Browsing by Author "Loewenstein, Richard J."

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    Dissociation : Vol. 1, No. 3, p. 003-012 : Open Trial Of Clonazepam In The Treatment Of Posttraumatic Stress Symptoms in MPD
    (Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-09) Loewenstein, Richard J.; Hornstein, Nancy L.; Farber, Barbara
    Few consistently helpful psychopharmacological interventions have been described in the treatment of multiple personality disorder. We report a successful open trial of clonazepam for posttraumatic stress symptoms in a group of patients with multiple personality disorder. Patients reported notable, sustained improvement in sleep, nightmares, flashbacks, panic attacks and other posttraumatic stress disorder symptoms while undergoing clonazepam treatment. The authors discuss the limitations of the current study and suggest a phenomenological framework for pharmacological interventions in multiple personality disorder.
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    Dissociation : Vol. 1, No. 4, p. 017-023 : A comparison study of dissociative symtoms in patients with complex partial seizures, MPD, and posttraumatic stress disorder
    (Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1988-12) Loewenstein, Richard J.; Putnam, Frank W., 1947-
    Depersonalization and dissociative symptoms have been widely reported in chronic seizure disorder patients, especially those with temporal lobe involvement and complex partial seizures (CPS). It has been theorized that development of multiple personality disorder (MPD) may be related to temporal lobe pathology. We administered the Dissociative Experiences Scale (DES) to 12 male patients with severe chronic epilepsy, primarily of the complex partial type. Patients had had epilepsy from one to thirty years. Most were being evaluated for intractable seizures occurring several times per week. DES data on the epileptic patients were compared with DES data on 9 male MPD patients and 39 male PTSD patients. MPD and PTSD patients were significantly different from CPS patients on median DES scores and all DES sub-scale scores. MPD and PTSD patients were far more similar on the DES, although MPD patients had a significantly higher score on the dissociation/psychogenic amnesia sub-scale of the DES. The authors conclude that there is little data to support a relationship between MPD, dissociation, and epilepsy.
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    Dissociation : Vol. 3, No. 3, p. 135-143 : The clinical phenomenology of males with MPD: a report of 21 cases
    (Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Loewenstein, Richard J.; Putnam, Frank W., 1947-
    We describe 21 male patients meeting DSM-111-R and NIMH criteria for multiple personality disorder (MPD). They were compared with female patients in the NIMH data base on MPD and dissociative disorders. Striking similarities between males and females were found on most variables. Both groups had extensive childhood histories of sexual and physical abuse far exceeding the prevalences reported for other clinical and non-clinical populations. There were trends for males to have more alcoholism and antisocial behavior. Generally, males had more subtle clinical presentations than females and reported fewer alter personalities. Implications of these findings and the limitations of the present study are discussed.
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    Dissociation : Vol. 7, No. 1, p. 003-011 : Diagnosis, epidemiology, clinical course, treatment, and cost effectiveness of treatment for dissociative disorders and MPD: report submitted to the Clinton administration task force on health care financing reform
    (Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03) Loewenstein, Richard J.
    Dissociative disorders are highly prevalent mental disorders in North America with a reported prevalence of about ten per cent in the general population. The prevalence of these disorders is related to the prevalence of trauma in the general population. Multiple personality disorder (MPD) is a severe chronic mental disorder that affects about one per cent of the general population in North America and is associated with an early childhood history of severe trauma, primarily multiple forms of abuse before the age of five. MPD patients are already present in the mental health treatment system in substantial numbers. MPD patients commonly average 6 to 12 years in unproductive treatment and/or social welfare systems prior to correct diagnosis. There is evidence of considerable treatment efficacy for an intensive form of psychotherapy for MPD. Further, there is evidence for cost effectiveness of treatment of MPD with substantial savings once correct treatment is initiated. Despite this, there appear to be subgroups of MPD patients with one patient group showing rapid resolution of all dissociative psychopathology and another group showing more chronicity. The latter group does achieve cost effectiveness for treatment, but at a slower rate. One major variable in discriminating these groups was the length of time in the mental health treatment system before correct diagnosis with the more slowly responsive group having a much longer chronic treatment career prior to correct diagnosis.
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    The Dissociative Subtype of PTSD Interview (DSP-I): Development and Psychometric Properties
    (Taylor & Francis Group, 2019-05-28) Eidhof, Marloes B.; June ter Heide, Jackie; van Der Aa, Niels; Schreckenbach, Monika; Schmidt, Ulrike; Brand, Bethany L.; Lanius, Ruth A.; Loewenstein, Richard J.; Spiegel, David; Vermetten, Eric
    The inclusion of the dissociative subtype of post-traumatic stress disorder (PTSD-DS) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) reflects the importance of assessing PTSD-DS. We developed the Dissociative Subtype of PTSD Interview (DSP-I). This clinician-administered instrument assesses the presence and severity of PTSD-DS (i.e., symptoms of depersonalization or derealization) and contains a supplementary checklist that enables assessment and differentiation of other trauma-related dissociative symptoms (i.e., blanking out, emotional numbing, alterations in sensory perception, amnesia, and identity confusion). The psychometric properties were tested in 131 treatment-seeking individuals with PTSD and histories of multiple trauma, 17.6 % of whom met criteria for PTSDDS in accordance with the DSP-I. The checklist was tested in 275 treatment-seeking individuals. Results showed the DSP-I to have high internal consistency, good convergent validity with PTSD-DS items of the CAPS-5, and good divergent validity with scales of somatization, anxiety and depression. The depersonalization and derealization scales were highly associated. Moreover, the DSP-I accounted for an additional variance in PTSD severity scores of 8% over and above the CAPS-5 and number of traumatic experiences. The dissociative experiences of the checklist were more strongly associated with scales of overall distress, somatization, depression, and anxiety than scales of depersonalization and derealization. In conclusion, the DSP-I appears to be a clinically relevant and psychometrically sound instrument that is valuable for use in clinical and research settings.