Dissociation : Vol. 7, No. 1 (March 1994)
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Item Open Access Dissociation : Vol. 7, No. 1, p. 000: Cover, table of contents(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03)Item Open Access Dissociation : Vol. 7, No. 1, p. 001-002: Editorial: Dissociation or dissociations? Multiple personality disorder or multiple personality disorders?(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03) Kluft, Richard P., 1943-Item Open Access 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.Item Open Access Dissociation : Vol. 7, No. 1, p. 012-022 : Application of contextual therapy to the treatment of multiple personality disorder(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03) Benjamin, Lynn R.; Benjamin, RobertContextual Therapy, as developed by Ivan Boszormenyi-Nagy, M.D., is a system of family therapy which describes an ethical and relational way of appreciating interactions in families and of conducting therapy among members in families. In addition to its conventional use in the interpersonal domain in MPD families, the authors propose that contextual principles may also be useful in an analogous application of its ideas to the internal, intrapsychic system of alters within an MPD client. Included are a synopsis of contextual concepts, a description of seven problem areas in the treatment of MPD and a contextual perspective on each one, two case examples supplying these principles, and a summary of recent interviews with Drs. Ivan and Catherine Nagy about the application of their concepts to this specialized field. Contextual therapy principles add a crucial ethical dimension to MPD work which provides important benefits for both clients and therapists.Item Open Access Dissociation : Vol. 7, No. 1, p. 023-027 : The factor structure of the dissociative experiences scale in college students(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03) Sanders, Barbara; Green, James A.A factor analysis of the Dissociative Experiences Scale (DES) in college students indicates that the scale contains three distinct, though correlated dimensions: imaginative involvement, depersonalization/derealization, and amnesia. The similarity of the DES factor structure in this non-clinical sample to that found in psychiatric groups and other non-clinical samples offers some assurance that what is reflected in the overall DES score is similar in the different populations. On the other hand, subtle but statistically reliable sex differences were found on the imaginative involvement and amnesia factors, suggesting that combining the data of men and women, as has been done in previous factor analytic studies of the DES, may be inappropriate. If these gender-related differences are confirmed, their possible significance in the etiology and phenomenology of dissociative disorders should be considered.Item Open Access Dissociation : Vol. 7, No. 1, p. 028-034 : Dissociative experiences and dissociative disorders in a non-clinical university student group(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03) Murphy, Patricia EngleIn a non-random sample of 415 students at the University of Idaho, the distribution of Dissociative Experience Scale (DES) scores was positively skewed with 9% of the sample scoring above 30 on the instrument. Dissociative Disorders Interview Schedule (DDIS) interviews were conducted with eighteen individuals who scored above 30 on the DES and a stratified random sample of nine people who scored less than 30. The interviewers were blind to the participants' DES scores. Of the eighteen people who were interviewed and scored above 30 on the DES, sixteen met the criteria for one of the dissociative disorders (89%), including four who met the criteria for multiple personality disorder (MPD). This suggests that those who score above 30 on the DES in a university sample may be at risk for one of the dissociative disorders. It further suggests that from 5% to 10% of groups similar to those sampled may be at risk for a dissociative disorder.Item Open Access Dissociation : Vol. 7, No. 1, p. 035-043 : A group for partners and parents of MPD clients. Part I: process and format(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03) Benjamin, Lynn R.; Benjamin, RobertA group for partners and parents of clients with MPD provides an effective system of support and education. It enhances a sense of community, reduces the effects of stigma and secondary traumatization, and allows for the sharing of issues and concerns in a nonthreatening environment. The group is a key part of our family treatment approach to dissociative disorders. This paper outlines a rationale for such a group, its history, format, and a summary of the process including co-therapy issues, parallel process dynamics, combined individual and group therapy issues, members 'reactions to the group, and the effects of the group on the therapist.Item Open Access Dissociation : Vol. 7, No. 1, p. 044-050 : Dissociation in alleged extraterrestrial abductees(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03) Powers, Susan MarieDissociative symptoms were assessed in twenty persons who claim extraterrestrial abduction. This paper presents the results of two inventories: the MMPI subscale for Post-traumatic Stress Disorder (PTSD) and the Perceptual Alteration Scale. To obtain comparative data, two other groups of twenty subjects each were given the inventories: sightees, people who report witnessing unidentified flying objects but do not recall extraterrestrial contact, and individuals who recall childhood sexual abuse. The sightee group served as a control whereas the sexually abused group was included to explore any similarities between alleged abductees and sexually abused persons. PTSD symptoms were manifested by 45 % of the abductees, 0 % of the sightees, and 70% of the sexually abused subjects. Dissociation symptoms were demonstrated by 70% of the abductees, 10% of the sightees, and 100 % of the sexually abused subjects. These results suggest that distressed individuals alleging extraterrestrial abduction may benefit from therapies designed to address dissociation and PTSD.Item Open Access Dissociation : Vol. 7, No. 1, p. 051-062 : Chronic claims of alien abduction and some other traumas as self-victimization syndromes(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03) Schnabel, JimThis paper discusses the case of an alleged alien abduction victim who claimed a wide range of dissociation-related and traumatic experiences, with a heavy thematic emphasis upon sexual abuse, extending back to a traumatic non-abuse incident in childhood, for which she apparently was never amnesic. Certain aspects of her history seem consistent with dissociative disorders, organic mental disorders, and Miinchausen's syndrome. This case and the alien abduction syndrome as well as some oral narratives associated with multiple personality disorder and "Satanic ritual abuse," do not derive exclusively from severe exogenous trauma and may be viewed more usefully as manifestations of manipulative self-victimization syndromes.Item Open Access Dissociation : Vol. 7, No. 1, p. 063-076 : Treatment trajectories in multiple personality disorder(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03) Kluft, Richard P., 1943-Despite rapid recent advances in the study of multiple personality disorder(MPD), many basic concerns remain unexplored or incompletely understood. One of these regards expectations about progress in treatment. The literature contains little that allows the clinician to estimate how a particular patient's response to therapy compares to that of other patients. Without such baselines confusion, exasperation, or complacency with respect to progress cannot be monitored and, if necessary, corrected, in a reasonable manner. In order to study treatment progress 31 MPD patients in ongoing treatment with the author as of July 31, 1990, were monitored along 12 dimensions through August 1, 1991. The progress of the 10 MPD patients most recently taken into treatment by the author and seen for at least three months was monitored as well. The results suggest that although steady stepwise improvement is quite unusual, many patients show indices of improvement on a year-by-year basis. MPD patients can be distributed into several subgroups by virtue of the trajectories of their treatment, and that reasonable expectations for progress vary widely according to the trajectory subgroup to which a given patient proves to belong.Item Open Access Dissociation : Vol. 7, No. 1, p. 077-078 : Review: Multiple personalities, multiple disorders: psychiatric classification and media influence(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-03) Gleaves, David H.; North, Carol S.; Ryall, J. M.; Ricci, D. A.; Wetzel, Richard D., Ph. D.