The lack of a measure for dissociative disorders in general mental health assessment tools has resulted in overlooking dissociative disorders in many epidemiological studies. CITATION
Spanos, N. P. (1994). Multiple identity enactments and multiple personality disorder: A sociocognitive perspective. Psychological Bulletin, 116(1), 143.
Some scholars who endorse the sociocognitive model suggest that DID is not a valid trauma-related mental disorder. This article suggests that DID is a sociohistorical product as people “learn to construe themselves as possessing multiple selves” (p. 143). CITATION
Dell, P. F. & O’Neil, J. A. (2009). Dissociation and the dissociative disorders: DSM-V and beyond. New York: Routledge.
This integrative book compiles excellent articles from outstanding experts in the field. Not only does this book provide readers with updated research findings, knowledge and theories about dissociation and dissociative disorders, but it also highlights the gaps in knowledge and suggests a research agenda for the field. Researchers, practitioners and students would find this book very informative and helpful in understanding the dissociation topics. CITATION
Ross, C. A. (1997). Dissociative identity disorder: Diagnosis, clinical features, and treatment of multiple personality disorder. New York: John Wiley & Sons.
First published in 1989 and revised in 1997, this book provides a comprehensive and detailed review of the history, diagnosis and clinical features, and the treatment of DID with materials throughout based on scientific findings and clinical and forensic experience. This book also discusses important issues related to DID, such as the false memory controversy and scepticisms on DID. Those who are interested in DID may consider this book as a useful reference. CITATION
Steinberg, M. & Schnall, M. (2000). The stranger in the mirror: Dissociation—The hidden epidemic. New York: HarperCollins.
This book introduces dissociation and dissociative disorders and discusses the use of a semi-structured interview to recognize the five core dissociative symptoms, namely amnesia, depersonalization, derealization, identity confusion and identity alteration. Although targeted at the general public, this easy-reading book is also an excellent reference book for mental health practitioners and researchers. CITATION