New Concerns Regarding the Diagnosis of DID- Sent to Me This Morning Via Email

I believe that this push to discredit Dissociative Identity Disorder is due to the fact that our government wants to keep this under wraps- basically because DID is CLOSELY related to extreme ritual abuse, like that which was implemented in the MKUltra program, and the powers that be think that if they can disregard the DID diagnosis, they can also disclaim the abuse that was inflicted to cause such a disorder. Whatever the case, their actions speak loudly- as one is asked why this whole thing with DID, which basically very few know about or understand, is being considered a “fad” by those who are involved with discrediting it. This “fad” has lasted decades- and behind it is extreme ritual abuse and many times government attempts at mind control- so there is a bit more to consider than a simple desire to go along with the crowd (which again is not even aware of DID as a whole). Specific to the individual, let me remind everyone that the PROFESSIONALS who wrote the DSM 5- felt that it was valid enough to INCLUDE in it’s diagnostic review once again- although FALSE MEMORY- and the ability to implant memories- is NO WHERE IN THE MANUEL, suggesting that DID is valid and real and false memories and the ability to implant them is not. Perhaps that is why we are now seeing once again a backlash against such disorders caused by such abuse, as it is obvious that the False Memory Syndrome Pedophile Protector Squad is WRONG in their claims that Dissociative Identity Disorder is a result of rogue therapists who “implant” memories to highly suggestible hysterical women. In any case- I wanted to post these letters of concern that were sent to me this morning in my email.

LETTERS TO THE EDITOR The Journal of Nervous and Mental Disease & Volume
201, Number 4, April 2013 p. 353 – 358

Growing Not Dwindling: Worldwide Phenomenon of Dissociative Disorders

To the Editor:

In the December 2012 issue of the Journal, Joel Paris, MD, wrote an
article about the
current status of dissociative identity disorder (DID) and the
dissociative disorder field in
general. He suggests that DID is merely a ‘‘fad’’ and that there is no
credible evidence
to connect traumatic experiences with the development of DID. We refute
several of the claims made by Dr Paris.

Our biggest concern as non-North American researchers is that Dr Paris
does not reference a single international study related to dissociative
disorders and DID, despite the considerable and increasing empirical literature
from around the world. His speculation that DID is not diagnosed outside
clinics that specialize in treating dissociation is not consistent with
current data. DID and dissociative disorders have been reliably found in general
psychiatric hospitals; psychiatric emergency departments; and private
practices in countries including England, the Netherlands, Turkey, Puerto Rico,
Northern Ireland, Germany, Finland, China, and Australia, among many others
(e.g., Dorahy et al., 2006; Leonard et al., 2005; Lewis-Ferna´ndez
et al., 2007; Lipsanen et al., 2004; Marti´nez-Taboas, 2005;
Marti´nez-Taboas et al., 1995, 2006; Middleton and Butler, 1998; Rodewald et al., 2011;
Sar, 2006; Sar et al., 2007b, 1996; Tutkun et al., 1998).

Much of the international research, using sophisticated epidemiological
and clinical research methods, has replicated dozens of times the finding that
dissociative processes and disorders (including DID) can be reliably
detected in a wide spectrum of different societies. Epidemiological general
population studies indicate that 1.1% to 1.5% meet diagnostic criteria for DID;
and 8.6% to 18.3%, for any DSM-IV dissociative disorder (Johnson et al.,
2006; Sar et al., 2007a). The international literature on DID and
dissociative disorders has been widely published in mainstream journals of
psychiatry and psychopathology and is inconsistent with Dr Paris’s conclusions….

Dr Paris also opines that there is only a ‘‘weak link’’ between child
abuse and psychopathology, quoting an article published 17 years ago. Current
research illustrates a very different picture. Persons with early abusive
experiences demonstrate increased illnesses (Green and Kimerling, 2004),
impaired work functioning (Lee and Tolman, 2006), serious interpersonal
difficulties (Van der Kolk and d’Andrea, 2010), and a high risk for traumatic
revictimization (Rich et al., 2004). The Adverse Childhood Experiences Study,
an American epidemiological study, has provided retrospective and
prospective data from more than 17,000 individuals on the effects of traumatic
experiences during the first 18 years of life.

This large study demonstrated the enduring, strongly proportionate, and
frequently profound relationship between adverse childhood experiences and
emotional states, health risks, disease burdens, sexual behavior, disability,
and health care costs, even decades later (Felitti and Anda, 2010).
Specifically, child sexual abuse (CSA)
has been related in various epidemiological studies to the subsequent
onset of a variety of psychiatric disorders….

In conclusion, Dr Paris’s assessment of the supposedly dwindling fad of
DID and dissociative disorders is not in keeping with current peer-reviewed
international research. The dissociative disorder field has been producing
solid and consistent evidence that provides guidance to clinicians and
researchers about the epidemiology, phenomenology, diagnosis, and treatment of
DID (and closely related conditions).

