Dissociation : Vol. 6, No. 1 (Mar. 1993)
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Item Open Access Dissociation : Vol. 6, No. 1, p. 076 : Abreaction re-evaluated: author's reply to Peterson(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Hart, Onno van der, 1941-; Brown, PaulItem Open Access Dissociation : Vol. 6, No. 1, p. 074-075 : Letter to the editor(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Peterson, JudithItem Open Access Dissociation : Vol. 6, No. 1, p. 066-073 : Multiple personality before “Eve”(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Crabtree, AdamThe history of the diagnosis and treatment of multiple personality during the 160-year period preceding The Three Faces of Eve falls into two periods: the magnetic sleep period and the dissociation period. Using magnetic sleep techniques, early investigators learned to control switching and trust the patient for guidance in the treatment. Recognition of dissociation as a means of dealing with traumatic material by forming multiple psychic centers led to an effective psychotherapy for multiple personality disorder. The etiological role of child abuse was not acknowledged until modern times, but statistical evidence of sexual crimes against children in late nineteenth-century France may provide a fruitful area of future research. A scrutiny of historical cases raises questions about the univocalness of the concept of multiple personality. It also reveals data that have not yet been fully acknowledged by modern clinicians.Item Open Access Dissociation : Vol. 6, No. 1, p. 054-065 : Interventions with children in dissociative families: a family treatment model(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Benjamin, Lynn R.; Benjamin, RobertInterventions with children are surveyed from the literature of the diverse fields of MPD, play therapy, family therapy, and sexual abuse and trauma. Within a family treatment model, play therapy and hypnotic interventions can be useful in helping a child master the physical, cognitive, emotional, and spiritual dimensions of trauma. When parents are able to participate in the child's therapy, they can become a very important ally in the therapeutic process. We emphasize rebuilding of trust in the relationship between the parents and the child. It is our belief that treatment of the child-parent subsystem of a dissociative family has the most potential to interrupt a transgenerational chain of dysfunctional family patterns.Item Open Access Dissociation : Vol. 6, No. 1, p. 047-053 : Utilizing clergy in the treatment of multiple personality disorder(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Bowman, Elizabeth S.; Amos, William E.Religious/existential issues arise frequently in the treatment of MPD, but therapists often feel reluctant or inadequate to address them. Collaboration with clergy can resolve specific religious questions efficiently while preventing ethical and boundary violations, and safeguarding against the inherent disturbance of therapeutic neutrality which accompanies disclosure of the therapist 's personal religious views. This article outlines types of counseling training and services by clergy and provides suggestions for locating appropriate clergy and initiating referrals. Four areas of clerical involvement in the treatment of MPD are discussed: 1) Traditional pastoral care (supportive listening, access to congregational support, transition from hospital to community). 2) Educating care givers about religious material. 3) Consultant for the treatment team (assessment of religious history, personal support of therapists). 4) Treatment interventions (long-term spiritual growth counseling, brief problem-focused religious counseling, performing rituals to celebrate resolution of abuse). Clinical examples of clergy-therapist collaboration are offered.Item Open Access Dissociation : Vol. 6, No. 1, p. 042-046 : Hypnotizability, absorption, and subscales of the Dissociative Experiences Scale in a nonclinical population(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Smyser, Cameron H.; Baron, David A.This study examined how the characteristics of hypnotizability and absorption relate to three sub-dimensions of dissociation, as measured by three subscales of the Dissociative Experiences Scale (DES); Bernstein & Putnam, 1986). Fifty-three normal volunteers completed the DES and the Tellegen Absorption Scale (TAS) (Tellegen & Atkinson, 1974), and were assessed for hypnotizability on the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) (Weitzenhoffer & Hilgard, 1962). The three subscales of the DES include Amnestic Experiences, Absorption, and Depersonalization (Carlson et al., 1990). Of the three DES subscales, the DES Absorption subscale was found to correlate strongly with both the SHSS:C and TAS, the DES Depersonalization subscale less strongly, and the DES Amnestic Experiences subscale only weakly with the SHSS:C and not at all with the TAS. These findings are generally consistent with those of previous studies (Frischholz et al.,1991; 