Dissociation : Vol. 2, No. 2 (June 1989)

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Dissociation : Vol. 2, No. 2, p.070-076 : Iatrogenic factors in the misdiagnosis of multiple personality disorder
(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-06) Coons, Philip M.
The diagnosis of multiple personality disorder (MPD) is fraught with difficulties leading to a frequent false negative diagnosis and an occasional false positive diagnosis. Proper diagnostic evaluation of a patient suspected of having MPD requires a familiarity with MPD, hypnotic phenomena, and a wide variety of other clinical syndromes. The clinician must use collateral data from old records and other individuals as well as provide sufficient time for the evaluation. Extreme caution is urged in forensic contexts. The use of extremely suggestive interviewing and/or hypnotic techniques is to be deplored. At times prolonged observation in the hospital or over the course of therapy is required. Clinicians should be patient, skilled in listening, and should keep an "open mind." Patient factors involved in producing misdiagnosis include distrust, fear of being labeled crazy, insistence on secrecy, amnesia, and conscious or unconscious deception.