Tuesday, April 11, 2006

Defining the controversy

Defining the controversy
One of the primary reasons for the on-going re-categorization of this condition is that there were so few documented cases (research in 1944 showed only 76[1]) of what was then referred to as multiple personality. Although the condition does have a long history stretching back in the literature some 300 years, it remains a rare disorder, affecting less than 1% of the population (Ross, 1997). Conversely, dissociation is now recognized as a symptomatic presentation in response to trauma, extreme emotional stress, and, as noted, in association with emotional dysregulation and borderline personality disorder[2]. Often regarded as a dynamic sub-symptomology, it has become more frequent as an ancillary diagnosis, rather than a primary diagnosis. [citation needed] A full blown DID diagnosis, that intends an individual is evidencing quantifiable multiple personalities and presents itself independently of a primary personality disorder, remains rare. [citation needed]
The DSM re-dressThere is considerable controversy over the validity of the Multiple personality profile as a diagnosis. Unlike the more empirically verifiable mood and personality disorders, dissociation is primarily subjective for both the patient, and the treatment provider. The relationship between dissociation and multiple personality creates conflict regarding the MPD diagnosis. While other disorders do, indeed, require a certain amount of subjective interpretation, those disorders more readily present with generally accepted, objective symptomology. The controversial nature of the dissociation hypothesis evidences itself quite clearly by the manner in which the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders has addressed, and re-dressed, the categorization over the years.
The 2nd Edition of the Diagnostic and Statistical Manual of Mental Disorders, referred to this diagnostic profile as Multiple Personality Disorder. The 3rd Edition of the DSM Manual grouped Multiple Personality Disorder in with the other 4 major dissociative disorders. The current edition, the DSM-IV-TR, categorizes the disorder as Dissociative Identity Disorder. The ICD-10 (International Statistical Classification of Diseases and Related Health Problems) continues to list the condition as multiple personality disorder.

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