Dissociation : Vol. 9, No. 4 (Dec. 1996)
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Item Open Access Dissociation : Vol. 9, No. 4, p. 274-281 : Trauma and dissociative experiences in eating disorders(Ridgeview Institute and the International Society for the Study of Dissociation, 1996-12) Grave, Riccardo Dalle; Oliosi, Manuela; Todisco, Patrizia; Bartocci, ClaudiaThis study investigates the relationship between trauma, dissociative experiences, and eating psychopathology in a group of eating disorder patients. The Dissociation Questionnaire (DIS-Q) and a semi-structured interview were used to assess 106 eating disorder patients at the start of an inpatient treatment program. DIS-Q scores were evaluated for the eating disorder patients and compared with the scores of 20 schizophrenic patients and 112 high school graduating students (controls). Of the eating disorder patients, 45.2% reported traumatic experiences. The highest trauma rate was reported by patients with bulimic symptoms. Significant differences were found in the prevalence of traumatic experiences between eating disorder patients and control subjects, but not between eating disorder and schizophrenic patients. The highest total DIS-Q scores were detected in bulimia nervosa and anorexia nervosa binge eating/purging type patients; the lowest DIS-Q scores were found in patients with binge eating disorder, schizophrenia, and controls. Eating disorder patients, in comparison with schizophrenic patients, reported significantly higher scores in identity confusion, loss of control, and absorption. However, the only dissociative features which seems to link trauma, dissociation, and eating disorders are identity confusion and loss of control, since absorption is not sensitive to the presence/absence of trauma.Item Open Access Dissociation : Vol. 9, No. 4, p. 289-299 : The use of EMDR in patients with dissociative identity disorder(Ridgeview Institute and the International Society for the Study of Dissociation, 1996-12) Lazrove, Steven; Fine, Catherine G., 1950-Hyperarousal during trauma inhibits the integration of memory. In DID, memory is further disrupted when alter personalities coalesce around individual memory fragments and either reenact conflicts or disown them. Eye Movement Desensitization and Reprocessing (EMDR) is an innovative psychotherapeutic method which accelerates information processing and facilitates the integration of fragmented traumatic memories. Following a successful EMDR session, patients report that the nature of the traumatic memory has changed and that the event is now less upsetting and “feels over.” A strategy for using EMDR to integrate traumatic memories in patients with dissociative identity disorder (DID) is presented and technical considerations for its implementation are discussed. To the extent that alter personalities often are based on memory fragments, integration of traumatic memory facilitates personality integration. EMDR may be a superior method for working with traumatic memories in that it appears to enhance memory integration and reformulate cognitions concomitantly.Item Open Access Dissociation : Vol. 9, No. 4, p. 282-288 : Dissociative identity disorder in a forensic psychiatric patient: a case report(Ridgeview Institute and the International Society for the Study of Dissociation, 1996-12) Nijenhuis, Ellert R.S.Criminal acts can be performed in a dissociative state. Since a percentage of male and female patients with dissociative disorders act out aggression and display criminal behaviors, some of them may be found in the criminal justice system. This case report demonstrates that the long-term failure to diagnose dissociative identity disorder in a forensic psychiatric patient permitted the continued existence of highly aggressive dissociative identity states, and near-relapses into homicidal behavior. The author concludes that careful screening for dissociative disorders and the provision of treatment for dissociative disorders in forensic settings is necessary. The risks of both false negative and false positive diagnoses should both be recognized.Item Open Access Dissociation : Vol. 9, No. 4, p. 261-273 : Memory recovery of childhood sexual abuse(Ridgeview Institute and the International Society for the Study of Dissociation, 1996-12) Albach, Francine, 1951-; Moormann, Peter Paul, 1949-; Bermond, BobIn this study, no empirical evidence was found for the notion that most patients recover memories of childhood sexual abuse because their therapist had suggested to them that they were abused as children. Instead, our data seem to suggest that memory recovery is a spontaneous phenomenon, triggered by abuse-related stimuli. The issue of traumatic versus ordinary memories was investigated by comparing a group of 97 sexually abused women with a group of 65 matched controls for memory impairments. Having experienced an episode of inability to recall the event (i.e., amnesia) appeared to be extremely rare (1 %) in the control group, but rather common (35 %) in the traumatized group. Other features of motivated forgetting, like intentionally avoiding to think about the event, just not having thought about it, and having experienced an amnestic turning point were significantly more frequently mentioned by the traumatized than by the control group as well. Characteristics of the abuse, such as early age or violence, did not appear to be predictive of abuse-related amnesia. However, an inverse relation was found between prolonged sexual abuse (extending into adulthood) and amnesia. Women who initially consented to the abuse to get attention from the perpetrator were found to be more amnestic.Item Open Access Dissociation : Vol. 9, No. 4, p. 253-260 : Dissociative identity disorder