Alfonso Marti´nez-Taboas, PhD
Department of Psychology
Carlos Albizu University
San Juan, Puerto Rico

Martin Dorahy, PhD
Department of Psychology
University of Canterbury
Christchurch, New Zealand

Vedat Sar, MD
Department of Psychiatry
Istanbul University
Istanbul, Turkey
Warwick Middleton, MD
Department of Psychiatry
University of Queensland
St Lucia, Australia

Christa Kru¨ger, MD
Department of Psychiatry
University of Pretoria
Pretoria, South Africa

Journal of Nervous & Mental Disease:
April 2013 – Volume 201 – Issue 4 – p 353–354
doi: 10.1097/NMD.0b013e318288d27f
Letters to the Editor

Disinformation About Dissociation Dr Joel Paris’s Notions About
Dissociative Identity Disorder

To the Editor:

We write to record our objections to both the form and the content of Dr
Joel Paris’s recent article entitled The Rise and Fall of Dissociative
Identity Disorder (Paris, 2012). His claim that dissociative identity disorder
(DID) is a ‘‘medical fad’’ is simply wrong, and he provides no substantive
evidence to support his claim. From the mistaken identification of Pierre
Janet as a psychiatrist in the first line (Janet was the most famous
psychologist of his day), it is replete with errors, false claims, and lack of
scholarship and just plainly ignores the published literature. Dr Paris
provided a highly biased article that is based on opinion rather than on
science. His review of the literature is extremely selective. Of 48 references, Dr
Paris cites exactly 7 peer-reviewed articles published from 2000 onward
(7/48 references equals 14%) and only
8 peer-reviewed, data-driven articles from before 2000 (8/48 equals 16%).
Rather than relying on the recent peer-reviewed, scientific literature,
Paris relied almost entirely on the non-peer-reviewed books, including a
popular press book written by a journalist whose methods and conclusions have
been strongly challenged.

He claims that interest and research in DID have waned, yet he fails to
cite the multitude of studies that have been conducted about it. In fact,
Dalenberg et al. (2007) documented evidence of the exact opposite pattern
described by Paris: ‘‘A search of the PILOTS database offered by the National
Center for Posttraumatic
Stress Disorder for articles on dissociation reveals 64 studies in
1985Y1989, 236 published in 1990Y1994, 426 published in 1995Y1999 and 477 in the
last 5-year block (2000Y2004)’’ (p. 401)….

In addition, he fails to cite a variety of neurobiological and
psychophysiological studies of DID documenting similar brain morphology abnormalities
in patients with DID to those of other traumatized patients (Reinders et
al., 2006; Vermetten et al., 2006). Despite failing to review this and other
relevant research, Dr Paris made the claim that ‘‘Neither the theory
behind the diagnosis nor the methods of treatment are consistent
with the current preference for biological theories’’ (p. 1078).
Furthermore, he fails to cite any research that has been done by researchers
outside North America. For example, Vedat Sar, MD, in Turkey has published more
than 70 articles and chapters on dissociative disorders and trauma
( index_2.htm), but Dr Paris failed to mention a single one….

A recent review in Psychological Bulletin by 2012) found strong support
for the etiological relationship of trauma and dissociation. These included
several large meta-analyses, some of which focused on patients with DID.
Dalenberg et al. (2012) found an effect size of r = 0.52 and 0.54 for the
relationship between childhood physical abuse and sexual abuse, respectively,
in studies that compared individuals with dissociative disorders with those
without dissociative disorders. In addition, Dalenberg et al. (2012) tested
eight different predictions of the trauma versus the fantasy
(sociocognitive/iatrogenic) model of dissociation. On each, careful of reviews of the
literature, including meta-analyses, on memory, suggestibility, and
neurobiology, among others, Dalenberg et al. (2012) found minimal scientific
evidence to support the fantasy model. Further, reviews have shown that there are
no research studies in the literature in any population studied to support
the iatrogenic/sociocognitive etiology of DID promulgated by Dr Paris (Brown
et al., 1999; Loewenstein, 2007)….

In summary, disagreement is healthy for our field. However, Dr Paris’s
article does not provide scholarly criticism based upon peer reviewed
research, scientific data, or accurate discussion of the history of psychiatry. His
point of view is incorrect and outmoded. It is the so-called false-memory,
iatrogenesis model of the dissociative disorders that is the fallen fad,
buried under the weight of rigorous data that contradict it. Dissociative
disorders have not risen and fallen. These existed before the fields of
psychiatry and psychology did. These are, alas, here to stay but are amenable to
better understanding and improved treatments.

Bethany Brand, PhD
Department of Psychology
Towson University, MD

Richard J. Loewenstein, MD
The Trauma Disorders Program
Sheppard Pratt Health System
Baltimore, MD
Department of Psychiatry
University of Maryland School of Medicine

David Spiegel, MD
Department of Psychiatry
and Behavioral Sciences
Stanford University School of Medicine

Journal of Nervous & Mental Disease:
April 2013 – Volume 201 – Issue 4 – p 354–356
doi: 10.1097/NMD.0b013e318288d2ee
Letters to the Editor

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