1992). Results are interpreted as supporting J.R. Hilgard 's (1970) theory of two developmental pathways to hypnotizability, one through absorption and the other through experience of trauma.Item Open Access Dissociation : Vol. 6, No. 1, p. 038-041 : Screening for MPD: clinical utility of the Questionnaire of Experiences of Dissociation(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Dunn, Gary E.; Ryan, Joseph J.; Paolo, Anthony M.; Miller, DarrellThe major purpose of this study was to determine the effectiveness of the Questionnaire of Experiences of Dissociation (QED) as a screening instrument for the diagnosis of multiple personality disorder (MPD). The QED was administered to 18 patients with MPD, 18 control subjects, 18 alcoholics, and 15 patients diagnosed with both PTSD and a substance abuse disorder. Using a cut-off score of 15, the QED correctly identified all MPD patients as needing further screening. None of the control subjects, and only one of the alcoholics, were incorrectly identified as requiring further evaluation. These preliminary findings suggest that the QED has good clinical utility as a screening tool for the identification of individuals who are afflicted with multiple personality disorder.Item Open Access Dissociation : Vol. 6, No. 1, p. 028-037 : The validation of the Dissociative Experiences Scale against the criterion of the SCID-D, using Receiver Operating Characteristics (ROC) analysis(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Draijer, Nel, 1950-; Boon, SuzetteObjective and method: The aim of this study is to analyze the utility of the Dissociative Experience Scale (DES) as a screener for dissociative disorders. The Structured Clinical Interview for DSM-IIIR Dissociative Disorders (SCID-D) was used as standard of comparison. Forty-three patients with a dissociative disorder and 36 control patients with a range of psychiatric diagnoses participated in the study. Results: The DES distinguishes dissociative disorder patients from non-dissociative disorder patients very well (p<.0001); diagnostic utility of the DES based on Receiver Operating Characteristic (ROC) analysis is excellent (AUC=.96). The optimal cut-off score of 25 yields good to excellent sensitivity (93 %) and specificity (86%). The positive predictive value of the DES (≥25) in random clinical samples is limited (.26 - .54) due to the relatively low estimated prevalence rate of dissociative disorders (5 - 15% respectively); the negative predictive value is high (.99). The use of a confirmatory interview such as the SCID-D is required to eliminate false positives.Item Open Access Dissociation : Vol. 6, No. 1, p. 016-027 : An update on the Dissociative Experience Scale(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Carlson, Eve B.; Putnam, Frank W., 1947-The authors review a wide range of studies that relate to the norms, reliability, and validity of the Dissociative Experiences Scale (DES). Appropriate clinical and research use of the scale are discussed together with factor analytic studies and fruitful statistical analysis methods. Current research with the DES is described and promising new research questions are highlighted. Suggestions are made for translating and using the DES in other cultures. A second version of the DES, which is easier to score, is included as an appendix.Item Open Access Dissociation : Vol. 6, No. 1, p. 003-015 : Clinical assessment of dissociative symptoms and disorders: the structured clinical interview for DSM-IV dissociative disorders (SCID-D)(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Steinberg, Marlene, 1953-; Cicchetti, Domenic; Buchanan, Josephine; Hall, Pamela; Rounsaville, BruceEarly detection of dissociative symptoms is essential for effective initiation of appropriate treatment. The author reviews a new diagnostic tool, the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) (Steinberg, 1993), which comprehensively evaluates the severity of five posttraumatic dissociative symptoms (amnesia, depersonalization, derealization, identity confusion, identity alteration) and the dissociative disorders. Several investigations have reported good-to-excellent reliability and validity of the SCID-D. This article describes the clinical assessment of dissociative symptoms, as well as the diagnosis of dissociative disorders using the SCID-D, based upon research at Yale University involving over 400 interviews over a 10-year time period. It is recommended that screening for dissociative disorders, as described in the SCID-D and the Interviewer's Guide to the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) (Steinberg, 1993), be included in the diagnostic evaluation of patients with either dissociative symptoms or with suspected/documented histories of trauma.Item Open Access Dissociation : Vol. 6, No. 1, p. 001-002 : Editorial(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03) Kluft, Richard P., 1943-Item Open Access Dissociation : Vol. 6, No. 1, p. 000 : Cover, table of contents(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1993-03)