in childhood: five turkish cases(Ridgeview Institute and the International Society for the Study of Dissociation, 1996-12) Zoroglu, Salih; Yargic, L. Ilhan; Tutkun, Hamdi; Ozturk, Mucahit; Sar, VedatIn this paper, the diagnostic processes, previous diagnoses, clinical symptomatology, life events, traumatic experiences, family histories, and treatment of five children (three girls and two boys between five and eleven years of age) with DID are presented. Clinical findings were headaches, aggressive behavior and outbursts, trance-like experiences, amnesias, inconsistent school performance, lying, sleep disturbances, and depressive symptoms. One of the patients had been treated previously under different diagnoses. The number of alter personalities ranged from two to eleven. One of the patients, a ten-year-old girl, had two distinct personality systems. All of the cases presented at least four Schneiderian first-rank symptoms except an eleven-year-old boy who had only one. All of the cases had amnesia between at least two alters during interviews initially, except for a five-year-old case who did not. A ten-year-old girl was treated successfully and her alter personalities integrated. The others discontinued the therapy.Item Open Access Dissociation : Vol. 9, No. 4, p. 244-252 : Dissociative identity disorder presenting as hysterical psychosis(Ridgeview Institute and the International Society for the Study of Dissociation, 1996-12) Tutkun, Hamdi; Yargic, L. Ilhan; Sar, VedatDissociative identity disorder (DID), formerly known as multiple personality disorder (MPD), usually presents with associated symptoms rather than with the main features of the disorder. It is necessary for the clinician to keep it in mind as a diagnostic probability and to know its various presentations and associated symptoms in order to recognize it. We observed during long-term evaluation of four cases of hysterical psychosis (HP), that they had DID with long-term histories of dissociative symptoms. Patients applying for care who manifest a single dissociative symptom, a dissociative disorder, a severe acute dissociative syndrome with regressive features, or a dramatic and therapy-resistant conversion symptom should be evaluated for other dissociative symptoms and especially for their chronicity. In our experience, one presenting form of dissociative identity disorder is a hysterical psychosis, a type of crisis situation in the context of the longitudinal course of the dissociative identity disorder.Item Open Access Dissociation : Vol. 9, No. 4, p. 232-243 : Delayed memories of child abuse: part II: an overview of research findings relevant to understanding their reliability and suggestibility(Ridgeview Institute and the International Society for the Study of Dissociation, 1996-12) Bowman, Elizabeth S.This article reviews data from four areas of memory research which are clinically relevant to understanding the reliability and suggestibility of delayed memories of abuse in dissociative disorder patients. Research supports the suggestibility of eyewitness memory for non-dramatic events, but not for personally experienced trauma. Hypnosis has been found to increase memory suggestibility and confidence in correct and incorrect memories in laboratory studies, while the accuracy of hypnotically recalled memories in psychotherapy have been highly supported by corroboration. High hypnotizability, however, appears more important than hypnosis in producing laboratory pseudomemories. Autobiographical memory research indicates that the reliability of adulthood memories prior to age three is uncertain, but some traumatic memories from age two persist. Accurate behavioral memories of trauma may persist when verbal ones are absent. Interview techniques greatly affect memory suggestibility, with free recall producing the least suggestibility. Therapists can minimize memory distortions by educating patients about memory reliability, using open-ended questions, avoiding hypnotic recall, using active memory source monitoring, and supportively exploring the reliability of emerging memories.Item Open Access Dissociation : Vol. 9, No. 4, p. 221-231 : Delayed memories of child abuse: part I: an overview of research findings on forgetting, remembering, and corroborating trauma(Ridgeview Institute and the International Society for the Study of Dissociation, 1996-12) Bowman, Elizabeth S.This article provides an overview of data from memory research which is clinically relevant to dealing with delayed memories of abuse in dissociative disorder patients. Studies indicate that childhood abuse is partly or completely forgotten by 12%-64% of adults. Amnesia has been consistently associated with earlier abuse, threats, and more types of abuse. Therapy is a factor in memory return in about half of persons, and is the sole trigger in one fourth of cases. Corroboration of delayed memories of child abuse has been found in 47%-74 % of outpatients reporting abuse in 85 %-94 % of dissociative disorder patients, and in 0%-3% of persons reporting ritual abuse. Studies suggest that extreme emotional arousal diminishes recall, but moderate arousal results in accurate enhanced recall of central events. Memories of real life trauma have low suggestibility, throwing doubt on the applicability of laboratory studies of eyewitness memory suggestibility to trauma memories. Implications for therapy are discussed.Item Open Access Dissociation : Vol. 9, No. 4, p. 219-220 : Editorial(Ridgeview Institute and the International Society for the Study of Dissociation, 1996-12) Draijer, Nel, 1950-Item Open Access Dissociation : Vol. 9, No. 4, p. 000 : Cover, table of contents(Ridgeview Institute and the International Society for the Study of Dissociation, 1996-12)